Is ageing a disease?

* Experts say fresh look would open new drug avenues

*Ageing research aims for longer health-span

By Kate Kelland, Health and
Science Correspondent

LONDON, (Reuters) – Is ageing a disease?

It’s clear that the simple fact of growing older —  chronological ageing — is relentless and unstoppable. But  experts studying the science of ageing say it’s time for a fresh  look at the biological process — one which recognises it as a  condition that can be manipulated, treated and delayed.

Taking this new approach would turn the search for drugs to  fight age-related diseases on its head, they say, and could  speed the path to market of drugs that treat multiple illnesses  like diabetes, heart disease and Alzheimer’s at the same time.

“If ageing is seen as a disease, it changes how we respond  to it. For example, it becomes the duty of doctors to treat it,”  said David Gems, a biogerontologist who spoke at a conference on  ageing in London last week called “Turning Back the Clock”.

At the moment, drug companies and scientists keen to develop  their research on ageing into tangible results are hampered by  regulators in the United States and Europe who will licence  medicines only for specific diseases, not for something as  general as ageing.

“Because ageing is not viewed as a disease, the whole  process of bringing drugs to market can’t be applied to drugs  that treat ageing. This creates a disincentive to pharmaceutical  companies to develop drugs to treat it,” said Gems.

The ability of humans to live longer and longer lives is  being demonstrated in abundance across the world.

Average life expectancies extended by as much as 30 years in  developed countries during the 20th century and experts expect  the same or more to happen again in this century.

A study published last year by Danish researchers estimated  that more than half of all babies born in wealthy nations since  the year 2000 will live to see their 100th birthdays.

“THERE’S ONE THING

WE’RE ALL MISSING”

But with greater age comes a heavier burden of age-related  disease.

Cases of dementia and Alzheimer’s, incurable brain-wasting  conditions, are expected to almost double every 20 years to  around 66 million in 2030 and over 115 million in 2050.

Diabetes, heart disease and cancer, and the cost of coping  with them in ageing populations, are also set to rise  dramatically in coming decades in rich and poor countries alike.

Nir Barzilai of the Albert Einstein College of Medicine at  Yeshiva University in New York, says one way of trying to face  down this enormous burden of disease is to look at the biggest  risk factor common to all of them — ageing.

“There’s one thing everybody is missing,” he said. “Ageing  is common for all of these diseases — and yet we’re not  investigating the common mechanism for all of them. We are just  looking at the specific diseases.”

To try to reverse that, Barzilai and many other scientists  around the world are studying the genes of the very old and  starting to find the genetic mechanisms, or pathways, that help  them beat off the dementias, cancers, heart diseases and other  age-related illnesses that bring down others who die younger.

By finding the genes thought to help determine longevity,  scientists think they may be able to mimic their action to not  only extend life span, but, crucially, extend health span.

“It is … looking increasingly likely that pharmacological  manipulation of these … pathways could form the basis of new  preventative medicines for diseases ageing, and ageing itself,”  said Andrew Dillin of the Salk Institute in California and the  Howard Hughes Medical Institute.

Gems says institutional and ideological barriers are  standing in the way — and a major one is the longstanding  traditional view that ageing is not a disease, but a natural,  benign process that should not be interfered with.

CHANGING ATTITUDES?

All three experts say, however, that the ground is shifting  in their direction.

There is now a “groundswell” of specialists in ageing, says  Dillin, who are lobbying the world’s biggest drug regulator, the  U.S. Food and Drug Administration, to consider redefining ageing  as a disease in its own right.

Major scientific research bodies like the U.S. National  Institutes of Health and the Medical Research Council in Britain  are also under pressure to put more emphasis — and funding —  into studying how ageing increases disease risk.

For biogerontologists, as scientists who study the biology  of ageing are known, the struggle is to convince people that  their goal in unpicking the science behind ageing is no longer  life, but healthier life.

“The whole reason that we study the ageing process is not  actually to make people live a lot longer, it’s to get people to  have a more healthy lifespan,” said Dillin.

He sees it as a matter of re-educating the public and health  authorities to see biological ageing in a new light.

“When we are in the public arena we tell people we’re  working on the ageing process, the first thing they think is  that we want to make a a 100-year-old person live to be 250 —  and that’s actually the furthest from the truth,” he said.

“What I want is for a 60-year-old person who is predisposed  to have Alzheimer’s to be able to delay that, live to be 80, and  get to know their grandchildren.”