The 12 Hallmarks of Aging

The consensus framework for aging biology.

Originally published in 2013 (with 9 hallmarks) and updated in 2023 (to 12), the Hallmarks of Aging provide a framework for understanding the cellular and molecular damage that accumulates over time.

The Hallmarks

Category	Hallmark	Targeted Intervention (Example)
Primary	Genomic Instability	DNA repair enzymes, NAD+ precursors
Primary	Telomere Attrition	Telomerase activators (Experimental)
Primary	Epigenetic Alterations	Reprogramming (Yamanaka factors - Future)
Primary	Loss of Proteostasis	Rapamycin (Autophagy)
Primary	Disabled Macroautophagy	Spermidine, Fasting
Antagonistic	Deregulated Nutrient Sensing	Metformin, mTOR inhibitors
Antagonistic	Mitochondrial Dysfunction	Urolithin A, Mitophagy inducers
Antagonistic	Cellular Senescence	Senolytics (Dasatinib + Quercetin)
Integrative	Stem Cell Exhaustion	Stem cell therapies, Exosomes
Integrative	Altered Intercellular Communication	Therapeutic Plasma Exchange (TPE)
Integrative	Chronic Inflammation	Anti-inflammatories, NSAIDs
Integrative	Dysbiosis	Fecal microbiota transplant (Experimental)