Is ageing a disease ? The World Health Organisation might think so.
Multiple groups worldwide have been lobbying for the World Health Organisation (WHO) to classify ageing as a disease within the International Classification of Diseases (ICD). The proposal “Adding Ageing to the ICD” was presented at the Undoing Aging conference in Berlin earlier this year.
The lobbying paid off when the WHO published an updated version of the ICD this past June. As part of the update, the WHO implemented an extension code within the ICD-11 for “Ageing-related” (XT9T), implying the recognition of ageing as a major disease risk factor.
The ICD-10 hadn’t been updated since 1983, so ICD-11 will be the new standard for years to come.
This update carries significant implications and opportunity for the scientific research community.
Why?
Previously, the absence of this official classification and recognition was a major barrier for research funding, clinical evaluations, and regulatory approval of ageing-related interventions.
Now, the new code for “Ageing-related” can be added to any other relevant condition listed in the ICD-11 to form new conditions such as “ageing-related lung atrophy” or “ageing-related primary immunodeficiency” as examples. This will create new R&D opportunities for innovative anti-ageing medical biotechnologies, which can then be clinically evaluated and approved, and insurance companies will be able to provide coverage for approved therapies indicated for the disease.
What does this mean for you ?
The WHO just officially recognised that the process of ageing is a major risk factor for diseases.
It’s already known that as you get older, your probability of survival decreases due to the process of ageing — a gradual decline in physiological integrity and function, leading to a higher vulnerability to death and development of diseases.
It’s also known that after the age of 70, most people will suffer from one or more of the following diseases, which are the top five causes of death worldwide.
1. Heart Disease
2. Cancer
3. Respiratory Disease
4. Diabetes
5. Dementia
By and large, the above are considered diseases of old age. The implementation of the new “ageing-related” code is starting to seem more intuitive, isn’t it ?
However, ageing markers at the biochemical level were only recently defined in 2013, in a paper by Carlos Lopez-Otin, et al., titled “The Hallmarks of Aging”, published in Cell. I’d encourage you to check it out. It’s one of the most highly cited papers in the field of biology.
So now that our understanding of ageing is at a cellular and molecular level, we can now design medicines to target and treat. The new ICD code, in turn, will enable such anti-aging interventions to be approved by regulatory bodies like the FDA, EMA, PMDA, etc.
What this means for you is that we could see treatments targeting pro-ageing cellular pathways in our lifetime.
That’s great, what’s next ?
The addition of an extension code for “ageing-related” within the ICD-11 is a step in the right direction, but the next milestone for the WHO would be to consider and treat ageing itself as a disease.
Think about that — ageing as a condition subject to prevention and treatment.
Instead of looking for the cure to heart disease, diabetes, or cancer, research labs would be looking for the cure to ageing, the gradual decline in physiological integrity and function that we all experience as we get older.
In fact, they already are.
There are over 200 biotechnology start ups working on anti-ageing research and development. Most of these efforts have been privately funded.
Arguably the most well-known is Calico (Calico Life Sciences LLC) — a Google-founded R&D company whose mission is “to harness advanced technologies to increase our understanding of the biology that controls lifespan”. Calico plans to use that knowledge to develop interventions to increase healthspan and lifespan. So far, Calico has not disclosed much about its R&D findings — understandably so — but research efforts are known to focus on the influences of caloric intake on overall health, how cellular ageing affects cell behaviour and breakdown, and using deep learning for predictive health analytics.
Big pharma is jumping on board, with AbbVie partnering with Calico in 2014 and announcing the extension of this partnership earlier this year. Note that’s only one pharma example.
The latest biotech start-up to make headlines is Elevian with $5.5 million in seed funding to pursue research in the realm of the effects of “young blood”. Specifically, they’ll be looking at developing drugs that increase the activity levels of GDF11, a circulating factor that mirrors the effects of young blood in old mammals, repairing the brain, heart, muscle, and other tissues. Elevian is not the first biotech to pursue the “young blood” space.
One of the funding sources for Elevian was the Longevity Fund, which as of August 2017, had raised $22 million in its second fund. The Longevity Fund is not the only venture capital to be investing primarily in longevity and diseases of ageing.
That said, regulatory changes do not happen overnight. While the research is progressing, the World Health Organisation’s ICD-11 will be presented at the World Health Assembly in May 2019. The changes will come into effect within Member States in January 2022.
In the meantime, if you found this news intriguing and would like to learn more about longevity science, I invite you to check out my earlier article “Can We Avoid Ageing ? 10 Must-See Talks on Human Longevity”, where I compiled a series of TED talks and conference speeches by longevity thought leaders.
