Abstract
Aging is a complex biological and societal challenge, where modest advances can yield substantial clinical and economic benefits. While model organisms have uncovered key mechanisms of aging, their physiological relevance to humans remains limited. Astronauts offer a uniquely informative human model: despite being healthy and highly selected, they exhibit many hallmarks of aging and experience comparable declines in cardiovascular, musculoskeletal, cognitive and immune function—often on accelerated timelines. These changes are largely driven by four core exposures of the space environment: microgravity, circadian disruption, ionizing radiation and social isolation. Here, by tracing how environmental factors affect biological processes such as mitochondrial dysfunction, altered cytoskeletal dynamics, chronic inflammation and other canonical hallmarks of aging, we position spaceflight as a powerful model for human aging—one that unites environmental stress biology, multi-omic systems approaches and clinical research to advance both astronaut health and the healthspan of aging populations on Earth.
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References
López-Otín, C., Blasco, M. A., Partridge, L., Serrano, M. & Kroemer, G. Hallmarks of aging: an expanding universe. Cell https://doi.org/10.1016/j.cell.2022.11.001 (2023).
Kelley, A. et al. National Institute on Aging’s 50th anniversary: advancing aging research and the health and well-being of older adults. J. Am. Geriatr. Soc. 72, 1574–1582 (2024).
Holtze, S. et al. Alternative animal models of aging research. Front. Mol. Biosci. https://doi.org/10.3389/fmolb.2021.660959 (2021).
Argentieri, M. A. et al. Integrating the environmental and genetic architectures of aging and mortality. Nat. Med. 31, 1016–1025 (2025).
Wild, C. P. Complementing the genome with an ‘exposome’: the outstanding challenge of environmental exposure measurement in molecular epidemiology. Cancer Epidemiol. Biomarkers Prev. 14, 1847–1850 (2005).
Vico, L. & Hargens, A. Skeletal changes during and after spaceflight. Nat. Rev. Rheumatol. 14, 229–245 (2018).
Han, H., Jia, H., Wang, Y. F. & Song, J. P. Cardiovascular adaptations and pathological changes induced by spaceflight: from cellular mechanisms to organ-level impacts. Mil. Med. Res. https://doi.org/10.1186/s40779-024-00570-3 (2024).
Seidler, R. D., Mao, X. W., Tays, G. D., Wang, T. & zu Eulenburg, P. Effects of spaceflight on the brain. Lancet Neurol. 2, 826–835 (2024).
Zu Eulenburg, P. et al. Changes in blood biomarkers of brain injury and degeneration following long-duration spaceflight. JAMA Neurol. https://doi.org/10.1001/jamaneurol.2021.3589 (2021).
Winer, D. A. et al. Astroimmunology: the effects of spaceflight and its associated stressors on the immune system. Nat. Rev. Immunol. https://doi.org/10.1038/s41577-025-01226-6 (2025).
Afshinnekoo, E. et al. Fundamental biological features of spaceflight: advancing the field to enable deep-space exploration. Cell 183, 1162–1184 (2020).
Meredith, S. J. et al. Factors that influence older adults’ participation in physical activity: a systematic review of qualitative studies. Age Ageing 52, afad145 (2023).
Davis, M. G. et al. Objectively measured physical activity in a diverse sample of older urban UK adults. Med. Sci. Sports Exerc. 43, 647–654 (2011).
Gaskill, M. Astronaut exercise - NASA. nasa.gov https://www.nasa.gov/missions/station/iss-research/astronaut-exercise/ (2024).
Kehler, D. S., Theou, O. & Rockwood, K. Bed rest and accelerated aging in relation to the musculoskeletal and cardiovascular systems and frailty biomarkers: a review. Exp. Gerontol. https://doi.org/10.1016/j.exger.2019.110643 (2019).
ElGindi, M. et al. Effects of an aged tissue niche on the immune potency of dendritic cells using simulated microgravity. NPJ Aging 9, 14 (2023).
Park, J. H., Moon, J. H., Kim, H. J., Kong, M. H. & Oh, Y. H. Sedentary lifestyle: overview of updated evidence of potential health risks. Korean J. Fam. Med. 41, 365–373 (2020).
Healy, G. N., Matthews, C. E., Dunstan, D. W., Winkler, E. A. H. & Owen, N. Sedentary time and cardio-metabolic biomarkers in US adults: NHANES 200306. Eur. Heart J. 32, 590–597 (2011).
Blodgett, J., Theou, O., Kirkland, S., Andreou, P. & Rockwood, K. The association between sedentary behaviour, moderate-vigorousphysical activity and frailty in NHANES cohorts. Maturitas 80, 187–191 (2015).
Lin, Z. et al. Correlation between sedentary activity, physical activity and bone mineral density and fat in America: National Health and Nutrition Examination Survey, 2011–2018. Sci. Rep. 13, 10054 (2023).
Raffin, J. et al. Sedentary behavior and the biological hallmarks of aging. Ageing Res. Rev. https://doi.org/10.1016/j.arr.2022.101807 (2023).
Buchheim, J. I. et al. Stress related shift toward inflammaging in cosmonauts after long-duration space flight. Front. Physiol. 10, 85 (2019).
Li, L., Coull, B. A., Zilli Vieira, C. L. & Koutrakis, P. High-resolution national radon maps based on massive indoor measurements in the United States. Proc. Natl Acad. Sci. USA. 122, e2408084121 (2025).
Turner, M. C. et al. Radon and COPD mortality in the American Cancer Society Cohort. Eur. Respir. J. 39, 1113–1119 (2012).
Dong, S. et al. Synergistic effects of particle radioactivity (gross β Activity) and particulate matter ≤2.5μm aerodynamic diameter on cardiovascular disease mortality. J. Am. Heart Assoc. 11, e025470 (2022).
Furukawa, S. et al. Space radiation biology for ‘living in space’. Biomed. Res. Int. https://doi.org/10.1155/2020/4703286 (2020).
Rask, J., Vercoutere, W., Navarro, B. & Krause, A. Space Faring: The Radiation Challenge Radiation Educator Guide (National Aeronautics and Space Administration, 2008).
Park, J. et al. Spatial multi-omics of human skin reveals KRAS and inflammatory responses to spaceflight. Nat. Commun. 15, 4773 (2024).
da Silveira, W. A. et al. Comprehensive multi-omics analysis reveals mitochondrial stress as a central biological hub for spaceflight impact. Cell 183, 1185–1201 (2020).
Beheshti, A. et al. Genomic changes driven by radiation-induced DNA damage and microgravity in human cells. Int. J. Mol. Sci. https://doi.org/10.3390/ijms221910507 (2021).
National Academies of Sciences, Engineering, and Medicine. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System (The National Academies Press, 2020).
Fakoya, O. A., McCorry, N. K. & Donnelly, M. Loneliness and social isolation interventions for older adults: a scoping review of reviews. BMC Public Health 20, 129 (2020).
Courtin, E. & Knapp, M. Social isolation, loneliness and health in old age: a scoping review. Health Soc. Care Community https://doi.org/10.1111/hsc.12311 (2017).
Guarnera, J., Yuen, E. & Macpherson, H. The impact of loneliness and social isolation on cognitive aging: a narrative review. J. Alzheimers Dis. Rep. https://doi.org/10.3233/ADR-230011 (2023).
Matthews, T. et al. Social isolation, loneliness, and inflammation: a multi-cohort investigation in early and mid-adulthood. Brain Behav. Immun. 115, 727–736 (2024).
Mehrabi, F. & Béland, F. Effects of social isolation, loneliness and frailty on health outcomes and their possible mediators and moderators in community-dwelling older adults: a scoping review. Arch. Gerontol. Geriatr. https://doi.org/10.1016/j.archger.2020.104119 (2020).
Friedman, E. & Bui, B. A psychiatric formulary for long-duration spaceflight. Aerosp. Med. Hum. Perform. https://doi.org/10.3357/AMHP.4901.2017 (2017).
Reppert, S. M. & Weaver, D. R. Coordination of circadian timing in mammals. Nature 418, 935–941 (2002).
Schulz, P. & Steimer, T. Neurobiology of Circadian Systems (CNS Drugs, 2009).
Li, J., Vitiello, M. V. & Gooneratne, N. S. Sleep in normal aging. Sleep Med. Clin. https://doi.org/10.1016/j.jsmc.2017.09.001 (2018).
Luo, J. et al. Prevalence and risk factors of poor sleep quality among chinese elderly in an urban community: results from the Shanghai aging study. PLoS ONE 8, e81261 (2013).
Quante, M. et al. Zeitgebers and their association with rest-activity patterns. Chronobiol. Int. 36, 203–213 (2019).
Guo, J.-H. et al. Keeping the right time in space: importance of circadian clock and sleep for physiology and performance of astronauts. Mil. Med. Res. 1, 23 (2014).
Dijk, D. et al. Sleep, performance, circadian rhythms, and light-dark cycles during two space shuttle flights. Am. J. Physiol. Regul. Integr. Comp. Physiol. https://doi.org/10.1152/ajpregu.2001.281.5.R1647 (2001).
van Leeuwen, W. M. A. et al. Sleep restriction increases the risk of developing cardiovascular diseases by augmenting proinflammatory responses through IL-17 and CRP. PLoS ONE 4, e4589 (2009).
Canever, J. B., Queiroz, L. Y., Soares, E. S., de Avelar, N. C. P. & Cimarosti, H. I. Circadian rhythm alterations affecting the pathology of neurodegenerative diseases. J. Neurochem. 168, 1475–1489 (2024).
ElGindi, M. & Teo, J. Exploring ageing in microgravity. Nat. Rev. Bioeng. https://doi.org/10.1038/s44222-025-00309-2 (2025).
Ledberg, A. Exponential increase in mortality with age is a generic property of a simple model system of damage accumulation and death. PLoS ONE https://doi.org/10.1371/journal.pone.0233384 (2020).
Schmauck-Medina, T. et al. New hallmarks of ageing: a 2022 Copenhagen ageing meeting summary. Aging 29, 6829–6839 (2022).
Sayed, N. et al. An inflammatory aging clock (iAge) based on deep learning tracks multimorbidity, immunosenescence, frailty and cardiovascular aging. Nat. Aging 1, 598–615 (2021).
Campisi, M., Cannella, L. & Pavanello, S. Cosmic chronometers: Is spaceflight a catalyst for biological ageing. Ageing Res. Rev. https://doi.org/10.1016/j.arr.2024.102227 (2024).
Franceschi, C. et al. Inflamm-aging. An evolutionary perspective on immunosenescence. Ann. N. Y. Acad. Sci. 908, 244–254 (2000).
Flynn, M. G., Markofski, M. M. & Carrillo, A. E. Elevated inflammatory status and increased risk of chronic disease in chronological aging: inflamm-aging or inflamm-inactivity? Aging Dis https://doi.org/10.14336/AD.2018.0326 (2019).
D’Orazio, J., Jarrett, S., Amaro-Ortiz, A. & Scott, T. UV radiation and the skin. Int. J. Mol. Sci. https://doi.org/10.3390/ijms140612222 (2013).
Matsumura, Y. & Ananthaswamy, H. N. Toxic effects of ultraviolet radiation on the skin. Toxicol. Appl. Pharmacol. https://doi.org/10.1016/j.taap.2003.08.019 (2004).
Ahmed, M., Cerda, I. & Maloof, M. Breaking the vicious cycle: the interplay between loneliness, metabolic illness, and mental health. Front. Psychiatry 14, 1134865 (2023).
Kim, C. S. et al. Experiencing social exclusion changes gut microbiota composition. Transl. Psychiatry 12, 254 (2022).
Koyama, Y. et al. Interplay between social isolation and loneliness and chronic systemic inflammation during the COVID-19 pandemic in Japan: results from U-CORONA study. Brain Behav. Immun. 94, 51–59 (2021).
Fonseca Costa, S. S. & Ripperger, J. A. Impact of the circadian clock on the aging process. Front. Neurol. https://doi.org/10.3389/fneur.2015.00043 (2015).
Leproult, R., Holmbäck, U. & Van Cauter, E. Circadian misalignment augments markers of insulin resistance and inflammation, independently of sleep loss. Diabetes 63, 1860–1869 (2014).
Zhang, C. et al. BMAL1 collaborates with CLOCK to directly promote DNA double-strand break repair and tumor chemoresistance. Oncogene 42, 967–979 (2023).
Luxton, J. J. & Bailey, S. M. Twins, telomeres, and aging-in space! Plast. Reconstr. Surg. 147, 7S–14S (2021).
Luxton, J. J. et al. Temporal telomere and DNA damage responses in the space radiation environment. Cell Rep 33, 108435 (2020).
Schumacher, B., Pothof, J., Vijg, J. & Hoeijmakers, J. H. J. The central role of DNA damage in the ageing process. Nature https://doi.org/10.1038/s41586-021-03307-7 (2021).
Azzam, E. I., Jay-Gerin, J. P. & Pain, D. Ionizing radiation-induced metabolic oxidative stress and prolonged cell injury. Cancer Lett https://doi.org/10.1016/j.canlet.2011.12.012 (2012).
Cooke, M. S., Evans, M. D., Dizdaroglu, M. & Lunec, J. Oxidative DNA damage: mechanisms, mutation, and disease. FASEB J 17, 1195–1214 (2003).
Fang, E. F. et al. NAD+ in aging: molecular mechanisms and translational implications. Trends Mol. Med. 23, 899–916 (2017).
Furman, D. et al. Chronic inflammation in the etiology of disease across the life span. Nat. Med. 25, 1822–1832 (2019).
Baechle, J. J. et al. Chronic inflammation and the hallmarks of aging. Mol. Metab. https://doi.org/10.1016/j.molmet.2023.101755 (2023).
Capri, M. et al. Long-term human spaceflight and inflammaging: does it promote aging? Ageing Res. Rev. https://doi.org/10.1016/j.arr.2023.101909 (2023).
Garrett-Bakelman, F. E. et al. The NASA twins study: A multidimensional analysis of a year-long human spaceflight. Science 364, 2019 (1979).
Crucian, B. E. et al. Immune system dysregulation during spaceflight: Potential countermeasures for deep space exploration missions. Front. Immunol. https://doi.org/10.3389/fimmu.2018.01437 (2018).
Mehta, S. K. et al. Latent virus reactivation in astronauts on the international space station. NPJ Microgravity 3, 11 (2017).
Barbieri, M., Bonafè, M., Franceschi, C. & Paolisso, G. Insulin/IGF-I-signaling pathway: an evolutionarily conserved mechanism of longevity from yeast to humans. Am. J. Physiol. Endocrinol. Metab. https://doi.org/10.1152/ajpendo.00296.2003 (2003).
Barzilai, N. & Ferrucci, L. Insulin resistance and aging: A cause or a protective response. J. Gerontol. Ser. A Biol. Sci. Med. Sci. https://doi.org/10.1093/gerona/gls145 (2012).
Hughson, R. L. et al. Increased postflight carotid artery stiffness and inflight insulin resistance resulting from 6-mo spaceflight in male and female astronauts. Am. J. Physiol. Heart Circ. Physiol. 310, 628–638 (2016).
Mathyk, B. A. et al. Spaceflight induces changes in gene expression profiles linked to insulin and estrogen. Commun. Biol. 7, 692 (2024).
Sapudom, J., Alatoom, A., Tipay, P. S. & Teo, J. C. Matrix stiffening from collagen fibril density and alignment modulates YAP-mediated T-cell immune suppression. Biomaterials 315, 122900 (2025).
Schafer, M. J. et al. Cellular senescence mediates fibrotic pulmonary disease. Nat. Commun. 8, 14532 (2017).
Du, H. et al. Tuning immunity through tissue mechanotransduction. Nat. Rev. Immunol. 23, 174–188 (2023).
Lee, M., Du, H., Winer, D. A., Clemente-Casares, X. & Tsai, S. Mechanosensing in macrophages and dendritic cells in steady-state and disease. Front. Cell Dev. Biol. https://doi.org/10.3389/fcell.2022.1044729 (2022).
Andreeva, E. et al. Real and simulated microgravity: focus on mammalian extracellular matrix. Life https://doi.org/10.3390/life12091343 (2022).
Wu, F. et al. Single-cell analysis identifies conserved features of immune dysfunction in simulated microgravity and spaceflight. Nat. Commun. 15, 4795 (2024).
Chen, Z., Luo, Q., Lin, C., Kuang, D. & Song, G. Simulated microgravity inhibits osteogenic differentiation of mesenchymal stem cells via depolymerizing F-actin to impede TAZ nuclear translocation. Sci. Rep. 6, 30322 (2016).
Neelam, S. et al. Changes in nuclear shape and gene expression in response to simulated microgravity are linc complex-dependent. Int. J. Mol. Sci. 21, 6762 (2020).
Chakraborty, M. et al. Mechanical stiffness controls dendritic cell metabolism and function. Cell Rep 34, 108609 (2021).
Ghosh, T. S., Shanahan, F. & O’Toole, P. W. The gut microbiome as a modulator of healthy ageing. Nat. Rev. Gastroenterol. Hepatol. 19, 565–584 (2022).
Shemtov, S. J. et al. The intestinal immune system and gut barrier function in obesity and ageing. FEBS J. 290, 4163–4186 (2023).
Valdes, A. M., Walter, J., Segal, E. & Spector, T. D. Role of the gut microbiota in nutrition and health. BMJ 361, 36–44 (2018).
Voorhies, A. A. et al. Study of the impact of long-duration space missions at the International Space Station on the astronaut microbiome. Sci. Rep. 9, 9911 (2019).
Tierney, B. T. et al. Longitudinal multi-omics analysis of host microbiome architecture and immune responses during short-term spaceflight. Nat. Microbiol. https://doi.org/10.1038/s41564-024-01635-8 (2024).
Liu, Z. et al. Effects of spaceflight on the composition and function of the human gut microbiota. Gut Microbes 11, 807–819 (2020).
Sun, N., Youle, R. J. & Finkel, T. The mitochondrial basis of aging. Mol. Cell 61, 654–666 (2016).
Palikaras, K., Lionaki, E. & Tavernarakis, N. Mechanisms of mitophagy in cellular homeostasis, physiology and pathology. Nat. Cell Biol. 20, 1013–1022 (2018).
Capri, M. et al. Recovery from 6-month spaceflight at the International Space Station: muscle-related stress into a proinflammatory setting. FASEB J 33, 5168–5180 (2019).
Murgia, M. et al. Spaceflight on the ISS changed the skeletal muscle proteome of two astronauts. NPJ Microgravity 10, 60 (2024).
Barros, R. P. A. & Gustafsson, J. Å. Estrogen receptors and the metabolic network. Cell Metab. 14, 289–299 (2011).
Houerbi, N. et al. Secretome profiling reveals acute changes in oxidative stress, brain homeostasis, and coagulation following short-duration spaceflight. Nat. Commun. 15, 4862 (2024).
Stein, T. P. & Leskiw, M. J. Oxidant damage during and after spaceflight. Am. J. Physiol. Endocrinol. Metab. 278, 375–382 (2000).
Shammas, M. A. Telomeres lifestyle, cancer, and aging. Curr. Opin. Clin. Nutr. Metab. Care 14, 28–34 (2011).
Overbey, E. G. et al. The Space Omics and Medical Atlas (SOMA) and international astronaut biobank. Nature https://doi.org/10.1038/s41586-024-07639-y (2024).
Al-Turki, T. M. et al. Telomeric RNA (TERRA) increases in response to spaceflight and high-altitude climbing. Commun. Biol. 7, 698 (2024).
DeBoy, E. A. et al. Familial clonal hematopoiesis in a long telomere syndrome. N. Engl. J. Med. 388, 2422–2433 (2023).
Trinchant, N. M. et al. Clonal hematopoiesis before, during, and after human spaceflight. Cell Rep. 33, 108458 (2020).
Hastings, M. H. et al. Cardiac ageing: from hallmarks to therapeutic opportunities. Cardiovasc. Res. https://doi.org/10.1093/cvr/cvae124 (2024).
Bonanni, A., Basile, M., Montone, R. A. & Crea, F. Impact of the exposome on cardiovascular disease. Eur. Heart J. 25, B60–B64 (2023).
Lavie, C. J., Ozemek, C., Carbone, S., Katzmarzyk, P. T. & Blair, S. N. Sedentary behavior, exercise, and cardiovascular health. Circ. Res. 124, 799–815 (2019).
Lecacheur, M., Ammerlaan, D. J. M. & Dierickx, P. Circadian rhythms in cardiovascular (dys)function: approaches for future therapeutics. NPJ Cardiovasc. Health 1, 21 (2024).
Xia, N. & Li, H. Loneliness, social isolation, and cardiovascular health. Antioxid. Redox Signal. 28, 837–851 (2018).
Chiao, Y. A. & Rabinovitch, P. S. The aging heart. Cold Spring Harb. Perspect. Med. 5, a025148 (2015).
Fleg, J. L. et al. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation 112, 674–682 (2005).
Gepner, A., Korcarz, C., Colangelo, L., Liu, K. & Stein, J. Longitudinal effects of a decade of aging on carotid artery stiffness: the multiethnic study of atherosclerosis. Stroke 45, 48–53 (2013).
Berry, C. A. Apollo 7 to 11 - Medical Concerns and Results (International Congress of Aerospace Medicine, 1969).
Baran, R. et al. Microgravity-related changes in bone density and treatment options: a systematic review. Int. J. Mol. Sci. https://doi.org/10.3390/ijms23158650 (2022).
Scott, J. M., Stoudemire, J., Dolan, L. & Downs, M. Leveraging spaceflight to advance cardiovascular research on Earth. Circ. Res. 130, 942–957 (2022).
Arbeille, P., Provost, R. & Zuj, K. Carotid and femoral artery intima-media thickness during 6 months of spaceflight. Aerosp. Med. Hum. Perform. 87, 449–453 (2016).
Grigoriev, A. I., Kotovskaya, A. R. & Fomina, G. A. The human cardiovascular system during space flight. Acta Astronaut. 68, 1495–1500 (2011).
Delp, M. D., Charvat, J. M., Limoli, C. L., Globus, R. K. & Ghosh, P. Apollo lunar astronauts show higher cardiovascular disease mortality: Possible deep space radiation effects on the vascular endothelium. Sci. Rep. 6, 29901 (2016).
Vernikos, J. & Schneider, V. S. Space, gravity and the physiology of aging: parallel or convergent disciplines? A mini-review. Gerontology 56, 157–166 (2010).
Strollo, F. et al. Space Flight-promoted insulin resistance as a possible disruptor of wound healing. Front. Bioeng. Biotechnol. 10, 868999 (2022).
Strollo, F. & Vernikos, J. Aging-like metabolic and adrenal changes in microgravity: state of the art in preparation for Mars. Neurosci. Biobehav. Rev. 126, 236–242 (2021).
Beheshti, A., McDonald, J. T., Miller, J., Grabham, P. & Costes, S. V. Genelab database analyses suggest long-term impact of space radiation on the cardiovascular system by the activation of FYN through reactive oxygen species. Int. J. Mol. Sci. 20, 661 (2019).
Nguyen, H. P., Tran, P. H., Kim, K. S. & Yang, S. G. The effects of real and simulated microgravity on cellular mitochondrial function. NPJ Microgravity https://doi.org/10.1038/s41526-021-00171-7 (2021).
Brown, D. I. & Griendling, K. K. Regulation of signal transduction by reactive oxygen species in the cardiovascular system. Circ. Res. 116, 531–549 (2015).
Xu, K. Y., Zweier, J. L. & Becker, L. C. Hydroxyl radical inhibits sarcoplasmic reticulum Ca2+ ATPase function by direct attack on the ATP binding site. Circ. Res. 90, 76–81 (1997).
van der Pol, A., van Gilst, W. H., Voors, A. A. & van der Meer, P. Treating oxidative stress in heart failure: past, present and future. Eur. J. Heart Fail 21, 425–435 (2019).
Moreno-Villanueva, M. et al. Transcriptomics analysis reveals potential mechanisms underlying mitochondrial dysfunction and T cell exhaustion in astronauts’ blood cells in space. Front. Immunol. 15, 1512578 (2024).
Santulli, G., Xie, W., Reiken, S. R. & Marks, A. R. Mitochondrial calcium overload is a key determinant in heart failure. Proc. Natl Acad. Sci. USA 112, 11389–11394 (2015).
Ungvari, Z., Kaley, G., De Cabo, R., Sonntag, W. E. & Csiszar, A. Mechanisms of vascular aging: new perspectives. J. Gerontol. Ser. A Biol. Sci. Med. Sci. 65A, 1028–1041 (2010).
Goodwin, T. J. & Christofidou-Solomidou, M. Oxidative stress and space biology: an organ-based approach. Int. J. Mol. Sci. https://doi.org/10.3390/ijms19040959 (2018).
Sarafrazi, N., Wambogo, E. A. & Shepherd, J. A. Osteoporosis or low bone mass in older adults: United States, 2017–2018. NCHS Data Brief 405, 1–8 (2020).
Frangogiannis, N. G. Transforming growth factor-β in myocardial disease. Nat. Rev. Cardiol. 19, 435–455 (2022).
Dobaczewski, M., Chen, W. & Frangogiannis, N. G. Transforming growth factor (TGF)-β signaling in cardiac remodeling. J. Mol. Cell. Cardiol. 51, 600–606 (2011).
Beheshti, A., Ray, S., Fogle, H., Berrios, D. & Costes, S. V. A microRNA signature and TGF-β1 response were identified as the key master regulators for spaceflight response. PLoS ONE 13, e0199621 (2018).
Vernice, N. A., Meydan, C., Afshinnekoo, E. & Mason, C. E. Long-term spaceflight and the cardiovascular system. Precis. Clin. Med. 3, 284–291 (2020).
Hughson, R. L., Helm, A. & Durante, M. Heart in space: effect of the extraterrestrial environment on the cardiovascular system. Nat. Rev. Cardiol. 15, 167–180 (2018).
Hernandez-Navarro, I. et al. Replicative endothelial cell senescence may lead to endothelial dysfunction by increasing the BH2/BH4 ratio induced by oxidative stress, reducing BH4 availability, and decreasing the expression of eNOS. Int. J. Mol. Sci. 25, 9890 (2024).
Luu, N. et al. Aging-associated decline in vascular smooth muscle cell mechanosensation is mediated by Piezo1 channel. Aging Cell 23, e14036 (2024).
Ludtka, C. & Allen, J. B. The effects of simulated and real microgravity on vascular smooth muscle cells. Gravit. Space Res. 12, 46–59 (2024).
Gallo, C., Ridolfi, L. & Scarsoglio, S. Cardiovascular deconditioning during long-term spaceflight through multiscale modeling. NPJ Microgravity 6, 27 (2020).
Behnke, B. J. et al. Effects of spaceflight and ground recovery on mesenteric artery and vein constrictor properties in mice. FASEB J. 27, 399–409 (2013).
Kang, H., Fan, Y., Sun, A., Jia, X. & Deng, X. Simulated microgravity exposure modulates the phenotype of cultured vascular smooth muscle cells. Cell Biochem. Biophys. 66, 121–130 (2013).
Zhang, J. et al. Long-term simulated microgravity fosters carotid aging-like changes via Piezo1. Cardiovasc. Res. 120, 548–559 (2024).
Hoffmann, B. et al. Mechanical deconditioning of the heart due to long-term bed rest as observed on seismocardiogram morphology. NPJ Microgravity 8, 25 (2022).
Keaveny, T. M. et al. Age-dependence of femoral strength in white women and men. J. Bone Miner. Res. 25, 994–1001 (2010).
Cruz-Jentoft, A. J. et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48, 16–31 (2019).
Faulkner, J. A., Larkin, L. M., Claflin, D. R. & Brooks, S. V. Age-related changes in the structure and function of skeletal muscles. Clin. Exp. Pharmacol. Physiol. 34, 1091–1096 (2007).
Papadopoulou, S. K. Sarcopenia: a contemporary health problem among older adult populations. Nutrients https://doi.org/10.3390/nu12051293 (2020).
Stavnichuk, M., Mikolajewicz, N., Corlett, T., Morris, M. & Komarova, S. V. A systematic review and meta-analysis of bone loss in space travelers. NPJ Microgravity 6, 13 (2020).
Hargens, A. R. & Vico, L. Analogs of microgravity: space research without leaving the planet long-duration bed rest as an analog to microgravity. J. Appl. Physiol. 120, 891–903 (2016).
Moosavi, D. et al. The effects of spaceflight microgravity on the musculoskeletal system of humans and animals, with an emphasis on exercise as a countermeasure: a systematic scoping review. Physiol. Res. 70, 119–151 (2021).
Trappe, S. et al. Exercise in space: human skeletal muscle after 6 months aboard the International Space Station. J. Appl. Physiol. 106, 1159–1168 (2009).
Weinbaum, S., Cowin, S. C. & Zeng, Y. A model for the excitation of osteocytes by mechanical loading-induced bone fluid shear stresses. J. Biomech. 27, 339–360 (1994).
Qin, L., Liu, W., Cao, H. & Xiao, G. Molecular mechanosensors in osteocytes. Bone Res. https://doi.org/10.1038/s41413-020-0099-y (2020).
Yang, X., Sun, L. W., Liang, M., Wang, X. N. & Fan, Y. B. The response of wnt/ß-catenin signaling pathway in osteocytes under simulated microgravity. Microgravity Sci. Technol. 27, 473–483 (2015).
Chang, X., Xu, S. & Zhang, H. Regulation of bone health through physical exercise: mechanisms and types. Front. Endocrinol. https://doi.org/10.3389/fendo.2022.1029475 (2022).
Kobayashi, Y., Maeda, K. & Takahashi, N. Roles of Wnt signaling in bone formation and resorption. Jpn Dent. Sci. Rev. 44, 76–82 (2008).
Allen, D. L. et al. Effects of spaceflight on murine skeletal muscle gene expression. J. Appl. Physiol. 106, 582–592 (2009).
Cannavo, A. et al. Are skeletal muscle changes during prolonged space flights similar to those experienced by frail and sarcopenic older adults? Life https://doi.org/10.3390/life12122139 (2022).
Fitts, R. H. et al. Prolonged space flight-induced alterations in the structure and function of human skeletal muscle fibres. J. Physiol. 588, 3567–3592 (2010).
Lexell, J. Human aging, muscle mass, and fiber type composition. J. Gerontol. A Biol. Sci. Med. Sci. 50, 11–16 (1995).
Ploutz-Snyder, L. et al. Risk of impaired performance due to reduced mass, strength, and endurance. nasa.gov https://humanresearchroadmap.nasa.gov/evidence/reports/Muscle.pdf (2015).
Yuan, S. & Larsson, S. C. Epidemiology of sarcopenia: prevalence, risk factors, and consequences. Metab. Clin. Exp. https://doi.org/10.1016/j.metabol.2023.155533 (2023).
Colón, C. J. P. et al. Muscle and bone mass loss in the elderly population: advances in diagnosis and treatment. J. Biomed. 3, 40–49 (2018).
Corrêa, D. A. et al. Twice-daily sessions result in a greater muscle strength and a similar muscle hypertrophy compared to once-daily session in resistance-trained men. J. Sports Med. Phys. Fitness 62, 324–336 (2022).
2023 Alzheimer’s disease facts and figures. Alzheimers Dement. 19, 1598–1695 (2023).
Zhang, W., Xiao, D., Mao, Q. & Xia, H. Role of neuroinflammation in neurodegeneration development. Signal Transduct. Target. Ther. https://doi.org/10.1038/s41392-023-01486-5 (2023).
Smith, E. E. et al. Systemic determinants of brain health in ageing. Nat. Rev. Neurol. https://doi.org/10.1038/s41582-024-01016-z (2024).
Todd, K. L. et al. Ventricular and periventricular anomalies in the aging and cognitively impaired brain. Front. Aging Neurosci. 9, 445 (2018).
Wilson, D. M. et al. Hallmarks of neurodegenerative diseases. Cell 186, 693–714 (2023).
Palmer, J. E. et al. Autophagy, aging, and age-related neurodegeneration. Neuron 113, 29–48 (2025).
Livingston, G. et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 396, 413–446 (2020).
Flynn-Evans, E., Gregory, K., Arsintescu, L. & Whitmire, A. Evidence report: risk of performance decrements and adverse health outcomes resulting from sleep loss, circadian desynchronization, and work overload in human health and performance risks of space exploration missions NASA human research roadmap. nasa.gov https://humanresearchroadmap.nasa.gov/evidence/reports/sleep.pdf (2016).
Bloomberg, J. J. et al. Evidence report: risk of impaired control of spacecraft/associated systems and decreased mobility due to vestibular/sensorimotor alterations associated with space flight. nasa.gov https://humanresearchroadmap.nasa.gov/Evidence/reports/SM.pdf (2016).
De la Torre, G. G. Cognitive neuroscience in space. Life 4, 281–294 (2014).
Roberts, D. R. et al. Prolonged microgravity affects human brain structure and function. Am. J. Neuroradiol. 40, 1878–1885 (2019).
Clément, G. R. et al. Challenges to the central nervous system during human spaceflight missions to Mars. J. Neurophysiol. 123, 2037–2063 (2020).
Masarapu, Y. et al. Spatially resolved multiomics on the neuronal effects induced by spaceflight in mice. Nat. Commun. 15, 4778 (2024).
Allen, B. D. et al. Mitigation of helium irradiation-induced brain injury by microglia depletion. J. Neuroinflamm. 17, 159 (2020).
Holley, J. M. et al. Characterization of gene expression profiles in the mouse brain after 35 days of spaceflight mission. NPJ Microgravity 8, 35 (2022).
Van Ombergen, A. et al. Brain ventricular volume changes induced by long-duration spaceflight. Proc. Natl Acad. Sci. USA 116, 10531–10536 (2019).
Fujita, S. et al. Characterization of brain volume changes in aging individuals with normal cognition using serial magnetic resonance imaging. JAMA Netw. Open 6, E2318153 (2023).
Li, Y. et al. Decreased CSF clearance and increased brain amyloid in Alzheimer’s disease. Fluids Barriers CNS 19, 21 (2022).
Malis, V. et al. Age-related decline of intrinsic cerebrospinal fluid outflow in healthy humans detected with non-contrast spin-labeling MR imaging. Magn. Reson. Med. Sci. 23, 66–79 (2024).
Da Mesquita, S., Fu, Z. & Kipnis, J. The meningeal lymphatic system: a new player in neurophysiology. Neuron 100, 375–388 (2018).
Smith, S. K. & Musiek, E. S. Impact of circadian and diurnal rhythms on cellular metabolic function and neurodegenerative diseases. Int. Rev. Neurobiol. 154, 393–412 (2020).
Mestre, H., Mori, Y. & Nedergaard, M. The brain’s glymphatic system: current controversies. Trends Neurosci. 43, 458–466 (2020).
Hulme, B. et al. Epigenetic regulation of BMAL1 with sleep disturbances and Alzheimer’s disease. J. Alzheimers Dis. 77, 1783–1792 (2020).
Niu, L. et al. Chronic sleep deprivation altered the expression of circadian clock genes and aggravated Alzheimer’s disease neuropathology. Brain Pathol. 32, e13028 (2022).
Leng, Y., Musiek, E. S., Hu, K., Cappuccio, F. P. & Yaffe, K. Association between circadian rhythms and neurodegenerative diseases. Lancet Neurol. 18, 307–318 (2019).
Acharya, M. M. et al. New concerns for neurocognitive function during deep space exposures to chronic, low dose-rate, neutron radiation. eNeuro 6, ENEURO.0094-19.2019 (2019).
Wu, M. Y. et al. Cranial irradiation impairs intrinsic excitability and synaptic plasticity of hippocampal CA1 pyramidal neurons with implications for cognitive function. Neural Regen. Res. 17, 2253–2259 (2022).
Romberg, C. et al. Induction and expression of GluA1 (GluR-A)-independent LTP in the hippocampus. Eur. J. Neurosci. 29, 1141–1152 (2009).
Beckhauser, T. F., Francis-Oliveira, J. & De Pasquale, R. Reactive oxygen species: physiological and physiopathological effects on synaptic plasticity. J. Exp. Neurosci. 10, 23–48 (2016).
Hawkley, L. C. & Cacioppo, J. T. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann. Behav. Med. 40, 218–227 (2010).
Knezevic, E., Nenic, K., Milanovic, V. & Knezevic, N. N. The role of cortisol in chronic stress, neurodegenerative diseases, and psychological disorders. Cells https://doi.org/10.3390/cells12232726 (2023).
Bartleson, J. M. et al. SARS-CoV-2, COVID-19 and the aging immune system. Nat. Aging 1, 769–782 (2021).
Crooke, S. N., Ovsyannikova, I. G., Poland, G. A. & Kennedy, R. B. Immunosenescence and human vaccine immune responses. Immun. Ageing https://doi.org/10.1186/s12979-019-0164-9 (2019).
Thomasini, R. L. et al. Aged-associated cytomegalovirus and Epstein-Barr virus reactivation and cytomegalovirus relationship with the frailty syndrome in older women. PLoS ONE 12, e0180841 (2017).
Shaw, A. C., Goldstein, D. R. & Montgomery, R. R. Age-dependent dysregulation of innate immunity. Nat. Rev. Immunol. 13, 875–887 (2013).
Thomas, R., Wang, W. & Su, D. M. Contributions of age-related thymic involution to immunosenescence and inflammaging. Immun. Ageing https://doi.org/10.1186/s12979-020-0173-8 (2020).
Qi, Q. et al. Diversity and clonal selection in the human T-cell repertoire. Proc. Natl Acad. Sci. USA 111, 13139–13144 (2014).
Cancro, M. P. Annual review of immunology: age-associated B cells. Ann. Rev. Immunol. 10, 49 (2025).
Prabhakar, M., Ershler, W. B. & Longo, D. L. Bone marrow, thymus and blood: changes across the lifespan. Aging Health 5, 385–393 (2009).
Crucian, B. et al. Incidence of clinical symptoms during long-duration orbital spaceflight. Int. J. Gen. Med. 9, 383–391 (2016).
Rykova, M. P., Antropova, E. N., Larina, I. M. & Morukov, B. V. Humoral and cellular immunity in cosmonauts after the ISS missions. Acta Astronaut. 63, 697–705 (2008).
Crucian, B. et al. Alterations in adaptive immunity persist during long-duration spaceflight. NPJ Microgravity 1, 15013 (2015).
Rooney, B. V., Crucian, B. E., Pierson, D. L., Laudenslager, M. L. & Mehta, S. K. Herpes virus reactivation in astronauts during spaceflight and its application on earth. Front. Microbiol. https://doi.org/10.3389/fmicb.2019.00016 (2019).
Bennett, J. M. et al. Inflammation and reactivation of latent herpesviruses in older adults. Brain Behav. Immun. 26, 739–746 (2012).
Tomusiak, A. et al. Development of an epigenetic clock resistant to changes in immune cell composition. Commun. Biol. 7, 934 (2024).
Benjamin, C. L. et al. Decreases in thymopoiesis of astronauts returning from space flight. JCI Insight 1, e88787 (2016).
Steffen, J. M. & Musacchia, X. J. Thymic involution in the suspended rat: adrenal hypertrophy and glucocorticoid receptor content. Aviat. Space Environ. Med. 57, 162–167 (1986).
Duggal, N. A., Pollock, R. D., Lazarus, N. R., Harridge, S. & Lord, J. M. Major features of immunesenescence, including reduced thymic output, are ameliorated by high levels of physical activity in adulthood. Aging Cell 17, e12750 (2018).
Zöphel, D., Hof, C. & Lis, A. Altered Ca2+ homeostasis in immune cells during aging: role of ion channels. Int. J. Mol. Sci. https://doi.org/10.3390/ijms22010110 (2020).
Tsai, S. et al. Insulin receptor-mediated stimulation boosts t cell immunity during inflammation and infection. Cell Metab. 28, 922–934 (2018).
Makhijani, P. et al. Regulation of the immune system by the insulin receptor in health and disease. Front. Endocrinol https://doi.org/10.3389/fendo.2023.1128622 (2023).
Montoliu, T., Hidalgo, V. & Salvador, A. The relationship between loneliness and cognition in healthy older men and women: the role of cortisol. Psychoneuroendocrinology 107, 270–279 (2019).
Shen-Orr, S. S. et al. Defective signaling in the JAK-STAT pathway tracks with chronic inflammation and cardiovascular risk in aging humans. Cell Syst. 3, 374–384 (2016).
Moreno-Villanueva, M., Wong, M., Lu, T., Zhang, Y. & Wu, H. Interplay of space radiation and microgravity in DNA damage and DNA damage response. NPJ Microgravity https://doi.org/10.1038/s41526-017-0019-7 (2017).
Pariset, E. et al. DNA damage baseline predicts resilience to space radiation and radiotherapy. Cell Rep. 33, 108434 (2020).
Shi, L. et al. Spaceflight and simulated microgravity suppresses macrophage development via altered RAS/ERK/NFκB and metabolic pathways. Cell. Mol. Immunol. 18, 1489–1502 (2021).
Rappaport, S. M. & Smith, M. T. Environment and disease risks. Science 330, 460–461 (2010).
He, Y. et al. Comparisons of polyexposure, polygenic, and clinical risk scores in risk prediction of type 2 diabetes. Diabetes Care 44, 935–943 (2021).
Topol, E. J. High-performance medicine: the convergence of human and artificial intelligence. Nat. Med. 25, 44–56 (2019).
Lenharo, M. The testing of AI in medicine is a mess. Here’s how it should be done. Nature 632, 722–724 (2024).
Palaniappan, K., Lin, E. Y. T., Vogel, S. & Lim, J. C. W. Gaps in the global regulatory frameworks for the use of artificial intelligence (AI) in the healthcare services sector and key recommendations. Healthcare https://doi.org/10.3390/healthcare12171730 (2024).
Scott, R. T. et al. Biomonitoring and precision health in deep space supported by artificial intelligence. Nat. Mach. Intell. https://doi.org/10.1038/s42256-023-00617-5 (2023).
Pavez Loriè, E. et al. The future of personalized medicine in space: from observations to countermeasures. Front. Bioeng. Biotechnol. https://doi.org/10.3389/fbioe.2021.739747 (2021).
Theriot, C. A. et al. TOPICAL: enabling a precision health system for deep space exploration. IEEE Open J. Eng. Med. Biol. 4, 162–167 (2023).
Fries, J. The compression of morbidity. Milbank Q. 61, 397–419 (1983).
Buettmann, E. G. et al. Similarities between disuse and age-induced bone loss. J. Bone Min. Res. 37, 1417–1434 (2022).
Madsen, S. K. et al. Mapping ventricular expansion onto cortical gray matter in older adults. Neurobiol. Aging 36, S32–S41 (2015).
Khalil, M. et al. Serum neurofilament light levels in normal aging and their association with morphologic brain changes. Nat. Commun. 11, 812 (2020).
Varma, V. et al. Longitudinal progression of blood biomarkers reveals a key role of astrocyte reactivity in preclinical Alzheimer’s disease. Med. https://doi.org/10.1016/j.medj.2025.100724 (2025).
Bateman, R. J. et al. Clinical and biomarker changes in dominantly inherited Alzheimer’s disease. N. Engl. J. Med. 367, 795–804 (2012).
Palmqvist, S., Mattsson, N. & Hansson, O. Amyloid biomarkers: pushing the limits of early detection. Brain 139, 1008–1010 (2016).
Lakatta, E. G. & Levy, D. Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: part I: aging arteries: a ‘set up’ for vascular disease. Circulation 107, 139–146 (2003).
Scott, J. M. et al. Effects of exercise countermeasures on multisystem function in long duration spaceflight astronauts. NPJ Microgravity 9, 11 (2023).
Pido-Lopez, J., Imami, N. & Aspinall, R. Both age and gender affect thymic output: more recent thymic migrants in females than males as they age. Clin. Exp. Immunol. 125, 409–413 (2001).
Ferrucci, L. & Fabbri, E. Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat. Rev. Cardiol. 15, 505–522 (2018).
Angioni, R. et al. Age-severity matched cytokine profiling reveals specific signatures in COVID-19 patients. Cell Death Dis. 11, 957 (2020).
Acknowledgements
We thank J. Baechle for discussions related to this manuscript. This work was supported in part through funds derived from the Buck Institute for Research on Aging (to D.A.W. and D.F.), the Buck Bioinformatics Core (to D.F.), the Natural Sciences and Engineering Research Council of Canada (NSERC, grant RGPIN-2024-05532, to D.A.W.) and the Huiying Memorial Foundation (to D.A.W.).
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D.F. and D.A.W. are cofounders of Cosmica Biosciences, a company that studies altered biological aging in spaceflight exposures. F.W. is a stakeholder in Cosmica Biosciences. The remaining authors declare no competing interests.
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Nature Aging thanks Jeremy Teo, who co-reviewed with Mei ElGindi; Charles Wang, who co-reviewed with Zhong Chen; and Evandro Fei Fang for their contribution to the peer review of this work.
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Manwaring-Mueller, M., Du, H., Valentino, T.R. et al. The case for space as a model of accelerated aging. Nat Aging (2026). https://doi.org/10.1038/s43587-026-01105-2
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DOI: https://doi.org/10.1038/s43587-026-01105-2