Introduction. The prevalence of sarcopenia, which causes falls, disability, and metabolic disorders, necessitates the search for physiological methods of activating endogenous geroprotective mechanisms, in particular, stimulation of exerkine production, suppression of AMP-activated protein kinase (AMPK), and inflammaging, as opposed to the currently used pharmacological approaches. Objective. To evaluate the effectiveness of a physical rehabilitation program as a non-drug method of activating endogenous geroprotection. Materials and Methods. Thirty-five women aged 65–69 years participated in the pilot project. The 12-month program consisted of two stages: a diagnostic stage (laboratory and clinical-functional monitoring) and a rehabilitation stage. The rehabilitation stage included an adaptation period of 8 weeks, with visits three times a week, and a maintenance period of 40 weeks with a frequency of sessions twice a week in the clinic and five times a week independently. Physical rehabilitation sessions included balance, strength, flexibility, and aerobic exercises. Effectiveness was assessed based on changes in glycemic indicators (glucose, HbA1c), C-reactive protein (CRP) levels, anthropometry, and functional tests (gait speed, stand-up and go test). Results and discussion. Patients included in the program had chronic somatic pathology (arterial hypertension, musculoskeletal pathology accompanied by pain syndrome, type 2 diabetes mellitus), for which they received drug therapy. After 6 months of program implementation, positive dynamics were recorded: an improvement in glycemic indicators by 11.9%, a decrease in the level of C-reactive protein by 15% compared to baseline values. Improvement in neuromuscular balance and mobility was recorded: the time of the «stand and go» test decreased from 15 to 13 seconds (improvement of 13%), the increase in walking speed was 0.09 m/s. Refusal to use a cane was recorded in 100% of patients (n = 21) who previously used one. Conclusion. The physical rehabilitation program demonstrated its effectiveness as a method for activating endogenous geroprotective mechanisms, contributing to improved metabolic control (reduced glycemia and the inflammatory marker CRP), the prevention of sarcopenia, and increased functional independence in patients. The findings support the integration of prolonged rehabilitation programs into geriatric practice.