Numerous scientists in the field of aging research declare their goal to be "healthy aging," which has always seemed to me to be a contradiction in terms. Aging is by definition a process of becoming more frail, more diseased, more damaged. There is a certain amount of politics in all of this, a result of all too many researchers still unwilling to talk in public about extending healthy life spans. Thus healthy aging and compression of morbidity become code phrases to allow these people to discuss the science of aging while pretending that efforts to prevent age-related disease will not extend life spans. Yet successful prevention of age-related disease must extend overall life span. Aging is an accumulation of tissue damage, and age-related disease is the result of that damage. Meaningful treatments for age-related disease will work by reducing levels of damage and thus extend life. An unwillingness to directly engage with this point is a part of the problem we face in finding sufficient funding and support for aging research to make rapid progress.
The current research topic inquires: "Should we treat aging as a disease?" Yet, in this inquiry, the question "Can aging be considered a disease?" is secondary, while the more primary question really must be "Is aging treatable?" Paradoxically, the answer given to the second question largely determines the answer to the first. The perceived unchangeable, and hence untreatable, nature of aging is the root cause for many subsequent rationalizations, even to the point of claiming the desirability of aging-derived suffering and death. This is a well recognized psychological phenomenon sometimes referred to as "apologism" or even "deathism," a ramification of the "sour grapes syndrome," vilifying something that we think we cannot attain, while accepting as "good" or "healthy" something that we believe is inevitable for us (such as degenerative aging). Yet, I argue that, historically, medical tradition has always recognized the morbid character of aging and endeavored to fight it. The rationalizations of aging as "natural," "justified," or "healthy" could never entirely prevail.
I argue that acknowledging the possibility of successful intervention into the aging process, in other words treating aging as a curable disease, has been a long and highly respected tradition of biomedical thought. It may just be observed that the proactive attitudes, aimed to ameliorate degenerative aging, tend to intensify thanks to the advancement of technological capabilities. Presently, the list of supporters of the cause of "curing aging" grows rapidly. The reason for this increase may be objective and tectonic. The world is rapidly aging, threatening grave consequences for the global society, in particular economy, which forces the society to seek solutions. On the other hand, biomedical science and technology are developing rapidly as well, increasing the feasibility of intervention and fostering our hope that a solution may be found.
Those may be "the push and the pull" or "the stick and the carrot" mighty forces that prompt more and more scientists and lay persons to move over to the camp of "treating aging as a disease," toward investing more and more time and effort for its amelioration or even cure, as soon as possible, for the benefit of all. Yet, the very idea of "treating aging as a disease," or some other title given to a morbid, debilitating and deadly condition, is by no means an intellectual novelty. It is a long established commonsensical intellectual tradition and a profound and ancient human desire. With the growing aging population and increasing technological capabilities, this idea is achieving an ever greater prominence. Eventually, the question whether aging should be considered "a treatable disease" may be reduced to technological capacity and semantics. While degenerative aging, that is the accumulation of structural damage, impairment of metabolic balance and functioning, may be seen as a disabling and deteriorative process that requires prevention and treatment, using advanced biomedical technology; the achievement of healthy longevity may be its cure.