Many of us feel aging is a natural process, after all, everyone “gets it,” and disease is more of a deviation or aberration of nature. The proponents of aging as disease point out that aging is related to the apparent random degradation of our DNA, that aging serves no evolutionary purpose, and is more a “consequence of evolutionary neglect, not evolutionary intent.”  And without an evolutionary role, why consider it natural? Of course, that aging serves no purpose, is a statement made by those with a stake in the outcome, us, and we may be biased in that regard. We may be unaware of aging evolutionary purpose.
From a practical clinical view, what signs and symptoms are associated with aging that differentiates it from other maladies of old age? While science has identified at least nine hallmarks of aging,  each with their signs and symptoms, there are no biomarkers to describe aging overall. Most studies utilize chronological age, and we all know of fit 80-year-olds and decrepit 40-year-olds, so it is too non-specific to be helpful in anything more than a general way. And even if we were to agree on a set of criteria, what is the underlying “cause” that we will want to modify – in truth, it varies for everyone, only when we aggregate do we begin to see some patterns to our declining years.