August 14, 2024

12 Hallmarks of Aging and What You Can Do to Slow the Aging Process

Written By

Perry Santanachote

Medically Reviewed By

Kimberly Hartzfeld, DO

Lifeforce Physician

Aging is a universal journey we all embark on, whether we like it or not. And while aging may be inevitable, we now have the agency to choose whether or not we surrender to the passage of time. 

As scientists continue to explore how aging impacts our bodies and why we become more susceptible to various conditions as we grow older, their research has uncovered 12 key signs of aging that take place during this natural process — and how we can meet them on our own terms.

Understanding the hallmarks of aging can provide valuable insights into how we can potentially mitigate its effects. “The good news is that modifiable factors such as diet and lifestyle changes can improve the hallmarks of aging,” says Christina Kang, Certified Nutrition Specialist, and Lifeforce Health Coach and Senior Program Manager. “Increasing the hallmark accelerates aging, and decreasing it slows it. Some would say even to the point of reversing aging, although this is hotly debated.”

Here, Kang explains the 12 hallmarks of aging, examining the biological and lifestyle factors that contribute to these changes, and shares expert tips to help you stay vital and healthy. While you can’t turn back the clock, you can get time on your side by taking charge of how you age. 

Primary Hallmarks

Primary hallmarks reflect cellular damages that progressively accumulate over time and unambiguously contribute to aging. 

1. Genomic Instability

As we age, our DNA becomes more prone to damage from various factors like UV radiation, toxins, and processed foods. This accumulation of genetic damage can disrupt normal cellular functions, contribute to age-related diseases like organ dysfunction, and increase the risk of cancer by promoting mutations. Research has shown that environmental toxins like heavy metals and air pollution can also lead to genomic instability.

2. Telomere Attrition

Telomeres are protective caps at the ends of chromosomes necessary for cell division. They shorten with each division, eventually becoming so short that cells lose their ability to divide and function properly. Roughly 30 billion cells turnover daily, so cell division is critically important. By limiting the capacity for cells to regenerate, telomere attrition contributes to aging and related diseases.

3. Epigenetic Alterations

Gene expression changes that don't involve DNA sequence modifications are called epigenetic alterations. They are controlled by the epigenome, which consists of chemical compounds and proteins that can turn genes on or off in cells. These modifications influence cellular function and are implicated in health issues like metabolic disorders and inflammation. However, various lifestyle factors within your control can significantly influence them.

4. Loss of Proteostasis

Proteostasis is about maintaining properly folded and functional proteins while removing damaged ones. As we age, this process becomes less efficient, accumulating damaged proteins that can disrupt cellular functions and contribute to various age-related diseases, including neurodegenerative disorders, cancer, and cardiovascular diseases.

5. Disabled Macroautophagy

Macroautophagy, or autophagy, is a crucial cellular process for eliminating and recycling cellular waste. When macroautophagy is impaired due to age and environmental stressors, cells may accumulate toxic cellular debris that can lead to cellular dysfunctions, including neurodegenerative disorders, metabolic diseases, and certain cancers.

What You Can Do to Improve Primary Hallmarks of AgingWhat You Can Do to Improve Primary Hallmarks of Aging

A multifaceted approach is key to improving these primary hallmarks and preventing age-related diseases. In a clinical study of Alzheimer’s disease, researchers found that simultaneous lifestyle changes — nutrition, physical exercise, sleep, stress, brain stimulation, detoxification, and targeted supplementation — prevented or delayed the disease. So, adopting all these changes is your best bet rather than doing one or two.

Antagonistic Hallmarks

Antagonistic hallmarks, which reflect responses to damage, play a more nuanced role in the aging process. “These hallmarks may have a hormetic component to them where just a little bit promotes health, but too much leads to accelerated aging,” says Kang.  

6. Mitochondrial Dysfunction

Mitochondria, the cell's powerhouses, produce essential energy for cellular functions. Oxidative stress and factors like toxins, poor diet, and lack of exercise can contribute to mitochondrial dysfunction, which is linked to neurodegenerative diseases like Alzheimer’s and Parkinson’s, cardiovascular diseases, and metabolic conditions such as obesity and type 2 diabetes. 

7. Cellular Senescence

Cells can only divide a finite number of times, a limit set by genetics. Within these cells are structures known as telomeres, which shorten with each division cycle. When telomeres become too short, cells enter a state called cell senescence, where they can no longer divide. Senescent cells prevent the spread of cancer and aid in healing. However, their accumulation releases chemicals (senescence-associated secretory phenotypes, or SASPs) that cause chronic inflammation, which can lead to age-related diseases like arthritis, cardiovascular diseases, neurodegenerative disorders, obesity-associated metabolic syndrome, and diabetes.

8. Deregulated Nutrient Sensing

Nutrient sensing is how cells detect and respond to nutrients. When deregulated, the body can’t effectively detect nutrients like glucose, amino acids, and fatty acids. This desensitization can lead to metabolic imbalances like diabetes and diseases such as cancer. Nutrient sensing is highly responsive and can become deregulated due to stress and excessive calorie intake, particularly from high-sugar foods.

What You Can Do to Improve Antagonistic Hallmarks of Aging

Reducing calorie intake has been shown to slow biological aging, improve metabolic health, and decrease the accumulation of senescent cells. Diabetes drugslike metformin can also target nutrient-sensing pathways to mimic the effects of caloric restriction and improve metabolic health​​.

Integrative Hallmarks of AgingIntegrative Hallmarks

Integrative hallmarks emerge when your body can no longer compensate for the accumulated damage from primary and antagonistic hallmarks. “These hallmarks can be a significant driver of the clinical phenotypes or observable characteristics seen in aging such as organ decline and reduced physical function,” says Kang.

9. Stem Cell Exhaustion

Stem cells can divide and differentiate into specialized cells, ensuring tissue and organ renewal throughout your life. However, stem cells gradually lose this ability as we age, contributing to tissue and organ aging. While some stem cell exhaustion is typical, factors like environment, lifestyle, and disease can accelerate it, leading to weakened immune function, decreased skin elasticity, tissue degeneration, impaired muscle regeneration, and slower wound healing.

10. Altered Intercellular Communication

Intercellular communication coordinates cellular activities, maintains tissue homeostasis, and responds to physiological cues. Some of these signals may get dropped as cells age, potentially leading to hormonal imbalances, uncontrolled cell growth, and tumor formation. Disruptions can also affect immune cell response, leading to autoimmune conditions or increased susceptibility to infections.

11. Dysbiosis of Gut Microbiota

Your intestinal microbiota (bacteria, viruses, fungi, and other microorganisms) is vital for digestion, metabolism, immune regulation, and pathogen protection. Dysbiosis occurs when there is an imbalance and reduced diversity of microbes, causing digestive issues, immune dysfunction, metabolic disorders, and mental health problems. Aging, stress, infections, diet, and physical activity are all factors that can disrupt the balance. However, it’s never too late to restore gut microbiota.

12. Chronic Inflammation

As you age, your body undergoes increased cell death, more free radicals, and chronic inflammation, known as inflammaging. This persistent, low-level inflammation gradually damages tissues and organs, accelerating aging. Chronic inflammation leads to many age-related diseases, including cardiovascular disease, diabetes, Alzheimer's disease, and cancer.

What You Can Do to Improve Integrative Hallmarks of Aging

This article has been medically reviewed by Kimberly Hartzfeld, DO, ABOG American Board of Obstetrics and Gynecology, IFMCP Institute for Functional Medicine Certified Practitioner.