The question of whether ageing is a disease has sparked intense debate among scientists, philosophers and policymakers. Traditionally, ageing has been viewed as an inevitable, natural process—a gradual decline in biological function that affects all living organisms. But in recent years, a growing number of researchers argue that ageing should be classified as a disease, one that can and should be treated, delayed or even reversed. This shift in perspective could revolutionize medicine, extend human lifespans and redefine what it means to grow old.
At the heart of the debate is the distinction between ageing as a natural process and ageing as a pathological condition. Proponents of classifying ageing as a disease point to the fact that it is the leading risk factor for a host of deadly conditions, including cancer, Alzheimer’s, cardiovascular disease and osteoporosis. Ageing is associated with the accumulation of cellular damage, the decline of regenerative capacities and the dysfunction of vital organs. These changes are not random; they follow predictable patterns and can be targeted with medical interventions. If a condition causes suffering, impairs function and can be mitigated with treatment, they argue, then it meets the criteria of a disease.
The World Health Organization defines a disease as a disorder of structure or function in a human, animal or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury. By this definition, ageing fits the bill. It is a disorder of structure and function that produces a wide range of symptoms, from wrinkles and gray hair to arthritis and dementia. It affects every part of the body and is not the result of a single injury but a complex, systemic process. If hypertension, diabetes and osteoporosis—all age-related conditions—are classified as diseases, why not ageing itself?
Critics, however, argue that ageing is a natural and universal process, not a disease. They contend that classifying ageing as a disease could pathologize a normal part of life, leading to the medicalization of old age and the stigmatization of the elderly. Ageing, they say, is not a deviation from the norm but the norm itself. Every living organism ages, and attempting to classify it as a disease risks reducing the complexity of human existence to a medical problem in need of a cure. Moreover, they warn that framing ageing as a disease could divert resources and attention away from addressing the social, economic and psychological challenges of an ageing population.
Yet, the line between natural processes and diseases has always been blurry. Menopause, for example, was once considered a natural part of ageing but is now recognized as a medical condition that can be treated with hormone therapy. Similarly, osteoporosis was long seen as an inevitable consequence of getting older, but it is now classified as a disease and treated with medications that slow bone loss. If these conditions can be medicalized, why not ageing itself? The distinction between a natural process and a disease may be less about biology and more about our ability to intervene.
The scientific community is increasingly treating ageing as a modifiable risk factor. Researchers have identified the so-called “hallmarks of ageing,” a set of cellular and molecular changes that drive the ageing process. These include genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion and altered intercellular communication. Each of these hallmarks represents a potential target for intervention. Drugs like rapamycin, metformin and senolytics are being tested for their ability to slow or reverse these processes, with promising results in animal models and early human trials.
In 2018, the World Health Organization included ageing in its International Classification of Diseases (ICD-11) under the code “MG2A: Ageing-related diseases.” While this does not classify ageing itself as a disease, it acknowledges the role of ageing in the development of other conditions. Some argue that this is a step in the right direction, but others believe it doesn’t go far enough. If ageing is the root cause of so many diseases, they contend, then it should be classified and treated as a disease in its own right.
The implications of classifying ageing as a disease are profound. It would accelerate research and development into anti-ageing therapies, attract more funding and encourage a shift in how we approach healthcare. Instead of treating individual age-related diseases in isolation, we could focus on addressing the underlying cause: ageing itself. This could lead to a new era of preventive medicine, where the goal is not just to extend lifespan but to extend healthspan—the period of life free from chronic disease and disability.
But the classification of ageing as a disease also raises ethical and societal questions. If ageing is a disease, does that mean everyone has the right to treatment? Who would have access to anti-ageing therapies, and who would be left behind? Would society become even more ageist, with those who can afford to stay young enjoying privileges denied to others? And what would it mean for our sense of identity and purpose if we could live indefinitely? These are questions that go beyond science and touch on the very essence of what it means to be human.
Ultimately, the debate over whether ageing is a disease may be less about semantics and more about priorities. Whether we call it a disease or a natural process, the fact remains that ageing is the single greatest risk factor for the conditions that kill most people in the developed world. By treating ageing as a medical problem, we open the door to new possibilities for intervention, prevention and cure. The question is not whether we can afford to medicalize ageing, but whether we can afford not to. As the global population ages and the burden of age-related diseases grows, the case for treating ageing as a disease becomes ever more compelling. The future of medicine may depend on it.
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