Engineering healthy aging: A review of biomedical platforms for mechanistic intervention in geriatric decline

The accelerating demographic shift toward an older global population presents profound challenges to healthcare systems worldwide, primarily through a surge in chronic, degenerative, and comorbid conditions. In this context, traditional therapeutic approaches often prove inadequate for addressing the multifactorial biological deterioration inherent to the aging process. Biomedical engineering (BME) has emerged as a pivotal interdisciplinary frontier, offering mechanistically driven, integrative strategies to counteract age-related decline. This review provides a comprehensive overview of recent progress across four critical BME domains: smart wearable devices, intelligent prosthetic systems, regenerative technologies, and advanced diagnostic imaging. Rather than providing a mere technological inventory, the discussion emphasizes how these platforms actively engage with fundamental hallmarks of aging, including cellular senescence, stem cell dysfunction, immune decline, and tissue microenvironmental imbalance. Additionally, this review elucidates the multiscale mechanisms through which BME solutions exert therapeutic effects, ranging from real-time physiological monitoring to targeted molecular interventions. Furthermore, the analysis considers the clinical translatability of these innovations, addressing technical, regulatory, and ethical barriers that shape their path to implementation. The article concludes by outlining future directions and highlighting the importance of interdisciplinary collaboration in accelerating the translation of BME-based strategies toward a future of healthy and functional longevity.