Translating Geroscience Into Clinical Practice: Molecular Targets, Emerging Therapies, and Lifestyle Strategies for Healthy Longevity

Population aging has intensified interest in interventions that preserve function and delay multiple chronic diseases by modifying the biology of aging.The field now spans molecular geroscience, experimental therapeutics, biomarker development, and preventive medicine, but the maturity of evidence varies substantially.This study aimed to synthesize foundational mechanisms, clinical and translational strategies, and lifestyle determinants relevant to healthy longevity, while distinguishing established practice from emerging or unproven interventions.A critical narrative review of PubMed/MEDLINE and reference lists was conducted from January 2000 through August 2026.Priority was given to consensus frameworks, human randomized trials, prospective cohorts, systematic reviews, and influential mechanistic studies.Evidence was interpreted according to study design, clinical relevance, reproducibility, and safety.The expanded 12hallmark framework depicts aging as an interconnected network involving genomic damage, impaired maintenance systems, maladaptive stress responses, inflammation, and dysbiosis.Senolytics, epigenetic reprogramming, nicotinamide adenine dinucleotide (NAD+) augmentation, mechanistic target of rapamycin (mTOR) inhibition, metformin, and spermidine are biologically plausible, but none yet has definitive evidence of extending lifespan in healthy humans.Epigenetic clocks are useful research biomarkers, although a lower clock estimate is not synonymous with rejuvenation or proven risk reduction.By contrast, cardiorespiratory fitness, muscle strength, dietary quality, restorative and regular sleep, avoidance of tobacco, management of cardiometabolic risk, and social connection are supported by much stronger human-outcome evidence.Responsible longevity medicine should integrate geroscience with rigorous preventive care, use biomarkers as adjuncts rather than diagnoses, and reserve experimental geroprotectors for well-designed trials.The near-term opportunity is not radical life extension, but compression of morbidity through scalable, equitable, and evidence-based preservation of health span.