Is aging a disease? A review of the Serono Symposia Workshop held under the auspices of the 3rd World Congress on the Aging Male. February 9, 2002, Berlin, Germany.

On February 9, 2002, Serono Symposia sponsored a workshop at The 3rd World Congress on The Aging Male that was held in Berlin, Germany at the Hotel Inter-Continental. The title of the workshop 'Is aging a disease?', was intended to convey recent interest in the subject of aging as a clinically relevant entity and to discuss causes and approaches to its management. The Workshop was co-chaired by Drs Viktor Büber and Richard F. Walker. Speakers included Drs George R. Merriam, Heinrich M. Schulte, Felice Strollo and Richard F. Walker. Topics were arranged to proceed from a general overview of fundamental aspects of the aging process and their clinical consequences to specific aspects of the diagnosis and treatment of age-related disorders that could be associated with neuroendocrine dysfunction. F. Strollo initiated the series of lectures by reviewing some of the biological theories of aging and suggesting that maladaptive changes within the central nervous and endocrine systems play a major role in contributing to the cascade of events defined as senescence. R. Walker expanded upon this background by differentiating aging and disease. He suggested that while the process of aging is not a disease, it is directly responsible for the development of functional decrements causal of the intrinsic disease, frailty and general morbidity that occur in direct relation to advancing chronological age. From this generalized approach of linking age and disease, G. Merriam discussed a specific example in which age-related decrements in neuroendocrine dysfunction could contribute, at least in part, to senescent changes in body composition and physiological function. Specifically, he provided evidence that the gradual decline in growth hormone (GH) and testosterone secretion during aging is accompanied by anatomical and functional changes resembling pathogenic hormone deficiency. He went on to discuss possible interventions into this process, specifically showing data to support the view that a combination of GH secretagogues and sex hormones may be of value in sustaining health and vitality in the elderly. As an extension of this discussion, H. M. Schulte compared and contrasted age changes in sex hormone secretion between genders, and also stressed that the diagnosis and management of endocrine changes during life has become a serious challenge to those physicians intending to intervene in the aging process. Because the relationship of reduced hormone secretion to disease in the elderly is presently unclear, the Workshop concluded on a note of caution that guidelines for the replacement of endocrine substances as a prophylactic approach to aging have yet to be defined.