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

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.