Ageing is the greatest risk factor driving both morbidity and mortality. While research has yielded few solutions to chronic diseases of ageing — such as cardiovascular diseases, most cancers, and neurodegenerative and metabolic syndromes — in the past few decades, findings point to the existence of underlying biological pathways that unite the diseases associated with ageing.

Even while basic questions around such fundamental processes are being explored, there are already therapies in clinical trials. As with fundamental geroscience, here the goal is to reduce the health impacts of ageing. A range of interventions, from small-molecule drugs to gene therapy, are now in various early stages of investigation. Their endpoints are necessarily specific disease outcomes, more with an eye toward prevention, and, importantly, these trials will yield insights that are predicted to inform a range of interventions in the ageing process, from lifestyle changes to technologies to, eventually, pharmacological and even gene therapies that will lead to longer, healthier lives..

A fundamental shift is under way. This foundational reconceptualisation of ageing as a disease will lead to a new kind of public-health programme based on “healthspan extension”. The endgame of such a programme is a society-wide eradication of frailty, of high late-life health expenditures and of low quality of late-life. These are crucial aims in an ageing global population: the primary goal is not years added to lifespan, but to “healthspan”, where health, wellbeing and quality of life remains high until death.²

KEY TAKEAWAYS

Advances in our scientific understanding of ageing are making it clear that there is no reason to treat it as an untreatable process. Breakthroughs in Fundamental geroscience are revealing many of the processes associated with ageing in the human body and opening up possible ways to slow, halt or mitigate their effects. As a result, research has begun to identify important Diagnostics, hallmarks and biomarkers of ageing. This is leading to a new frontier opening up in Healthspan therapies and interventions, which are aimed not primarily at prolonging life, but at extending the length of time for which an individual has a healthy and enjoyable experience of life. There are suggestions, though, that it might be possible to extend healthy lifespan and possibly to reverse processes associated with ageing. Such efforts at Lifespan extension and rejuvenation remain controversial, but techniques such as gene therapy and epigenetic reprogramming are being explored and may yet prove to have value.