February 17, 2004

Would Reclassifying Aging As A Disease Help?

This is my second post on the January 22, 2004 International Logevity Center debate, "Is Aging a Disease?"

Dr. Moody started out by making an important distinction between aging and senescence. Aging is simply a marking of time. Senescence is the deterioration that happens to all of us over time (and sometimes at different rates). There was little debate that the process of senescence is an unpleasant and undesirable biological process. And neither of the participants spoke as though it would be a bad thing if senescence were cured. The debate really centered on whether classifying senescence as a disease would be good policy.

Dr. Moody argued that reclassifying senescence as a disease would encourage money to be spent to cure it.
The only way Americans spend money on anything is if it is a disease. That’s the NIH legacy. That’s the politics of American health care. You show up at Congress and say, “Well, aging is kind of a natural thing, but it would be fun to know more about it. And that would be kind of a helpful thing for science.” They are not going to give you anything!
Obstetrics was offered as a counter-example. Neither pregnancy nor child-birth is considered a disease, but they are medicalized – you are treated by doctors for pregnancy and child birth. You could be treated for senescence without classifying it as a disease.

The participates also debated how this redefinition would affect those currently selling anti-aging treatments – much of which they agreed is pseudo-scientific junk.
MOODY: It would help them, because they would say, “We’ve been saying it’s a disease all along. Now Congress and the FDA have agreed with us. “Thank God they’re finally enlightened,” to use Arthur’s phrase.

CAPLAN: It would put them out of business, because they’d finally have people chase them down saying, “You’ve been on the side peddling all this stuff in the name of some mumbo jumbo. Now, prove what you are doing before you can go out there and make a claim to get after this. You show us the safety. You show us the efficacy. And real physicians, real scientists are now on the case, basically saying, “What’s the evidence? Are you in the journals? Where’s your peer review?”
I'm inclined to agree with Dr. Caplan on this. I'm not as happy about it as he is though. There is much money wasted on snake oil, but sometimes things just have to be tried. Both Dr. Moody and Dr. Caplan believe that it would be much better to have lengthy clinical trials on every anti-aging therapy before they are tried with people. Both of these men are professional scientists and it's not surprising that this is their bias.

Some current treatments seem to provide some benefit with very little risk. If reclassifying aging as a disease means that manufacturers will no longer be able to mention anti-aging when selling something like anti-oxidants, it may affect their sales. This may, in turn, affect availability. I'm not sure this is 100% a good thing.

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