title: Reverse geroscience: how does exposure to early diseases accelerate the age-related decline in health?
abstract: Aging is the major risk factor for both the development of chronic diseases and loss of functional capacity. Geroscience provides links among the biology of aging, the biology of disease, and the physiology of frailty, three fields where enormous progress has been made in the last few decades. While, previously, the focus was on the role of aging in susceptibility to disease and disability, the other side of this relationship, which is the contribution of disease to aging, has been less explored at the molecular/cellular level. Indeed, the role of childhood or early adulthood exposure to chronic disease and/or treatment on accelerating aging phenotypes is well known in epidemiology, but the biological basis is poorly understood. A recent summit co-organized by the National Institutes of Health GeroScience Interest Group and the New York Academy of Sciences explored these relationships, using three chronic diseases as examples: cancer, HIV/AIDS, and diabetes. The epidemiological literature clearly indicates that early exposure to any of these diseases and/or their treatments results in an acceleration of the appearance of aging phenotypes, including loss of functional capacity and accelerated appearance of clinical symptoms of aging-related diseases not obviously related to the earlier event. The discussions at the summit focused on the molecular and cellular relationships between each of these diseases and the recently defined molecular and cellular pillars of aging. Two major conclusions from the meeting include the desire to refine an operational definition of aging and to concomitantly develop biomarkers of aging, in order to move from chronological to physiological age. The discussion also opened a dialogue on the possibility of improving late-life outcomes in patients affected by chronic disease by including age-delaying modalities along with the standard care for the disease in question.
authors.affiliation: Division of Aging Biology, National Institute on Aging, NIH, Bethesda, Maryland.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Kohanski
authors.affiliation: Department of Medicine, University of California San Francisco, San Francisco, California.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Deeks
authors.affiliation: Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Claudia
authors.initials: C
authors.lastname: Gravekamp
authors.affiliation: Geriatrics Center and Institute of Gerontology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Halter
authors.affiliation: Department of Internal Medicine, Section on Infectious Diseases, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Kevin
authors.initials: K
authors.lastname: High
authors.affiliation: City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, California.
authors.forename: Arti
authors.initials: A
authors.lastname: Hurria
authors.affiliation: Division of Aging Biology, National Institute on Aging, NIH, Bethesda, Maryland.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Fuldner
authors.affiliation: Biobehavioral and Psychologic Branch, National Cancer Institute, NIH, Bethesda, Maryland.
authors.forename: Paige
authors.initials: P
authors.lastname: Green
authors.affiliation: Division of AIDS, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, Maryland.
authors.forename: Robin
authors.initials: R
authors.lastname: Huebner
authors.affiliation: Division of Aging Biology, National Institute on Aging, NIH, Bethesda, Maryland.
authors.forename: Francesca
authors.initials: F
authors.lastname: Macchiarini
authors.affiliation: Division of Aging Biology, National Institute on Aging, NIH, Bethesda, Maryland.
authors.forename: Felipe
authors.initials: F
authors.lastname: Sierra
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D000375:Aging / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D006801:Humans; D009369:Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor
keywords: AIDS; HIV; aging; cancer; diabetes; geroscience