Clinical Evaluation Criteria for Aging and Aging-related Multimorbidity
Ilia Stambler, Vetek (Seniority) – the Movement for Longevity and Quality of Life, Tel Aviv, Israel
Alexey Moskalev, Institute of Biology, Komi Scientific Center (RAS), Syktyvkar, Russia
About this Research Topic
It is increasingly clear that population aging brings a train of degenerative, malignant and other chronic diseases, such as cancer, type 2 diabetes, chronic obstructive pulmonary disease, neurodegenerative diseases, heart disease, aggravation of infectious diseases. This is also accompanied by other diverse functional, physical and mental impairments. These conditions do not emerge separately from each other, but have related aetiologies and mutually exacerbate each other. This multitude of morbid conditions has been often termed as “multimorbidity” or “co-morbidity”. Moreover, it has been suggested that a promising approach to address the entire host of old-age-related morbidities would be by treating their underlying determinative factors – namely fundamental degenerative processes of aging.
Yet, there is currently no agreed method to estimate the direct effects of therapy on tackling the aging process as such, for which there is presently no agreed formal or clinical definition or criteria. Moreover, essentially, there is no agreed formal or clinical definition and criteria for old-age multimorbidity either. Correspondingly, there are no agreed scientifically grounded criteria to select interventions against degenerative aging and old-age multimorbidity or to evaluate their effectiveness. There are clinical methods to diagnose individual age-related diseases and dysfunctions, and assess interventions against those individual diseases and dysfunctions. Yet their integrated evaluation as “aging-related ill health” or “multimorbidity”, as well as the selection and evaluation of effective interventions against these conditions, remain as unresolved methodological challenges. As a result, there is no agreed formal conceptual basis for incentivizing industrial development, nor regulatory adoption, of diagnostics and therapies against degenerative aging and aging-related multimorbidity.
This Research Topic seeks Original Research, Review and Opinion articles that can contribute to establishing the methodological basis for developing, and regulatory adoption of, diagnostic criteria for aging and aging-related multimorbidity. The topic encourages articles exploring clinical criteria for aging and old-age multimorbidity that utilize diverse physiological, functional, genetic, epigenetic and other biomarkers and advanced methods of bioinformatics and cost-effectiveness analysis. Preference will be given to the research of diagnostic criteria that could be plausibly accepted by regulatory authorities and assist in designing clinical trials and applications against degenerative aging and multimorbidity, and for the wide adoption of resulting diagnostics and therapies.
In particular, we aim to cover the following points:
1. Developing diagnostic clinical criteria for degenerative aging and old-age multimorbidity, clarifying their clinical definitions.
2. Developing evaluation criteria for the effectiveness and safety of therapies against degenerative aging and old-age multimorbidity, defining endpoints, risks vs. benefits.
3. Selecting the most informative and economic diagnostic parameters (e.g. biomarkers and functional indices) for aging and old-age multimorbidity.
4. Developing guidelines and analytical methodologies for clinical testing of interventions against degenerative aging and old-age multimorbidity, taking into consideration age differential, long-term and synergistic effects.
5. Suggesting regulatory guidelines for diagnosis and therapy of degenerative aging and old-age multimorbidity, with a special emphasis on optimizing safety vs. efficacy, standardization, cost-effectiveness, affordability and availability to the public.
Keywords: aging, multimorbidity, diagnosis, therapy, regulation
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