[Theories of biological aging: An integrative review]

In this article, we review the main theories of biological aging, exploring the interaction of genetic, epigenetic, metabolic, immunological, and ecological factors in this process. For this purpose, we examine and discuss theories such as the allocation of metabolic resources, pleiotropic antagonism, genetic regulation, codon restriction, replicative senescence, action of free radicals, caloric restriction, catastrophic error, immunological theory, neuroendocrine theory, programmed aging, epigenetics of aging, grandmother and caregiver theories and ecological biophysical theory. We identify the contribution of different biological mechanisms to aging, emphasizing the complementarity of theories such as the allocation of metabolic resources, pleiotropic antagonism, and caloric restriction, providing a more comprehensive view of the phenomenon. In conclusion, we highlight the need to consider diverse perspectives in aging research, recognizing the absence of a single explanation. Integrating these theories is crucial to comprehensively understand the process and develop effective interventions in health and well-being in old age.

Human Aging and Age-Related Diseases: From Underlying Mechanisms to Pro-Longevity Interventions

As human life expectancy continues to rise, becoming a pressing global concern, it brings into focus the underlying mechanisms of aging. The increasing lifespan has led to a growing elderly population grappling with age-related diseases (ARDs), which strains healthcare systems and economies worldwide. While human senescence was once regarded as an immutable and inexorable phenomenon, impervious to interventions, the emerging field of geroscience now offers innovative approaches to aging, holding the promise of extending the period of healthspan in humans. Understanding the intricate links between aging and pathologies is essential in addressing the challenges presented by aging populations. A substantial body of evidence indicates shared mechanisms and pathways contributing to the development and progression of various ARDs. Consequently, novel interventions targeting the intrinsic mechanisms of aging have the potential to delay the onset of diverse pathological conditions, thereby extending healthspan. In this narrative review, we discuss the most promising methods and interventions aimed at modulating aging, which harbor the potential to mitigate ARDs in the future. We also outline the complexity of senescence and review recent empirical evidence to identify rational strategies for promoting healthy aging.

Seven knowledge gaps in modern biogerontology

About a year ago, members of the editorial board of Biogerontology were requested to respond to a query by the editor-in-chief of the journal as to what one question within their field of ageing research still needs to be asked and answered. This editorial is inspired by the wide range and variety of questions, ideas, comments and suggestions received in response to that query. The seven knowledge gaps identified in this article are arranged into three main categories: evolutionary aspects of longevity, biological survival and death aspects, and heterogeneity in the progression and phenotype of ageing. This is not an exhaustive and exclusive list, and may be modified and expanded. Implications of these knowledge gaps, especially in the context of ongoing attempts to develop effective interventions in ageing and longevity are also discussed.

Ageing without senescence: A critical absence in social gerontology?

This paper addresses the absence of the term 'senescence' in recent social science literature on ageing. The significance of this omission is considered in light of the emerging standpoint of gero-science, which argues that the central processes defining ageing are concerned with the rising probability of functional decline, development of degenerative disease and death. From this perspective, the separation of ageing and senescence sustains the myth that there exist forms of ageing that are exempt from senescence. The persistence of this myth underlies ageing studies, the sociology of later life and most social gerontology. While there have been undoubted benefits arising from this bracketing out of senescence, the argument of this paper is that the continuing advances associated with this standpoint are outweighed by the need to seriously engage with the consequences of contemporary societal ageing and the centrality of the processes of senescence in establishing an adequate understanding of ageing, its correlates and contingencies and its personal and social consequences.

How Justified is the Assumption of Programmed Aging in Reminiscence of Weismann's Theories?

Theories about the benefits of death and the resulting increased likelihood of programmed aging are controversial, advocated only by a minority. The extent to which their assumptions might be justified should be investigated. To this end, various approaches to the possible utility or origin were considered, particularly potential benefits of the faster generational change caused by possible evolutionary compound interest. Reference was made to the thinking of Weismann, the father of regulated aging theories, who advocated non-adaptive concepts at the end of his career. In a thought experiment, circadian rhythms are discussed as a possible molecular source of aging regulation.

Exploring the effects of birth order on human lifespan in Polish historical populations, 1738–1968

While the relationships between birth order and later outcomes in life, including health and wealth, have been the subject of investigation for several decades, little or no data exist regarding the relationship between birth order and life expectancy in the Polish population. The aim of this study was to explore the link between birth order and lifespan in Polish historical populations. We obtained 8523 records from a historical dataset that was established for parishioners from the borough of Bejsce, including 4463 males and 4060 females. These data pertain to the populations that lived over a long period in a group of localities for which parish registers were well preserved. The Mann-Whitney U test, the Kruskal-Wallis ANOVA and ANCOVA were run. The results strongly suggest that birth order affects male longevity. However, no such association was found for females. On balance, the hypothesis that first-born boys live longer because they are born to relatively younger parents has received some empirical support and deserves further study. We hypothesise that the effects of birth order on human health and lifespan might be overshadowed by other factors, including educational attainment, socioeconomic status and lifestyle.

Role of cell competition in ageing

Recent advances in rapid medical detection and diagnostic technology have extended both human health and life expectancy. However, ageing remains one of the critical risk factors in contributing to major incapacitating and fatal conditions, including cancer and neurodegeneration. Therefore, it is vital to study how ageing attributes to (or participates in) endangering human health via infliction of age-related diseases and what must be done to tackle this intractable process. This review encompasses the most recent literature elaborating the role of cell competition (CC) during ageing. CC is a process that occurs between two heterogeneous populations, where the cells with higher fitness levels have a competitive advantage over the neighbouring cells that have comparatively lower fitness levels. This interaction results in the selection of the fit cells, within a population, and elimination of the viable yet suboptimal cells. Therefore, it is tempting to speculate that, if this quality control mechanism works efficiently throughout life, can it ultimately lead to a healthier ageing and extended lifespan. Furthermore, the review aims to collate all the important state of the art publications that provides evidence of the relevance of CC in dietary restriction, stem cell dynamics, and cell senescence, thus, prompting us to advocate its contribution and in exploring new avenues and opportunities in fighting age-related conditions.

From gerontology to geroscience: a synopsis on ageing

Biological ageing can be tentatively defined as an intrinsic and inevitable degradation of biological function that accumulates over time at every level of biological organisation from molecules to populations. Senescence is characterised by a progressive loss of physiological integrity, leading to impaired function and increased vulnerability to death. With advancing age, all components of the human body undergo these cumulative, universal, progressive, intrinsic and deleterious (CUPID) changes. Although ageing is not a disease per se, age is the main risk factor for the development of a panoply of age-related diseases. From a mechanistic perspective, a myriad of molecular processes and components of ageing can be studied. Some of them seem especially important and they are referred to as the hallmarks of ageing. There is compelling evidence that senescence has evolved as an emergent metaphenomenon that originates in the difficulty in maintaining homeodynamics in biological systems. From an evolutionary perspective, senescence is the inevitable outcome of an evolutionarily derived equilibrium between the amount of resources devoted to somatic maintenance and the amount of resources devoted to sexual reproduction. Single-target, single-molecule and disease-oriented approaches to ageing are severely limited because they neglect the dynamic, interactive and networking nature of life. These limitations notwithstanding, many authors promote single-target and disease-oriented approaches to senescence, e.g. repurposed drugs, claiming that these methods can enhance human health and longevity. Senescence is neither a disease nor a monolithic process. In this review, the limitations of these methods are discussed. The current state of biogerontology is also summarised.

If ageing is a disease, then life is also a disease

Ageing is distinct from a disease. Sound arguments have been adduced to explain that senescence cannot be understood as a pathological process. Nevertheless, this distinction is believed to be artificial (Holliday 1995), and other eminent researchers argue that the senescence-pathology dichotomy is also misleading. Recently, it has been suggested that ageing should be classified as a complex pathological syndrome or a ‘pre-disease’ that is treatable. Proponents of this new paradigm argue that: (i) modern evolutionary theory predicts that ‘although organismal senescence is not an adaptation, it is genetically programmed’, (ii) ‘insofar as it is genetically determined, organismal senescence is a form of genetic disease’ (Janac et al. 2017) and (iii) ‘ageing is something very much like a genetic disease: it is a set of pathologies resulting from the action of pleiotropic gene mutations’ (Gems 2015). Also new generations of researchers, free of these traditional shackles, come with the belief that it is time to classify ageing as a disease, as the distinction between normal dysfunction and abnormal dysfunction is not completely clear and should be abandoned. Although they marshal their arguments in a convincing manner, persuasive counterarguments can be mounted. Here, the senescence-pathology dichotomy is critically discussed. A deeper analysis of this subject reveals the underlying problem of undefined terminology in science.

The dynamic nature of ageing: novel findings, therapeutic avenues and medical interventions

Ageing is one of the most complex and difficult problems for humans to face and for science to solve. Although human senescence was viewed as a passive and uncontrollable process of deteriora­tion over time with little or no genetic regulation, the concept that ageing is caused by both genetic and environmental factors is now generally accepted, even though it remains difficult to distinguish between ageing sensu stricto and the effects of age-related diseases. Empirical data show that mechanisms of ageing are highly conserved during evolution. Moreover, it has been established that there are specific molecular ‘instructions’ for ageing, which suggests that a better understanding of the molecular biology of ageing will open new possibilities regarding future interventions. The complexity of ageing diminishes the possibility that any general theory will completely explain this metaphenomenon. Likewise, it is highly unlikely that any medication can stop or reverse human senescence. Nevertheless, ageing as a dynamic and malleable metaphenomenon can be modulated by a variety of influences. The concept of the shrinkage of the homeo­dynamic space with age, i.e. homeostenosis, is especially interesting and intriguing as it shows that novel therapeutic approaches and rational strategies can help delay the onset of the ageing-associated pathologies by enhancing the homeodynamic capabilities of the body. The aim of this article is to present current data from evolutionary and molecular gerontology and discuss them within the ambit of this review which is devoted to the dynamic, emergent and plastic nature of human ageing and implications for future inter­ventions.

Human ageing, longevity and evolution: can ageing be programmed?

Understanding the proximate and ultimate causes of ageing is one of the key challenges in current biology and medicine. These problems are so important that they are sometimes referred to as the Holy Grail of biology and the Great Conundrum in biogerontology. From an evolutionary perspective, ageing is due to a failure of selection that is caused either by declining strength of selection after the onset of sexual reproduction (Medawar’s theory and Charlesworth’s model) or pleiotropic constraints (Williams’ theory). According to the disposable soma theory, which was proposed by Kirkwood and Holliday, ageing is driven by the accumulation of damage during life and failures of defensive and repair mechanisms as the more an animal expends on sexual reproduction, the less it can expend on bodily maintenance, and vice versa. Although these standard models rule out the possibility that ageing is programmed, there is no consensus about the nature of ageing within the life history in current biogerontology. Interestingly, empirical studies show that there are molecular instructions for ageing and evolutionarily conserved mechanisms for ageing, which seems inconsistent with the idea that ageing is a matter of neglect or a consequence of a failure of selection due to pleiotropic constraints. Here, selected arguments for programmed (i.e. either determined and adaptive or prearranged but non-adaptive) and non-programmed ageing are discussed. Recent advances in biogerontology that cast new light on these problems are outlined here in the context of the idea that the pace of ageing can act as an adaptation in nature, even though ageing is non-programmed and non-adaptive.

Human ageing as a dynamic, emergent and malleable process: from disease-oriented to health-oriented approaches

Over the decades, biogerontology has matured as a scientific discipline. Currently, a number of theoretical frameworks are available to researchers when interpreting empirical data. Despite the great progress that has been made, a comprehensive understanding of biological processes that shape ageing is lacking. Senescence is a dynamic, plastic and highly complex metaphenomenon whose aetiology remains unclear. The paucity of information notwithstanding, some researchers promote ‘anti-ageing’ drugs and formulae every now and again. The rationale behind this concept is that ageing can be reduced to a mixture of biochemical reactions. Furthermore, the distinction between ageing and disease has been questioned on the grounds that ageing is the root of age-related diseases. It has been claimed that disease-oriented approaches can help delay ageing and prevent age-related diseases. Although these methods seem incongruous from an evolutionary standpoint, they become popular amongst the public. Moreover, if ageing is classified as a disease, this situation is likely to be exacerbated. Therefore, it is important to recognise the limitations of these reductionist and disease-oriented approaches. Only holistic and evidence-based strategies might be useful in slowing down ageing and preventing age-related diseases in the future.

Leukocyte count, systemic inflammation, and health status in older adults: a narrative review

Epidemiological and clinical studies suggest that elevated leukocyte count within the normal range can predict cardiovascular and total mortality in older adults. These findings are remarkable because this simple and common laboratory test is included in routine medical check-ups. It is well known that chronic systemic inflammation (inflammaging) is one of the hallmarks of aging and an important component of obesity-associated insulin resistance that can lead to type 2 diabetes and other health problems in both overweight individuals and elderly people. To understand the molecular mechanisms linking increased systemic inflammation with aging-associated diseases and elevated leukocyte counts in the elderly is to unravel the multiplicity of molecular factors and mechanisms involved in chronic low-grade systemic inflammation, the gradual accumulation of random molecular damage, age-related diseases, and the process of leukopoiesis. There are several possible mechanisms through which chronic low-grade systemic inflammation is associated with both higher leukocyte count and a greater risk of aging-associated conditions in older adults. For example, the IL-6 centric model predicts that this biomediator is involved in chronic systemic inflammation and leukopoiesis, thereby suggesting that elevated leukocyte count is a signal of poor health in older adults. Alternatively, an increase in neutrophil and monocyte counts can be a direct cause of cardiovascular events in the elderly. Interestingly, some authors assert that the predictive ability of elevated leukocyte counts with regard to cardiovascular and allcause mortality among older adults surpass the predictive value of total cholesterol. This review reports the recent findings on the links between elevated but normal leukocyte counts and the increased risks of all-cause, cardiovascular, and cancer mortality. The possible molecular mechanisms linking higher but normal leukocyte counts with increased risk of aging-associated diseases in the elderly are discussed here.

Association of serum bilirubin with longevity: Evidence from a retrospective longitudinal study and cross-sectional data

Bilirubin is a potent antioxidant and an important anti-inflammatory factor. Therefore, there has been an increasing focus on serum bilirubin as a negative risk factor of cardiovascular mortality in men and an indicator of improved survival in both sexes, but the direct mechanisms of these links and the causes of sex differences are not well understood. Moreover, the evidence from longitudinal studies on effects of bilirubin on longevity is limited. In this study, we retrospectively analyzed two groups of older adults to explore age-dependent changes in serum bilirubin levels and their associations with long-term survival in both sexes. Longitudinal data from 142 individuals (68 men and 74 women) aged 45 to 70 years were compared with cross-sectional data from 225 individuals (113 men and 112 women). The latter group was divided into four categories of survival, i.e. 53, 63, 68, and 76+ based on data on lifespan. ANOVA, t-test, and regression analysis were run. The analysis of the longitudinal data showed an increase in serum total bilirubin levels in men (0.3038e0.093x, R2 = 0.667) and women (0.1838e0.0187x, R2 = 0.950), while the analysis of cross-sectional data revealed a U-shaped pattern of age-related changes in men (0.001x2 - 0.1263x + 4.4524, R2 = 0.999) but an inverted U-shaped pattern in women (0.0006x2 + 0.072x - 1.6924, R2 = 0.195). On balance, these results suggest that elevated but normal bilirubin levels might confer a survival advantage in older men but not women. Alternatively, the positive relationship between serum total bilirubin and lifespan was not causal but coincidental. Further studies are needed to elucidate the direct mechanisms of the association between serum bilirubin levels and longevity in elderly people of both sexes.