Human longevity refers to the duration of human life, encompassing both the maximum potential lifespan and average life expectancy, which are influenced by a complex interplay of genetic, environmental, and lifestyle factors. The longest verified human lifespan is 122 years and 164 days, achieved by Jeanne Calment of France, who died in 1997, while the global average life expectancy reached approximately 73.4 years as of 2024, with variations by sex (around 71 years for males and 76 years for females) and region (up to 86 years in places like Monaco and Hong Kong).[1][2][3]Genetic factors account for about 25% of the variation in human longevity, as determined by twin studies, with specific genes such as APOE, FOXO3, and CETP associated with extended lifespan through roles in cell maintenance, DNA repair, and nutrient-sensing pathways like IGF-1 and TOR. Environmental and lifestyle elements play a dominant role in the remaining variation, including access to healthcare, nutrition, sanitation, and behaviors such as avoiding smoking, maintaining a healthy weight, and managing stress, which have enabled many centenarians (individuals aged 100 or older) to live independently while delaying chronic diseases like type 2 diabetes and cardiovascular conditions. First-degree relatives of centenarians often exhibit longer lifespans and later disease onset, underscoring a heritable component modulated by these non-genetic influences.[4][2]Over the past two centuries, human longevity has dramatically increased due to public health advancements, such as reductions in infant mortality, control of infectious diseases through vaccination and sanitation, and improvements in medical care, raising U.S. life expectancy from around 47 years in 1900 to 78.4 years as of 2023 (following a dip to 76.1 years in 2021 and rebound from 77.5 years in 2022, both influenced by the COVID-19 pandemic). These gains highlight how societal changes, including clean water access and reduced exposure to environmental hazards, have extended both lifespan and healthspan—the period of life spent in good health and functional independence—beyond genetic predispositions alone.[2][1][4][5]Contemporary research on human longevity emphasizes extending healthspan to maximize quality of life, with studies on supercentenarians (aged 110 or older) revealing potential protective mechanisms against age-related decline, though radical life extension beyond current limits remains implausible in the near term without breakthroughs in addressing fundamental aging processes. Efforts in this field, including epigenetic analyses and dietary interventions like calorie restriction or Mediterranean-style eating, continue to explore how lifestyle can activate longevity-promoting genetic pathways, offering hope for further societal benefits in productivity and reduced disease burden.[2][4]
Biological Foundations
Definition and Measurement
Human longevity refers to the duration of an individual's life, often emphasizing the potential to achieve an extended lifespan beyond the average for the species.[6] It is distinct from average lifespan, which represents the typical length of life in a population as measured by life expectancy, and from maximum lifespan, the theoretical upper limit observed in humans, estimated at around 115-125 years based on cellular constraints like the Hayflick limit.[7] The Hayflick limit describes the finite number of divisions (approximately 40-60) that normal human cells can undergo before entering senescence, linking cellular aging to organismal longevity limits.[8]Longevity is quantified primarily through demographic metrics derived from mortality data. Life expectancy at birth calculates the average number of years a newborn is expected to live, based on current age-specific death rates in a population. Conditional life expectancy extends this by estimating remaining years at a specific age, such as age 65, accounting for survival to that point and providing insights into later-life longevity.[9] Additionally, healthy life expectancy (HALE) measures the average years lived in full health, subtracting periods of disability or poor health from total life expectancy; globally, HALE at birth was 63.5 years as of 2019 World Health Organization estimates, though the COVID-19 pandemic temporarily reversed some gains in related metrics by 2020-2021.[10]Central to understanding longevity are distinctions between chronological age—the elapsed time since birth—and biological age, which reflects the physiological state and cumulative wear on the body.[11] Biological age can be assessed via biomarkers of aging, such as epigenetic clocks that analyze DNA methylation patterns to estimate aging rates across tissues. The Horvath clock, a prominent multi-tissue epigenetic predictor, correlates methylation at specific CpG sites with chronological age while revealing deviations indicative of accelerated or decelerated biological aging.[12]The systematic measurement of longevity evolved from early vital statistics in 17th-century Europe. In 1662, John Graunt published Natural and Political Observations Made upon the Bills of Mortality, analyzing London parish records of births and deaths to construct the first life table, estimating life expectancy and mortality patterns despite incomplete data.[13] This foundational work laid the groundwork for modern actuarial methods, transitioning from rudimentary tallies to probabilistic models of population longevity.[14]
Mechanisms of Aging
Aging is characterized by a progressive decline in physiological integrity, driven by interconnected biological processes at the molecular, cellular, and systemic levels. These mechanisms collectively contribute to the functional deterioration observed in human tissues and organs over time. Central to understanding human longevity is the framework of hallmarks of aging, which identifies key processes that manifest with age, accelerate aging when experimentally intensified, and can be mitigated to extend healthy lifespan.[15][16]The original nine hallmarks, proposed in 2013, encompass genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication. These represent common denominators of aging across organisms, with particular relevance to mammals, including humans. An updated framework in 2023 expanded this to twelve hallmarks by integrating disabled macroautophagy, chronic inflammation, and dysbiosis, while reorganizing others into primary (damage-causing), antagonistic (responses to damage), and integrative (culminating in organismal decline) categories. Each hallmark reflects a disruption that accumulates over decades, leading to impaired homeostasis and increased vulnerability to disease.[15][16]Telomere attrition exemplifies a primary hallmark, where the protective caps at chromosome ends progressively shorten, limiting cellular replication. Telomeres consist of repetitive TTAGGG sequences that prevent end-to-end chromosomal fusions and degradation of genetic material. During each cell division, DNA polymerase cannot fully replicate the lagging strand, resulting in a loss of approximately 50-200 base pairs per replication cycle. This shortening is counteracted in stem and germ cells by telomerase, a ribonucleoprotein enzyme that adds telomeric repeats using its RNA template. In most somatic cells, however, telomerase activity is minimal, enforcing a replicative limit known as the Hayflick limit—typically around 50 population doublings for human fibroblasts—beyond which cells enter senescence.[17][18]The oxidative stress theory posits that reactive oxygen species (ROS), generated primarily in mitochondria during aerobic respiration, inflict cumulative damage on cellular components, accelerating aging. Free radicals like superoxide and hydroxyl radicals react with DNA, lipids, and proteins, causing mutations, peroxidation, and misfolding that impair function. This theory, first articulated in 1956, links mitochondrial ROS production to the progressive accumulation of oxidative lesions, which correlates with age-related pathologies. While antioxidants mitigate some damage, the theory emphasizes an imbalance where ROS exceed cellular defenses, contributing to hallmark processes like genomic instability and mitochondrial dysfunction.[19][15]Chronic inflammation, termed "inflammaging," and immunosenescence represent integrative hallmarks that exacerbate age-related decline. Inflammaging refers to a persistent, low-grade systemic inflammation driven by elevated pro-inflammatory cytokines such as IL-6 and TNF-α, stemming from accumulated cellular damage and immune dysregulation. This creates a vicious cycle, promoting further tissueinjury and disease susceptibility. Immunosenescence involves the functional waning of adaptive immunity, including thymic involution, reduced T-cell diversity, and impaired responses to pathogens, while innate immunity becomes hyperactive. These processes, conceptualized in 2000 as evolutionary trade-offs for survival in early life, underlie the increased morbidity in older adults.[20][16]
Influencing Factors
Genetic Determinants
Human longevity is influenced by genetic factors, with twin studies estimating that heritability accounts for approximately 50% of variation in lifespan, as revised by a 2025 meta-analysis accounting for confounding factors like assortative mating.[21] This estimate arises from comparisons of monozygotic and dizygotic twins, where shared genetics explain a significant portion of differences in age at death.[22] In the Framingham Heart Study, heritability appears to increase with attained age, reaching higher levels among individuals surviving to 85 years or older, suggesting that genetic factors become more prominent in exceptional longevity.[23]Several key genes and pathways have been identified as contributors to longevity through genome-wide association studies (GWAS) and candidate gene analyses. The FOXO3 gene, encoding a transcription factor involved in stress resistance and metabolism, harbors variants strongly associated with exceptional lifespan; for instance, specific single nucleotide polymorphisms (SNPs) in FOXO3 are enriched in centenarians across diverse populations, including Japanese and German cohorts.[24] Conversely, the APOE ε4 allele, a variant of the apolipoprotein Egene, is linked to reduced lifespan due to its role in increasing susceptibility to Alzheimer's disease and cardiovascular issues.[25] The insulin-like growth factor 1 (IGF-1) signaling pathway also modulates longevity, where reduced activity—often through genetic variations—promotes extended lifespan by enhancing cellular stress resistance and delaying age-related decline, as observed in human cohorts with lower IGF-1 levels.[26] Sirtuins, particularly SIRT1, contribute via their NAD+-dependent deacetylase activity, which supports DNA repair and genomic stability; overexpression or activation of SIRT1 has been tied to lifespan extension in model organisms and correlates with human longevity traits.[27]Genome-wide association studies have advanced understanding by identifying polygenic risk scores (PRS) for longevity, aggregating the effects of multiple SNPs. A 2019 meta-analysis of GWAS data from over 2.1 million individuals pinpointed 12 genetic loci associated with parental lifespan, explaining about 7% of variation and highlighting pathways like lipid metabolism and inflammation.[22] In Ashkenazi Jewish centenarians, studies from around 2019 and later have shown that PRS for longevity often reflect lower genetic risk for age-related diseases, such as Alzheimer's, with rare protective variants in genes like IGF1R enriched in this group.[28] Recent 2025 GWAS have further identified rare coding variants and novel loci, such as in the HLA-DRB1 immune-related region, associated with survival beyond 90-100 years, emphasizing polygenic and immunogenetic contributions to extreme longevity.[29][30] These scores underscore the polygenic nature of longevity, where small effects from numerous variants cumulatively influence survival to extreme ages.Epigenetic mechanisms, particularly DNA methylation patterns, enable transgenerational inheritance of longevity traits by transmitting environmental influences across generations without altering the DNA sequence. In humans, specific methylation marks at longevity-associated loci have been observed in offspring of long-lived parents, suggesting heritable epigenetic modifications that enhance resilience to aging stressors like oxidative damage.[31] These patterns interact briefly with core aging mechanisms, such as modulating telomere attrition through gene regulation.[32] However, evidence for stable transgenerational effects in humans remains emerging and context-dependent.
Environmental and Lifestyle Influences
Lifestyle factors play a significant role in modulating human longevity, with behaviors such as smoking, physical inactivity, and poor sleep patterns exerting detrimental effects. Smoking is a leading modifiable risk factor, reducing life expectancy by approximately 10 years on average compared to non-smokers, according to data from the Centers for Disease Control and Prevention (CDC).[33] Regular physical activity, particularly meeting the guideline of 150 minutes per week of moderate-intensity exercise, is associated with a 3- to 7-year extension in life expectancy, as evidenced by dose-response meta-analyses of prospective cohort studies.[34] Optimal sleep duration of 7 to 9 hours per night supports telomere maintenance, a marker of cellular aging, while chronic sleep deprivation shorter than 7 hours is linked to accelerated telomere shortening and increased mortality risk.[35]Dietary patterns also substantially influence longevity outcomes through their impact on chronic disease risk. Adherence to the Mediterranean diet, characterized by high intake of fruits, vegetables, whole grains, and healthy fats, has been shown to reduce all-cause mortality by 23% in large cohort studies, building on findings from the PREDIMED randomized trial that demonstrated cardiovascular event reductions.[36] Caloric restriction without malnutrition, typically involving a 20-30% reduction in energy intake, extends lifespan in animal models and slows the pace of biological aging in humans, as measured by DNA methylation clocks in the CALERIE trial.[37]Environmental exposures further shape longevity disparities. Fine particulate matter (PM2.5) air pollution is estimated to reduce global average life expectancy by about 1 year and 8 months as of 2023 data, with higher impacts in polluted regions, per analyses from the Health Effects Institute and WHO data.[38] Higher socioeconomic status (SES) correlates with a 5- to 10-year gain in life expectancy compared to lower SES groups, driven by differences in living conditions, education, and resources, as documented in U.S. longitudinal studies.[39] Access to healthcare amplifies these effects, with restricted access accounting for up to 10% of premature deaths and reducing life expectancy, particularly through unaddressed preventable conditions.[40]Strong social connections emerge as a protective factor against mortality, independent of other risks. A seminal 2010 meta-analysis by Holt-Lunstad et al., synthesizing data from 148 studies involving over 300,000 participants, found that individuals with robust social relationships have a 50% greater likelihood of survival compared to those with weak or insufficient connections.[41] These environmental and lifestyle influences often interact with genetic predispositions to determine overall longevity trajectories.
Historical and Demographic Trends
Evolution of Human Lifespan
In prehistoric times, human life expectancy at birth was estimated to be around 30-35 years, primarily due to high rates of infant and child mortality from disease, injury, and environmental hazards.[42] Skeletal evidence from Neanderthal remains, such as those analyzed from sites in Europe dating back 40,000-400,000 years, indicates that few individuals survived beyond age 40, with the largest proportion of deaths occurring in early adulthood (ages 20-40).[43] This pattern persisted into early modern human populations, where archaeological data from Paleolithic and Neolithic sites similarly show average lifespans limited by infectious diseases and predation, though those who reached adulthood often lived into their 50s or 60s.[44]During ancient civilizations, such as in Bronze Age societies (3300-1200 BCE) and classical Greece and Rome (510-330 BCE), average life expectancy remained low at 20-38 years, again skewed by infant mortality rates exceeding 30% and prevalent epidemics.[45] Regional differences emerged early; for instance, in pre-Columbian Mesoamerica, estimates ranged from 24-32 years based on burial records, reflecting similar challenges from malnutrition and conflict.[46] In Europe, by the 18th century, more reliable records from Sweden—established through the Tabellverket system—reveal life expectancy at birth around 35 years in 1750, with women averaging 36.6 years and men 33.7 years, still hampered by famines and poor sanitation but slightly higher than in contemporaneous non-European regions like parts of Asia and Africa, where data suggest 25-30 years due to tropical diseases and lower agricultural stability.[47][48]The 19th and 20th centuries marked a profound shift, driven by public health advancements like improved sanitation, clean water systems, and vaccination programs, which dramatically reduced infectious disease mortality.[49] In the United States, for example, these measures contributed to a 25-year increase in life expectancy from 1900 to 1999, with infectious disease control alone accounting for nearly 29 years of gains by curbing infant and child deaths.[50] Globally, life expectancy rose from approximately 31 years in 1900 to 48 years by 1950, according to United Nations estimates, fueled by widespread smallpox vaccination campaigns that eradicated the disease by 1980 and effectively doubled life expectancy in many developing nations by preventing millions of child deaths.[51] However, this progress was uneven and interrupted by events like the 1918 influenza pandemic, which temporarily reduced global life expectancy by 10-20 years through excess mortality, particularly among young adults, dropping U.S. figures by up to 12 years in a single year.[52][53] Wars, such as World War I and II, similarly caused regional setbacks, with Europe's life expectancy stagnating or declining in affected areas due to combat losses and disrupted healthcare.[54]
Current Global Patterns
As of 2024, global life expectancy at birth stands at 73.3 years, reflecting a partial rebound from pandemic-related setbacks, with projections estimating an increase to 77.0 years by 2050 according to United Nations data.[55][56] This average masks significant regional variations; for instance, Japan records the highest life expectancy at 84.0 years, driven by advanced healthcare systems and dietary factors, while Chad has one of the lowest at 55.1 years, attributable to challenges like infectious diseases and limited medical access.[57][58] These disparities highlight how socioeconomic development and public health infrastructure profoundly influence longevity across continents.Gender differences persist globally, with women outliving men by approximately 5 years on average, a gap rooted in biological factors such as hormonal protections and behavioral patterns like lower rates of risky behaviors among women.[59] The COVID-19 pandemic exacerbated vulnerabilities, causing a sharp decline in global life expectancy by 1.8 years between 2019 and 2021 due to excess mortality, particularly affecting men and lower-income regions; by 2023, recovery had restored levels to pre-pandemic trends in many areas, though some countries in sub-Saharan Africa and Latin America continue to lag.[60]Socioeconomic inequalities further widen these patterns, as evidenced by correlations between income disparity—measured by the Gini coefficient—and reduced lifespan; for example, a 1% increase in the Gini coefficient is associated with a 0.17-year decrease in female life expectancy, potentially shortening lives by 2-4 years in high-inequality settings.[61] Urban-rural divides compound this, with urban populations generally enjoying 2-5 years higher life expectancy than rural counterparts worldwide, owing to better access to healthcare, nutrition, and sanitation, though rapid urbanization in developing regions is narrowing this gap in some contexts.[62]
Exceptional Cases and Comparisons
Verified Supercentenarians
Supercentenarians are individuals verified to have lived to 110 years or older, with the Gerontology Research Group (GRG) serving as the primary authority for such validations through rigorous documentation review.[63] The current record for the longest verified human lifespan is held by Jeanne Calment of France, who lived from 1875 to 1997, reaching 122 years and 164 days.[64] Her age was confirmed by the GRG using multiple primary sources, including birth and baptismal records, census data, and marriage certificates, establishing her as the benchmark for extreme human longevity.[64]Among recent verified supercentenarians, Lucile Randon of France achieved 118 years before her death in 2023, validated by the GRG with contemporaneous documents spanning her lifetime.[64] Inah Canabarro Lucas of Brazil, born on June 8, 1908, reached 116 years and 326 days before passing on April 30, 2025, her age confirmed through Brazilian civil registries and international records.[64] As of November 17, 2025, Ethel Caterham of the United Kingdom, born August 21, 1909, holds the title of the oldest living verified person at 116 years and 88 days, supported by UK birth and census documentation.[64] These cases illustrate the rarity of reaching such ages, with only a handful validated annually by the GRG.[65]The GRG employs strict validation criteria to ensure authenticity, requiring at least three independent primary documents—such as birth certificates, early-life censuses, or sibling records—that align without discrepancies, particularly for claims over 110 years to counter potential fraud or errors in historical records.[66] This process, developed since the 1980s, rejects claims lacking contemporaneous evidence from the first 20 years of life, with fewer than one-third of submitted cases meeting the standards.[67] Validation often involves international collaboration to access archives, emphasizing metrics like mortality rates at extreme ages derived from verified cases.[68]Demographically, verified supercentenarians are overwhelmingly female, comprising approximately 89% of the 234 living cases tracked by the GRG as of November 2025, a pattern attributed to biological resilience rather than reporting biases.[69] Certain ancestries show higher representation, such as those from Okinawa, Japan, where verified supercentenarians like the late Tomiko Itooka (1908–2024, reached 116 years) reflect regional longevity clusters validated through Japanese koseki family registers.[70] Similarly, Sardinia, Italy, has produced verified cases like Alfonsina Serra (1904–2016, 111 years), confirmed via Italian civil records, highlighting genetic and environmental factors in these populations.[64] Such outliers may involve genetic determinants, as explored in related sections on hereditary influences.[68]
Comparisons with Other Species
Human longevity, with a verified maximum lifespan of 122 years achieved by Jeanne Calment, is moderate when compared to other species.[71] Among mammals, the bowhead whale (Balaena mysticetus) holds the record for the longest lifespan, exceeding 211 years, attributed to enhanced DNA repair mechanisms and low metabolic rates that mitigate age-related damage.[72] In contrast, the naked mole rat (Heterocephalus glaber), a small rodent, reaches up to 32 years while exhibiting negligible senescence, meaning it shows no significant increase in mortality or decline in reproductive capacity with age, due to robust cellular maintenance and cancer resistance.[73] Reptiles like the Galápagos tortoise (Chelonoidis niger) demonstrate exceptional longevity, with lifespans up to 190 years, supported by slow metabolism and efficient antioxidant defenses.[74]Evolutionary theories explain these variations through trade-offs in resource allocation. The disposable soma theory, proposed by Thomas Kirkwood in 1977, posits that organisms prioritize energy toward growth and reproduction over somatic maintenance, leading to accumulated damage and aging; this trade-off results in shorter lifespans in species with high reproductive investment. Humans are unique among mammals in possessing a prolonged post-reproductive lifespan, often spanning decades after menopause around age 50, which may have evolved to enhance kin survival through grandmaternal care rather than direct reproduction.[75]In mammals, lifespan often scales allometrically with body mass, following the relationship where maximum lifespan is roughly proportional to body mass raised to the power of 0.2, reflecting slower metabolic rates in larger species that reduce oxidative damage accumulation.[76] This scaling explains why larger mammals like whales outlive smaller ones like mice, though exceptions such as the naked mole rat highlight additional genetic factors overriding size constraints.Model organisms provide insights into longevity mechanisms conserved across species. The nematode Caenorhabditis elegans has a wild-type lifespan of 2-3 weeks, but mutations in the daf-2 gene, which encodes an insulin-like receptor, can double this to over 4 weeks by activating stress resistance pathways.[77] Laboratory mice (Mus musculus) typically live 2-3 years under standard conditions, serving as a mammalian model where genetic manipulations reveal parallels to human aging processes.[78]
Interventions and Extensions
Dietary and Behavioral Strategies
Dietary and behavioral strategies play a pivotal role in promoting human longevity by influencing metabolic health, cellular repair, and overall well-being through accessible daily practices. These approaches, grounded in epidemiological and clinical evidence, emphasize sustainable habits rather than extreme measures, often drawing from observational studies of long-lived populations and controlled trials demonstrating physiological benefits.Intermittent fasting, such as the 16:8 method (eating within an 8-hour window) or alternate-day fasting, has been linked to autophagy activation, a cellular process that clears damaged components and supports longevity. In rodents, these regimens extend lifespan by 11% to 80%, depending on the protocol and initiation age, with alternate-day fasting showing up to 80% increases in rats starting at 5 weeks of age.[79]Human trials indicate metabolic improvements, including greater weight loss (6.3 kg vs. 4.0 kg over 14 weeks) and reduced diastolic blood pressure (by 4 mm Hg) with early time-restricted eating compared to longer eating windows, alongside enhanced mood.[80]Regular exercise regimens, combining aerobic and resistance training, significantly mitigate age-related decline and reduce mortality risk. Aerobic activities meeting guidelines of at least 150 minutes per week (approximately 30 minutes per day) are associated with a 29% lower all-cause mortality risk in adults.[81] Resistance training preserves muscle mass and prevents sarcopenia, with moderate-to-high intensity programs (60-85% of one-repetition maximum, 8-15 repetitions, 2-3 sets, over 12 weeks) increasing lean body mass by 0.84 kg and improving strength metrics like leg extension by 43% in older adults.[82]Insights from Blue Zones—regions like Okinawa and Sardinia with exceptionally high centenarian rates, up to five times the global average—highlight integrated habits for longevity. Okinawans follow a plant-based diet emphasizing beans and soy, practice the "hara hachi bu" rule (eating until 80% full), and cultivate ikigai (a sense of purpose) that adds up to seven years to life expectancy; Sardinians incorporate moderate Cannonau wine consumption (1-2 glasses daily with meals) and strong social bonds through family and faith communities, which contribute 4-14 additional years.[83]Stress management via mindfulness meditation, such as 8-week Mindfulness-Based Stress Reduction (MBSR) programs, reduces cortisol levels and supports telomere maintenance, markers of cellular aging. Meta-analyses confirm meditation interventions lower cortisol in at-risk samples, with effects more pronounced in high-stress groups.[84] These programs increase telomerase activity (up to 43% in some cohorts) and preserve telomere length, preventing declines observed in controls, thereby potentially extending healthspan.[85]
Pharmacological and Medical Approaches
Pharmacological and medical approaches to human longevity focus on interventions that modulate key aging pathways, such as nutrient sensing and cellular senescence, through clinically tested drugs and therapies. These strategies aim to delay age-related diseases rather than treat them directly, drawing from preclinical evidence in model organisms and emerging human trials. While many remain off-label or investigational, they represent promising avenues for extending healthspan by targeting molecular mechanisms like AMPK activation and mTOR inhibition. Recent 2025 reviews highlight that while rapamycin shows immune and cardiovascular benefits in short-term human trials, evidence for direct longevity extension in healthy adults remains limited and unproven in large cohorts.[86][87]Metformin, a widely used antidiabetic drug, is explored off-label for its potential anti-aging effects by activating AMP-activated protein kinase (AMPK), which regulates cellular energy homeostasis and reduces inflammation.[88] Preclinical studies in worms, mice, and nonhuman primates demonstrate that metformin slows aging biomarkers, including epigenetic clocks, and extends lifespan in these models. A 2024 study (published early 2025) showed metformin's geroprotective effects in nonhuman male primates by decelerating aging clocks.[89] In humans, the proposed Targeting Aging with Metformin (TAME) trial plans a six-year study involving approximately 3,000 elderly participants across 14 U.S. institutions to evaluate metformin's ability to delay multiple age-related conditions like cancer, dementia, and heart disease as a primary aging intervention.[90] As of 2025, the trial is in the planning and fundraising stage, with recruitment anticipated but not yet initiated. Preclinical and smaller human studies suggest potential benefits of metformin in enhancing resilience against age-related decline without significant adverse effects in nondiabetic populations.[91]Rapamycin, an inhibitor of the mechanistic target of rapamycin (mTOR) pathway, has shown robust lifespan extension in preclinical models by promoting autophagy and reducing protein synthesis excesses associated with aging. A seminal 2009 study in genetically heterogeneous mice reported that rapamycin, administered late in life (starting at 600 days of age), extended median lifespan by 9% in males and 14% in females, with maximal lifespan increases up to 23% across sexes and sites.[92] These effects were independent of caloric restriction and persisted even when treatment began after mid-life, highlighting mTOR's role in late-stage interventions. In human applications, low-dose rapamycin is under investigation for improving immune function in older adults, with clinical trials demonstrating enhanced vaccine responses and reduced immunosenescence markers, such as improved T-cell proliferation.[93] As of 2025, short-term trials confirm benefits in adaptive immunity without major immunosuppression risks at intermittent dosing, though long-term longevity outcomes remain unproven in large cohorts.[87]Senolytics, drugs that selectively eliminate senescent cells to alleviate their secretory phenotype and tissue dysfunction, include the combination of dasatinib (a tyrosine kinase inhibitor) and quercetin (a flavonoid). This regimen clears senescent cells in preclinical models, reducing inflammation and improving tissue function. In human trials, dasatinib plus quercetin has decreased senescent cell burden in adipose tissue and skin, correlating with improved physical function in small cohorts of older adults with frailty or chronic conditions. UNITY Biotechnology's clinical programs, such as the 2025 Phase 2b ASPIRE trial of UBX1325 for diabetic macular edema, reported improvements in visual acuity (e.g., 5.6-letter gains versus sham), though it missed non-inferiority to standard treatments in some endpoints. Earlier general senolytic trials (e.g., dasatinib plus quercetin) have shown reductions in senescent cell burden and improvements in physical function in frail older adults, but larger phase III studies are needed to confirm systemic benefits for conditions like age-related macular degeneration or diabetic kidney disease.[94] These intermittent treatments (e.g., 3 days per month) show a favorable safety profile, with transient side effects like nausea, positioning senolytics as a targeted approach to mitigate multimorbidity in aging.[95]Hormone therapies targeting growth hormone (GH) signaling, such as peptide analogs, aim to counteract age-related hormonal imbalances that accelerate cellular aging. Epitalon, a synthetic tetrapeptide mimicking pineal gland factors, acts as a GH regulator and extends telomeres in animal models by activating telomerase, the enzyme that maintains chromosomal ends. Studies in mice and rats demonstrate that epitalon increases telomere length, reduces chromosomal aberrations, and prolongs lifespan by 10-20% without tumorigenic risks, effects linked to enhanced DNA repair and reduced oxidative stress.[96]In vitro and rodent models further show epitalon's role in antagonizing excessive GH/IGF-1 signaling, which promotes senescence, thereby supporting tissue regeneration and immune modulation. While human data are limited to observational pineal peptide studies, epitalon's mechanism suggests potential for adjunctive use in age-related telomere attrition, pending rigorous clinical validation.[97]
Future Prospects and Challenges
Emerging Research Directions
Recent advancements in gene editing have targeted aging-related genetic pathways using CRISPR-Cas9 technology, with promising results in preclinical models. In 2024, researchers developed high-throughput CRISPR-Cas9 screening platforms to identify gene knockouts that enhance neural stem cell activation in aged mice, revealing regulators of aging such as those influencing NSC proliferation and differentiation.[98] A February 2025 study employed a whole-genome, multiparametric CRISPR screen to pinpoint 43 genes that rescue cellular phenotypes associated with progeria, including nuclear abnormalities and premature senescence in human fibroblasts and mouse models.[99] These efforts build on earlier work, such as adenine base editing in 2025 mouse studies that reduced progerin expression, improving body weight, bone density, and lifespan in progeria models by up to 25%.[100]Stem cell therapies leveraging induced pluripotent stem cells (iPSCs) represent a frontier in tissue regeneration for longevity, focusing on partial cellular reprogramming to restore youthful function without full dedifferentiation. Altos Labs, founded in 2022, has advanced Yamanaka factor-based reprogramming since 2023, demonstrating in mouse models the extension of lifespan and reversal of age-related decline in tissues like muscle and brain.[101] Following the appointment of Joan Mannick as chief medical officer in August 2025, the company is preparing for early human trials of cellular rejuvenation programs targeting mesenchymal drift and chromatinreprogramming to combat age-associated diseases, with preclinical data showing improved cell resilience and reduced senescence markers.[102] These efforts aim to translate iPSC-derived therapies into clinical applications for systemic rejuvenation.Artificial intelligence and big data analytics are accelerating longevity research by predicting biological age and designing targeted interventions. Insilico Medicine's generative AI platform, Pharma.AI, has enabled the discovery of novel antifibrotic drugs, including a TNIK inhibitor for idiopathic pulmonary fibrosis (IPF) that advanced to Phase II trials by June 2025, demonstrating safety and efficacy in reducing lung fibrosis progression.[103] In August 2025, their AI-driven aging clock model achieved high accuracy in biological age prediction (R² = 0.84, mean absolute error = 2.68 years) across human datasets, linking accelerated aging to fibrotic diseases.[104] A September 2025 analysis further uncovered connections between IPF severity and biological age acceleration using multi-task neural networks, informing AI-optimized drug candidates that target aging pathways like inflammation and extracellular matrix remodeling.[105]Xenotransplantation, particularly pig-to-human organ transplants using gene-edited organs, offers potential to extend life in patients with end-stage organ failure, addressing a critical barrier to longevity. In September 2025, the FDA approved clinical trials by eGenesis for genetically modified pig kidney transplants in up to 50 dialysis patients aged 50 and older, with edits eliminating porcine endogenous retroviruses and enhancing compatibility to prevent rejection.[106] Early 2025 trials at Massachusetts General Hospital demonstrated successful implantation of gene-edited pig kidneys in living recipients, sustaining function for weeks and averting immediate dialysis needs, thus prolonging survival in terminal cases.[107] These developments, including a November 2025 trial initiation at NYU Langone for kidney transplants—as of November 17, 2025, with the first surgery performed on November 5—highlight xenotransplantation's role in bridging organ shortages and supporting extended healthy lifespans.[108]
Societal and Ethical Dimensions
Pursuing extended human longevity raises significant economic challenges, particularly the escalation of healthcare costs associated with aging populations. The global population aged 60 and older is projected to double to 2.1 billion by 2050, intensifying demands on health systems worldwide.[109] This demographic shift is expected to drive substantial increases in healthcare expenditures, largely due to age-related diseases and long-term care needs. However, longevity could also yield economic benefits by extending productive working lives; reducing the incidence of major chronic diseases could enhance GDP through improved labor participation and productivity.[110]Concerns about overpopulation are amplified by advances in longevity, as reduced mortality rates contribute to sustained population growth and heightened resource pressures. United Nations projections indicate the world population will peak at around 10.4 billion by the mid-2080s before stabilizing, with longevity potentially prolonging this trajectory by delaying natural declines in birth rates relative to death rates.[111] Extended lifespans could exacerbate strains on finite resources such as water, food, and energy, as larger cohorts of older individuals increase consumption demands without corresponding reductions in environmental impact.[112] This dynamic risks widening inequalities in resource distribution, particularly in low-income regions where demographic trends already challenge sustainable development.[113]Ethical issues surrounding longevity interventions center on equity in access, with anti-aging technologies often prioritizing affluent populations. Billionaire-funded initiatives, such as Alphabet's Calico Labs established in 2013, have drawn critiques for focusing resources on high-cost research that may benefit only the wealthy, sidelining broader public health priorities like infectious diseases.[114] These concerns underscore the need for equitable distribution of any breakthroughs, echoing transhumanist philosopher Nick Bostrom's call for technologies that enhance healthspan without restricting benefits to elites.Debates on quality versus quantity of life emphasize extending healthspan over mere lifespan to prevent prolonged frailty. Philosopher Nick Bostrom argues that true longevity progress should increase healthy years, avoiding "zombie-like senility" where individuals endure extended periods of dependency without vitality.[115] This perspective aligns with broader ethical discussions, prioritizing interventions that maintain cognitive and physical function to ensure extended life enhances human flourishing rather than merely postponing death.[116] Such arguments highlight the moral imperative to focus on comprehensive well-being amid demographic shifts toward longer lives.[117]