Rethinking how medicine can approach aging

A review published in the journal JAMA highlights innovative strategies to slow the biological aging process, an emerging approach with significant potential to prevent or delay multiple chronic diseases at once, one of the most pressing challenges in modern medicine today.

The review, co-authored by Steven R. Cummings, M.D., a senior physician-scientist at Sutter Health’s Sequoia Center for the Science of Aging, and led by Stephen B. Kritchevsky, Ph.D., of Wake Forest University School of Medicine, calls for a shift in medical thinking from treating one disease at a time, such as heart disease, cancer or kidney disease, to targeting the biology of aging itself. This approach, known as geroscience, aims to extend “healthspan,” the number of years people live free from disease and disability.

Using geroscience to predict care outcomes

“By 2050, the number of U.S. adults over age 65 will grow by more than 30 million,” says Dr. Cummings. “If we continue treating one disease at a time, the U.S. health system will be overwhelmed. A geroscience approach could help people live longer, healthier lives by delaying or preventing multiple conditions at once.”

Geroscience focuses on a person’s biological age, measured by biological properties such as epigenetics, instead of one’s calendar age. Dr. Cummings and other scientists at Sutter’s San Francisco Coordinating Center (SFCC), led by Brian Chen, Ph.D., are testing geroscience principles in the care of Sutter patients. They are working to determine whether biological age, derived from fundamental pathways of aging, better predicts medical outcomes including hospitalization over one’s calendar age.

Testing existing, approved therapies to preserve health with aging

The review describes several promising therapies currently being studied, including metformin, a decades-old diabetes drug that may slow multiple aging-related processes; GLP-1 receptor agonists such as semaglutide, used for diabetes and obesity, which may mimic the effects of calorie restriction linked to longer life; and senolytics, a class of drugs that selectively clear senescent “zombie” cells that contribute to chronic inflammation and tissue damage.

While none of these therapies are yet U.S. FDA-approved to directly target aging, the authors note clinical trials are underway and could pave the way for new standards of care that preserve overall function and independence.

“Our research at the SFCC is studying pathways that can be modulated to potentially slow aging and promote a healthy lifespan for patients at Sutter and around the world,” says Dr. Cummings.