Why and How We Age, and Is That Process Modifiable?

Aging is an almost-universal biological process that is better understood in terms of an evolutionary explanation than in terms of a medical or adaptationist explanation. The major advances in human longevity which took place in developed countries during the past century arose from decreases in external (e.g., environmental) sources of mortality, and not from any effect on the aging process. Laboratory studies show that the aging process is under genetic control, can be manipulated, and can be expressed in three different phenotypes. The adult lifespan consists of the health span (ages 20-55 yrs) and the senescent span (ages 55+), with a relatively short but variable transition phase between the two. The most socially desirable phenotype would be that where the transition phase is delayed and the health span extended with little effect on the senescent span. The genetic, nutritional, cell-signaling and pharmecutical interventions inducing this phenotype are discussed. The genetic architecture of senescence is discussed and its stochastic nature made clear. The social and ethical consequences of pharmecutical intervention into the aging process are briefly discussed.