# Does a medical condition need to affect less than 50% of the population to be considered a disease **URL:** \ **Category:** Factual Questions\ **Created:** [July 26, 2017, 7:30pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189 "2017-07-26T19:30:07Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [July 26, 2017, 7:30pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/1 "2017-07-26T19:30:07Z")
I was watching a video by an anti aging researcher, he claimed getting fda support to study treatments for aging was difficult because you can’t call something a disease if it affects more than 50% of the public and since aging affects everyone, they couldn’t call it a disease in need of treatment. Is that true? Something like 75% of elderly people have hypertension, that is considered a disease. About 70% of people are overweight, that is considered a disease. ---
**Author:** ![SpoilerVirgin](https://avatars.discourse-cdn.com/v4/letter/s/4491bb/32.png) [@SpoilerVirgin](https://boards.straightdope.com/u/SpoilerVirgin)\ **Post date:** [July 26, 2017, 8:03pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/2 "2017-07-26T20:03:01Z")
This has nothing to do with the classification of disease, and everything to do with the FDAs attempts to prevent people from making unproven “anti-aging” claims. The FDA doesn’t want people to go around claiming that their wrinkle cream or snake oil is anti-aging and selling it to consumers as a medical treatment. The FDA is not the organization you would go to if you wanted support for primary research on aging. That would be the National Institute on Aging, which offers plenty of grants for actual [research](https://www.nia.nih.gov/research/grants-funding) into aging. The FDA is who you would go to if you wanted your particular treatment approved, and they take a dim view of anti-aging treatments, because, as you point out, aging itself is not a disease. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [July 26, 2017, 9:30pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/3 "2017-07-26T21:30:58Z")
Its more of a debate topic, but aging can be considered a disease since it is the root cause of most of our medical conditions that require doctors interventions. Delaying the aging process by 5-20 years would increase both health span and life expectancy. ---
**Author:** ![SpoilerVirgin](https://avatars.discourse-cdn.com/v4/letter/s/4491bb/32.png) [@SpoilerVirgin](https://boards.straightdope.com/u/SpoilerVirgin)\ **Post date:** [July 26, 2017, 9:45pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/4 "2017-07-26T21:45:49Z")
> [@Wesley\_Clark](#): > > Its more of a debate topic, but aging can be considered a disease since it is the root cause of most of our medical conditions that require doctors interventions. Delaying the aging process by 5-20 years would increase both health span and life expectancy. But treatment, which is what the FDA addresses, is about specific conditions, not about “aging” in general. There is no such thing as “delaying the aging process.” If you have a treatment that prevents some biological change, then it is a treatment addressing that specific process, not an “anti-aging” treatment. You’re still going to be 20 years older, you just might not have certain conditions that were previously associated with that age. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [July 26, 2017, 10:09pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/5 "2017-07-26T22:09:14Z")
The only cure for aging is death. But there are many things associated with aging that can be treated or cured, and there’s plenty of research on those things. You can research treatments for arteriosclerosis, or cancer, or gray hair. It’s speculated that a lot of aging-related diseases are related to shortening of telomeres: You could research treatments to slow or reverse that. But aging itself is going to happen with or without the negative effects. ---
**Author:** ![ZurBob](https://avatars.discourse-cdn.com/v4/letter/z/71e660/32.png) [@ZurBob](https://boards.straightdope.com/u/ZurBob)\ **Post date:** [July 26, 2017, 10:32pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/6 "2017-07-26T22:32:23Z")
Come on, folks. I don’t think the intent of the OP is to refer to research on the cessation of the aging process as a literal stoppage of time, but rather an attempt to lessen the maladies that tend to affect aging people. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [July 26, 2017, 10:38pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/7 "2017-07-26T22:38:57Z")
And pick any of those maladies, and you can study it and get federal funding for your studies. ---
**Author:** ![SpoilerVirgin](https://avatars.discourse-cdn.com/v4/letter/s/4491bb/32.png) [@SpoilerVirgin](https://boards.straightdope.com/u/SpoilerVirgin)\ **Post date:** [July 26, 2017, 10:43pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/8 "2017-07-26T22:43:50Z")
> [@ZurBob](#): > > Come on, folks. I don’t think the intent of the OP is to refer to research on the cessation of the aging process as a literal stoppage of time, but rather an attempt to lessen the maladies that tend to affect aging people. Yes, but the point is that when an “anti-aging researcher” claims that the FDA won’t allow research on anti-aging, what he means is that the FDA will not approve treatments that claim to be anti-aging, because there is no such thing. The FDA will test claims that a treatment treats a specific condition associated with aging, such as high blood pressure, or heart disease, or Alzheimers, but not that is is an “anti-aging” treatment. ---
**Author:** ![ZurBob](https://avatars.discourse-cdn.com/v4/letter/z/71e660/32.png) [@ZurBob](https://boards.straightdope.com/u/ZurBob)\ **Post date:** [July 26, 2017, 11:05pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/9 "2017-07-26T23:05:35Z")
> [@SpoilerVirgin](#): > > Yes, but the point is that when an “anti-aging researcher” claims that the FDA won’t allow research on anti-aging, what he means is that the FDA will not approve treatments that claim to be anti-aging, because there is no such thing. The FDA will test claims that a treatment treats a specific condition associated with aging, such as high blood pressure, or heart disease, or Alzheimers, but not that is is an “anti-aging” treatment. I understand this point… Apparently you did not understand my point concerning the snark. ---
**Author:** ![Dissonance](https://avatars.discourse-cdn.com/v4/letter/d/85f322/32.png) [@Dissonance](https://boards.straightdope.com/u/Dissonance)\ **Post date:** [July 26, 2017, 11:06pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/10 "2017-07-26T23:06:17Z")
> [@Wesley\_Clark](#): > > I was watching a video by an anti aging researcher, he claimed getting fda support to study treatments for aging was difficult because you can’t call something a disease if it affects more than 50% of the public and since aging affects everyone, they couldn’t call it a disease in need of treatment. Is that true? Pretty much everyone will catch the common cold during their life. Do you think the FDA doesn’t consider it a disease? ---
**Author:** ![ZurBob](https://avatars.discourse-cdn.com/v4/letter/z/71e660/32.png) [@ZurBob](https://boards.straightdope.com/u/ZurBob)\ **Post date:** [July 26, 2017, 11:14pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/11 "2017-07-26T23:14:34Z")
Actually, I _ **am** _ confused by the OP’s reference to the 50% breakpoint to be considered a disease. Cite please? ---
**Author:** ![watchwolf49](https://avatars.discourse-cdn.com/v4/letter/w/e9c0ed/32.png) [@watchwolf49](https://boards.straightdope.com/u/watchwolf49)\ **Post date:** [July 26, 2017, 11:17pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/12 "2017-07-26T23:17:33Z")
Part of the FDA’s mandate is to prevent charlatans and snake-oil salesmen from claiming their product is “FDA Approved” … schucksters applying for anti-aging gizmos are being turned away from the door “Aging isn’t a disease” … Aging is a dimension … I’m not sure which Federal agency regulates the use of time/space … ---
**Author:** ![ZurBob](https://avatars.discourse-cdn.com/v4/letter/z/71e660/32.png) [@ZurBob](https://boards.straightdope.com/u/ZurBob)\ **Post date:** [July 26, 2017, 11:49pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/13 "2017-07-26T23:49:14Z")
I understand peoples’ notion of the FDA’s supposed concern related to claims about “magic cures for aging”. However, in this day and age, there are none. It is worth pointing out: The FDA has given a relative free hand to the “herbal” **supplement** industry, wherein lies the majority of blame for anti-aging concoctions and public deception. The\* FDA regulated drug manufacturers \*have yet to promote (to my knowledge) any such potion. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [July 27, 2017, 12:35am UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/14 "2017-07-27T00:35:51Z")
> [@ZurBob](#): > > Actually, I _ **am** _ confused by the OP’s reference to the 50% breakpoint to be considered a disease. Cite please? It was a youtube speech by David Sinclair about aging, he stated that if a condition affected more than 50% of people it wasn’t considered a disease by a gov. agency. No idea which speech. ---
**Author:** ![Wendell\_Wagner](https://avatars.discourse-cdn.com/v4/letter/w/8491ac/32.png) [@Wendell\_Wagner](https://boards.straightdope.com/u/Wendell_Wagner)\ **Post date:** [July 27, 2017, 1:21am UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/15 "2017-07-27T01:21:10Z")
Arguably, it’s not even true that everyone ages: > **[Brooke Greenberg](https://en.wikipedia.org/wiki/Brooke_Greenberg)** > > Brooke Megan Greenberg (January 8, 1993 – October 24, 2013) was an American woman who remained physically and cognitively similar to a toddler, despite her increasing age. She was about 30 in (76 cm) tall, weighed about 16 lb (7.3 kg) and had an estimated mental age of nine months to one year. Brooke's doctors termed her condition Syndrome X. > Brooke was born on January 8, 1993 to parents Howard and Melanie Greenberg at Sinai Hospital in Baltimore, Maryland. She was delivered by Caesarean secti... ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [July 27, 2017, 2:18am UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/16 "2017-07-27T02:18:18Z")
I’ll bet that you could find government agencies which consider lactose intolerance a “disease”. ---
**Author:** ![watchwolf49](https://avatars.discourse-cdn.com/v4/letter/w/e9c0ed/32.png) [@watchwolf49](https://boards.straightdope.com/u/watchwolf49)\ **Post date:** [July 27, 2017, 2:31am UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/17 "2017-07-27T02:31:34Z")
> [@Chronos](#): > > I’ll bet that you could find government agencies which consider lactose intolerance a “disease”. [National Institute of Diabetes and Digestive and Kidney Diseases](https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance) ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [July 27, 2017, 4:41am UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/18 "2017-07-27T04:41:31Z")
Okay, so a youtube video claiming that 50% bit is just wrong, as demonstrated by the very counterfactual conditions mentioned in the op. The difficulty for aging instead has been in defining “the aging process” in a way that allows for study in any sort of reasonable way. The approach that has gotten the FDA’s sort of blessing is to instead focus on delaying [the co-morbidities of aging](http://www.sciencemag.org/news/2015/09/feature-man-who-wants-beat-back-aging). > [@](#): > > … Within the last decade or so, researchers have settled upon what Felipe Sierra, director of the division of aging biology at the National Institute on Aging (NIA), calls “the major pillars of aging.” These pathways and mechanisms, roughly half a dozen in all, affect metabolism, growth, response to stress, stem cell vigor, inflammation, and proteostasis—the cell’s quality control system for proteins. And their identification has opened the door to a previously outlandish notion. It “allows us to think that, okay, if we understand how this happens, we can maybe manipulate it,” Sierra says. > > MORE THAN A DECADE AGO, Barzilai and others began lobbying FDA to consider drugs that might do just that. But those discussions bogged down, he says, after the sides couldn’t agree on the kinds of biomarkers associated with aging that could be quantified and tracked during a clinical trial. > > Barzilai now believes the answer is to design a drug trial that, rather than targeting aging per se, tries instead to delay the onset of “comorbidities”: the chronic diseases whose incidence rises sharply as people get older. “Basically, I think the FDA will be more willing to accept something called ‘comorbidities’ than it is to accept something called ‘aging,’” Barzilai says. “Even in our mind, in my mind, aging is not a disease,” he adds. “It’s, you know, humanity! You’re born, you die, you age in between … I’m kind of saying, ‘I don’t care what they want to call it, if I can delay it.’” > > The comorbidity strategy is key to a concept known as the “longevity dividend,” first proposed by a group of public policy and health care experts in 2006. The idea is that slowing down the process of aging, even modestly, would have enormous benefits for quality of life and the economics of health care. “We’re not arguing—and we’ve never argued—that we’re trying to achieve life extension,” says Olshansky, who has pushed the concept while criticizing some of the more outlandish claims in the aging field, such as British gerontologist Aubrey de Grey’s prediction that human life spans of 1000 years are possible. “We’ll probably live a little longer if we succeed, but that’s not the goal,” Olshansky says. “The goal is the extension of the period of healthy life.” … > > … But the FDA drug approval process abides by the “one disease, one drug” model. Would the agency be open to a trial that had multiple illnesses as an endpoint? As an initial step, earlier this year Sierra organized seminars at FDA in which NIA researchers described recent findings in the biology of aging. In May, Robert Temple, deputy director of FDA’s Center for Drug Evaluation and Research, spoke at an NIA retreat. > > Encouraged by the tenor of these discussions, Barzilai and a core group of collaborators—Einstein’s Jill Crandall; Austad; Olshansky; Stephen Kritchevsky at Wake Forest School of Medicine (where the multi-center trial would probably be based); and James Kirkland, a diabetes researcher at the Mayo Clinic, among others—pushed ahead with plans for the trial. … > > … SANDY WALSH, an FDA spokeswoman, says the agency does not comment on drugs under development or under investigation. But in a followup communication to the AFAR group, Barzilai says, FDA indicated that although it is not yet convinced that the proposed trial design can establish that metformin has an anti-aging effect, the agency recognizes the potential value in a drug that could improve quality of life and survival—whether the indication sought is aging or multiple morbidities—and is not opposed to the idea of a trial. … Note that the FDA has not actually approved the trial, that’s not how it works. The FDA has instead signaled that they will, with positive results, accept the broad basket of co-morbidities of aging as _a modifiable condition_ and thus an official “indication” for which treatments can be developed and approved. The other possible approach is to define “the aging process” as some index of the broad basket of those biomarkers of cellular aging, such as telomere length, [various epigenetic changes](http://www.nature.com/news/biomarkers-and-ageing-the-clock-watcher-1.15014), or other so-called biological clocks. But hard to define those as “conditions” or “indications” themselves and as above, the FDA has been less open to potentially accepting those in that way. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [July 27, 2017, 12:27pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/19 "2017-07-27T12:27:41Z")
> [@SpoilerVirgin](#): > > This has nothing to do with the classification of disease, and everything to do with the FDAs attempts to prevent people from making unproven “anti-aging” claims. The FDA doesn’t want people to go around claiming that their wrinkle cream or snake oil is anti-aging and selling it to consumers as a medical treatment. > > The FDA is not the organization you would go to if you wanted support for primary research on aging. That would be the National Institute on Aging, which offers plenty of grants for actual [research](https://www.nia.nih.gov/research/grants-funding) into aging. The FDA is who you would go to if you wanted your particular treatment approved, and they take a dim view of anti-aging treatments, because, as you point out, aging itself is not a disease. This analysis is pretty much on target. As for David Sinclair proclaiming on YouTube that anti-aging isn’t taken seriously because it’s ubiquitous, remember that he’s the guy largely responsible for hyping resveratrol as a Miracle Molecule, and along the way parlaying his work into a hugely profitable tech firm acquisition by one of the big drug companies, while spawning a raft of supplement company imitators who’ve taken his promotional efforts to new levels. _“Sinclair’s discovery also provided a lesson about the danger of hype for a cluster of scientists exploring such a wish-fulfilling field. Suddenly, Sinclair was bouncing around TV calling resveratrol “as close to a miraculous molecule as you can find.” “David was a little over the top,” Guarente says. “I mean, he was saying, ‘If we’re right about this, it’s the most important discovery of all time.’ And that ticks people off.” When GSK shut down the biotech’s Cambridge offices a few years after buying it, laying off a number of employees and folding what remained into the larger corporation, many scientists in the field pounced. They included Guarente-lab alumni like Kennedy and Kaeberlein, who believe a molecule called Target of Rapamycin is a better bet than sirtuins for anti-aging efforts. While resveratrol had been shown to activate sirtuins in yeast, they pointed out, it had mixed results in animal studies, proving effective in fat mice but not regular-size ones. Both Sinclair and Guarente, who are paid consultants to GSK, insist that the company hasn’t given up on sirtuins, or resveratrol-related activators, but Sinclair has clearly been chastened. “At the time, I thought it important to bring attention to the field and show that it was legitimate,” he told me, “but I regret that I was a lightning rod for criticism.””_ > **[An MIT Scientist Claims That This Pill Is the Fountain of Youth](https://www.thecut.com/2016/08/is-elysium-healths-basis-the-fountain-of-youth.html)** > > Leonard Guarente is certain he’s succeeded where doctors (and quacks) before him have failed. His pill will either extend lives or tarnish his career. There seems to be a new Miracle Anti-Aging Molecule popping up every few months, leaving resveratrol in the dust. It’s not the FDA’s job to “support” research into these molecules, nor to approve the overheated and dubious claims for them. By the way, be wary of anyone affiliated with the American Academy of Anti-Aging Medicine, which [this article](http://www.nytimes.com/2007/04/15/business/yourmoney/15aging.html?mcubz=0) describes as a “trade group” (to put it kindly), and which in my view represents the darker for-profit side of anti-aging drum-beating (their big thing at one time was human growth hormone, and probably still is for some practitioners). ---
**Author:** ![ftg](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ftg/32/2801_2.png) [@ftg](https://boards.straightdope.com/u/ftg)\ **Post date:** [July 27, 2017, 1:03pm UTC](https://boards.straightdope.com/t/does-a-medical-condition-need-to-affect-less-than-50-of-the-population-to-be-considered-a-disease/792189/20 "2017-07-27T13:03:39Z")
While aging is universal, having an aging related issue isn’t. Far fewer than 50% of the population is experiencing aging issues. Similarly, far fewer than 50% of the population has a cold at any given time. I think this matters since Influenza is clearly a disease and at some point well over 50% of the population gets it. Clearly it’s rational to have the CDC and so on working on averting it. Saying the flu isn’t a disease would be very stupid. And of course the “50% standard” is a total fiction anyway.