Fight Aging!

Here I'll point out a recent objection to the formal classification of aging as a disease, which seems to merge at the edges with an objection to treating aging at all, or an objection to aiming high, or the belief that significant progress in this field is not plausible. The latter is, sadly, a common position in the field of aging research. At the very least there is a strong separation of the ideas of aging and disease, which doesn't seem to me to be justified. Aging and age-related disease are only made separate in concept, divided by the names we give to various states and processes. At the low level in our cellular biochemistry it is the same forms of damage that give rise to what is called normal aging and what is called an age-related disease. Matters of degree only separate "healthy" (in decline, less than they were) senior individuals from patients diagnosed with specific age-related diseases.

Is aging a disease? Mutaz Musa answers this question in the affirmative. In response to his article, we suggest that, aside from containing fundamental logical flaws, Musa's argument produces a simplistic picture of the complexities of aging, both as a concept and as an actual phenomenon. While the author's opinion appears to be driven by a sincere desire to optimize people's lives, his approach might in fact be counterproductive: by pathologizing aging, he creates more, not less, challenges to ascribe meaning to age-related physical decline. The questions raised in Musa's piece are nonetheless thought-provoking, as he confronts assumptions about what constitutes disease and what causes aging. In particular, Musa asks us - researchers who study the various processes of aging - to consider how we define aging, disease, and the causes and effects that link these phenomena.

There are logical flaws in Musa's opening statements. "No longer considered an inevitability, growing older should be and is being treated like a chronic condition," he writes. This proclamation contains argumentative entanglements that are common in the field of aging research, and which should be considered carefully. Musa's first claim, that "growing older is no longer considered an inevitability," only makes sense if you consider "growing older" not as a descriptive term for the latter stages of the time that passes from birth to death, but as another way of denoting the state of becoming frail, diseased, mentally and physically infirm, and so on. Aging researchers have found that such decline is not an inevitable occurrence associated with aging (backed up and famously articulated in research frameworks such as Successful Aging). But stating that some or all of these effects may be avoided is not the same as saying that "growing older is no longer considered an inevitability."

Another illustrative example of shifts in logic and meaning occurs when Musa writes about age-related changes in the body, arguing that some of these show "that perfectly normal processes that are critical to survival will quite naturally lead to disease. In a biological sense, the mere passage of time is pathological." Here, Musa turns the fact that some routine processes lead to pathology into an argument that these processes are, therefore, pathological. That some processes lead to pathology does not mean that these processes are responsible for disease. Even a process like the production of reactive oxygen species (ROS) through mitochondrial function does not automatically lead to dangerously damaged DNA - it can, but only if there are no antioxidants available, and if DNA repair mechanisms are compromised in some way. We don't define smoking as a disease, we define lung cancer as a disease: smoking is a risk factor, but does not always lead to lung cancer. By collapsing causal risk factors and pathology into one, aging researchers will not become better equipped to deal with the complexity of either part. Nor will anyone benefit from a pathologization of bodily processes that happen in everyone, at all times.

Further, to propose, as Musa does, that if some process over time leads to pathology, then "the mere passage of time" in a biological sense is pathological, is an inductive fallacy. A fallacy that ignores the multiple processes and effects happening in the body over time, all the time, where some have effects most people want, and some do not. Regardless of our abilities to traverse our senior years illness free, we will all, eventually, die. Conflating aging and illness, however, weakens our ability to impart meaning to such inevitability. It seems that while Musa comes to represent an approach to aging that will undoubtedly attract research funding that will help scientists find ways to allow people to live physically healthier lives, it is also an approach that seeks to reduce complex issues to more simple models, thus creating an illusion - or at least the hope - of control and of biotechnological solutions to issues that also have existential and social aspects. This approach overemphasizes the importance of prolonging life at the expense of coming to terms with the possibilities of frailty and various forms of decline - not to mention death - in later life. This will not create less suffering. It will create unrealistic expectations of future scientific mastery of the human condition, telling us that frailty and decline should be avoided at all costs. This is neither a healthy psychological reaction to frailty and decline, nor will it ultimately lead to anything but individual disappointment and a mistrust of a science that promises more than it can deliver.

Link: http://www.the-scientist.com/?articles.view/articleNo/47849/title/Opinion--Aging--Not-a-Disease/