The paradigm of life extension.

The certainty of aging and death is a major concern of humans with a consequent endless search for methods to contract aging’s effects and delay death as long as possible. Charlatans may take advantage of the wish of people to live longer, proposing miraculous, unproven, and profitable antiaging products. Conversely, key advances in the understanding of the mechanism(s) behind the biology of aging and the increase in human life expectancy during the 20th century worldwide, make it possible that postponing natural death may indeed be plausible. Prolongation of life expectancy with disability is an empty prize. Interventions that prolong not only life span but also health span involve lifestyle strategies, as well as diagnosis of diseases at an early stage and appropriate use of advanced medical care. Human life expectancy has increased continuously for 150 years and functional status has improved, driven by improved sanitation, socioeconomic conditions, and medical advances. Nevertheless, recent data reveal no change in disability rates between 2000 and 2005 among older noninstitutionalized Americans. A slowing in life extension pace as a result of the poor lifestyle of modern young people is anticipated. Fundamental humanitarian and economic reasons call for the need to implement strategies to improve quality of life in old age. The rapid increase in the aged population will pose major challenges to health care systems in the coming years. This will have consequences on the sustainability of modern society. The search for ways to prolong health expectancy, with effective prevention of disability, has become a primary goal in medicine. Life extension with genetic manipulation and caloric restriction has been obtained in a wide array of animal models— yeasts, worms, flies, mice, primates. Translation into humans awaits verification. Numerous studies on exercise interventions and the Mediterranean dietary pattern have consistently demonstrated not only a decrease in mortality but also a reduction in several age-associated diseases, hence,