The most pressing problem of our age

BMJ 2003; 326 doi: (Published 12 June 2003) Cite this as: BMJ 2003;326:1297
  1. Thomas B L Kirkwood (, professor of medicine1
  1. 1 University of Newcastle Institute for Ageing and Health, Henry Wellcome Laboratory for Biogerontology Research, Newcastle General Hospital, Newcastle upon Tyne NE4 6BE

    The increasing proportion of elderly people in Western populations has focused attention on the ageing process. Professor Kirkwood discusses what we know about ageing and the reasons for infirmity in old age

    Most of us, professionally and privately, find ageing an uncomfortable subject. From a personal perspective, the reason is obvious: none of us particularly relishes the fact of our own mortality or the prospect that before our life is over we can expect its quality to be impaired by a spectrum of age related disabilities and diseases. Professionally, ageing evokes a curious mixture of reactions. For some, it is just too complicated and frustrating a process to take seriously. For others, it represents ultimate failure in a medical model founded on the idea of curing disease. For a growing number, it is the most intriguing biomedical problem of our time.

    Is ageing a disease? Surely not; it is a normal part of the life cycle. But if this is the case, what are we aiming for when we do research into the ageing process? Surveys of public opinion about the desirability of extending human life span show that, in spite of our seeming fascination with the “secret of eternal youth,” we are deeply ambivalent about making people live longer. We seem to be caught in a trap of our own making. Great creativity and effort have been expended on preventing “premature” death. But now that we have produced conditions in Western countries in which five out of six infants can expect to see their 65th birthdays, we are much less sure what to do about all these older people.

    In recent years ageing has risen up the social and political agenda. It has prompted high level attention from the United Nations, with its research agenda on ageing for the …

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