Ageing as a Risk Factor for Disease

Aug 7, 2025Transactions of the American Clinical and Climatological Association

Healthy Aging: Benefits and Challenges of Aging Science

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Abstract

Nearly half of all median life expectancy gains have occurred in the last two to three centuries.

Aging is the strongest risk factor for major health issues like cancer, heart disease, and neurodegenerative diseases.
The geroscience hypothesis suggests that mechanisms of aging may drive multiple chronic illnesses and functional decline.
Twelve identified hallmarks of aging include genomic stability, telomere length, and inflammation, among others.
Evidence for causal associations between these aging mechanisms and health outcomes is becoming increasingly robust.
Interventions based on geroscience could potentially reduce the overall burden of illness more effectively than treating individual diseases.

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Aging is a recent development in human history with nearly half of all median life expectancy gains occurring in the last two to three centuries. Aging is the strongest risk factor for medical conditions that predominately account for morbidity, mortality, and health care costs: cancer, heart disease, stroke, arthritis, and neurodegenerative disease. The geroscience hypothesis postulates that mechanisms of aging simultaneously drive multiple chronic illnesses and functional decline/disability, and intervening in the rate of aging can prevent multiple diseases. Geroscience now relies on 12 identified "hallmarks" or "pillars" of aging that involve alterations in genomic stability/repair, telomere length, epigenetics, proteostasis, macroautophagy, nutrient-sensing, mitochondrial function, cellular senescence, stem cell regeneration, intercellular communication, inflammation, and the microbiome. These pillars are mechanisms/pathways associated with aging, and evidence for causal associations is rapidly becoming more robust. Geroscience-based interventions may reduce illness burden-preserving function and independence-to a greater degree than addressing illnesses one by one. However, the pathway from promise to success is riddled with obstacles and potential pitfalls. Even success can have negative impacts on human populations and our planet that will require major shifts in society. Both the promises and perils of geroscience are likely to shape medical research and ethical debate for years to come.

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Ageing as a Risk Factor for Disease

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