Ageing and International Classification of Diseases
Khaltourina D.1,2,3, Matveyev Yu.2
1 - International Longevity Alliance, 2 - Council for Public Health and the Problems of Demography, Moscow, Russia
3 - Department of the Integrated Prevention Programs, Federal State Institution 'National Research Center for Preventive Medicine' of the Ministry of Healthcare of the Russian Federation, Moscow
The concept of “disease” varies significantly between different legal contexts. US legislation defines a disease as “a damage to an organ, part, structure, or system of the body such that it does not function properly (e.g., cardiovascular disease), or a state of health leading to such dysfunctioning (e.g., hypertension); except that diseases resulting from essential nutrient deficiencies (e.g., scurvy, pellagra) are not included in this definition.” (21 CFR 101.93(g)(1)). According to the Federal Law of the Russian Federation 323-FZ from November 21, 2011, a disease is “impairment of body functions, working capacity, ability to adapt to the changes in environment and internal environment with simultaneous changes in protective, compensating and adapting body reactions and mechanisms, which emerge due to pathogenic factor exposure ”.
Ageing damages the body and impairs its functioning and protective, compensating and adapting reactions and mechanisms. Keeping in mind the modern broad definition of a pathogenic factor, ageing meets the definition of a disease by both American and Russian laws. Investments in prospective geroprotective technologies require advances in legislation, so that they may be properly registered and introduced into clinical practice.
Some national mechanisms to recognize a pathological process as a disease exist, but the International Classification of Diseases (WHO ICD), issued by the World Health Organization, is the main authority.
The WHO ICD 10, in “General symptoms and signs” section, already recognizes “Senility” (R54) as a disease (state). This state is defined as “Age-related physical debility” in the ICD-10-CM (the US version of ICD); it includes signs such as frailty, old age, senility, senile atrophy, senile asthenia, senile debility, etc. However, the pathological processes of ageing begin in early adulthood, which should be reflected in the ICD. Senility is actually an end state, so the conceptual framework of the international healthcare system should be to recognize ageing as a syndromic complex of pathological processes that start in youth and develop gradually.
WHO ICD 11 revision criteria of acknowledging certain process or state a disease include clinical research of causal mechanisms, agents and interventions. We developed a set of aging-related pathological aging based on WHO ICD11 inclusion criteria and pathophysiological approach, which can be found at: http://icd-11.org/index.php?title=Daria_Khaltourina,_Yury_Matveyev_and_Anca_Iovita/.
We would like to thank A. Zhavoronkov, E. Debonneuil, A. Iovita, S. Hills, V. Matveyeva, D. Medvedev, A. Moskalev, P. Spigel, T. Gneteyeva, V. Udalova, for the advice.
Khaltourina D.1,2,3, Matveyev Yu.2
1 - International Longevity Alliance, 2 - Council for Public Health and the Problems of Demography, Moscow, Russia
3 - Department of the Integrated Prevention Programs, Federal State Institution 'National Research Center for Preventive Medicine' of the Ministry of Healthcare of the Russian Federation, Moscow
The concept of “disease” varies significantly between different legal contexts. US legislation defines a disease as “a damage to an organ, part, structure, or system of the body such that it does not function properly (e.g., cardiovascular disease), or a state of health leading to such dysfunctioning (e.g., hypertension); except that diseases resulting from essential nutrient deficiencies (e.g., scurvy, pellagra) are not included in this definition.” (21 CFR 101.93(g)(1)). According to the Federal Law of the Russian Federation 323-FZ from November 21, 2011, a disease is “impairment of body functions, working capacity, ability to adapt to the changes in environment and internal environment with simultaneous changes in protective, compensating and adapting body reactions and mechanisms, which emerge due to pathogenic factor exposure ”.
Ageing damages the body and impairs its functioning and protective, compensating and adapting reactions and mechanisms. Keeping in mind the modern broad definition of a pathogenic factor, ageing meets the definition of a disease by both American and Russian laws. Investments in prospective geroprotective technologies require advances in legislation, so that they may be properly registered and introduced into clinical practice.
Some national mechanisms to recognize a pathological process as a disease exist, but the International Classification of Diseases (WHO ICD), issued by the World Health Organization, is the main authority.
The WHO ICD 10, in “General symptoms and signs” section, already recognizes “Senility” (R54) as a disease (state). This state is defined as “Age-related physical debility” in the ICD-10-CM (the US version of ICD); it includes signs such as frailty, old age, senility, senile atrophy, senile asthenia, senile debility, etc. However, the pathological processes of ageing begin in early adulthood, which should be reflected in the ICD. Senility is actually an end state, so the conceptual framework of the international healthcare system should be to recognize ageing as a syndromic complex of pathological processes that start in youth and develop gradually.
WHO ICD 11 revision criteria of acknowledging certain process or state a disease include clinical research of causal mechanisms, agents and interventions. We developed a set of aging-related pathological aging based on WHO ICD11 inclusion criteria and pathophysiological approach, which can be found at: http://icd-11.org/index.php?title=Daria_Khaltourina,_Yury_Matveyev_and_Anca_Iovita/.
We would like to thank A. Zhavoronkov, E. Debonneuil, A. Iovita, S. Hills, V. Matveyeva, D. Medvedev, A. Moskalev, P. Spigel, T. Gneteyeva, V. Udalova, for the advice.
