Fiscal Sustainability Report. (2025). Scottish Fiscal Commission.
Rowe , J.W. (1997). Successful aging. Gerontologist. doi: 10.1093/geront/37.4.433
Tessier , A.J. (2025). Optimal dietary patterns for healthy aging. Nat Med. doi: 10.1038/s41591-025-03570-5
Khan , S. (2017). Molecular and physiological manifestations and measurement of aging in humans.. Aging Cell. doi: 10.1111/acel.12601
Hamczyk, M. (2020). Biological Versus Chronological Aging: JACC Focus Seminar. Journal of the American College of Cardiology. doi: 10.1016/j.jacc.2019.11.062
Argentieri , M.A. (2025). Integrating the environmental and genetic architectures of aging and mortality. Nat Med. doi: 10.1038/s41591-024-03483-9
Teschendorff , A.E. (2025). Epigenetic ageing clocks: statistical methods and emerging computational challenges. Nat Rev Genet.. doi: 10.1038/s41576-024-00807-w
Shen, X. (2024). Nonlinear dynamics of multi-omics profiles during human aging. Nat Aging. doi: 10.1038/s43587-024-00692-2
Horvath, S. (2013). DNA methylation age of human tissues and cell types. Genome Biol. doi: 10.1186/gb-2013-14-10-r115
Hannum, G. (2013). Genome-wide methylation profiles reveal quantitative views of human aging rates.. Mol. Cell. doi: 10.1016/j.molcel.2012.10.016
Rutledge, J. (2022). Measuring biological age using omics data. Nature Reviews Genetics. doi: 10.1038/s41576-022-00511-7
Horvath, S. (2018). DNA methylation-based biomarkers and the epigenetic clock theory of ageing. Nat. Rev. Genet. doi: 10.1038/s41576-018-0004-3
Waziry , R. (2023). Effect of long-term caloric restriction on DNA methylation measures of biological aging in healthy adults from the CALERIE trial. . Nat Aging. doi: 10.1038/s43587-023-00432-y
Yaskolka Meir, A. (2023). The effect of polyphenols on DNA methylation-assessed biological age attenuation: the DIRECT PLUS randomized controlled trial. . BMC Med. doi: 10.1186/s12916-023-03067-3
Ammous , F. (2025). Physical Activity Is Associated With Decreased Epigenetic Aging: Findings From the Health and Retirement Study. J Cachexia Sarcopenia Muscle. doi: 10.1002/jcsm.13873
Nagata, M. (2024). Influence of physical activity on the epigenetic clock: evidence from a Japanese cross-sectional study.. Clin Epigenetics. doi: 10.1186/s13148-024-01756-1
Coronel-Oliveros, C. (2025). Creative experiences and brain clocks. Nat Commun. doi: 10.1038/s41467-025-64173-9
Fahy , G.M. (2019). Reversal of epigenetic aging and immunosenescent trends in humans. . Aging Cell. doi: 10.1111/acel.13028
Srour, L. (2025). Deep aging clocks: AI-powered strategies for biological age estimation. Ageing Research Reviews. doi: 10.1016/j.arr.2025.102889
Haugg , F. (2025). Imaging biomarkers of ageing: a review of artificial intelligence-based approaches for age estimation. Lancet Healthy Longev. doi: 10.1016/j.lanhl.2025.100728
Kroemer, G. (2025). From geroscience to precision geromedicine: Understanding and managing aging. Cell. doi: 10.1016/j.cell.2025.03.011
López-Otín, C. (2023). Hallmarks of aging: An expanding universe. Cell. doi: 10.1016/j.cell.2022.11.001
Plaza-Diaz, J. (2022). Impact of Physical Activity and Exercise on the Epigenome in Skeletal Muscle and Effects on Systemic Metabolism. Biomedicines. doi: https://doi.org/10.3390/biomedicines10010126
Joehanes, R. (2016). Epigenetic Signatures of Cigarette Smoking. Circulation: Cardiovascular Genetics. doi: 10.1161/circgenetics.116.001506
Herzog, C. (2024). Cigarette smoking and e-cigarette use induce shared DNA methylation changes linked to carcinogenesis. Cancer Research. doi: 10.1158/0008-5472.CAN-23-2957
Hipp , M.S. (2019). The Proteostasis Network and Its Decline in Ageing. Nature Reviews Molecular Cell Biology. doi: 10.1038/s41580-019-0101-y
Lehtonen, . (2019). Dysfunction of Cellular Proteostasis in Parkinson’s Disease. Frontiers in Neuroscience. doi: 10.3389/fnins.2019.00457
Feng, Y. (2013). The machinery of macroautophagy. Cell Research. doi: 10.1038/cr.2013.168
Littlewood, K. (2025). Metabolic dysfunction over a life course key to healthy ageing inequality. Aging Clin Exp Res. doi: 10.1007/s40520-025-03034-3
Costantino, S. (2019). GLP-1-based therapies to boost autophagy in cardiometabolic patients: From experimental evidence to clinical trials. . Vascular Pharmacology. doi: 10.1016/j.vph.2019.03.003
Efeyan, . (2015). Nutrient-sensing mechanisms and pathways. Nature. doi: 10.1038/nature14190
Johnson, . (2018). Nutrient Sensing, Signaling and Ageing: The Role of IGF-1 and mTOR in Ageing and Age-Related Disease. Sub-cellular biochemistry. doi: 10.1007/978-981-13-2835-0_3
Hotamisligil, G.S. (2008). Nutrient sensing and inflammation in metabolic diseases. Nature Reviews Immunology. doi: 10.1038/nri2449
Mannick, J.B. (2021). Targeting the biology of ageing with mTOR inhibitors to improve immune function in older adults: phase 2b and phase 3 randomised trials. Lancet Healthy Longev. doi: 10.1016/S2666-7568(21)00062-3
Mannick, J.B. (2018). TORC1 inhibition enhances immune function and reduces infections in the elderly. Sci. Transl. Med. doi: 10.1126/scitranslmed.aaq1564
Lawrence, H. (2022). Impact of social deprivation on clinical outcomes of adults hospitalised with community-acquired pneumonia in England: a retrospective cohort study. BMJ Open Respir Res.. doi: 10.1136/bmjresp-2022-001318
Zong, Y. (2024). Mitochondrial dysfunction: Mechanisms and Advances in Therapy.. Signal Transduction and Targeted Therapy. doi: 10.1038/s41392-024-01839-8
Desdin-Mico, G. (2020). T cells with dysfunctional mitochondria induce multimorbidity and premature senescence. Science. doi: 10.1126/science.aax0860
Huang, W. (2022). Cellular senescence: the good, the bad and the unknown. . Nature Reviews Nephrology. doi: 10.1038/s41581-022-00601-z
Coppe, J.P. (2008). Senescence-associated secretory phenotypes reveal cell-nonautonomous functions of oncogenic RAS and the p53 tumor suppressor.. PLOS Biol. doi: 10.1371/journal.pbio.0060301
Poliwoda, S. (2022). Stem cells: a Comprehensive Review of Origins and Emerging Clinical Roles in Medical Practice. Orthopedic Reviews. doi: 10.52965/001c.37498
Lawton, A. (2024). Running on empty: Exploring stem cell exhaustion in geriatric musculoskeletal disease. Maturitas . doi: 10.1016/j.maturitas.2024.108066
Liu, M. (2017). Adipose-Derived Mesenchymal Stem Cells from the Elderly Exhibit Decreased Migration and Differentiation Abilities with Senescent Properties. . Cell Transplantation,. doi: 10.1177/0963689717721221
Li, X. (2023). Inflammation and aging: signaling pathways and intervention therapies. . Sig Transduct Target Ther . doi: 10.1038/s41392-023-01502-8
McDonald, D. (2018). American Gut: an Open Platform for Citizen Science Microbiome Research.. mSystems. doi: 10.1128/msystems.00031-18
Shen, Y. (2025). Gut Microbiota Dysbiosis: Pathogenesis, Diseases, Prevention, and Therapy.. MedComm. doi: 10.1002/mco2.70168
Claesson , M.J. (2012). Gut microbiota composition correlates with diet and health in the elderly. Nature. doi: 10.1038/nature11319
Johnstone, A. (2025). Consensus statement on exploring the Nexus between nutrition, brain health and dementia prevention. Nutr Metab (Lond). doi: 10.1186/s12986-025-00981-6
Quan, W. (2022). Association of dietary meat consumption habits with neurodegenerative cognitive impairment: an updated systematic review and dose–response meta-analysis of 24 prospective cohort studies.. Food & Function. doi: 10.1039/d2fo03168j
Franz, C. (2010). The Extracellular Matrix at a Glance. Journal of Cell Science. doi: 10.1242/jcs.023820
Fafian-Labora, J.A. (2020). Classical and Nonclassical Intercellular Communication in Senescence and Ageing. . Trends in Cell Biology. doi: 10.1016/j.tcb.2020.05.003
Selman, M. (2021). Fibroageing: An ageing pathological feature driven by dysregulated extracellular matrix-cell mechanobiology. Ageing Research Reviews. doi: 10.1016/j.arr.2021.101393
Kwon, K.Y. (2026). How social isolation accelerates biological aging: Exploring underlying behavioral and psychological mechanisms. Social Science & Medicine. doi: 10.1016/j.socscimed.2025.118874
Steptoe, A. (2013). Social Isolation, Loneliness, and All-Cause Mortality in Older Men and Women.. Proceedings of the National Academy of Sciences. doi: 10.1073/pnas.1219686110
Fagan, A. (2024). A qualitative exploration of the lives lived by Irish centenarians. Journal of Aging Studies. doi: 10.1016/j.jaging.2024.101252
Rodríguez-Mañas, L. (2023). Good nutrition across the lifespan is foundational for healthy aging and sustainable development.. Frontiers in Nutrition. doi: 10.3389/fnut.2022.1113060
Shannon, O.M. (2021). Mediterranean diet and the hallmarks of ageing. Eur J Clin Nutr . doi: 10.1038/s41430-020-00841-x
Mikkila , V. (2005). Consistent dietary patterns identified from childhood to adulthood: the Cardiovascular Risk in Young Finns Study. . Br J Nutr. doi: 10.1079/bjn20051418
World Health Organization . (2019). Commercial Foods for Infants and Young Children in the WHO European Region. A Study of the Availability, Composition and Marketing of Baby Foods in Four European Countries. . Retrieved from
https://www.who.int/europe/publications/i/item/9789289057783 [accessed 27 December 2025]
Assmann, K.E. (2018). Association between adherence to the Mediterranean diet at midlife and healthy aging in a cohort of French adults.. J. Gerontol. A Biol. Sci. Med. Sci..
Gopinath, B. (2016). Adherence to dietary guidelines and successful aging over 10 years. J. Gerontol. A Biol. Sci. Med. Sci. .
Leij-Halfwerk, S. (2019). Prevalence of protein-energy malnutrition risk in European older adults in community, residential and hospital settings, according to 22 malnutrition screening tools validated for use in adults =65 years: A systematic review and meta-analysis. Maturitas .. doi: 10.1016/j.maturitas.2019.05.006.
Dent, E. (2023). Malnutrition in older adults. The Lancet. doi: 10.1016/S0140-6736(22)02612-5
Lorenzo-López, L. (2017). Nutritional determinants of frailty in older adults: a systematic review.. BMC Geriatr. . doi: 10.1186/s12877-017-0496-2.
Correa-Burrows , P. (2025). Long-Term Obesity and Biological Aging in Young Adults. . JAMA Netw Open. doi: 10.1001/jamanetworkopen.2025.20011
Salvestrini, V. (2019). Obesity may accelerate the aging process. . Front Endocrinol (Lausanne). doi: 10.3389/fendo.2019.00266
Tam, B.T. (2020). Obesity and ageing: two sides of the same coin. . Obes Rev. doi: 10.1111/obr.12991
Marinac, C.R. (2019). Rising cancer incidence in younger adults: is obesity to blame? . Lancet Public Health. doi: 10.1016/S2468-2667(19)30017-9
Cizza, G. (2012). Rising incidence and challenges of childhood diabetes: a mini review. . J Endocrinol Invest. .
Ragusa, F.S. (2025). Weight of time: exploring the link between obesity and aging.. Aging Clin Exp Res. doi: 10.1007/s40520-025-03106-4
Qiu, Y. (2025). Exercise attenuates the hallmarks of aging: Novel perspectives. J Sport Health Sci. doi: 10.1016/j.jshs.2025.101108
Public Health Scotland. (2024). Estimating the burden of disease attributable to physical inactivity in Scotland. [accessed 29 December 2025]
Hamaya, R. (2025). Association between frequency of meeting daily step thresholds and all-cause mortality and cardiovascular disease in older women. British Journal of Sports Medicine. doi: 10.1136/bjsports-2025-110311
Ungvari, Z. (2023). The multifaceted benefits of walking for healthy aging: from blue zones to molecular mechanisms.. GeroScience . doi: 10.1007/s11357-023-00873-8
Hirvensalo , M. (2011). Life-course perspective for physical activity and sports participation. . European Review of Aging and Physical Activity.. doi: 10.1007/s11556-010-0076-3
Skelton, D. (2018). How do muscle and bone strengthening and balance activities (MBSBA) vary across the life course, and are there particular ages where MBSBA are most important?. J Frailty Sarcopenia Falls.. doi: 10.22540/JFSF-03-074
Montero-Fernandez, N. (2013). Role of exercise on sarcopenia in the elderly.. Eur J Phys Rehabil Med.
Young, A. (1994). Applied physiology of strength and power in old age. . Int J Sports Med.. doi: doi: 10.1055/s-2007-1021037
Skelton, D. (1999). Exercise for falls management:Rationale for an exercise programme aimed at reducing postural instability.. Physiotherapy Theory &Practice. .
Davidson, R. (2023). Ageing, sport and physical activity participation in Scotland. Front Sports Act Living. doi: 10.3389/fspor.2023.1213924
Meisters, R. (2021). Does Loneliness Have a Cost? A Population-Wide Study of the Association Between Loneliness and Healthcare Expenditure. Int J Public Health .. doi: 10.3389/ijph.2021.581286
Lindsay-Smith, G. (2018). A mixed methods case study exploring the impact of membership of a multi-activity, multicentre community group on social wellbeing of older adults.. BMC Geriatr. . doi: 10.1186/s12877-018-0913-1.
Shvedko, A. (2018). Physical Activity Intervention for Loneliness (PAIL) in community-dwelling older adults: protocol for a feasibility study. Pilot Feasibility Stud.. doi: 10.1186/s40814-018-0379-0
Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. (1998). Lancet.
Bannister, C.A. (2014). Can people with type 2 diabetes live longer than those without? A comparison of mortality in people initiated with metformin or sulphonylurea monotherapy and matched, non-diabetic controls. Diabetes Obes. Metab.
Campbell, J.M. (2017). Metformin reduces all-cause mortality and diseases of ageing independent of its effect on diabetes control: a systematic review and meta-analysis. Ageing Research Reviews.
King, P. (1999). The UK Prospective Diabetes Study (UKPDS): clinical and therapeutic implications for type 2 diabetes. Br J Clin Pharmacol.
Yang, Y. (2024). Metformin decelerates aging clock in male monkeys. Cell. doi: 10.1016/j.cell.2024.08.021
Chavda, V.P. (2024). Unlocking longevity with GLP-1: A key to turn back the clock?. Maturitas. doi: 10.1016/j.maturitas.2024.108028
Moiz, A. (2025). Efficacy and Safety of Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss Among Adults Without Diabetes : A Systematic Review of Randomized Controlled Trials. Ann Intern Med. doi: 10.7326/ANNALS-24-01590
Colhoun , H.M. (2024). Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial.. Nat Med. doi: 10.1038/s41591-024-03015-5
Edison, P. (2025). Liraglutide in mild to moderate Alzheimer’s disease: a phase 2b clinical trial. Nature Medicine. doi: phase 2b clinical trial
Prado, C.M. (2024). Muscle matters: the effects of medically induced weight loss on skeletal muscle. The Lancet Diabetes & Endocrinology . doi: 10.1016/S2213-8587(24)00272-9
Wilding , J. (2022). Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension.. Diabetes Obes Metab. . doi: 10.1111/dom.14725
West, J. (2026). Weight regain after cessation of medication for weight management: systematic review and meta-analysis. BMJ. doi: https://doi.org/10.1136/bmj-2025-085304
The expanding role of GLP-1 receptor agonists: a narrative review of current evidence and future directions. (2025). eClinicalMedicine. doi: 10.1016/j.eclinm.2025.103363
Arai, Y. (2015). Inflammation, but not telomere length, predicts successful ageing at extreme old age: a longitudinal study of semi-supercentenarians.. EBioMedicine . doi: 10.1016/j.ebiom.2015.07.029
Sayed, N. (2021). An inflammatory aging clock (iAge) based on deep learning tracks multimorbidity, immunosenescence, frailty and cardiovascular aging. . Nat. Aging . doi: 10.1038/s43587-021-00082-y
Campisi , J. (2019). From discoveries in ageing research to therapeutics for healthy ageing.. Nature. doi: 10.1038/s41586-019-1365-2
ClinicalTrials.gov. (2025). An Open-Label Intervention Trial to Reduce Senescence and Improve Frailty in Adult Survivors of Childhood Cancer. Retrieved from
https://clinicaltrials.gov/study/NCT04733534 [accessed 5 January 2026]
Raffaele , M. (2022). The costs and benefits of senotherapeutics for human health. Lancet Healthy Longev. doi: 10.1016/S2666-7568(21)00300-7
Ellison-Hughes, G.M. (2020). First evidence that senolytics are effective at decreasing senescent cells in humans. EBioMedicine. doi: 10.1016/j.ebiom.2019.09.05
Saliev, T. (2025). Targeting Senescence: A Review of Senolytics and Senomorphics in Anti-Aging Interventions. Biomolecules. doi: 10.3390/biom15060860