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. 2022 Nov 21;77(11):2168-2174.
doi: 10.1093/gerona/glac039.

What Is an Aging-Related Disease? An Epidemiological Perspective

David G Le Couteur  1   2 , Janani Thillainadesan  1   2
Affiliations

What Is an Aging-Related Disease? An Epidemiological Perspective

David G Le Couteur et al. J Gerontol A Biol Sci Med Sci. .

Abstract

There are no established or standardized definitions of aging-related disease. Data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 were used to model the relationship between age and incidence of diseases. Clustering analysis identified 4 groups of noncommunicable diseases: Group A diseases with an exponential increase in incidence with age; Group B diseases with an exponential increase in incidence that usually peaked in late life which then declined or plateaued at the oldest ages; and Groups C and D diseases with an onset in earlier life and where incidence was stable or decreased in old age. From an epidemiological perspective, Group A diseases are "aging-related diseases" because there is an exponential association between age and incidence, and the slope of the incidence curves remains positive throughout old age. These included the major noncommunicable diseases dementia, stroke, and ischemic heart disease. Whether any of the other diseases are aging-related is uncertain because their incidence either does not change or more often decreases in old age. Only biological studies can determine how the aging process contributes to any of these diseases and this may lead to a reclassification of disease on the basis of whether they are directly caused by or are in continuity with the biological changes of aging. In the absence of this mechanistic data, we propose the term "aging-related disease" should be used with precision based on epidemiological evidence.

Keywords: Age-related disease; Beta growth; Gompertz; Incidence.

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Figures

Figure 1.
Figure 1.
Examples of the 4 types of relationships between age and incidence of disease from the Global Burden of Disease database (GBD) for (A) Group A: Alzheimer’s disease and other dementias; (B) Group B: atrial fibrillation and flutter; (C) Group C: gastroesophageal reflux disease; and (D) Group D: schizophrenia. The curves have been fitted with the Gompertz–Makeham formula (green line) and beta growth curve (blue line). The curves on the right show the relationship between age and the rate of change of incidence. In these graphs, positive values indicate that incidence is increasing with age and negative values indicate that incidence is decreasing.
Figure 2.
Figure 2.
The relationship between the sociodemographic index (SDI) on the relationship between age and incidence of disease for Group A diseases where sociodemographic index has minimal affect on incidence: (A) Alzheimer’s disease, (B) cardiomyopathy and myocarditis, (C) chronic obstructive pulmonary disease, and (D) ischemic stroke. Note: Blue symbols = high sociodemographic index; dark red symbols = low sociodemographic index.
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