Can Precision Gerontomedicine Reverse Biological Age?

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Can Precision Gerontomedicine Reverse Biological Age?

At the Frailty in Older Adults 2025 Congress, Yves Rolland, MD, PhD, professor of internal medicine and geriatrics at the Gerontopôle of Toulouse, Toulouse, France.

He is the clinical research director of the IHU HealthAge and the WHO Collaborating Centre for Frailty, Clinical Research and Geriatric Training highlighting the connections between intrinsic capacity, biological ageing, and age-related diseases.

He explained that biological ageing is driven by gerogenes, which, when activated, promote age-related conditions similar to how oncogenes drive tumour formation.

These gerogenes can be targeted through preventive, nonpharmacologic interventions, such as those implemented in the Integrated Care for Older People (ICOPE) programme.

Evidence and Context

Biological and chronological ages do not always match, and at the same age, newer generations perform better than older generations.

A study published in Nature Aging found that a 70-year-old man born in the 1950s had the same physical and mental abilities as a 60-year-old man born in the 1940s based on two large cohorts from different countries.

This shows that intrinsic abilities can change depending on life circumstances such as access to healthcare, education, and financial resources.

A decline in these abilities is now understood to be closely tied to biological ageing and is a strong predictor of future dependency.

Ageing Mechanisms

Alterations in intrinsic capacity are linked to the acceleration of the biological mechanisms of ageing, creating conditions for the development of age-related pathologies such as cardiovascular disease, neurologic disorders, and cancer.

Could these pathologies be prevented by targeting their underlying mechanisms? This is the focus of geroscience, which aims to develop novel gerotherapies.

Gerotherapy has long been considered inaccessible; however, it is now seriously considered and has attracted growing interest from industrial stakeholders.

According to a recent literature review, biological ageing is accelerated by the activation of gerogenes or slowed by suppressor genes.

Age-related pathologies would depend on these genes, similar to what has been described for oncogenes and tumour suppressor genes in oncology.

Targeting Gerogenes

These gerogenes are modulated by lifestyle, environmental, and psychological factors.

It has been shown that they can be influenced by nonpharmacologic interventions deployable at scale, such as those promoted by the ICOPE programme: reducing sedentary lifestyles, preventing malnutrition and weight loss, providing cognitive stimulation and psychological support, and maintaining sensory capacities such as hearing and vision.

Rolland emphasised a growing shift towards preventive and precision approaches in geriatric medicine, adding that personalised analysis of ageing biomarkers using new genetic and proteomic techniques, combined with clinical and functional measures, artificial intelligence, and clinical interviews, will make it possible to identify the most appropriate gerotherapies.

ICOPE

ICOPE-INTENSE, a research project developed by IHU HealthAge with international collaborators, is competing in the XPRIZE Healthspan, a 7-year, $101 million global competition aimed at transforming approaches to human ageing.

The programme, built on WHO’s ICOPE framework, evaluates nonpharmacologic interventions for their effects on biological ageing, with outcomes tracked in motor performance, cognition, and immune function.

Eligibility criteria included age 65-85 years, overweight status, reduced mobility, low physical activity, and cognitive impairment.