NEURO NUGGETS

BY DR MOHD WAEL

Dr Wael MY Mohamed is with the Department of Basic Medical Science, Kulliyyah of Medicine, International Islamic University Malaysia( IIUM).

" Artificially separating ageing from illness might hinder efforts to understand and control biological decline. Simply, ageing is " inseparable from pathology."

However, if an illness can be stopped, prevented, and slowed, then ageing is a disease. Philosophers, physicians, and scientists have debated this issue for centuries.

Still, as more nations face the realities of an ageing population, the discussion has gained new momentum. It could have a significant impact on everything from the course of future research to the treatment of older adults in society.

This is the beginning of a very fastexpanding field. If a new approach makes sense, I believe people are willing to consider it in different ways.

Over time, there have been significant changes in the categorisation of what is considered a disease. In the past, the onset of hypertension in older adults was not considered a clinical problem until the 1960s.

Most people now understand that noticeably high blood pressure is not at all innocuous. Crucially, reclassifying hypertension- high blood pressure- as a disease sparked financing and scientific interest in finding efficient cures.

Once a condition is defined as a problem, scientific attention tends to follow. Others see ageing as an " optimal, almost benign decline " that is layered with specific disorders.

BIOLOGICAL DECLINE

This viewpoint is too simple, and artificially separating ageing from illness might hinder efforts to understand and control biological decline. Simply, ageing is " inseparable from pathology."

We need to consider how senescent cells- damaged cells that exhibit harmful behaviours and proliferate with age- contribute to both the classic phenotypic features of ageing, such as wrinkles and greying hair, as well as conditions like cardiovascular disease, osteoporosis, and cognitive impairment.

Eliminating these cells in animal models may result in " dramatic increases " in longevity and health span, indicating

that at least some aspects of ageing may be " treatable and reversible ".

Some researchers studying the biology of ageing are looking for a single cellular or molecular mechanism that could account for the wide range of functional deficits associated with ageing.

Given the wide range of factors influencing the continuous deterioration in physiological organisation and function, some contend that a single causative factor is unlikely.

There is no single mechanism likely to explain ageing in its entirety. Still, it is suggested that a few key processes, such as the build-up of senescent cells, combine to drive ageing and a number of age-related illnesses.

Formally classifying ageing as a disease would probably have the most effect on the financing and regulatory frameworks that oversee biomedical research, rather than in scientific labs.

PARADIGM SHIFT

In nations like the United States, where government research agencies and regulatory organisations prioritise illnesses with precisely defined and quantifiable clinical outcomes, such a classification would be " a paradigm shift ".

Defined as a disease, ageing " would unleash substantial research funding, accelerate drug development, and ultimately

facilitate the approval of geroprotective therapies," according to researchers.

In a similar vein, categorising ageing as a disease might accelerate the development of effective treatments. Whether we are committed to addressing these problems is the central question. If we consider ageing an illness, the path to cures becomes clearer.

Sure, ageing ramps up the risk of just about every chronic condition under the sun— but unlike diseases, you can ' t exactly ' catch ' ageing. You ' re either diseased or not. But ageing? Well, who on this planet doesn ' t have that software update running in the background?"

By now, the debate about whether ageing deserves a spot in the official Disease Hall of Fame has become so repetitive that even seasoned scientists are starting to sigh dramatically.

At every major conference, once the evening progresses and the beverages flow, someone inevitably brings it up again. Cue the groans, the eye rolls, and the sudden desire of several experts to " step out for fresh air " that suspiciously lasts an hour.

And so, the question echoes through the futuristic halls of science like an ancient riddle: If everyone ages, can ageing ever truly be called a disease- and, more importantly, what would happen if we finally decide it is?

So tell me- where do you stand in this cosmic debate?- The HEALTH