Boosting Lifespan: Public Health and Longevity Medicine

A new editorial published May 18, 2026, in *Volume 18 of Aging-US* examines how public health systems must adapt to support aging populations facing chronic diseases and functional decline. Authors Jochen Mierau from the University of Groningen and Marco Demaria, Editor-in-Chief of *Aging-US* and affiliated with the European Research Institute for the Biology of Ageing (ERIBA), argue that modern longevity depends on integrating public health interventions, clinical treatments, and emerging longevity therapies. Historically, lifespan gains stemmed from sanitation, vaccination, and nutrition, but today’s challenges—such as pollution, sedentary lifestyles, and ultra-processed foods—require a broader approach. The authors highlight interconnected risks like cellular senescence, inflammation, and metabolic dysfunction, which accelerate aging and increase disease vulnerability. They stress that these cannot be addressed solely through disease-specific treatments. The editorial proposes a three-tiered strategy: public health measures to reduce baseline risks, clinical medicine to treat established diseases, and longevity interventions to slow biological decline before pathology appears. This framework aims to extend both lifespan and healthspan by targeting core aging mechanisms like proteostasis impairment. Implementation challenges include developing reliable biomarkers for biological aging, ensuring equitable therapy access, and adapting healthcare systems to prioritize prevention. The authors emphasize that outcomes like physical function, cognitive resilience, and quality of life should complement traditional metrics like mortality rates. The proposed model integrates these layers across the life course to build system-wide resilience in aging societies.