Ill or just old? Towards a conceptual framework of the relation between ageing and disease.
Ill or just old? Towards a conceptual framework of the relation between ageing and disease.
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DOI：
10.1186/1471-2318-3-7
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发表时间：
2003-12-19
期刊：
影响因子：
4.1
通讯作者：
Westendorp, Rudi G J
中科院分区：
文献类型：
--
作者：
Izaks, Gerbrand J;Westendorp, Rudi G J
背景：这个人是生病了还是老了？这个问题反映了一位医生在解读一位寻求帮助的老人的诉求时的思考之心。许多医生认为衰老不是一种疾病。因此，已经进行了各种尝试来将病理性衰老与正常衰老分开。然而，与晚年引起疾病的病理过程不同的正常衰老过程的存在可能受到质疑。讨论：衰老是体细胞损伤的累积，导致细胞功能障碍，最终导致器官功能障碍和死亡风险增加。类似地，慢性疾病在生命早期开始，在临床上变得明显并最终导致残疾或死亡之前，其发展缓慢。疾病的定义也受到当前观点和科学理解的影响，通常，当身体变化被认为是新疾病的症状时，这是个人创造力的行为。然而，新疾病很少是真正新的。大多数新疾病都未被诊断出来，因为它们的体征和症状没有被识别或被以其他方式解释。因此，老年人的许多身体变化尚未被认为是一种疾病，因此被归因于正常衰老。因此，正常衰老和晚年疾病之间的区别在很大程度上是任意的。总结：我们认为正常衰老不能与晚年疾病的病理过程分开，我们建议避免这种区别。
BACKGROUND: Is this person ill or just old? This question reflects the pondering mind of a doctor while interpreting the complaints of an elderly person who seeks his help. Many doctors think that ageing is a non-disease. Accordingly, various attempts have been undertaken to separate pathological ageing from normal ageing. However, the existence of a normal ageing process distinct from the pathological processes causing disease later in life can be questioned.DISCUSSION: Ageing is the accumulation of damage to somatic cells, leading to cellular dysfunction, and culminates in organ dysfunction and an increased vulnerability to death. Analogously, chronic diseases initiate early in life and their development is slow before they become clinically apparent and culminate in disability or death. The definition of disease is also subject to current opinions and scientific understanding and usually, it is an act of individual creativity when physical changes are recognised as symptoms of a new disease. New diseases, however, are only rarely really new. Most new diseases have gone undiagnosed because their signs and symptoms escaped recognition or were interpreted otherwise. Many physical changes in the elderly that are not yet recognised as a disease are thus ascribed to normal ageing. Therefore, the distinction between normal ageing and disease late in life seems in large part arbitrary.SUMMARY: We think that normal ageing cannot be separated from pathological processes causing disease later in life, and we propose that the distinction is avoided.