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Reclassifying ageing as a disease could help us live healthier for longer

 1 November 2019   Public Science

Experts call on the World Health Organisation, governments and medical communities to develop common classifications and systems to diagnosis and treat age-related diseases.

An international team of researchers, including our colleague Jesús Gil, have put forward a position statement, published in Science, which lays out a new healthcare framework to help ageing populations stay healthier for longer. This comes after Prof Gil also gave evidence at the House of Lords Science and Technology committee earlier this week about the status of treatments that target cellular senescence for age-related disease. You can watch the video from the House of Lords here and also read about Jesús’ latest research on the topic here.

The statement is a ‘call to action’ to governments, the World Health Organisation (WHO) and the scientific and medical community to come together and develop the classifications and staging systems utilising the framework as the basis for diagnosing and treating age-related diseases, including directly treating all ageing tissue and organs.

Age-related diseases without adequate diagnostic criteria and severity staging limits the ability for prevention or treatment and limits the ability to develop new drugs and interventions. Ultimately, this impacts the quality of life for members of society as they age.

Unmet needs of ageing populations

Ageing populations involve urgent and unmet healthcare and economic needs related to chronic disease and multi-morbidity, which require solutions at the national and international level. People worldwide are living longer.

Today, for the first time in history, most people can expect to live into their sixties and beyond. By 2020, the number of people aged 60 years and older will outnumber children younger than 5 years. By 2050, the world’s population aged 60 years and older is expected to total 2 billion, up from 900 million in 2015 [1].

Common conditions in older age include back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, sarcopenia and dementia. Additionally, as people age, they are more likely to experience several conditions at the same time, including advanced conditions that may have been building up over decades, which then lead to other diseases and health risks. Dedicated research, new disease terminology, metrics and analytical methods are needed for a wide range of ageing issues in order to effectively diagnose and treat them.

Designing the framework

Currently the classification and severity staging of age-related diseases is limited because it is inconsistent, incomplete and non-systematic. Some types of disease that can be found in many organs, such as intrinsic organ ageing, or organ atrophy or wasting, are classified in one organ but not another.

To help tackle this problem an international group of experts, scientists and medics, led by University of Liverpool Honorary Fellow Dr Stuart Calimport and supported by University of Liverpool Reader Dr Joao Pedro de Magalhaes, created a position statement which lays out a framework for properly and comprehensively classifying and staging the severity of ageing-related diseases. Importantly the statement includes ageing at the tissue and organ level as well as organ atrophy, pathologic remodelling and calcification, and ageing-related systemic and metabolic diseases.

Dr Stuart Calimport, said:

“This framework will increase our ability to develop drugs and interventions that target the processes of ageing and that can accumulate with age, which would have unprecedented benefits in relation to the treatment and prevention of serious diseases.”

Dr Joao Pedro de Magalhaes, said:

“Ageing is the greatest biomedical challenge of the 21st century.  As such, this framework will increase our ability to develop longevity drugs and interventions that target diseases related to the ageing process.”

Guiding policy and practice

While ageing is classified as a condition within the WHO International Classification of Diseases (ICD-11) in relation to intrinsic skin ageing and photoageing, the framework proposes the classification of ageing as conditions in all organs, along with the comprehensive classification of all ageing-related diseases and syndromes.

Prof Jesús Gil, said:

“The proposed framework will make possible to trial drugs targeting the underlying causes of ageing, this could have benefits that go far beyond palliating the symptoms of a single disease”

 

As part of this work, initial classification submissions related to age-related diseases in line with the framework have already been submitted to the latest version of WHO ICD-11.

Researchers from thirty-six establishments and six countries were involved in the position statement including Harvard University, MIT, University College London, Stanford University, University of Cambridge, Imperial College London, MRC London Institute of Medical Sciences, The Buck Institute for Research on Ageing, The University of Exeter, The Max Planck Institute for Biology of Ageing, and the National Institute on Aging.

The full paper, entitled ‘To help aging populations, classify organismal senescence’ [2] was published in Science on 31 October. Read the full position statement here.

 

References

  1. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
  2. Calimport SRG, Bentley BL et al. (2019). ‘To help aging populations, classify organismal senescence’. Science, 366 (6465), 576-578.