Scientists are beginning to test the idea that aging itself, rather than the diseases that come with it, could become a direct target of medicine, as researchers work toward the first human trials of interventions on the biology of aging.
No intervention that slows biological aging or extends healthy years has yet been proven to work in people, according to Daniel Belsky, associate professor of epidemiology at the Columbia University Mailman School of Public Health and the Robert N. Butler Columbia Aging Center.
The emerging approach would measure and influence the biological changes that accumulate with age before they contribute to disease, with the aim of extending not only lifespan but also the years spent in good health, known as health span.
Aging has biology. This biology drives diseases.
Nir Barzilai, director of the institute for aging research at Albert Einstein College of Medicine in New York City, told CNN that instead of waiting for diabetes, cardiovascular disease or cancer to emerge and treating each separately, medicine could eventually act on aging processes that feed several conditions at once.
Belsky said laboratory experiments in organisms from roundworms to mice have shown that medicines, exercise and calorie restriction can slow the accumulation of cellular changes linked to aging and extend the animals’ lives.
“We don’t know yet whether we can really do this. But we do have an alignment of evidence to argue this is possible. And we now have a mobilization of resources to actually test it,” Belsky said, adding that researchers were “seeing the ground shift in advancing toward those human clinical trials.”
To run such trials, scientists are looking for biological measures of aging that go beyond chronological age. One approach uses epigenetics, tracking chemical tags known as methyl groups bonded to DNA, which Belsky said “could track the passage of time in a human body.”
Belsky’s FAST project, which stands for Finding Aging Biomarkers by Searching Existing Trials, is collecting data on proteins, metabolites and epigenetic marks in white blood cells to identify indicators that respond to interventions, according to CNN.
The central obstacle is time: Belsky said a trial testing whether a treatment taken at age 40 or 50 prevents chronic disease could have to follow participants for two or three decades. Researchers hope a biomarker shown to reliably predict long-term outcomes could serve as a “surrogate endpoint,” shortening clinical trials.
As the research advances, longevity clinics are spreading. Mayo Clinic opened its Healthy Longevity Clinic in the United States in 2023, and Singapore’s National University Health System has set up a similar program pairing detailed assessment with tailored interventions.
Some scientists have warned the field needs stronger regulation. In Abu Dhabi, the Department of Health in October 2024 introduced what it called the world’s first licensing framework for Healthy Longevity Medicine Centers, and it licensed the Institute for Healthier Living Abu Dhabi as the first state-designated specialized center.
Allan Boston, the institute’s chief operating officer, told CNN that cellular aging was once seen as unavoidable. “It’s not inevitable. There are things we can now start to do about that. That changes the whole concept of medicine,” he said, adding that greater understanding of cellular processes could let therapies “slow it down and even potentially reverse it.”
Belsky said people need not wait for new drugs or specialist clinics, noting that sleep, exercise, community and diet are proven steps. “These are things where almost all of us can make progress,” he said. “We can add healthy years to our lifespan even without these new drugs.”