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. 2010 Jun;32(2):155-60.
doi: 10.1007/s11357-009-9120-5. Epub 2009 Nov 11.

What determines age-related disease: do we know all the right questions?

David A Juckett  1
Affiliations

What determines age-related disease: do we know all the right questions?

David A Juckett. Age (Dordr). 2010 Jun.

Abstract

The average human lifespan has increased throughout the last century due to the mitigation of many infectious diseases. More people now die of age-related diseases than ever before, but these diseases have been resistant to elimination. Progress has been made in treatments and preventative measures to delay the onsets of these diseases, but most cancers and vascular diseases are still with us and they kill about the same fraction of the population year after year. For example, US Caucasian female deaths from breast plus genital cancers have remained a fairly constant approximately 7% of the age-related disease deaths from 1938 to 1998 and have been consistently approximately 2-fold greater than female colon plus rectal cancer deaths over that span. This type of stability pattern pervades the age-related diseases and suggests that intrinsic properties within populations determine these fractions. Recognizing this pattern and deciphering its origin will be necessary for the complete understanding of these major causes of death. It would appear that more than the random processes of aging drive this effect. The question is how to meaningfully approach this problem. This commentary discusses the epidemiological and aging perspectives and their current limitations in providing an explanation. The age of bioinformatics offers hope, but only if creative systems approaches are forthcoming.

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Figures

Fig. 1
Fig. 1
Total Caucasian female deaths as a fraction of all age-related deaths in a given year (US Department of Health and Human Services, 1939). Age-related deaths consist of total deaths minus those from infections, early infancy, complications of pregnancy, violence, and poisonings. a Disease deaths that have varied significantly over the recent decades. For syphilis and tuberculosis, the denominator also includes infectious diseases. b Examples of disease deaths that have remained predominantly stable. Plotted on the same scale as (a) for ease in comparison
Fig. 2
Fig. 2
Changes in cancer mortality (SEER Cancer Statistics Review 1975). a Percent changes in the average age-specific mortality rates for various cancers between 1950 and 2005. b Percent increase in 5-year survival after diagnosis, between the 1955–1959 era and the 1996–2004 era, for the same diseases listed in panel a
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