Preventive clinical approaches in active aging
Keywords:
Healthy Aging; Aging; Preventive Medicine; Geroscience; Health PromotionAbstract
Introduction: population aging is one of the most significant health challenges of the 21st century. Preventive medicine applied to active aging aims to extend disability-free life expectancy through evidence-based interventions.
Objective: to critically analyze current evidence on preventive clinical approaches to active aging, integrating classical perspectives on tiered prevention with emerging geroscience paradigms, and to provide a structured framework for their application in clinical practice.
Methods: a narrative literature review was conducted using the MEDLINE, Cochrane, and CINAHL databases. Articles published between 2020 and 2025, systematic reviews, clinical guidelines, and consensus documents from international organizations were included. The search strategy combined terms related to aging, primary, secondary, and tertiary prevention, and geroscience.
Results: the evidence is structured into three levels of prevention. Primary prevention includes vaccination (pneumococcal, influenza, and shingles), structured physical activity, and population-based screening. Secondary prevention incorporates blood biomarkers and early detection of chronic diseases. Tertiary prevention focuses on the optimal management of established diseases. The geroscience paradigm is emerging, proposing interventions targeting the biological mechanisms of aging, including senolytics, metformin, and GLP-1 agonists.
Conclusions: preventive approaches to active aging require stratification based on individual health profiles. The integration of lifestyle interventions, tailored screenings, and emerging geroscience strategies represents the most promising path to reducing morbidity and extending functional health in the older population.
Downloads
References
1. Martinović A, Mantovani M, Trpchevska N, Novak E, Milev NB, Bode L, et al. Climbing the longevity pyramid: overview of evidence-driven healthcare prevention strategies for human longevity. Front Aging [Internet]. 2024 [citado 29/05/2026];5:1473980. Disponible en: https://doi.org/10.3389/fragi.2024.1495029
2. Lenartowicz M. Prevention of Disease in Older Adults. En: Merck Manual Professional Version [Internet]. Kenilworth, NJ: Merck & Co.; 2025 [citado 29/05/2026]. Disponible en: https://www.msdmanuals.com/professional/geriatrics/prevention-of-disease-and-disability-in-older-adults/prevention-of-disease-in-older-adults
3. Kritchevsky SB, Cummings SR. Geroscience: A Translational Review. JAMA [Internet]. 2025 Sep 23 [citado 29/05/2026];334(12):1094-1102. Disponible en: https://doi.org/10.1001/jama.2025.11289
4. Izquierdo M, de Souto Barreto P, Arai H, Bischoff-Ferrari HA, Cadore EL, Cesari M, et al. Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR). J Nutr Health Aging [Internet]. 2025 [citado 29/05/2026];29(1):100401. Disponible en: https://doi.org/10.1016/j.jnha.2024.100401
5. Tenchov R, Sasso JM, Wang X, Zhou QA. Antiaging Strategies and Remedies: A Landscape of Research Progress and Promise. ACS Chem Neurosci [Internet]. 2024 Feb 7 [citado 29/05/2026];15(3):408-446. Disponible en: https://doi.org/10.1021/acschemneuro.3c00532
6. Lenartowicz M, Wasserman MR. Overview of Prevention in Older Adults. En: MSD Manual Professional Edition [Internet]. Kenilworth, NJ: Merck & Co.; 2025 [citado 29/05/2026]. Disponible en: https://www.msdmanuals.com/professional/geriatrics/prevention-of-disease-and-disability-in-older-adults/overview-of-prevention-in-older-adults
7. Mironov S, Borysova O, Morgunov I, Zhou Z, Moskalev A. A Framework for an Effective Healthy Longevity Clinic. Aging Dis [Internet]. 2024 Jul 15 [citado 29/05/2026];16(4):1971-1986. Disponible en: https://doi.org/10.14336/AD.2024.0328-1
8. Masini A, Cherasco N, Conti A, Pighini I, Barone-Adesi F, Panella M. Preventive Pathways for Healthy Ageing: A Systematic Literature Review. Geriatrics (Basel) [Internet]. 2025 Feb 18 [citado 29/05/2026];10(1):31. Disponible en: https://doi.org/10.3390/geriatrics10010031
9. Cocchi C, Zazzara MB, Levati E, Calvani R, Onder G. How to promote healthy aging across the life cycle. Eur J Intern Med [Internet]. 2025 May [citado 29/05/2026];135:5-13. Disponible en: https://doi.org/10.1016/j.ejim.2025.03.003
10. American Geriatrics Society Expert Panel on Person-Centered Care. Person-Centered Care: A Definition and Essential Elements. J Am Geriatr Soc [Internet]. 2016 Jan [citado 29/05/2026];64(1):15-18. Disponible en: https://doi.org/10.1111/jgs.13866
11. Md Mehedi Hasan, Md Fazle Rabbi Rahat, Nafisa Anjum, Mary Dioise Ramos, Nazmus Sakib. Enhancing vaccination uptake for healthy aging through context-aware mHealth systems: A systematic literature review for future smart healthcare. Smart Health [Internet]. 2026 [citado 29/05/2026];41:100665. Disponible en: https://doi.org/10.1016/j.smhl.2026.100665
12. Cunningham C, O' Sullivan R, Caserotti P, Tully MA. Consequences of physical inactivity in older adults: A systematic review of reviews and meta-analyses. Scand J Med Sci Sports [Internet]. 2020 May [citado 29/05/2026];30(5):816-827. Disponible en: https://doi.org/10.1111/sms.13616
13. Khan KM, Thompson W, Roberts KC, et al. Move more, age well: prescribing physical activity for older adults. CMAJ [Internet]. 2025 [citado 29/05/2026];197(3):E59-E67. Disponible en: https://doi.org/10.1503/cmaj.231336
14. US Preventive Services Task Force, Krist AH, Davidson KW, Mangione CM, Barry MJ, Cabana M, Caughey AB, et al. Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors: US Preventive Services Task Force Recommendation Statement. JAMA [Internet]. 2020 Nov 24 [citado 29/05/2026];324(20):2069-2075. Disponible en: https://doi.org/10.1001/jama.2020.21749
15. Sundaresan S, Rajapriya P, Lavanya SK. Aging and cancer: Clinical role of tumor markers in the geriatric population (Review). Med Int (Lond) [Internet]. 2024 Mar 6 [citado 29/05/2026];4(3):21. Disponible en: https://doi.org/10.3892/mi.2024.145
16. Ramachandran R. Evidence and opportunity costs of lifestyle interventions in clinical medicine. BMJ Med [Internet]. 2022 Sep 13 [citado 29/05/2026];1(1):e000336. Disponible en: https://doi.org/10.1136/bmjmed-2022-000336
17. Ubaida-Mohien C, Tanaka T, Tian Q, Moore Z, Moaddel R, Basisty N, Simonsick EM, Ferrucci L. Blood Biomarkers for Healthy Aging. Gerontology [Internet]. 2023 [citado 29/05/2026];69(10):1167-1174. Disponible en: https://doi.org/10.1159/000530795
18. Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol [Internet]. 2020 Feb [citado 29/05/2026];72(2):220-233. Disponible en: https://doi.org/10.1002/art.41142
19. American Diabetes Association Professional Practice Committee. 13. Older Adults: Standards of Care in Diabetes-2025. Diabetes Care [Internet]. 2025 Jan 1 [citado 29/05/2026];48(1 Suppl 1):S266-S282. Disponible en: https://doi.org/10.2337/dc25-S013
20. Jarocki M, Green S, Wu HHL, Chinnadurai R. Cardiorenal Syndrome in the Elderly: Challenges and Considerations. Geriatrics [Internet]. 2025 [citado 29/05/2026];10(4):104. Disponible en: https://doi.org/10.3390/geriatrics10040104
21. Venkatesan P. GOLD COPD report: 2025 update. Lancet Respir Med [Internet]. 2025 Jan [citado 29/05/2026];13(1):e7-e8. Disponible en: https://doi.org/10.1016/S2213-2600(24)00413-2
22. Ji S, Xiong M, Chen H, Liu Y, Zhou L, Hong Y, Wang M, Wang C, Fu X, Sun X. Cellular rejuvenation: molecular mechanisms and potential therapeutic interventions for diseases. Signal Transduct Target Ther [Internet]. 2023 Mar 14 [citado 29/05/2026];8(1):116. Disponible en: https://doi.org/10.1038/s41392-023-01343-5
23. Chen S, Gan D, Lin S, Zhong Y, Chen M, Zou X, Shao Z, Xiao G. Metformin in aging and aging-related diseases: clinical applications and relevant mechanisms. Theranostics [Internet]. 2022 Mar 6 [citado 29/05/2026];12(6):2722-2740. Disponible en: https://doi.org/10.7150/thno.71360
24. Czajkowski K, Herbet M, Murias M, Piątkowska-Chmiel I. Senolytics: charting a new course or enhancing existing anti-tumor therapies? Cell Oncol (Dordr) [Internet]. 2025 Apr [citado 29/05/2026];48(2):351-371. Disponible en: https://doi.org/10.1007/s13402-024-01018-5
25. Ortiz GU, de Freitas EC. Semaglutide as a possible therapy for healthy aging: Targeting the hallmarks of aging. Ageing Res Rev [Internet]. 2024 Dec [citado 29/05/2026];102:102582. Disponible en: https://doi.org/10.1016/j.arr.2024.102582
26. Eppard M, Passos JF, Victorelli S. Telomeres, cellular senescence, and aging: past and future. Biogerontology [Internet]. 2024 Apr [citado 29/05/2026];25(2):329-339. Disponible en: https://doi.org/10.1007/s10522-023-10085-4
27. Li X, Li Y, Hao Q, Jin J, Wang Y. Metabolic mechanisms orchestrated by Sirtuin family to modulate inflammatory responses. Front Immunol [Internet]. 2024 [citado 29/05/2026];15:1448535. Disponible en: https://doi.org/10.3389/fimmu.2024.1448535
28. Naugle KM, Naugle KE, Teegardin M, Kaleth AS. Physical Activity to Prevent the Age-Related Decline of Endogenous Pain Modulation. Exerc Sport Sci Rev [Internet]. 2023 Oct 1 [citado 29/05/2026];51(4):169-175. Disponible en: https://doi.org/10.1249/JES.0000000000000325
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Dario Martínez-Vázquez, Dunia Vázquez-Martínez, Nadina Travieso-Ramos
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who have publications with this journal agree to the following terms: Authors will retain their copyrights and grant the journal the right of first publication of their work, which will be publication of their work, which will be simultaneously subject to the Creative Commons Attribution License (CC-BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g.: deposit it in an institutional telematic archive or publish it in a volume). Likewise, and according to the recommendations of the Medical Sciences Editorial (ECIMED), authors must declare in each article their contribution according to the CRediT taxonomy (contributor roles). This taxonomy includes 14 roles, which can be used to represent the tasks typically performed by contributors in scientific academic production. It should be consulted in monograph) whenever initial publication in this journal is indicated. Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which may produce interesting exchanges and increase citations of the published work. (See The effect of open access). https://casrai.org/credit/
