Defining an ageing-related pathology: international consensus statement

Abstract

Background: Around the world, individuals are living longer, but an increased average lifespan does not always equate to an increased healthspan. With advancing age, the increased prevalence of ageing-related diseases can have a significant impact on health status, functional capacity, and quality of life. It is therefore vital to develop comprehensive classification and staging systems for ageing-related pathologies, diseases and syndromes, as this will allow societies to better identify, quantify, understand, and meet the healthcare, workforce, wellbeing, and socioeconomic needs of ageing populations, while supporting the development and use of interventions to prevent or to slow, halt or reverse the progression of ageing-related pathologies, diseases and syndromes. Methods: The foundation for developing such classification and staging systems is to define the scope of what constitutes an ageing-related pathology, disease or syndrome. To this end, a consensus meeting was hosted by the International Consortium to Classify Ageing-Related Pathology, Diseases and Syndromes (ICCARPDS), on February 19th, 2024, in Cardiff, UK. It was attended by 150 recognised experts, representing multiple specialties, from 65 different institutions and 15 countries across the globe, either in-person or virtually. Discussions and voting were centred around provisional criteria to define an ageing-related pathology, disease or syndrome, that had been distributed prior to the meeting: (1) Must develop/ progress with increasing chronological age. (2) Must cause functional decline. (3) Must predict mortality. (4) There must be evidence from studies in humans. (5) Mendelian disorders are excluded. The participants debated each of these criteria and, where relevant, proposed refined wording for the statements, which were subsequently voted on. Each criterion required a consensus agreement of ≥70% for approval. Results: The accepted criteria for an ageing-related pathology, disease or syndrome were: 1. Develops and/or progresses with increasing chronological age. 2. Should be associated with, or contribute to, functional decline, or an increased susceptibility to functional decline. 3. There must be evidence from studies in humans. Conclusions: Criteria for an ageing-related pathology, disease or syndrome have been discussed and agreed by an international consortium of subject experts. These criteria will now be used by the ICCARP for the classification and subsequently staging of ageing-related pathologies.