Defining an Ageing-Related Pathology, Disease or Syndrome: International Consensus Statement

doi:10.1101/2024.09.02.24312951

Defining an Ageing-Related Pathology, Disease or Syndrome: International Consensus Statement

2024 · doi:10.1101/2024.09.02.24312951

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Defining an Ageing-Related Pathology, Disease or Syndrome: International Consensus Statement | medRxiv /* */ /* */ <!-- <!-- /*! * yepnope1.5.4 * (c) WTFPL, GPLv2 */ (function(a,b,c){function d(a){return"[object Function]"==o.call(a)}function e(a){return"string"==typeof a}function f(){}function g(a){return!a||"loaded"==a||"complete"==a||"uninitialized"==a}function h(){var a=p.shift();q=1,a?a.t?m(function(){("c"==a.t?B.injectCss:B.injectJs)(a.s,0,a.a,a.x,a.e,1)},0):(a(),h()):q=0}function i(a,c,d,e,f,i,j){function k(b){if(!o&&g(l.readyState)&&(u.r=o=1,!q&&h(),l.onload=l.onreadystatechange=null,b)){"img"!=a&&m(function(){t.removeChild(l)},50);for(var d in y[c])y[c].hasOwnProperty(d)&&y[c][d].onload()}}var j=j||B.errorTimeout,l=b.createElement(a),o=0,r=0,u={t:d,s:c,e:f,a:i,x:j};1===y[c]&&(r=1,y[c]=[]),"object"==a?l.data=c:(l.src=c,l.type=a),l.width=l.height="0",l.onerror=l.onload=l.onreadystatechange=function(){k.call(this,r)},p.splice(e,0,u),"img"!=a&&(r||2===y[c]?(t.insertBefore(l,s?null:n),m(k,j)):y[c].push(l))}function j(a,b,c,d,f){return q=0,b=b||"j",e(a)?i("c"==b?v:u,a,b,this.i++,c,d,f):(p.splice(this.i++,0,a),1==p.length&&h()),this}function k(){var a=B;return a.loader={load:j,i:0},a}var l=b.documentElement,m=a.setTimeout,n=b.getElementsByTagName("script")[0],o={}.toString,p=[],q=0,r="MozAppearance"in l.style,s=r&&!!b.createRange().compareNode,t=s?l:n.parentNode,l=a.opera&&"[object Opera]"==o.call(a.opera),l=!!b.attachEvent&&!l,u=r?"object":l?"script":"img",v=l?"script":u,w=Array.isArray||function(a){return"[object Array]"==o.call(a)},x=[],y={},z={timeout:function(a,b){return b.length&&(a.timeout=b[0]),a}},A,B;B=function(a){function b(a){var a=a.split("!"),b=x.length,c=a.pop(),d=a.length,c={url:c,origUrl:c,prefixes:a},e,f,g;for(f=0;f<d;f++)g=a[f].split("="),(e=z[g.shift()])&&(c=e(c,g));for(f=0;f<b;f++)c=x[f](c);return c}function g(a,e,f,g,h){var i=b(a),j=i.autoCallback;i.url.split(".").pop().split("?").shift(),i.bypass||(e&&(e=d(e)?e:e[a]||e[g]||e[a.split("/").pop().split("?")[0]]),i.instead?i.instead(a,e,f,g,h):(y[i.url]?i.noexec=!0:y[i.url]=1,f.load(i.url,i.forceCSS||!i.forceJS&&"css"==i.url.split(".").pop().split("?").shift()?"c":c,i.noexec,i.attrs,i.timeout),(d(e)||d(j))&&f.load(function(){k(),e&&e(i.origUrl,h,g),j&&j(i.origUrl,h,g),y[i.url]=2})))}function h(a,b){function c(a,c){if(a){if(e(a))c||(j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}),g(a,j,b,0,h);else if(Object(a)===a)for(n in m=function(){var b=0,c;for(c in a)a.hasOwnProperty(c)&&b++;return b}(),a)a.hasOwnProperty(n)&&(!c&&!--m&&(d(j)?j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}:j[n]=function(a){return function(){var b=[].slice.call(arguments);a&&a.apply(this,b),l()}}(k[n])),g(a[n],j,b,n,h))}else!c&&l()}var h=!!a.test,i=a.load||a.both,j=a.callback||f,k=j,l=a.complete||f,m,n;c(h?a.yep:a.nope,!!i),i&&c(i)}var i,j,l=this.yepnope.loader;if(e(a))g(a,0,l,0);else if(w(a))for(i=0;i (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0];var j=d.createElement(s);var dl=l!='dataLayer'?'&l='+l:'';j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;j.type='text/javascript';j.async=true;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-P4HH5NV'); Skip to main content Home About Submit ALERTS / RSS Search for this keyword Advanced Search Defining an Ageing-Related Pathology, Disease or Syndrome: International Consensus Statement View ORCID Profile Emma Short , View ORCID Profile Ian M. Adcock , View ORCID Profile Bilal Al-Sarireh , View ORCID Profile Ann Ager , View ORCID Profile Ramzi Ajjan , View ORCID Profile Naveed Akbar , View ORCID Profile Michael A. Akeroyd , View ORCID Profile Ghada Alsaleh , Ghada Al-Sharbatee , View ORCID Profile Kambiz Alavian , View ORCID Profile Winfried Amoaku , View ORCID Profile Julie Andersen , View ORCID Profile Chrystalina Antoniades , View ORCID Profile Mark J. Arends , View ORCID Profile Sue Astley , View ORCID Profile Denize Atan , View ORCID Profile Richard Attanoos , View ORCID Profile Johannes Attems , View ORCID Profile Steve Bain , View ORCID Profile Konstantinos Balaskas , View ORCID Profile Gabriel Balmus , View ORCID Profile Manohar Bance , View ORCID Profile Thomas M. Barber , View ORCID Profile Ajoy Bardhan , View ORCID Profile Karen Barker , View ORCID Profile Peter Barnes , View ORCID Profile Gemma Basatemur , View ORCID Profile Adrian Bateman , View ORCID Profile Moises Evandro Bauer , View ORCID Profile Christopher Bellamy , View ORCID Profile Edwin van Beek , View ORCID Profile Ilaria Bellantuono , Emyr Benbow , View ORCID Profile Sunil Bhandari , View ORCID Profile Rahul Bhatnagar , View ORCID Profile Philip Bloom , View ORCID Profile Dawn Bowdish , View ORCID Profile Melissa Bowerman , View ORCID Profile Melanie Burke , View ORCID Profile Roxana Carare , View ORCID Profile Emma Victoria Carrington , View ORCID Profile Jorge Iván Castillo-Quan , View ORCID Profile Peter Clegg , View ORCID Profile James Cole , Carlo Cota , View ORCID Profile Paul Chazot , Christopher Chen , View ORCID Profile Ying Cheong , View ORCID Profile Gary Christopher , View ORCID Profile George Church , View ORCID Profile David Clancy , View ORCID Profile Paul Cool , View ORCID Profile Francesco Del Galdo , View ORCID Profile Mayank Dalakoti , View ORCID Profile Soumit Dasgupta , View ORCID Profile Colleen Deane , View ORCID Profile Devesh Dhasmana , View ORCID Profile Stefan Dojcinov , View ORCID Profile Monia Di Prete , View ORCID Profile Huaidong Du , View ORCID Profile Niharika A Duggal , View ORCID Profile Toby Ellmers , View ORCID Profile Costanza Emanueli , View ORCID Profile Mark Emberton , View ORCID Profile Jorge D. Erusalimsky , View ORCID Profile Laurence Feldmeyer , View ORCID Profile Alexander Fleming , View ORCID Profile Karen Forbes , View ORCID Profile Thomas C. Foster , View ORCID Profile Daniela Frasca , View ORCID Profile Ian Frayling , Daniel Freedman , Tamas Fülöp , View ORCID Profile Georgina Ellison-Hughes , View ORCID Profile Gus Gazzard , View ORCID Profile Christopher George , View ORCID Profile Jesus Gil , Richard Glassock , View ORCID Profile Rob Goldin , John Green , View ORCID Profile Robyn Guymer , View ORCID Profile Hasan Haboubi , View ORCID Profile Lorna Harries , View ORCID Profile Simon Hart , View ORCID Profile Douglas Hartley , Sebri Hasaballa , View ORCID Profile Christin Henein , Maggie Helliwell , View ORCID Profile Emily Henderson , Rakesh Heer , Kristofer Holte , Iskander Idris , View ORCID Profile David Isenburg , View ORCID Profile Juulia Jylhävä , View ORCID Profile Ahmed Iqbal , View ORCID Profile Simon W. Jones , Rajesh Kalaria , View ORCID Profile Venkateswarlu Kanamarlapudi , View ORCID Profile Werner Kempf , View ORCID Profile Alexandra J. Kermack , View ORCID Profile Jemma Kerns , View ORCID Profile Albert Koulman , View ORCID Profile Adnan H. Khan , View ORCID Profile James Kinross , View ORCID Profile Katarina Klaucane , View ORCID Profile Yamini Krishna , View ORCID Profile Harinderjit Singh Gill , View ORCID Profile Edward Lakatta , Ezio Laconi , View ORCID Profile Alpar Lazar , View ORCID Profile Christiaan Leeuwenburgh , Samantha Leung , View ORCID Profile Xuan Li , View ORCID Profile Ian van der Linde , View ORCID Profile Luísa V. 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Witkowski , View ORCID Profile Leonard L.L. Yeo , Tham Yhi Chung , Emma Yu , View ORCID Profile Michael Zemel , View ORCID Profile Stuart R.G. Calimport , View ORCID Profile Barry L. Bentley doi: https://doi.org/10.1101/2024.09.02.24312951 Emma Short 1 Cardiff Metropolitan University , UK 2 Swansea Bay University Health Board , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Emma Short Ian M. Adcock 3 Imperial College , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ian M. Adcock Bilal Al-Sarireh 2 Swansea Bay University Health Board , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Bilal Al-Sarireh Ann Ager 4 Cardiff University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ann Ager Ramzi Ajjan 5 University of Leeds , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ramzi Ajjan Naveed Akbar 6 Oxford University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Naveed Akbar Michael A. Akeroyd 7 University of Nottingham , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Michael A. Akeroyd Ghada Alsaleh 6 Oxford University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ghada Alsaleh Ghada Al-Sharbatee 8 Wessex Deanery , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Kambiz Alavian 3 Imperial College , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Kambiz Alavian Winfried Amoaku 7 University of Nottingham , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Winfried Amoaku Julie Andersen 9 Buck Institute for Research on Ageing , California, USA Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Julie Andersen Chrystalina Antoniades 6 Oxford University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Chrystalina Antoniades Mark J. Arends 10 University of Edinburgh , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Mark J. Arends Sue Astley 11 University of Manchester , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Sue Astley Denize Atan 12 University of Bristol , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Denize Atan Richard Attanoos 13 Cardiff and Vale University Health Board , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Richard Attanoos Johannes Attems 14 Newcastle University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Johannes Attems Steve Bain 15 Swansea University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Steve Bain Konstantinos Balaskas 16 Moorfields Eye Hospital , UK 17 University College London , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Konstantinos Balaskas Gabriel Balmus 18 University of Cambridge , UK 19 Transylvanian Institute of Neuroscience , Cluj-Napoca, Romania Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Gabriel Balmus Manohar Bance 18 University of Cambridge , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Manohar Bance Thomas M. Barber 20 Warwick University , UK 21 University Hospitals Coventry and Warwickshire NHS Trust , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Thomas M. Barber Ajoy Bardhan 22 University of Birmingham , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ajoy Bardhan Karen Barker 6 Oxford University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Karen Barker Peter Barnes 3 Imperial College , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Peter Barnes Gemma Basatemur 18 University of Cambridge , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Gemma Basatemur Adrian Bateman 23 University of Southampton , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Adrian Bateman Moises Evandro Bauer 24 Pontifical Catholic University of Rio Grande do Sul , Brazil Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Moises Evandro Bauer Christopher Bellamy 10 University of Edinburgh , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Christopher Bellamy Edwin van Beek 10 University of Edinburgh , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Edwin van Beek Ilaria Bellantuono 25 University of Sheffield , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ilaria Bellantuono Emyr Benbow 11 University of Manchester , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Sunil Bhandari 26 Hull University Teaching Hospitals NHS Trust , UK 27 Hull York Medical School , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Sunil Bhandari Rahul Bhatnagar 12 University of Bristol , UK 28 North Bristol NHS Trust 29 University of Southern Denmark , Denmark Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Rahul Bhatnagar Philip Bloom 3 Imperial College , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Philip Bloom Dawn Bowdish 30 McMaster University , Canada Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Dawn Bowdish Melissa Bowerman 31 Keele University , UK 32 Robert Jones and Agnes Hunt Orthopaedic Hospital , Oswestry, UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Melissa Bowerman Melanie Burke 5 University of Leeds , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Melanie Burke Roxana Carare 23 University of Southampton , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Roxana Carare Emma Victoria Carrington 3 Imperial College , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Emma Victoria Carrington Jorge Iván Castillo-Quan 33 Harvard Medical School , USA Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Jorge Iván Castillo-Quan Peter Clegg 34 University of Liverpool , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Peter Clegg James Cole 17 University College London , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for James Cole Carlo Cota 35 San Gallicano Dermatological Institute , Rome Find this author on Google Scholar Find this author on PubMed Search for this author on this site Paul Chazot 36 Durham University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Paul Chazot Christopher Chen 37 National University of Singapore , Singapore Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ying Cheong 23 University of Southampton , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ying Cheong Gary Christopher 15 Swansea University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Gary Christopher George Church 33 Harvard Medical School , USA Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for George Church David Clancy 38 Lancaster University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for David Clancy Paul Cool 31 Keele University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Paul Cool Francesco Del Galdo 5 University of Leeds , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Francesco Del Galdo Mayank Dalakoti 39 National University Heart Centre , Singapore Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Mayank Dalakoti Soumit Dasgupta 34 University of Liverpool , UK 40 Alder Hey Children’s Hospital , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Soumit Dasgupta Colleen Deane 23 University of Southampton , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Colleen Deane Devesh Dhasmana 41 St Andrew’s University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Devesh Dhasmana Stefan Dojcinov 2 Swansea Bay University Health Board , UK 15 Swansea University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Stefan Dojcinov Monia Di Prete 42 San Gallicano Dermatological Institute , Rome, UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Monia Di Prete Huaidong Du 6 Oxford University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Huaidong Du Niharika A Duggal 22 University of Birmingham , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Niharika A Duggal Toby Ellmers 3 Imperial College , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Toby Ellmers Costanza Emanueli 3 Imperial College , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Costanza Emanueli Mark Emberton 17 University College London , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Mark Emberton Jorge D. Erusalimsky 1 Cardiff Metropolitan University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Jorge D. Erusalimsky Laurence Feldmeyer 43 Bern University Hospital , Switzerland Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Laurence Feldmeyer Alexander Fleming 44 Kinexum , USA Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Alexander Fleming Karen Forbes 5 University of Leeds , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Karen Forbes Thomas C. Foster 45 University of Florida , USA Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Thomas C. Foster Daniela Frasca 46 University of Miami Miller School of Medicine , USA Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Daniela Frasca Ian Frayling 4 Cardiff University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ian Frayling Daniel Freedman 47 Surrey and Sussex NHS Trust , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Tamas Fülöp 48 University of Sherbrooke , Canada Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site Georgina Ellison-Hughes 49 Kings College London , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Georgina Ellison-Hughes Gus Gazzard 17 University College London , UK 50 NIHR Biomedical Research Centre , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Gus Gazzard Christopher George 15 Swansea University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Christopher George Jesus Gil 3 Imperial College , UK 51 MRC Laboratory of Medical Sciences , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Jesus Gil Richard Glassock 52 Geffen School of Medicine at UCLA , USA Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site Rob Goldin 3 Imperial College , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Rob Goldin John Green 4 Cardiff University , UK 13 Cardiff and Vale University Health Board , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Robyn Guymer 53 Centre for Eye Research Australia, University of Melbourne , Australia Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Robyn Guymer Hasan Haboubi 13 Cardiff and Vale University Health Board , UK 15 Swansea University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Hasan Haboubi Lorna Harries 54 University of Exeter , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Lorna Harries Simon Hart 27 Hull York Medical School , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Simon Hart Douglas Hartley 7 University of Nottingham , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Douglas Hartley Sebri Hasaballa Find this author on Google Scholar Find this author on PubMed Search for this author on this site Christin Henein 16 Moorfields Eye Hospital , UK 17 University College London , UK 55 National Institute for Health Research Biomedical Research Centre for Ophthalmology , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Christin Henein Maggie Helliwell Find this author on Google Scholar Find this author on PubMed Search for this author on this site Emily Henderson 12 University of Bristol , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Emily Henderson Rakesh Heer 3 Imperial College , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site Kristofer Holte 56 Royal Victoria Hospital , Belfast, UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Iskander Idris 7 University of Nottingham , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site David Isenburg 17 University College London , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for David Isenburg Juulia Jylhävä 57 Karolinska Institutet , Stockholm, Sweden 58 University of Tampere , Tampere, Finland Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Juulia Jylhävä Ahmed Iqbal 25 University of Sheffield , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ahmed Iqbal Simon W. Jones 22 University of Birmingham , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Simon W. Jones Rajesh Kalaria 14 Newcastle University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site Venkateswarlu Kanamarlapudi 15 Swansea University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Venkateswarlu Kanamarlapudi Werner Kempf 59 University Hospital Zurich , Switzerland Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Werner Kempf Alexandra J. Kermack 60 University of Surrey , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Alexandra J. 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Khan James Kinross 3 Imperial College , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for James Kinross Katarina Klaucane 62 St Thomas’s Hospital , London, UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Katarina Klaucane Yamini Krishna 34 University of Liverpool , UK 63 Liverpool University Hospitals NHS Foundation Trust , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Yamini Krishna Harinderjit Singh Gill 64 University of Bath , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Harinderjit Singh Gill Edward Lakatta 65 National Institute on Aging , NIH, USA Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Edward Lakatta Ezio Laconi 66 Università di Cagliari , Italy Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site Alpar Lazar 67 University of East Anglia , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Alpar Lazar Christiaan Leeuwenburgh 45 University of Florida , USA Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Christiaan Leeuwenburgh Samantha Leung 68 Lagan Valley Hospital , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Xuan Li 18 University of Cambridge , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Xuan Li Ian van der Linde 69 Anglia Ruskin University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ian van der Linde Luísa V. Lopes 70 Universidade de Lisboa , Portugal Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Luísa V. 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Medina 34 University of Liverpool , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site Soma Meran 4 Cardiff University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Soma Meran Claudia Metzler-Baddeley 4 Cardiff University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Claudia Metzler-Baddeley Ignor Meglinksi 75 Aston University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ignor Meglinksi Neta Milman 76 Technion Israel Institute of Technology , Israel Find this author on Google Scholar Find this author on PubMed Search for this author on this site Christina Mitteldorf 77 University Medical Center Goettingen , Germany Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ruth Montgomery 78 Yale School of Medicine , USA Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ruth Montgomery Andrew Conway Morris 18 University of Cambridge , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Andrew Conway Morris Beda Mühleisen 79 University of Basel , Switzerland Find this author on Google Scholar Find this author on PubMed Search for this author on this site Abhik Mukherkee 7 University of Nottingham , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Andrew Murray 18 University of Cambridge , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Andrew Murray Scott Nelson 80 University of Glasgow , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Scott Nelson Anna Nicolaou 11 University of Manchester , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Anna Nicolaou Alexander Nirenberg 81 Australasian College of Cutaneous Oncology , Victoria, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Simon Noble 4 Cardiff University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Simon Noble Lisa S. Nolan 49 Kings College London , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Lisa S. 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Plack 11 University of Manchester , UK 38 Lancaster University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Christopher J. Plack Franze Progatzsky 6 Oxford University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Sonja Pyott 49 Kings College London , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Kaukab Rajput 88 Great Ormond Street Hospital , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Sameera Rashid 89 The Christie NHS Foundation , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Sameera Rashid J. Arjuna Ratnayaka 23 University of Southampton , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for J. Arjuna Ratnayaka Sudhira A.B. Ratnayake 34 University of Liverpool , UK 40 Alder Hey Children’s Hospital , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Sudhira A.B. Ratnayake Manuel Rodriguez-Justo 17 University College London , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Manuel Rodriguez-Justo Arianna Carolina Rosa 90 University of Turin , Italy Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Arianna Carolina Rosa Andrew Rule 91 Mayo Clinic , USA Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Andrew Rule Gareth J. Sanger 92 Queen Mary University of London , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Gareth J. Sanger Ian Sayers 7 University of Nottingham , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ian Sayers Andrew Saykin 93 Indiana University School of Medicine , USA Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Andrew Saykin Dinesh Selvarajah 25 University of Sheffield , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Dinesh Selvarajah Jaswinder Sethi 23 University of Southampton , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Jaswinder Sethi Cathy Shanahan 49 Kings College London , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site Shai Shen-Orr 76 Technion Israel Institute of Technology , Israel Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Shai Shen-Orr Carl Sheridan 34 University of Liverpool , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Carl Sheridan Paul Shiels 80 University of Glasgow , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Paul Shiels Kastytis Sidlauskas 92 Queen Mary University of London , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Sobha Sivaprasad 16 Moorfields Eye Hospital , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Sobha Sivaprasad Judith Sluimer 10 University of Edinburgh , UK 94 Maastricht University Medical Center , Maastricht, The Netherlands 95 RWTH Aachen University, Medical Faculty , Aachen, Germany Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site Gary Small 96 Hackensack Meridian School of Medicine , USA Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Gary Small Peter Smith 23 University of Southampton , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site Rebecca Smith 3 Imperial College , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Rebecca Smith Sarah Snelling 6 Oxford University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Sarah Snelling Ioakim Spyridopoulos 14 Newcastle University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ioakim Spyridopoulos Ramasamy Srinivasa Raghavan 97 Royal Surrey NHS Foundation Trust , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ramasamy Srinivasa Raghavan David Steel 14 Newcastle University , UK 98 Sunderland Eye Infirmary , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for David Steel Karen P Steel 49 Kings College London , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Karen P Steel Claire Stewart 99 Liverpool John Moores University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Claire Stewart Keeron Stone 1 Cardiff Metropolitan University , UK 100 National Cardiovascular Research network , Wales, UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Keeron Stone Selvarani Subbarayan 101 University of Aberdeen , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Mark Sussman 102 San Diego State University , USA Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Mark Sussman Jonas Svensson 57 Karolinska Institutet , Stockholm, Sweden Find this author on Google Scholar Find this author on PubMed Search for this author on this site Vyshnavi Tadanki Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ai Lyn Tan 5 University of Leeds , UK 71 Leeds Teaching Hospitals NHS Trust , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ai Lyn Tan Rudolph E. Tanzi 33 Harvard Medical School , USA 103 Massachusetts General Hospital , USA Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Rudolph E. Tanzi Amanda Tatler 7 University of Nottingham , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Amanda Tatler Adriana A. S. Tavares 10 University of Edinburgh , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Adriana A. S. Tavares Tengku Amatullah Madeehah Tengku Mohd 104 Universiti Sains Islam , Malaysia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Tengku Amatullah Madeehah Tengku Mohd Ana Tiganescu 5 University of Leeds , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Ana Tiganescu James Timmons 92 Queen Mary University of London , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Jeremy Tree 15 Swansea University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Jeremy Tree Drupad Trivedi 11 University of Manchester , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Drupad Trivedi Emmanuel A. Tsochatzis 17 University College London , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Emmanuel A. Tsochatzis Dialechti Tsimpida 23 University of Southampton , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Dialechti Tsimpida Elisabeth J Vinke 105 Erasmus MC University Medical Centre Rotterdam , Netherlands Find this author on Google Scholar Find this author on PubMed Search for this author on this site Anna Whittaker 106 University of Stirling , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Anna Whittaker Neeru A. Vallabh 34 University of Liverpool , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Neeru A. Vallabh Kristin Veighey 23 University of Southampton , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Kristin Veighey Zoe C. Venables 107 Norfolk and Norwich University Hospital , UK 108 Norwich Medical School , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Zoe C. Venables Venkat Reddy 17 University College London , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Venkat Reddy Meike W. Vernooij 105 Erasmus MC University Medical Centre Rotterdam , Netherlands Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Meike W. Vernooij Chris Verschoor 85 Health Sciences North Research Institute , ON, Canada Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Chris Verschoor Manlio Vinciguerra 99 Liverpool John Moores University , UK 109 Medical University of Varna , Varna, Bulgaria Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Manlio Vinciguerra Vesna Vukanovic 15 Swansea University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Vladyslav Vyazovskiy 6 Oxford University , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Vladyslav Vyazovskiy James Walker 5 University of Leeds , UK Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for James Walker Richard Wakefield 5 University of Leeds , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Richard Wakefield Adam J. Watkins 7 University of Nottingham , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Adam J. Watkins Anthony Webster 6 Oxford University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Anthony Webster Caroline Weight 38 Lancaster University , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Caroline Weight Birgit Weinberger 110 Universität Innsbruck, Institute for Biomedical Ageing Research , Austria Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Birgit Weinberger Susan L. Whitney 111 University of Pittsburgh , USA Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Susan L. Whitney Rosalind Willis 23 University of Southampton , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Rosalind Willis Jacek M. Witkowski 112 Medical University of Gdańsk , Poland Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Jacek M. Witkowski Leonard L.L. Yeo 37 National University of Singapore , Singapore Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Leonard L.L. Yeo Tham Yhi Chung 37 National University of Singapore , Singapore Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site Emma Yu 18 University of Cambridge , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site Michael Zemel 113 University of Tennessee , USA Roles: Professor Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Michael Zemel Stuart R.G. Calimport 1 Cardiff Metropolitan University , UK 17 University College London , UK Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Stuart R.G. Calimport Barry L. Bentley 1 Cardiff Metropolitan University , UK 17 University College London , UK 33 Harvard Medical School , USA 114 Shriners Children’s, Boston , MA, USA Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Barry L. Bentley For correspondence: bbentley{at}cardiffmet.ac.uk Abstract Full Text Info/History Metrics Data/Code Preview PDF 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. 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 utilisation of interventions to prevent or to slow, halt or reverse the progression of ageing-related pathologies. 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 Pathologies (ICCARP), on February 19 th , 2024, in Cardiff, UK, and was attended by 150 recognised experts. Discussions and voting were centred on provisional criteria that had been distributed prior to the meeting. The participants debated and voted on these. Each criterion required a consensus agreement of ≥70% for approval. Results The accepted criteria for an ageing-related pathology, disease or syndrome were: Develops and/or progresses with increasing chronological age. Should be associated with, or contribute to, functional decline, or an increased susceptibility to functional decline. Evidenced by studies in humans. Conclusions Criteria for an ageing-related pathology, disease or syndrome have been agreed by an international consortium of subject experts. These criteria will now be used by the ICCARP for the classification and ultimately staging of ageing-related pathologies, diseases and syndromes. Introduction The World Health Organization has reported that around the world, people are living longer, and that every country is experiencing growth in both the number and the proportion of older people in the population [ 1 ]. Despite increasing average longevity, evidence suggests that the proportion of years lived in good health has remained broadly constant, which implies that some of the additional years of life are spent in poorer health [ 1 ] and many individuals live with multimorbidity. Ageing is characterised inter alia by the time-related progressive accumulation of damage, which can occur at molecular, cellular, tissue, organ, and system levels. This can have a detrimental effect on an individual’s intrinsic capacity, and can impact physiological, cognitive, psychological, and social functioning, and/ or socioeconomic status and productivity levels. Over recent decades, research has led to a significant increase in the understanding of the biological features of ageing, but this has not yet been translated into clinically relevant classification and staging systems for ageing-related pathologies. In the International Classification of Diseases, 11 th revision (ICD-11) [ 2 ], there is a causality code related to ageing (XT9T) [ 2 , 3 , 4 ] to classify entities ‘caused by biological processes which persistently lead to the loss of organism’s adaptation and progress in older ages’ [ 2 ] and a code under ‘General symptoms, signs or clinical findings’ (MG2A) for ‘ageing associated decline in intrinsic capacity . ’ [ 2 ] Furthermore, there are several entities that are described as being associated with increasing age, for example photoageing of the skin, intrinsic ageing of the skin or hearing loss. However, the existing approach to ageing-related pathologies is superficial and non-standardised. In 2019, Calimport et al . called for the systematic and comprehensive classification and staging of ageing-related pathologies at the metabolic, tissue, organ, and systemic levels [ 5 ]. It was recommended that such a classification system should be adopted by the ICD to guide policy and practice as well as to enable appropriate clinical guidance, systems, resources, and infrastructure [ 5 ]. However, progress in developing such classification and staging systems has been slow, and there is an urgent need for accelerated efforts to identify, characterise, name and classify ageing-related pathologies, diseases and syndromes. To this end, the International Consortium for the Classification of Ageing-Related Pathologies (ICCARP) was established in 2023, comprising 16 international working groups, initially to develop the classification systems. The ICCARP is led by a research team at Cardiff Metropolitan University. Fourteen working groups have been structured on a system-specific basis: audiovestibular; breast; cardiovascular; dermatology; endocrine and metabolic; gastrointestinal, pancreatic, hepatobiliary; gynaecology; immunology; musculoskeletal; nephrology; neurology; ophthalmology; respiratory and urology. In addition, there are scientific advisory and standardisation groups. Overall, the working groups comprise around 300 clinicians, research scientists and allied health professionals who are recognised subject experts in their fields. Methods The hybrid International Consensus Meeting to Define an Ageing-Related Pathology, Disease or Syndrome was hosted in Cardiff, UK, on February 19 th , 2024. Before the meeting, the primary research team (Dr Emma Short, Dr Barry Bentley and Dr Stuart Calimport, Cardiff Metropolitan University) had developed five potential criteria to define an ageing-related pathology, disease or syndrome: Must develop/ progress with increasing age. Must cause functional decline. Must predict mortality. Evidenced by studies in humans. Mendelian disorders are excluded. These criteria were distributed to all ICCARP working group members one month before the meeting, for comments and feedback. Based on the feedback received during this initial consultation period, a sixth criterion was added: Should not be primarily accounted for by an extrinsic carcinogen/ environmental toxin/ infectious agent/ injury. 150 working group members attended the meeting, representing 65 different institutions from 15 countries. Most individuals participated virtually (93%). Each criterion was debated sequentially, and where relevant, refined wording was suggested. At the end of each discussion, participants were invited to vote as to whether they agreed with the criterion. Voting options were: “Yes”, “Yes with reservations”, “No”, and “Abstain”. Reservations raised were subsequently discussed, and participants were re-polled where modified wording had been proposed. Voting was performed through a Teams anonymous online poll for the virtual attendees and through the raising of hands for in-person attendees. Each criterion required a consensus agreement of ≥70% for approval, consisting of “Yes” or “Yes with reservations”. Results The criteria for defining an ageing-related pathology, disease or syndrome that were accepted 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, and (3) Evidenced by studies in humans. 1. Develops and/ or progresses with increasing chronological age The first criterion was agreed by 97% of the consortium. There was considerable discussion surrounding whether the criterion should include a specific age-related threshold. For example, it was suggested that the criterion should explicitly state that it was referring to pathologies of adulthood. However, it was acknowledged that ‘adulthood’ potentially has different definitions, including a chronological age of 18 years or when an individual reaches skeletal maturity or at the end of puberty, and it was highlighted that the maturation of different body systems can occur at different chronological ages. Furthermore, it was recognised that several chronic diseases traditionally thought of as ‘older age-related diseases’, for example, type 2 diabetes mellitus, are now being observed in younger populations [ 6 ] and that some ageing-related pathologies can even be present from the time of conception. It is vital that pathologies can be identified at very early stages for purposes of reversal or prevention of progression. The conclusion was to avoid an arbitrary cut-off point, since some phenomena attributed to ageing can be identified in chronologically young individuals. It would not be appropriate to exclude such individuals from clinically relevant classification and staging systems. 2. Should be associated with, or contribute to, functional decline, or an increased susceptibility to functional decline There was 99% agreement with the inclusion of criterion 2, with the understanding that functional decline refers to a decrement in physiological, physical, cognitive or socioeconomic functioning, but the working groups would define the specific details on a system-specific basis. The original suggestion, ‘must cause functional decline’ was reformulated based on several points raised by the working group members. ‘Must’ was considered too restrictive, so was amended to ‘should’. It was reinforced that ageing-related pathologies do not always cause functional decline, but rather, some play a contributory role, alongside other contributory factors, and some do not directly result in functional decline but are associated with functional decline or have a bi-directional relationship. Furthermore, it was acknowledged that some ageing-related pathologies might be silent, especially if there is functional reserve within the system, and will only become apparent if there is an additional insult or an additional pathology develops. For example, clonal haematopoiesis can be clinically silent [ 7 ], but it can manifest as a patient becoming systemically unwell because of an infection (the additional insult), even if it does not develop into myelodysplasia or leukaemia. To recognise this, the criterion was reworded to include ‘increased susceptibility to functional decline’. Whilst some participants suggested that ageing-related functional decline should be defined as ‘decline that is irreversible’, this was rejected by the majority of the consortium, who agreed that functional decline may be transient or chronic but need not be permanent, for example it may be reversed following an intervention. Whilst some functional decline may be irreversible at the current time, this is not always true, and it is hoped that some declines could be halted or reversed once mechanistic causes are identified. 3. Evidenced by studies in humans 92% of the consortium agreed with criterion 3. It is recognised that whilst data from animal studies may provide supporting evidence and can help understand disease mechanisms and develop treatments, it is imperative that there is significant evidence from studies in humans. The ICD is a classification system for humans only and as such, relies on evidence from studies in humans. Download figure Open in new tab Figure 1: % agreement with criteria Rejected criteria and further discussions Mortality The criterion ‘Must predict mortality’ was rejected. Whilst 8% of voters supported this criterion and 54% felt that it should be included as part of criterion 2, the 70% threshold was not met. Initially, it was highlighted that mortality is a given, so if a mortality-related criterion were to be included, a more appropriate wording might be ‘Associated with an increased risk of mortality’. This would reflect the notion that the incidence of death in a population or cohort with a specific ageing-related pathology, disease or syndrome would be higher than in a pathology-free cohort and/or that ageing-related pathologies shorten life. However, following extensive discussion, the consortium felt that, on balance, it would be inappropriate to accept a mortality-based criterion. This was on the basis that many ageing-related pathologies or diseases do not have a direct impact on risk of death but may have a moderating role, for example hearing loss or osteoarthritis, and that there are many confounding factors involved in the risk of death. Inherited/ Mendelian disorders The original criterion ‘Mendelian disorders are excluded’ had been suggested primarily to exclude diseases or disorders that develop as a result of a highly penetrant, monogenic variant. However, such diseases may have underlying mechanisms that are also observed in ageing-related pathologies, and it could be clinically important to classify and stage such changes, in all contexts. Furthermore, inherited genetic variants, even if they have not yet been identified or are of very low penetrance, can contribute to disease susceptibility, and cannot be ignored in the era of personalised medicine and targeted therapies. The initial criteria would have potentially excluded most progeroid syndromes, which would not be appropriate. 82% of voters disagreed with the inclusion of the suggested criterion, therefore it was rejected. Should not be primarily accounted for by an extrinsic carcinogen/ environmental toxin/ infectious agent/ injury It was agreed not to exclude pathologies, diseases or syndromes that are primarily accounted for by an extrinsic carcinogen, environmental toxin, infectious agent, or injury. This criterion was rejected by 77% of voters on the basis that it is simply not possible to discount the impact of extrinsic or environmental influences on the pathogenesis of many ageing-related pathologies. However, it is acknowledged that there may be specific pathologies, diseases or syndromes that could be excluded by the working groups. For example, the cardiovascular group may decide to include cardiac valve insufficiency as a general ageing-related disease but may exclude insufficiency directly caused by rheumatic fever or acute bacterial endocarditis. Frailty During the Consensus Meeting, there were lengthy discussions surrounding the concept of frailty and whether it should be included, in some way, as a criterion. The term frailty generated debate partly because there are different definitions of frailty, ‘ Frailty is a distinctive health state related to the ageing process in which multiple body systems gradually lose their in-built reserves’ (British Geriatric Society) [ 8 ] or ‘ Frailty is a state of increased vulnerability to poor resolution of homeostasis following a stress event, which increases the risk of adverse outcomes including falls, delirium and disability’ (Clegg et al .) [ 9 ]. Furthermore, different tools are used to measure frailty, for example the Edmonton Frail Scale (EFS) [ 10 ] or the Rockwood Clinical Frailty Scale [ 11 ] and there is currently no one agreed operational definition. Frailty is typically accepted as being a syndrome that results in a decreased ability to cope with a stressor [ 12 ], and this effectively has been captured in Criterion 2: ‘Should be associated with, or contribute to, functional decline, or an increased susceptibility to functional decline’. In addition to this, not all ageing-related pathologies increase the risk of frailty or are associated with frailty. Therefore, a frailty-based criterion was not accepted. Only 59 consortium members supported the inclusion of a criterion such as ‘Should be associated with an increased rate of mortality or frailty’ (54 votes) or ‘Should be associated with an increased risk of frailty’ (5 votes). Conclusions and future research The accepted criteria for an ageing-related pathology, disease or syndrome have now been determined and will be used by the ICCARP as the basis for all future classification work. It is important to highlight that the accepted criteria refer to biological and physiological ageing. This project seeks to identify, define and classify pathologies characterised by specific potentially quantifiable changes within cells, tissues and organs, with the acknowledgement that such changes may have a mosaic distribution. The criteria will be re-evaluated in the future to ensure they are still valid in the context of any new research findings. The next stage of the project is to identify all pathologies that meet the above criteria and to develop proposals for grouping and naming such entities as part of a comprehensive classification system of ageing-related pathologies. This will be done by the system-specific working groups, whilst recognising that there will be several overarching cross-discipline themes that will impact all body systems. Once the classification phase of the project is complete, this will be followed by defining the criteria for the staging parameters and biomarkers, and to identify these, where possible, for the classified entities. It is recognised that, currently, there may not be clinically validated methods for quantifying many of the pathologies that are classified, and even if there are methods of quantification, there may not be the evidence to determine how severity of a pathology correlates with clinical outcomes. However, it is hoped that, where possible, a systematic approach to identifying and defining biomarkers and staging parameters, for ageing-related pathologies will enable more precise and tailored interventions for ageing populations. Ultimately, such advancements are expected to enhance quality of life and extend healthspan, demonstrating significant personal, societal, economic and healthcare benefits. Data Availability All data produced in the present study are available upon reasonable request to the authors. Declarations of interest ACM sits on the scientific advisory board of Cambridge Infection Diagnostics and has received speaking fees from Biomerieux, Fischer and Paykel, Thermo Fisher and Boston Scientific. AAST declares submission of two patent applications (PCT/EP2019/066546 and PG450503GB/YR), one of which is currently being explored with Life Molecular Imaging. AAST has an active collaboration with Unilever. AAST is a recipient of a Wellcome Trust Technology Development Award (221295/Z/20/Z) focused on understanding synaptic changes over the course of a lifespan; and a CZI grant DAF2021-225273 and grant DOI https://doi.org/10.37921/690910twdfoo from the Chan Zuckerberg Initiative DAF, an advised fund of Silicon Valley Community Foundation (funder DOI 10.13039/100014989). AL has received financial support from Amgen, Apellis, Bayer, Boehringer Ingelheim, Eyebiotech, Outlook Therapeutics, Kriya and Roche. AN has received research grants from the BBSRC, BHF, Boots plc, SkinBioTherapeutics, Unilever, AstraZeneca and Waters, and provided consultancy for Intercos. AS receives support from multiple NIH grants (P30 AG010133, P30 AG072976, R01 AG019771, R01 AG057739, U19 AG024904, R01 LM013463, R01 AG068193, T32 AG071444, U01 AG068057, U01 AG072177, and U19 AG074879). He has also received support from Avid Radiopharmaceuticals, a subsidiary of Eli Lilly (in kind contribution of PET tracer precursor) and participated in Scientific Advisory Boards (Bayer Oncology, Eisai, Novo Nordisk, and Siemens Medical Solutions USA, Inc) and an Observational Study Monitoring Board (MESA, NIH NHLBI), as well as External Advisory Committees for multiple NIA grants. He also serves as Editor-in-Chief of Brain Imaging and Behavior, a Springer-Nature Journal. BLB sits on the scientific advisory board of Five Alarm Bio Ltd. Cambridge, UK. EJRVB is advisory board member of DeepHealth, a member of the steering committee of an Astra Zeneca sponsored study (PINPOINT) and owner of QCTIS Ltd (a Radiology consulting company). GB is the founder, director and CEO of Function RX Ltd. GP has acted as a consultant for Novartis, Roche, Pfizer, GlaxoSmithKline, Immatics and Astellas. He is a member of the Scientific Advisory Boards of Repair Biotechnologies, Inc., ImmuneAGE Bio, Inc., MoglingBio, Inc., SENS Foundation, Alpine Institute of Zurich, XPRIZE Healthspan. He owns equity in ImmuneAGE Bio, Inc. HSG (Harinderjit Singh Gill) has acted as a consultant for Smith & Nephew and Invibio. JG has acted as a consultant for Unity Biotechnology, Geras Bio, Myricx Pharma, and Merck KGaA. Pfizer and Unity Biotechnology have funded research in JG’s lab (unrelated to the work presented here). JG owns equity in Geras Bio. JG is a named inventor in MRC and Imperial College patents, both related to senolytic therapies. LH is the founder, director and CSO of SENISCA Ltd. PB has received research funding and/or one-off payments for advisory boards and/or speaker honoraria from: Iridex, Glaukos & BVI (EndoOptiks). PMM has received consulting/speaker’s fees from Abbvie, BMS, Celgene, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB, all unrelated to this manuscript, and is supported by the National Institute for Health Research (NIHR), University College London Hospitals (UCLH) and Biomedical Research Centre (BRC). RAA reports institutional research grants, honoraria, education support or consulting fees from Abbott Diabetes Care, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Menarini Pharmaceuticals, Merck Sharp & Dohme and Novo Nordisk. RG sits on advisory boards of Roche, Genentech, Belite Bio, AbbVie, Apellis, Astellas, Bayer, Boehringer Ingelheim, Janssen Pharmaceuticals, Ocular Therapeutix, Complement therapeutics, Character Bioscience. SLM has provided consultancy on behalf of her institution for Roche/Chugai, Sanofi, AbbVie, AstraZeneca, Pfizer; investigator on clinical trials for Sanofi, GSK, Sparrow; speaking/lecturing on behalf of her institution for Roche/Chugai, Vifor, Pfizer, UCB, Novartis, Fresenius Kabi and AbbVie; chief investigator on STERLING-PMR trial, funded by NIHR; patron of the charity PMRGCAuk. No personal remuneration was received for any of the above activities. Support from Roche/Chugai to attend EULAR2019 in person and from Pfizer to attend ACR Convergence 2021 virtually. SLM is supported in part by the NIHR Leeds Biomedical Research Centre (NIHR203331). The views expressed in this article are those of the authors and not necessarily those of the NIHR, the NIHR Leeds Biomedical Research Centre, the National Health Service or the UK Department of Health and Social Care. SS (Sobha Sivaprasad) has received financial support from AbbVie, Amgen, Apellis, Astellas, Bayer, Biogen, Boehringer Ingelheim, Eyebiotech, Eyepoint Phamaceuticals, Iveric Bio, Janssen Pharmaceuticals, Nova Nordisk, Optos, Ocular Therapeutix, Kriya Therapeutics, OcuTerra, Roche, Stealth Biotherapeutics and Sanofi. SSO holds is a consultant and holds equity in CytoReason. WA Consultancies/Advisory Board Memberships: Abbvie, Allergan, Alimera, Bayer, Novartis, Roche. Educational travel grants from Abbvie, Allergan, Alimera, Bayer, Novartis, Roche. Research grants from Allergan, Boerhinger Ingelheim, Bayer. International Consortium for the Classification of Ageing-Related Pathologies (ICCARP) All listed members are paper co-authors Acknowledgements This project was supported by a Longevity Impetus Grant from Norn Group. Footnotes Author list updated to include full names and affiliations. References 1. ↵ Ageing and Health 2022 . Available online: https://www.who.int/news-room/fact-sheets/detail/ageing-and-health (Accessed 29/04/2024 ). 2. ↵ ICD11 . Available online: https://icd.who.int/en (Accessed 29/04/2024 ). 3. ↵ Calimport SRG , Bentley BL . Aging Classified as a Cause of Disease in ICD-11 . Rejuvenation Res . 2019 Aug ; 22 ( 4 ): 281 . doi: 10.1089/rej.2019.2242 . PMID: 31319768 . OpenUrl CrossRef PubMed 4. ↵ Khaltourina D , Matveyev Y , Alekseev A , Cortese F , Iovita A. Aging Fits the Disease Criteria of the International Classification of Diseases . Mech Ageing Dev . 2020 Jul ; 189 : 111230 . doi: 10.1016/j.mad.2020.111230 . Epub 2020 Apr 3. PMID: 32251691 . OpenUrl CrossRef PubMed 5. ↵ Calimport SRG , Bentley BL , Stewart CE , Pawelec G , Scuteri A , Vinciguerra M , Slack C , Chen D , Harries LW , Marchant G , Fleming GA , Conboy M , Antebi A , Small GW , Gil J , Lakatta EG , Richardson A , Rosen C , Nikolich K , Wyss-Coray T , Steinman L , Montine T , de Magalhães JP , Campisi J , Church G. To help aging populations, classify organismal senescence . Science . 2019 Nov 1; 366 ( 6465 ): 576 – 578 . doi: 10.1126/science.aay7319 . PMID: 31672885 ; PMCID: PMC7193988 . OpenUrl Abstract / FREE Full Text 6. ↵ Lawrence JM , Divers J , Isom S , Saydah S , Imperatore G , Pihoker C , Marcovina SM , Mayer-Davis EJ , Hamman RF , Dolan L , Dabelea D , Pettitt DJ , Liese AD ; SEARCH for Diabetes in Youth Study Group . Trends in Prevalence of Type 1 and Type 2 Diabetes in Children and Adolescents in the US, 2001-2017 . JAMA . 2021 Aug 24; 326 ( 8 ): 717 – 727 . doi: 10.1001/jama.2021.11165 . Erratum in: JAMA. 2021 Oct 5;326(13):1331. PMID: 34427600 ; PMCID: PMC8385600 . OpenUrl CrossRef PubMed 7. ↵ Jaiswal S , Ebert BL . Clonal hematopoiesis in human aging and disease . Science . 2019 Nov 1; 366 ( 6465 ): eaan4673 . doi: 10.1126/science.aan4673 . PMID: 31672865 ; PMCID: PMC8050831 . OpenUrl Abstract / FREE Full Text 8. ↵ Turner G. Introduction to Frailty . Fit for Frailty Part 1 2014 . Available online: https://www.bgs.org.uk/resources/introduction-to-frailty (Accessed 29/04/2024 ). 9. ↵ Clegg A , Young J , Iliffe S , Rikkert MO , Rockwood K. Frailty in elderly people . Lancet . 2013 Mar 2; 381 ( 9868 ): 752 – 62 . doi: 10.1016/S0140-6736(12)62167-9 . Epub 2013 Feb 8. Erratum in: Lancet. 2013 Oct 19;382(9901):1328. PMID: 23395245 ; PMCID: PMC4098658 . OpenUrl CrossRef PubMed Web of Science 10. ↵ The Edmonton Frail Scale . Available online: https://edmontonfrailscale.org (Accessed 29/04/2024 ). 11. ↵ Moorhouse P , Rockwood K. Frailty and its quantitative clinical evaluation . J R Coll Physicians Edinb . 2012 ; 42 ( 4 ): 333 – 40 . doi: 10.4997/JRCPE.2012.412 . PMID: 23240122 . OpenUrl CrossRef PubMed 12. ↵ Xue QL . The frailty syndrome: definition and natural history . Clin Geriatr Med . 2011 Feb ; 27 ( 1 ): 1 – 15 . doi: 10.1016/j.cger.2010.08.009 . PMID: 21093718 ; PMCID: PMC302859 . OpenUrl CrossRef PubMed Web of Science View the discussion thread. 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Whitney , Rosalind Willis , Jacek M. Witkowski , Leonard L.L. Yeo , Tham Yhi Chung , Emma Yu , Michael Zemel , Stuart R.G. Calimport , Barry L. Bentley medRxiv 2024.09.02.24312951; doi: https://doi.org/10.1101/2024.09.02.24312951 Share This Article: Copy Citation Tools Defining an Ageing-Related Pathology, Disease or Syndrome: International Consensus Statement Emma Short , Ian M. Adcock , Bilal Al-Sarireh , Ann Ager , Ramzi Ajjan , Naveed Akbar , Michael A. Akeroyd , Ghada Alsaleh , Ghada Al-Sharbatee , Kambiz Alavian , Winfried Amoaku , Julie Andersen , Chrystalina Antoniades , Mark J. Arends , Sue Astley , Denize Atan , Richard Attanoos , Johannes Attems , Steve Bain , Konstantinos Balaskas , Gabriel Balmus , Manohar Bance , Thomas M. Barber , Ajoy Bardhan , Karen Barker , Peter Barnes , Gemma Basatemur , Adrian Bateman , Moises Evandro Bauer , Christopher Bellamy , Edwin van Beek , Ilaria Bellantuono , Emyr Benbow , Sunil Bhandari , Rahul Bhatnagar , Philip Bloom , Dawn Bowdish , Melissa Bowerman , Melanie Burke , Roxana Carare , Emma Victoria Carrington , Jorge Iván Castillo-Quan , Peter Clegg , James Cole , Carlo Cota , Paul Chazot , Christopher Chen , Ying Cheong , Gary Christopher , George Church , David Clancy , Paul Cool , Francesco Del Galdo , Mayank Dalakoti , Soumit Dasgupta , Colleen Deane , Devesh Dhasmana , Stefan Dojcinov , Monia Di Prete , Huaidong Du , Niharika A Duggal , Toby Ellmers , Costanza Emanueli , Mark Emberton , Jorge D. Erusalimsky , Laurence Feldmeyer , Alexander Fleming , Karen Forbes , Thomas C. Foster , Daniela Frasca , Ian Frayling , Daniel Freedman , Tamas Fülöp , Georgina Ellison-Hughes , Gus Gazzard , Christopher George , Jesus Gil , Richard Glassock , Rob Goldin , John Green , Robyn Guymer , Hasan Haboubi , Lorna Harries , Simon Hart , Douglas Hartley , Sebri Hasaballa , Christin Henein , Maggie Helliwell , Emily Henderson , Rakesh Heer , Kristofer Holte , Iskander Idris , David Isenburg , Juulia Jylhävä , Ahmed Iqbal , Simon W. Jones , Rajesh Kalaria , Venkateswarlu Kanamarlapudi , Werner Kempf , Alexandra J. Kermack , Jemma Kerns , Albert Koulman , Adnan H. Khan , James Kinross , Katarina Klaucane , Yamini Krishna , Harinderjit Singh Gill , Edward Lakatta , Ezio Laconi , Alpar Lazar , Christiaan Leeuwenburgh , Samantha Leung , Xuan Li , Ian van der Linde , Luísa V. Lopes , Antonello Lorenzini , Andrew Lotery , Pedro Machado , Sarah Mackie , Paolo Madeddu , Andrea Maier , Krishna Mukkanna , Pinelopi Manousou , Oonagh Markey , Claudio Mauro , Barry McDonnell , Reinhold J. Medina , Soma Meran , Claudia Metzler-Baddeley , Ignor Meglinksi , Neta Milman , Christina Mitteldorf , Ruth Montgomery , Andrew Conway Morris , Beda Mühleisen , Abhik Mukherkee , Andrew Murray , Scott Nelson , Anna Nicolaou , Alexander Nirenberg , Simon Noble , Lisa S. Nolan , Meritxell Nus , Canh Van On , Victor Osei-Lah , Mandy Peffers , Antony Palmer , Donald Palmer , Laura Palmer , William Parry-Smith , Graham Pawelec , Shahaf Peleg , Ranmith Perera , Andrew Pitsillides , Christopher J. Plack , Franze Progatzsky , Sonja Pyott , Kaukab Rajput , Sameera Rashid , J. Arjuna Ratnayaka , Sudhira A.B. Ratnayake , Manuel Rodriguez-Justo , Arianna Carolina Rosa , Andrew Rule , Gareth J. Sanger , Ian Sayers , Andrew Saykin , Dinesh Selvarajah , Jaswinder Sethi , Cathy Shanahan , Shai Shen-Orr , Carl Sheridan , Paul Shiels , Kastytis Sidlauskas , Sobha Sivaprasad , Judith Sluimer , Gary Small , Peter Smith , Rebecca Smith , Sarah Snelling , Ioakim Spyridopoulos , Ramasamy Srinivasa Raghavan , David Steel , Karen P Steel , Claire Stewart , Keeron Stone , Selvarani Subbarayan , Mark Sussman , Jonas Svensson , Vyshnavi Tadanki , Ai Lyn Tan , Rudolph E. Tanzi , Amanda Tatler , Adriana A. S. Tavares , Tengku Amatullah Madeehah Tengku Mohd , Ana Tiganescu , James Timmons , Jeremy Tree , Drupad Trivedi , Emmanuel A. Tsochatzis , Dialechti Tsimpida , Elisabeth J Vinke , Anna Whittaker , Neeru A. Vallabh , Kristin Veighey , Zoe C. Venables , Venkat Reddy , Meike W. Vernooij , Chris Verschoor , Manlio Vinciguerra , Vesna Vukanovic , Vladyslav Vyazovskiy , James Walker , Richard Wakefield , Adam J. Watkins , Anthony Webster , Caroline Weight , Birgit Weinberger , Susan L. Whitney , Rosalind Willis , Jacek M. Witkowski , Leonard L.L. Yeo , Tham Yhi Chung , Emma Yu , Michael Zemel , Stuart R.G. Calimport , Barry L. 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