Rewriting the Clock: Aging, Intervention, and the Push to Redefine Disease

If I had an extra hour every day, I would spend it...

This application classic is the Pumpkin Spice Latte of essay prompts: wildly overdone, kind of expected, and weirdly unavoidable. And yet, every time we encounter it, thousands of us pretend that this hypothetical 60 minutes will change the trajectory of humanity. We’ll finally write that novel, discover the cure to an obscure disease, win a Nobel Prize, or maybe even do all three. But let’s be honest: for most of us, that extra hour would dissolve into the background noise of daily life. We’d wake up ten minutes later, scroll through a few more TikToks, and spend a little longer debating whether to go to the gym before deciding to just go tomorrow. That’s the bonus hour, gone before it even knows it’s extra. But what if it wasn’t just an hour? What if you could get an extra month? An extra year? Maybe even ten?

Thanks to breakthroughs in aging research, that question is no longer just a lazy hypothetical. Scientists are beginning to ask whether aging, once considered an immutable force of nature, might actually be something we can delay, manage, or even treat. Drugs like Metformin and Rapamycin, originally developed for diabetes and immunosuppression, are now being repurposed for their potential to slow cellular aging. At the same time, pressure is mounting to reclassify aging as a disease. Together, these shifts have pushed the idea of gaining extra time beyond the realm of wishful thinking that turns bonus hours into Nobel Prizes. But what we do with that time, and who gets access to it, might expose not just what science makes possible but what society is willing, or unwilling, to make fair. Because if time really is the most valuable thing we have, then how we define it, regulate it, and distribute it might say more about us than we are ready to admit.

Despite growing scientific interest, aging has yet to be classified as a disease by the Food and Drug Administration (FDA), which continues to define it as a natural and biological process [6]. Similarly, other influential health bodies, such as the World Health Organization, have taken similar stances, focusing on aging healthily and age-associated decline without calling aging a condition in its own right [4]. This debate goes beyond dictionary definitions; it shapes what gets studied, funded, and ultimately delivered to patients. Such ambiguity has created a regulatory limbo: researchers cannot officially run clinical trials for anti-aging treatments because aging lacks formal recognition as a disease. Without FDA approval pathways, dedicated funding, or clear incentives, progress grinds to a halt, financial support dwindles, and the science remains stuck in preclinical gridlock [6].

Thus, some proponents of the classification of aging as a disease argue that the standstill movement of pharmaceuticals in biogerontology reflects a failure of policy rather than of science [1]. Certainly, the science is ready; we know cellular degeneration can be studied and potentially slowed. However, the FDA’s current system is built for discrete diseases with quick symptom onset and measurable outcomes. Aging doesn’t work like that. It’s gradual, multi-systemic, and notoriously hard to measure, making it incompatible with the approval models we currently use [6]. In a field where innovations are moving faster than the regulatory definitions meant to govern them, a regulatory reclassification would enable researchers to focus on aging itself rather than navigate complex administrative hurdles [5]. Indeed, promising drugs that already show significant efficacy in model organisms, like Rapamycin and Metformin, could finally be tested with long-term, large-scale studies instead of operating in the shadows of off-label use. Aging, defined as a disease, would transform longevity science from a patchwork of workarounds to a legitimate, regulated frontier of innovation.

Until then, scientists and biotech companies are forced to get creative. Consider studies like TAME, Targeting Aging with Metformin, which sidesteps the mention of aging altogether, instead looking at whether Metformin can delay multiple chronic diseases at once [3]. It’s regulatory rule-bending, not to deceive, but to function within a system that is not yet designed to ask the questions scientists are ready to answer. But while the system stalls, time doesn’t. Many of the researchers studying aging don’t have decades to wait for the FDA to catch up. It’s try or die. That’s why some of the same scientists who publicly urge caution about drugs like rapamycin are privately taking it themselves [7]. Simply put, it’s the research equivalent of “Do as I say, not as I do.”

Undoubtedly, such instances of off-label use reveal growing divides. Because aging is not classified as a disease, drugs like Rapamycin, when used preventatively, fall outside FDA-approved indications. As a result, patients must often pay out of pocket, bypassing insurance coverage entirely. These costs, combined with the need for access to longevity-focused physicians and private health networks, place anti-aging interventions firmly out of reach for most people. What emerges is a two-tiered healthcare system, where the wealthy not only receive better treatment, but they also potentially get more years of it [3]. 

Defining aging as a disease does not just risk changing how we treat older adults—it risks changing what we expect from them. As medical innovation continues to push the boundaries of life extension, choosing not to intervene has become increasingly stigmatized. In the current healthcare system, declining procedures like cardiac bypasses or transplants, even in one’s nineties, are condemned, even deemed as unnatural [3]. As sociologist Sharon Kaufman notes, what was once optional care is now standard, and what was once standard has become morally expected [3]. The technological imperative, the idea that we can intervene, has quietly become an ethical one: that we must. Framing aging itself as a disease would only deepen this shift, making it even harder for individuals to age on their own terms without being seen as irresponsible, irrational, or in decline. In the pursuit of treating aging, we may forget how to respect it.

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Ultimately, it is undeniable that science is ready to treat aging. Rather, the urgent question is whether we are, too. The stakes are higher than simply clinical trials or regulatory reform. When time becomes something to be purchased, prescribed, or postponed, it stops being a shared human experience and starts becoming a new kind of currency, one that not everyone can afford. In chasing longer lives, we risk narrowing down what it means to live well. And if we’re not careful, the future of aging won’t be defined by biology or breakthroughs but by who’s allowed to grow old with dignity and who’s quietly denied the chance.

Reviewed By: Aria Eaddy

Designed By: Sonali Patel

References:  

1. de Grey, A. D. N. J. (2005). Resistance to debate on how to postpone ageing is delaying progress and costing lives: Open discussions in the biogerontology community would attract public interest and influence funding policy. EMBO Reports, 6(Suppl 1), S49–S53. https://doi.org/10.1038/sj.embor.7400399 

2. Kaufman, S. R., Shim, J. K., & Russ, A. J. (2004). Revisiting the biomedicalization of aging: Clinical trends and ethical challenges. The Gerontologist, 44(6), 731–738. https://doi.org/10.1093/geront/44.6.731

3. Lugo, N. (2024, October 8). Breakthrough research: Common medication may hold key to slowing aging. Virtue Recovery Center. https://www.virtuerecoverycenter.com/breakthrough-research-common-medication-may-hold-key-to-slowing-aging/

4. Mendoza-Núñez, V. M., & Mendoza-Soto, A. B. (2024, February 24). Is aging a disease? A critical review within the framework of ageism. Cureus, 16(2), e54834. https://doi.org/10.7759/cureus.54834

5. Newcomb, T. (2023, January 6). Humans can start living longer—Once the FDA does this. Popular Mechanics. https://www.popularmechanics.com/science/health/a42419017/anti-aging-drugs-fda-approval/

6. Tournas, L., & Marchant, G. E. (2019). The fountain of youth revisited: Regulatory challenges and pathways for healthspan promoting interventions. Food and Drug Law Journal, 74, 405–426.

7. Whalen, J. (2024, March 15). A transplant drug shows promise for extending life. Should you take it? The Washington Post. https://www.washingtonpost.com/business/2024/03/15/rapamycin-longevity-drug/