What is an anti-aging treatment?

• A new, pragmatic conception of anti-aging treatment is proposed.
• Aging is a disease syndrome of multiple pathologies with multiple causes.
• Such pathologies exist in a variable rank order with respect to which limit life.
• Treatments that extend lifespan inhibit life-limiting sets of pathologies.
• An anti-aging treatment is any preventative approach to age-related pathology.

Key objectives of biogerontology are to understand the biology of aging and to translate scientific insight into interventions that improve late-life health — or anti-aging treatments. In this context, when considering the problem of how to effect translational research, it is useful to have a clear, consensus view on what exactly constitutes an anti-aging treatment. This essay critically assesses the understanding of this concept common among biogerontologists, and proposes a new definition. A current conception of anti-aging treatment imagines a primary cause of aging that is causally upstream of, and the cause of, all age-related pathology. Intervening in this aging process thus protects against the totality of age-related diseases. However, this underlying aging process remains an abstraction. By contrast, what is demonstrable is that interventions in model organisms can improve late-life health and extend lifespan. Furthermore, a safe deduction is that treatments that extend lifespan do so by reducing age-related pathology, both florid and subtle. What is currently identifiable about aging (i.e. senescence) is that it is a very complex disease syndrome, likely involving a number of biological mechanisms. Treatments that substantially extend lifespan must suppress multiple pathologies that otherwise limit lifespan, but whether they suppress the entire aging process remains undemonstrated. A more pragmatic and realistic definition of anti-aging treatment is any preventative approach to reduce late-life pathology, based on the understanding that senescence is a disease syndrome. This definition would encompass preventative approaches aimed at both broad and narrow spectra of age-related pathologies. Its adoption would facilitate translation, since it would shift the emphasis to medical practice, particularly the introduction of preventative approaches. Narrow spectrum anti-aging treatments (e.g. the cardiovascular polypill) could establish a practice that eventually extends to broader spectrum anti-aging treatments (e.g. dietary restriction mimetics).