A Review of Geroscience

To the Editor I appreciated the recent Review of geroscience, which is timely and has multiple strengths, including its description of the status of promising interventions that may alter the aging process. However, it seems puzzling that an important class of interventions was not mentioned: exercise. There is substantial evidence that some forms of exercise can influence aging-related biological pathways, not just single conditions such as sarcopenia. Exercise affects multiple aging-related pathways listed in the article as targets for altering the biological aging process, including increasing autophagy, decreasing systemic inflammation, increasing DNA repair and decreasing telomere shortening, and preserving mitochondrial function in multiple tissues, not just muscle. This omission seems particularly striking because unlike the other interventions listed, it is not experimental but has been extensively tested, is proven to be of benefit for a variety of conditions, and is included in current lifestyle recommendations. Noting the potential effects of exercise would provide clinicians and patients with a possible way of affecting aging-related pathways that can be recommended based on existing evidence of benefits and implemented without waiting for future research.