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. 2021 May 17;12:2862. doi: 10.1038/s41467-021-22922-6

Fig. 4. Model of how Circadian Medicine can be used as an optimized intervention to improve circadian rhythms and potentially promote lifespan.

Fig. 4

The top panel reflects the current evidence that, (1) aging-related pathways oscillate throughout the day; (2) circadian rhythms decline with age and restoring rhythms improves healthspan; and (3) CR, the most robust lifespan-extending intervention, remarkably protects against the age-dependent dampening of circadian rhythms. Circadian medicine introduces a time-of-day concept for administration of drugs. Considering most aging-related genes are circadian, perhaps there is an optimal time for interventions such as CR mimetics (CRMs). The hypothesis behind this model is that there is an optimal time to administer antiaging drugs, which can restore the proper rhythms targets, and consequently boost survival. If there were an optimal time, we would expect robust circadian rhythms even in an aged individual resembling a young state, potentially leading to lifespan extension. On the contrary, a suboptimal time of administration would not be effective or would require a higher dose to reach similar beneficial effect. Tailoring the treatment for each drug as to how often and what time of the day is still required, as it depends on pharmacokinetic properties, tissue-specific pathways, potential sex-differences, and other factors.