3 What is the relationship between osteoarthritis and ageing?

The relationship between osteoarthritis and ageing raises important questions about what exactly defines ‘normal’ ageing and whether the pathogenesis of osteoarthritis shares common pathways with other age-associated dysfunctions, or whether osteoarthritis is a time-dependent disorder distinct from normal ageing with a separate causative mechanism at work. Theories of ageing now emphasize the stochastic nature of the ageing process, that is the role played by accumulation of essentially random cell and tissue damage, such as somatic mutations, oxidative damage and the formation of aberrant proteins. The role of genetic factors in determining longevity and predisposition to age-associated diseases is probably in programming the efficiency of somatic maintenance functions and influencing the development of a durable soma. Gene-environment interactions, for example through lifestyle, can also be important. Many of the risk factors and mechanisms that are thought to contribute to osteoarthritis can be accommodated within this framework.