Is it Time to Call Aging a Disease? | Orthopedics This Week

Is it Time to Call Aging a Disease?

Source: Wikimedia Commons and Jean Bajean

Would our treatment for osteoarthritis (OA) change if we addressed aging as a disease—complete with diagnostic and treatment reimbursement codes?

Two professors, Richard Faragher, Professor of Biogerontology at the University of Brighton and Stuart Calimport, Honorary Fellow at the University of Liverpool and the Imperial College of London, raised that provocative point in their article “Why Ageing Should be Classified as a Disease” published in the journal The Conversation.

Yes, We’re Heading There

Surprisingly, we may be heading exactly to the point as the scientific focus of pharma and biologic companies moves from specific disease targets like OA to genomic and molecular diagnostics where the process of aging could well be treated as a codable “disease-state.”

From the early 1900s to, arguably, between 2010 and 2020, the dominant paradigm of drug and biologic discovery was to target a disease state and then seek a therapeutic to address that disease.

For more than eight decades, that meant that small molecule drugs and vaccines to treat arthritis and other diseases of aging.

In the mid-1990s, intracellular inhibitor therapies and epigenetic drugs became the rage and pulled therapeutics into molecular and cellular mechanisms of action.

Today, we are early into phenotype-based biologic and drug discovery techniques. Now the targets are oligonucleotide therapeutics, genome editing and pharmacogenetic diagnostics.

And…among the very promising areas of research is cell senescence including the resultant release of the raw material of osteoarthritis and other diseases of aging—inflammatory factors and enzymes.

The ICD System Won’t Work in an Era of Genomics and Molecular Diagnostics

In light of the direction of medical science, Drs. Faragher and Calimport argue that the current system of classifying disease is out of date.

“The International Classification of Disease (ICD system began in the 19th century and is regularly updated. It provides the codes used to classify and report medical diagnoses and procedures. And it is central to understanding the causes of illness and death around the world.”

The classification system is rooted in defining and grouping pathologies and diseases that, because of the “natural process” versus “disease” dichotomy, means that ageing changes are coded haphazardly—they are incomplete and inaccurate, and they overlap.”

The doctors argue that the ICD system should cover every pathology and disorders related to aging. The problem, they say, is that lack of classification and staging means that pathological aging changes are not recorded and, therefore, treatments are overlooked—like atrophy, calcification and so forth.

According to Faragher and Calimport, if the ICD coding systems were updated for aging, “current treatments, including diet and exercise, could be effectively applied. And there are several drugs, old and new, that could be used to prevent or reverse ageing.”

And, if aging is treated, what would be the implications for OA?

Next ICD Update Is January 1, 2022

Disease classification codes are supposed to reflect the latest in science and medicine.

Is it time to seriously consider aging as a disease classification?