A. von Eckardstein¹

¹Institute of Clinical Chemistry, University Hospital of Zurich, Raemistrasse 100, CH-8091 ZURICH

Mean life expectancy and, thereby, the prevalence of age-related diseases are increasing worldwide. We also witness a strong wish of both the individuals and the societies, to stay biologically young despite chronological aging, to conserve a high quality of life and to save costs. The increased prevalence of age-related diseases such as atherosclerosis, neurodegenerative diseases, renal insufficiency, osteoporosis and certain types of cancer is thought to reflect the exposure time to risk factors and the accumulating burden of tissue damage. In addition several risk factors become more frequent and severe with increasing age. Finally, aging is accompanied by various phenomena which are involved in the pathogenesis of these diseases, for example oxidation, cell death and loss of endocrine and immune functions. In this context clinical laboratories have three general functions, namely 1. to prevent premature aging by early diagnosis of its causes (e.g. genetic diseases, loss of endocrine or immune functions), 2. to diagnose age-related diseases and their risk factors for early intervention (e.g. cardiovascular, neurodegenerative, renal or bone diseases and cancer) and 3. to monitor the course and treatment of age-related diseases. Considerable progress has been made to reach the aims No. 2 and 3 for some diseases, e.g. prevention of atherosclerosis, but not for others, e.g. prevention and early diagnosis of neurodegenerative diseases including Alzheimer’s disease. Aim No. 1 has generated considerable hype especially in the context of life style and anti-aging campaigns. Notably blood levels of hormones are increasingly tested for the diagnosis of menopause, andropause, adrenopause and somatopause, although neither this diagnostic approach nor the derived therapeutic consequences, i.e. hormone replacement, are validated. In addition novel markers have to be developed and evaluated, for example molecular markers like telomer length and telomerase activity or oxidative stress markers.