Ageing and the border between health and disease

Abstract

Ageing is associated with a progressive degeneration of the tissues, which has a negative impact on the structure and function of vital organs and is among the most important known risk factors for most chronic diseases. Since the proportion of the world's population aged .60 years will double in the next four decades, this will be accompanied by an increased incidence of chronic age-related diseases that will place a huge burden on healthcare resources.There is increasing evidence that many chronic inflammatory diseases represent an acceleration of the ageing process. Chronic pulmonary diseases represents an important component of the increasingly prevalent multiple chronic debilitating diseases, which are a major cause of morbidity and mortality, particularly in the elderly. The lungs age and it has been suggested that chronic obstructive pulmonary disease (COPD) is a condition of accelerated lung ageing and that ageing may provide a mechanistic link between COPD and many of its extrapulmonary effects and comorbidities. In this article we will describe the physiological changes and mechanisms of ageing, with particular focus on the pulmonary effects of ageing and how these may be relevant to the development of COPD and its major extrapulmonary manifestations. @ERSpublications Premature ageing of the lung may constitute pathogenetic mechanisms contributing to COPD

Age-dependent elastin degradation is enhanced in chronic obstructive pulmonary disease

“…It is well-recognised that the impacts of COPD extend beyond the lung with many patients suffering systemic manifestations such as cardiovascular diseases that affect morbidity and mortality [1]. "Accelerated ageing" has been proposed as a mechanism that underlies many of the pulmonary and extrapulmonary consequences of COPD [2,3]. It is thought that a decline in organ function is a feature of ageing in response to the accumulation of cell and molecular damage, and in the case of COPD, noxious inhalants such as tobacco smoke increase this damage, thus accelerating the ageing process, leading to the development of COPD.…”

“…A pro-inflammatory state, metabolic impairments and respiratory muscle weakness contribute to deterioration of lung function [1,2]. Furthermore, a poor COPD prognosis appears to be associated with unintentional weight loss [3,4], which has been observed in ∼50% of severe COPD patients [5].…”

The ambition of the European Respiratory Journal: chapter 3

“…Although clinically focused, the reviews also provide extensive coverage of the basic science underlying their subject. State of the Art opened with a series on "Ageing, multimorbidity and the lung" [9][10][11][12] -a subject that will increasingly challenge all clinicians in the coming decades -and will broaden out to tackle many other pressing issues in respiratory medicine. .…”

Understanding age-related diseases: report of the 2015 Ageing Summit

“…George Kuchel (University of Connecticut, Storrs, CT, USA) shared observations that muscle performance typically declines more than muscle mass in the elderly. Mitochondrial dysfunction in the muscle results indeed in an increased release of reactive oxygen species and oxidative damage, which is thought to play a key role in ageing [27]. Michael Singer (Queen's University Kingston, Kingston, ON, Canada) further underlined the importance of the frailty concept by stating that there are no specific longevity genes, but that ageing is a matter of your ability to respond to environmental cues.…”