New Directions in Geroscience: Integrating Social and Behavioral Drivers of Biological Aging

Abstract

The "geroscience hypothesis" posits that slowing the physiological processes of aging would lead to delayed disease onset and longer healthspan and lifespan. This shift from a focus on solely treating existing disease to slowing the aging process is a shift toward prevention, including a focus on risk factors found in the social environment. Although geroscience traditionally has focused on the molecular and cellular drivers of biological aging, more fundamental causes of aging may be found in the social exposome-the complex array of human social environmental exposures that shape health and disease. The social exposome may interact with physiological processes to accelerate aging biology. In this commentary, we review the potential of these insights to shape the emerging field of translational geroscience. The articles in this special issue highlight how social stress and social determinants of health are associated with biomarkers of aging such as inflammation, epigenetic clocks, and telomeres, and spotlight promising interventions to mitigate stress-related inflammation. For geroscience to incorporate the social exposome into its translational agenda, studies are needed that elucidate and quantify the effects of social exposures on aging and that consider social exposures as intervention targets. The life course perspective allows us to measure both exposures and aging biology over time including sensitive periods of development and major social transitions. In addition, given rapid changes in the measurement of aging biology, which include machine learning techniques, multisystem phenotypes of aging are being developed to better reflect whole body aging, replacing reliance on single system biomarkers. In this expanded and more integrated field of translational geroscience, strategies targeting factors in the social exposome hold promise for achieving aging health equity and extending healthy longevity.

Figure 1:. An Expanded Translational Geroscience spans from social to genomic factors across the life course.

An individual’s aging biology is influenced by the social exposome, from environmental to individual factors (top triangle) and multisystem biological functioning (from physical function to genome) (lower triangle). Examining both social and biological factors, as well as interactions between them, should enable the most complete prediction of an individual’s risk for early disease and mortality. An ideal social exposome will foster slower aging biology over the lifecourse, and ultimately healthy aging trajectories with a compressed diseasespan. The social factors offer additional intervention targets for slowing aging. This Figure is adapted from one that Dr. Nancy Adler used in talks to emphasize that precision medicine needed to incorporate the social factors to be of greater utility in public health.