It is Time to Embrace 21st-Century Medicine

Abstract

We now have an opportunity to take a much more effective approach to extending healthspan, by targeting the biological mechanisms of aging directly. Since the mid-1990s, immense progress has been made in understanding the molecular causes of biological aging, which have been formalized as nine “Hallmarks of Aging” (López-Otín, Blasco, Partridge, Serrano, & Kroemer, 2013). These hallmarks represent specific, biological processes that contribute to age-related functional declines and disease risk. Importantly, by targeting these hallmarks with medications or other interventions, it is now possible to slow the biological aging process and, in some cases, even reverse the functional declines that occur during aging. For example, the drug rapamycin, which targets multiple hallmarks of aging, has been shown to improve the aged heart, brain, and immune system in rodents, such that old animals treated with this drug have shown functional rejuvenation in these organs (Kaeberlein & Galvan, 2019). A derivative of rapamycin is now being studied in clinical trials in people to determine whether it has the same immune-boosting effects in the older adults, with initial results looking quite promising (Mannick et al., 2018). This represents only one of several strategies for clinically targeting the Hallmarks of Aging, and it now seems certain that medicines to delay or reverse the biological aging process are only a matter of when, rather than if.