Should the FDA Recognize Aging as a Disease?

What’s the story? 

• The Food and Drug Administration (FDA) recognizes aging as a natural process of life, which some scientists are trying to change. There is a growing consensus among the scientific community that aging should be considered a disease.
• Exports are urging the FDA to classify aging as a disease to make it easier to approve drugs and therapies that seek to slow down the effects of aging on the human body. 
• If the FDA agrees to recognize aging as a disease, researchers and drug companies could develop and gain approval for treatments that not only delay the aging process, but could potentially stunt the progression of accompanying conditions. 

What is the scientific community saying?

• The World Health Organization (WHO), a supporter of this measure, described aging as “...the impact of the accumulation of a wide variety of molecular and cellular damage over time,” which scientists say is a significant risk factor for other fatal conditions.
• Supporting researchers say that while aging in and of itself is not an unnatural condition, the deterioration of the human body and its functions are symptoms of aging, just like that of a disease. Classifying aging as a disease would allow the medical community to directly fight the symptoms of aging to prevent another medical condition from developing. 
• David Sinclair, a geneticist at Harvard Medical School, argues that if we label aging differently, it will give the medical community a better chance at treating the health of the elderly and not just the diseases that accompany old age. He said:

"Many of the most serious diseases today are a function of aging. Thus, identifying the molecular mechanisms and treatments of aging should be an urgent priority. Unless we address aging at its root cause, we're not going to continue our linear, upward progress toward longer and longer life spans."

Importance of disease classifications

• What we consider a disease is strongly based on historical context and societal beliefs. Even if something may not look like a disease in today’s modern world, the classification could significantly affect public health. 
• For example, fever was once seen as a disease until it was realized to be a symptom. Homosexuality was considered a disease up until 1974 — only five decades ago. Alzheimer’s was seen as a consequence of old age until it was recognized as a disease in the early 20th century. Diseases need to be revised and redefined based on our changing culture and the needs of the public. 
• A 2015 study published in Frontiers in Genetics, which discussed the possibility of aging becoming a disease, said:

“In many cases, diseases also seem to lack a nominal sense, as there are no necessary and sufficient conditions that they must have to qualify as diseases, rather than as separate pathological conditions such as injuries, disabilities, and deformities.” 

What do opponents think?

• Opponents fear that considering aging a treatable condition would fuel an anti-aging beauty standard that would harm society, especially young women, and benefit the cosmetics industry. 
• Others point to the possibility of the stigma around old age growing stronger. Nir Barzilai, director of the Institute for Aging Research at the Albert Einstein College of Medicine, said: 

"Ageism is the biggest ism we have today in the world. The aging community is attacked...To go to those people with so many problems and now tell them, 'You're sick, you have a disease'? This is a no-win situation for the people we are trying to help."

What to expect from the FDA

• As pressure from the science community and drug industry increases, the FDA will likely address this issue in the near future. However, the agency would need to create guidelines on how to measure aging, which could take time. 
• The first step would be creating biomarkers for aging, which the FDA recently said it would be willing to do to identify early-stage Alzheimer’s.
• The FDA is also facing pressure from Congress to establish and clarify the regulatory pathways for emerging regenerative therapies, which today only target specific diseases or medical conditions, but could address the entire aging process in the future. This step would make these therapies accessible as preventative care solutions on a broad scale, meaning the FDA will need to regulate the market.

What do you think? Should the FDA classify aging as a disease?

-Jamie Epstein