The cellular and functional changes associated with aging are driven by the process of senescence: the biological process encoded into our genome where cells lose their ability to divide and function over the lifespan. This process is driven by mechanisms such as telomere shortening (where the protective caps at the end of chromosomes erode with time), oxidative stress and DNA methylation. As cells age and enter senescence, they secrete inflammatory cues that affect neighboring cells, accelerating the aging process and contributing to inflammation and tissue dysfunction, which are associated with age-related diseases like arthritis, cardiovascular disease and certain types of cancers. 

The signs and symptoms of aging more broadly include visible changes such as wrinkles, stooped posture, graying hair and reduced skin elasticity, alongside less obvious internal shifts like slower wound healing, declining bone density and reduced muscle mass (which can be mitigated by weight training). Understanding the biology of aging and senescence drives medical innovations aimed at extending human longevity and healthspan and empowers individuals to adopt evidence-based strategies to support their own longevity.

The health of your brain and nervous system are pivotal to maintaining quality of life as you age. However, aging can lead to structural and functional changes, including reduced neuroplasticity, loss of neurons (neurodegeneration) and cognitive decline. These changes are linked to conditions such as Alzheimer’s disease and Parkinson’s disease, which significantly impact longevity and independence. Despite these challenges, the brain has remarkable capacity for resilience even in older ages when supported by the right protocols. 

The neuroscience is clear: neuroplasticity still occurs in older adults, though it must be intentionally fostered through engagement in novel and stimulating experiences — like learning new skills, reading, solving puzzles and having meaningful social interactions. As we age, overall sleep quality and deep sleep naturally declines, making it even more important to prioritize adequate sleep. Physical exercise, particularly aerobic exercise and resistance training, increases blood flow to the brain and supports the release of neurotrophic factors that promote brain health while also bolstering mood and mental health. Additionally, limiting alcohol consumption while consuming a nutrient-rich diet abundant in omega-3 fatty acids, sufficient protein intake, antioxidants and vitamins provides the building blocks for maintaining neural integrity and supports healthy aging.

While many people dream of becoming centenarians or await technological breakthroughs to reverse aging altogether, foundational lifestyle and behavioral protocols remain the most effective strategies for promoting healthy longevity. 

To manage senescence, physician and longevity expert Dr. Peter Attia discussed the role of sirtuins, a family of proteins involved in aging and maintaining cellular health. Activating sirtuins can have several beneficial effects, such as enhancing mitochondrial biogenesis “synthesis,” improving DNA repair, and reducing the harmful products of senescent cells. Exercise and fasting naturally enhance sirtuin levels, and sirtuin activation has been shown to be enhanced by molecules like NAD and resveratrol, however more research is needed to determine if supplementing NAD (or precursors NMN or NR) positively affects lifespan. 

Managing inflammation is seen as another key factor in promoting longevity. A low-inflammatory diet primarily consists of unprocessed or minimally processed foods, including fruits and vegetables, whole grains, healthy fats and quality protein sources. Living a lower inflammatory lifestyle includes reducing exposure to toxins, getting adequate sleep, avoiding smoking and excessive alcohol consumption and managing chronic conditions like diabetes. These changes are important, even in old age, for enhancing overall health and delaying processes that lead to dysfunction and decline.