Aug 2026· Mechanisms of Ageing and Development· pp.
112236
· 0 citations
Medicine
TL;DR
Overall, aging outcomes reflect a dynamic equilibrium between damage and repair processes, and how this balance is modulated in long-lived individuals may inform strategies to promote healthy aging and delay the onset of age-related diseases.
Abstract
Aging is a dynamic and time-dependent process characterized by progressive functional decline across biological systems. Key hallmarks, including genomic instability, telomere attrition, loss of proteostasis, mitochondrial dysfunction, and immunosenescence, have been widely described, each reflecting distinct yet interconnected mechanistic frameworks. Rather than acting in isolation, these processes arise from complex interactions among cellular stressors, impaired repair mechanisms, and the cumulative burden of maladaptive responses. This system-level perspective explains the inter-individual variability in aging trajectories. Centenarians represent an extreme and informative model of successful aging, in which the balance between damage accumulation and repair is shifted toward the maintenance of physiological function. Their exceptional longevity is supported by coordinated genetic, epigenetic, metabolic, and immunological adaptations that enhance resilience to age-related stressors. Here, we summarize the biological drivers and theoretical frameworks of aging within an integrative context, focusing on mechanisms associated with extended healthspan in centenarians. We also examine the contribution of major animal models, highlighting their complementary roles in elucidating conserved and species-specific aging pathways. Overall, aging outcomes reflect a dynamic equilibrium between damage and repair processes. Understanding how this balance is modulated in long-lived individuals may inform strategies to promote healthy aging and delay the onset of age-related diseases.
A deeper understanding of these processes may contribute to the identification of innovative interventions for age-related disorders, such as therapies targeting specific components of the senescence-associated secretory phenotype or selectively modulating senescent cell burden.
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