Recently, however, geroscience has begun to find ways to separate the accumulation of chronological years from issues such as frailty, weakened immune response and the chronic diseases of age, such as neurodegenerative and metabolic disorders and most cancers. Though they were once considered an inevitable consequence of the passing of time, these and other “hallmarks of ageing” may be amenable to modulation. It is even possible that they may be caused by a single underlying biological process that could provide a powerful intervention target. This raises the possibility of not only preventing diseases individually but reversing the entire process that underpins their development.

A growing set of useful, well-characterised biomarkers is making it increasingly possible to predict what the unfolding of biological processes over time will do to a specific individual’s health. Among the most widely used is a statistical tool known as an epigenetic clock, which can benchmark the comparative rate of deterioration of an individual or their organs against population data. This measure of biological (rather than chronological) age offers not only diagnosis but new therapeutic targets. Abnormally fast deterioration, identified via these biomarkers,¹ may be corrected by epigenome editing to restore the system to a youthful state, for instance.

The ability to tinker with ageing via epigenetic modification is only one part of an ongoing reassessment of the wider human genome and how we can interact with it to extend healthy life. The non-coding elements that make up 98 per cent of the genome — until recently dismissed as “junk DNA” — have been revealed as an important but poorly understood source of age-related physiological deterioration. Now recast as the “dark genome”, this vast trove of elements may also prove a new source of biomarkers to diagnose and promote longevity and health.

Understanding how these elements change under the influence of lifestyle factors — exercise, diet, habits and so on — to accelerate or decelerate biological ageing is also a fast-moving area of research. A deeper understanding of the dark genome and epigenetic rejuvenation will reveal why certain lifestyle factors affect populations differently, Meanwhile, we are already entering an era of “lifestyle mimetics”: clinical trials are under way on small-molecule drugs that chemically imitate the consequences of lifestyle choices that contribute to resilience (fasting, for instance), or suppress processes that harm the system.

The most important focus in the near term is validation of biomarkers and targets. However, this will require better data, which can be obtained only through finding new ways to raise funds for research without compromising sensitive medical data. Investigations of the dark genome will create vast volumes of new data that could be usefully mined by AI for new insights, but this can only happen with innovative new trial designs built on a model that assures patient data integrity and trust.

KEY TAKEAWAYS

Many decades after scientific insights significantly extended human lifespan, research is making inroads into improving our healthspan — the amount of time for which we have a healthy, productive existence. Research has begun to identify important Biomarkers of ageing that help to identify potential problems and enable researchers to understand why some people age more robustly than others. The epigenome, a suite of mechanisms that regulate gene expression, are strongly associated with ageing. Rejuvenating the epigenome through various means is becoming a viable path towards increasing healthspan. A significant proportion of the genome that was previously ignored as “junk” is also now a target for healthspan extension. Certain parts of the dark genome seem to be involved in a number of ageing-associated processes, and finding ways to intervene here could prove impactful. Investigations of the role of Lifestyle modification in ageing are also proving fruitful. Patterns of sleep, exercise, nutrition and circadian rhythms are all associated with ageing, and improving the effectiveness of lifestyle interventions and understanding the biological transducers that mediate such effects could assist with the development of drugs that engender them.