Global population aging has heightened the urgency to understand and intervene in the biological process of aging. Anthocyanins, natural flavonoids widely present in the human diet, have emerged as promising candidates for promoting healthy aging. This review synthesizes current knowledge on the role of cellular senescence and chronic inflammation (inflammaging) as a core pathological loop driving age-related diseases, including cardiovascular and neurodegenerative disorders, diabetes, and cancer. We comprehensively examine the natural distribution, extraction methodologies, and structural diversity of anthocyanins, alongside a critical analysis of their stability and bioavailability-the primary barriers to clinical translation. This review further evaluates emerging strategies to overcome bioavailability limitations, including molecular modifications and advanced encapsulation technologies. Mechanistically, anthocyanins exert pleiotropic effects by modulating interconnected signaling networks (nuclear factor erythroid 2-related factor 2 (Nrf2), nuclear factor-kappa B (NF-κB), AMP-activated protein kinase (AMPK), Sirtuin 1 (SIRT1), phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt)), thereby attenuating oxidative damage, suppressing inflammatory cascades, restoring metabolic homeostasis, and counteracting cellular senescence. By integrating evidence from preclinical studies and emerging clinical trials, this review provides a framework for understanding both the therapeutic potential and current translational challenges of anthocyanins in the context of aging intervention.
