The proposed nine hallmarks of aging are grouped into three categories. In the top, those hallmarks considered to be the primary causes of cellular damage. In the middle, those considered to be part of compensatory or antagonistic responses to the damage. These responses initially mitigate the damage, but eventually, if chronic or exacerbated, they become deleterious themselves. In the bottom, there are integrative hallmarks that are the end result of the previous two groups of hallmarks and are ultimately responsible for the functional decline associated with aging.