Mitochondrial dysfunction and energy metabolism

Mitochondrial dysfunction is not defined as an isolated “ATP problem” in the Hallmarks of Ageing framework, but as a systemic shift in bioenergetics, redox signaling, quality control and immune metabolism. In the Hallmark update (2023), the mitochondrial axis remains central and explicitly interacts with “disabled macroautophagy”, chronic inflammation and other Hallmarks. For medical practice, this entails a double task: to understand the mechanisms scientifically correctly (including their adaptivity and tissue specificity) and to keep the clinical translation evidence-based – especially where mitochondria-targeted interventions are increasingly marketed as “longevity”, but the data situation is still endpoint- and population-dependent.