Brain aging: Unlocking personalized strategies for cognitive resilience

Brain aging is a complex biological process characterized by a progressive decline in cognitive function and increased vulnerability to neurodegenerative diseases. Although aging is inevitable, its trajectory varies significantly among individuals and is influenced by genetic, molecular, and environmental factors. The increase in global life expectancy has intensified the need for innovative strategies to address age-related cognitive disorders, shifting the focus from reactive treatments to proactive and precision-based interventions. This review summarizes the current knowledge on the mechanistic underpinnings of brain aging, including mitochondrial dysfunction, chronic neuroinflammation, epigenetic alterations, and the disruption of proteostasis. Cutting-edge diagnostic tools were highlighted, such as fluid biomarkers, advanced neuroimaging, and artificial intelligence (AI)-driven predictive models that enable the early detection of pathological changes. Emerging therapeutic approaches, ranging from senolytics and metabolic modulators to lifestyle interventions, have been discussed in the context of personalized therapies. Furthermore, this review summarized the challenges of data interoperability, ethical considerations of genetic risk disclosure, and the imperative for equitable access to these advances. By integrating multi-omics data with real-world metrics, precision medicine offers a transformative framework for preserving cognitive resilience. This review underscores the potential of tailored interventions to mitigate brain aging while addressing the scientific, clinical, and ethical hurdles that remain.