Cognitive Aging as a Disease

There is a debate over whether aging is a disease, and here is some insight into where the aging of the brain and neurodegenerative diseases fit into that larger argument: the "question of whether 'aging itself' is or is not a 'disease' has long been mooted in biogerontological circles, with a long-held rhetorical preference for asserting that it is not, but rather, that it is a risk factor for the specific diseases of aging. By contrast, the same fundamental semantic dispute was initially resolved in the opposite direction with regard to age-related cognitive decline and dementia, beginning in the early decades after Alois Alzheimer and Emil Kraepelin first identified the pathological basis of the Alzheimer's disease (AD) until the early 1970s. For most of the twentieth century, it was held that dementia occurring in younger people should be classified as a disease, whereas dementia should be expected and accepted when it occurred in people at more advanced ages, despite the knowledge that the lesions linked to Alzheimer's dementia accumulated throughout the course of "normal" aging in middle age and onward, and that the pathological basis of the disorder was the same in both cases. ... But beginning in the 1960s, a loose alliance led by social gerontologists but quickly coming to include biogerontologists, geriatricians, and patient advocacy groups successfully campaigned for a new understanding: that while some level of minor cognitive decline was indeed a 'normal' and inevitable part of aging, the newly-rediscovered clinicopathological entity, 'Alzheimer's disease,' was exactly that: a disease, against which the full force of public and private biomedical research should be mobilized in the pursuit of a cure." These debates are almost entirely driven by the state of regulation in medical development; in particular that the FDA does not approve treatments that are not aimed at a defined and accepted disease - and aging is not a disease to the regulators, so no-one can try to treat it legally. This is an abysmally stupid situation, but sadly par for the course wherever government becomes involved.



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