There's been some speculation that the ageing process itself contributes to Palumboism, since you never really see it in guys in their 20's, but it could simply be because a dozen or so years worth of 'roid/gh/insulin abuse may be required to produce the negative effects characteristic of this syndrome. It should also be noted that, like most diseases, some individuals seem to be genetically more susceptible to it than others. More research is definitely needed. I think some medical researcher needs to apply for a grant to further study this dreadful condition that is Palumboism.