For centuries, people have searched for ways to live longer and stay healthier as they age. From wrinkle creams and wellness trends to strict diets and rigorous exercise regimens, much of that effort has focused on preserving youth or delaying the visible signs of aging.
Today, scientists are focused on a different question: Can the biological processes of aging be slowed to help prevent the chronic diseases associated with growing older?
Alberto Aparicio, PhD, assistant professor in the Department of Bioethics and Health Humanities at The University of Texas Medical Branch (UTMB), studies the ethical and societal implications of longevity.
Alan Landay, PhD, is vice president of Team Science in the Division of Geriatrics and professor of Internal Medicine and Microbiology and Immunology at UTMB. He studies geroscience, an emerging field that seeks to prevent disease by targeting the biology of aging.
Together, their work represents a growing shift in medicine from treating the diseases of aging to understanding aging itself, and what it means to intervene in that process.
The pursuit of longer, healthier lives
“Humans have always searched for ways to slow or defeat aging,” Aparicio said. “We have heard myths about eternal youth, and we know about modern research involving calorie restriction, cellular regeneration, and genetics. Scientists have long wondered whether aging itself can be controlled.”
As a bioethicist, Aparicio is less interested in whether people can live longer than in what longer lives would mean for individuals and society.
“Discussions about longevity almost always center on the body, but research shows that when people say they want to live longer, they mean they want to remain healthy, mentally sharp, socially connected, independent, and purposeful,” Aparicio said. “Living longer has little appeal if those things are lost.”
He said today’s longevity industry, which includes medical research, biotechnology companies, nutrition and supplement manufacturers, and the fitness industry, often capitalizes on people’s fear of aging and death while paying less attention to the social factors that contribute to healthy aging.
“The question I am asking is: What do scientific advances mean for society?” he said. “Is medicine for treating disease, preventing disease, or extending life? And who will benefit from the longevity technologies that are being researched?”
Targeting the biology of aging
As research in geroscience advances, the ethical questions Aparicio raises become increasingly relevant. Rather than treating diseases after they develop, the field seeks to prevent them by targeting the biology of aging.
“In geroscience, we ask whether scientists can slow or modify the biological processes of aging that contribute to many chronic diseases in the first place,” Landay said. “The goal is to extend healthspan, the years people remain healthy and independent, rather than simply extending lifespan.”
Researchers say aging is driven by multiple interconnected biological processes, often called the “pillars” or “hallmarks” of aging.
“Examples include chronic inflammation, epigenetic changes, changes in the gut microbiome, and mitochondrial dysfunction,” Landay said. “We are studying whether targeting one or more of these processes can slow biological aging and delay multiple diseases at once.”
Rather than waiting for someone to develop Alzheimer’s disease or another chronic illness, researchers hope to intervene much earlier, preventing disease instead of treating damage that has already occurred.
Healthy aging begins sooner that you think
“Although researchers are studying medications and therapies that target the biology of aging, lifestyle remains one of the strongest interventions,” Landay said. “That includes regular physical activity, a healthy diet, quality sleep, social connections, and attention to mental health.”
Changing those habits is often harder than developing new drugs, he said, but they remain essential to healthy aging and extending healthspan.
“It’s important to remember that aging does not begin at retirement,” Landay said. “It occurs throughout life, even before birth. Nutrition, environmental exposures, and other factors early in life may influence how people age decades later.”
Social connection is another critical component of healthy aging, he said. A person who exercises regularly and eats well but lacks meaningful relationships may still face health challenges as they age.
Landay and his colleagues are also studying the gut microbiome, which researchers believe may influence aging by affecting inflammation, immune function, gut barrier integrity, and metabolism.
“We are studying whether blood markers might eventually provide a way to assess the health of a person’s microbiome without directly sampling the intestine,” he said.
The questions that go beyond the science
As scientists continue exploring therapies that could slow biological aging, Aparicio believes those advances must be matched by conversations about access, affordability, and the purpose of medicine.
Both researchers believe questions about who will benefit from longevity interventions, whether they will be affordable, and how they could affect health equity should be considered alongside the scientific advances themselves.
Whether those advances come through new therapies, lifestyle interventions, or a deeper understanding of aging, Aparicio and Landay agree that extending life is only part of the equation. The larger challenge will be ensuring those additional years are healthy, meaningful, and accessible to everyone.
“Rather than simply living beyond 100 years, I’d like to imagine a future where people can remain active, independent, mentally sharp, and free of chronic disease at that age,” Landay said. “The goal isn’t just to have a longer life. It’s to have a healthier life.”