A new publication by an international team of scientists has proposed a new healthcare framework to help older people stay healthier for longer by improving the development of therapies that target age-related diseases.
Society is aging, and we need to change healthcare for the better
This new publication urges World Health Organization (WHO), governments, and the medical science community to work together and develop classifications and staging systems using a new framework as a basis for diagnosing and treating age-related diseases.
Currently, many age-related diseases lack adequate diagnostic criteria and clinical-severity staging, which presents a serious barrier for developing new drugs and therapies for treating them. This lack of framework hampers the development of effective treatments for multiple age-related diseases.
Society is rapidly aging in many developed countries as the ratio of older people to younger people rises due to rising life expectancies. To put this in perspective, currently and for the first time in history, the majority of people can now expect to live to age 60 and beyond. By 2020, the number of people aged 60 plus will outnumber the amount of children aged 5 or under. By 2050, there are projected to be 2 billion people aged 60 or older, an increase from just 900 million in 2015.
This represents an urgent and unmet medical need as well as a serious economic problem, because these older people are often suffering from one or more chronic diseases, and the burden on healthcare systems and younger caregivers is considerable. In order to address this, dedicated research, new disease terminology and classification, aging biomarkers, and diagnostic methods are urgently needed in order to diagnose, develop therapies for, and treat a variety of age-related diseases.
Dr. Stuart Calimport, one of its creators, explained: “This framework will increase our ability to develop drugs and interventions that target the processes of aging and that can accumulate with age, which would have unprecedented benefits in relation to the treatment and prevention of serious diseases.”
A new framework for aging research
The current classification and severity staging of age-related diseases is limited because it is inconsistent, incomplete and non-systematic. For example, some diseases that can develop in multiple organs, such as intrinsic organ aging, are only classified in a single organ but not in other organs that suffer the same disease.
To solve this problem, an international group of scientists and medical practitioners led by Dr. Stuart Calimport and Dr. João Pedro de Magalhães has created a position statement that will act as the foundation for properly and comprehensively classifying and staging the severity of age-related diseases.
The statement includes aging at both the tissue and organ levels, organ atrophy, the pathologic remodeling and calcification of tissues, and age-related systemic and metabolic diseases. If adopted, such a framework could speed up progress in developing drugs and therapies that target the aging processes directly in order to delay, prevent or reverse age-related diseases.
It should be noted at this point that the WHO International Classification of Diseases (ICD-11) already classifies aging as a condition, but this is only in relation to intrinsic skin aging and photoaging. More recently, sarcopenia, the age-related loss of muscle mass, has also been included in its classification system. However, this new framework proposes the classification of aging as conditions in all organs along with the comprehensive classification of all aging-related diseases and syndromes.
Co-author Professor Judith Campisi from the Buck Institute for Research on Aging said: “Bringing WHO and other governments into the effort to identify and classify aging as a condition is the only way we are going to be able to address the unmet needs of aging populations around the world. This effort provides a framework that would guide policy and practice and enable appropriate interventions and the allocation of resources. This is particularly important in countries that have fewer resources to devote to caring for an aging population.”
As part of the new proposed framework, the researchers have already submitted initial classifications relating to age-related diseases to WHO for potential inclusion in the ICD-11.
Dr. João Pedro de Magalhães said: “Aging is the greatest biomedical challenge of the 21st century. As such, this framework will increase our ability to develop longevity drugs and interventions that target diseases related to the aging process.”
Globally, citizens exist for sustained periods in states of aging-related disease and multimorbidity. Given the urgent and unmet clinical, health care, workforce, and economic needs of aging populations, we need interventions and programs that regenerate tissues and organs and prevent and reverse aging-related damage, disease, and frailty (1). In response to these challenges, the World Health Organization (WHO) has called for a comprehensive public-health response within an international legal framework based on human rights law (1). Yet for a clinical trial to be conducted, a disease to be diagnosed, intervention prescribed, and treatment administered; a corresponding disease classification code is needed, adopted nationally from the WHO International Classification of Diseases (ICD). Such classifications and staging are fundamental for health care governance among governments and intergovernmental bodies. We describe a systematic and comprehensive approach to the classification and staging of organismal senescence and aging-related diseases at the organ and tissue levels in order to guide policy and practice and enable appropriate interventions and clinical guidance, systems, resources, and infrastructure.
Conclusion
This is a really important step forward in regulatory matters and, if successfully adopted by WHO, could have a dramatic impact on the development of drugs and therapies aimed at effectively treating age-related diseases. The current system leaves researchers with their hands tied, and with the looming crisis of an aging population, this framework is a much needed shot in the arm for healthcare and medical research and development.
