Çiğdem CİNDOĞLU, Fatma Zehra AĞAN
Acta Medica Ruha - 2026;4(3):169-180
The proportion of older adults is rapidly increasing worldwide as life expectancy rises, accompanied by a growing burden of age-related chronic diseases. However, increases in lifespan have not been paralleled by comparable gains in healthspan. This discrepancy has highlighted the need for a better understanding of the biological mechanisms underlying aging and for the development of new approaches to promote healthy aging. In recent years, longevity medicine has emerged as a multidisciplinary approach that seeks to extend healthspan by targeting the biological mechanisms underlying aging rather than viewing aging solely as an inevitable process. The Hallmarks of Aging, which define the fundamental biological features of aging, encompass a set of interconnected processes, including genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, disabled macroautophagy, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, altered intercellular communication, chronic inflammation, and dysbiosis. Over time, these mechanisms are associated with impaired cellular and tissue homeostasis and functional decline and may contribute to the development of age-related diseases and frailty. The Hallmarks of Aging framework conceptualizes aging not as the consequence of a single mechanism, but as a biological process shaped by the interplay of molecular, cellular, and systemic processes. Understanding these mechanisms is important not only for elucidating the biological foundations of aging but also for evaluating the processes that influence healthy aging. In this review, the fundamental biological mechanisms of aging are discussed within the Hallmarks of Aging framework, with particular emphasis on the interactions among these mechanisms and their implications for healthy aging in light of the current literature.
