We must treat aging as a disease. Lifespan or healthspan? 5

We must treat aging as a disease. Lifespan or healthspan? 5

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So that brings us to the very important part of the concept of lifespan and healthspan. And lifespan and healthspan are not necessarily correlated. So how does the disease process influence the aging process? You're right. They're not the same thing. Lifespan and health span are not the same things. Lifespan in humans has been increasing very rapidly, six hours a day, for almost 200 years now. Dr. Steven Austad, PhD. Dr. Anton Titov, MD. Healthspan has been growing less rapidly. And in fact, the length of unhealthy life at the very end is a little bit longer than it was even 20 or 30 years ago. So what we need to do is understand what determines healthspan. And we must think about it differently than we think about diseases. There's been a move in the field now to sort of reclassify aging as a disease. And I think while that may make sense, in a marketing sense, that is, it may get more attention. 


If we treat aging as if it were a disease. It is not a disease, but it influences diseases. Dr. Steven Austad, PhD. Dr. Anton Titov, MD. And then diseases, paradoxically, can also influence aging. One of the more interesting things we've learned recently is from people that are living with HIV that is very, very well controlled. And so there's a very little virus in the blood. But they have been aging at an accelerated rate. Does that has to do with some sort of low-level inflammation? We know that low-level chronic inflammation increases with age. It may has to do with some sort of response to the antiviral drugs that these people are taking chronically. We don't know. But it emphasizes the impact of diseases on aging, as well as aging on the disease. Dr. Steven Austad, PhD. Dr. Anton Titov, MD. 


We know that, for instance, cancer chemotherapy can accelerate aging. Chemotherapy can be great for treating cancer, but it does all kinds of bystander damage, as they call it. You bring up the issue of the aging influencing the disease. Still, also disease influences the aging. Dr. Steven Austad, PhD. Dr. Anton Titov, MD. Considering hundreds of billions of dollars that are spent on diseases, and especially fighting it at the very late stages, would it not make sense to direct more research to the fundamental process of aging and to see if you can influence cancer and dementia at a fundamental level? Yeah, that's a very good point. That's a very good point. And it's a point that we try to get across, which is that aging underlies all the major diseases, all the major causes of death. And if we can target and modify the underlying processes, then we have the possibility of delaying or preventing all of these diseases as a group. Think of it this way. 


I developed a cancer prevention drug, but it has several side effects. One of the side effects is it prevents dementia and on other side effects, it prevents heart disease and osteoarthritis, and a whole bunch of other things. That's what we're talking about. It's a completely different kind of thinking about biomedical intervention than what we've done before. If you think about it, the whole medical field is atomized into studying different diseases. We have our oncologists, our neurologists. But what's happened is this. As they started talking to one another in recent times, they realized that same process is underlying cancer and heart disease and neurodegenerative diseases. So maybe we have been doing this wrong. Maybe we want to target fundamental aging processes. One of the things that have prevented this is the Food and Drug Administration because they will only approve drugs for specific diseases. Dr. Steven Austad, PhD. Dr. Anton Titov, MD. 


And so a number of us had a meeting with the Food and Drug Administration about five years ago, trying to get their opinion on whether we could do a trial with a drug that targeted aging. But we couldn't say it in those terms. We had to say it in terms of a single drug that targeted multiple diseases. Dr. Steven Austad, PhD. Dr. Anton Titov, MD. And once we put it like that, FDA said, okay, yeah, in principle, we could approve a drug for that. And so we're hoping that the FDA changes its view on this. FDA doesn't, for instance, consider sarcopenia, an age-related muscle loss, a disease either. That means they can't approve drugs to treat sarcopenia. So there's this. This is more than a semantic issue. This is an issue that addresses how we do science, unfortunately. 

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