Summary: Longevity medicine is preventive care aimed at keeping people healthy for more of their lives, not only at treating disease once it appears. Most programs combine an intake, blood tests, clinician review, and follow-up. The best-supported parts overlap with standard cardiovascular prevention and exercise; many popular add-ons are still experimental.
This article is educational and is not medical advice. Talk with a licensed clinician about your own health.
What is longevity medicine?
Longevity medicine is a care model built around healthspan, meaning the number of years a person lives in good health, rather than lifespan alone. (Our Index entry on healthspan vs lifespan explains the difference in more detail.) In practice, it borrows from preventive cardiology, sports medicine, and geriatrics, and adds an interest in the biology of aging itself.
That biology is the subject of a research field called geroscience. Its central idea is that a small set of shared processes, such as cellular senescence, chronic inflammation, and declining mitochondrial function, drive many age-related diseases at once. A widely cited 2023 review in Cell organized these processes into twelve “hallmarks of aging,” and a 2025 follow-up by some of the same authors added two more (extracellular matrix changes and psychosocial isolation). Much of the evidence behind the hallmarks comes from animals, so the framework guides research questions more than it guides individual care today.
It helps to keep one regulatory fact in view. As of September 2026, no drug is approved by the U.S. Food and Drug Administration (FDA) to treat aging itself. Researchers designing aging trials note that the FDA does not currently treat aging as an indication. That is why the best-known proposed aging trial, TAME (Targeting Aging with Metformin), was designed around a composite of major age-related diseases (heart disease, cancer, dementia) and death instead of aging itself (Barzilai et al., Cell Metabolism, 2016; American Federation for Aging Research).
How is it different from primary care?
Primary care and longevity medicine overlap more than marketing suggests. The main differences are time, testing, and payment.
A typical primary care visit is short and focused on current problems and guideline-based screening. Longevity programs usually offer longer or more frequent visits, larger lab panels, and more attention to fitness, sleep, and body composition. Many are cash-pay memberships that insurance does not cover.
What longevity medicine does not do is replace primary care. Cancer screening, vaccinations, and management of conditions such as high blood pressure or diabetes still follow standard guidelines. A well-run program coordinates with your primary care clinician rather than working around them.
What happens in a typical longevity program?
Most programs follow a similar shape, whether they operate in person or online:
- Intake. A health history, family history, medication list, and questionnaires about sleep, activity, diet, and goals.
- Labs and assessments. Blood work, often with markers beyond a standard annual panel, and sometimes fitness or body-composition testing.
- Clinician review. A licensed clinician interprets results in context and discusses options. Any prescription decision belongs to that clinician.
- Follow-up. Repeat visits and periodic retesting to see whether anything has changed.
The follow-up step is where programs differ most. Some offer ongoing coaching and messaging; others are closer to a one-time assessment with a report. Our upcoming cost guide breaks down what those differences mean for price.
Which tests do programs commonly use?
Test menus vary, but a few categories appear often:
- Cardiovascular risk markers. Standard lipids, plus markers such as ApoB, lipoprotein(a), and high-sensitivity C-reactive protein. Our explainer on ApoB, Lp(a), and hs-CRP covers what each one measures and what guidelines say about them.
- Metabolic markers. Blood sugar and related measures.
- Fitness measures. Cardiorespiratory fitness (VO2 max) and grip strength are associated with lower mortality in large observational studies. In a Cleveland Clinic cohort of 122,007 adults who had treadmill tests, the fittest group had an 80% lower adjusted risk of death than the least fit group over a median of 8.4 years (Mandsager et al., JAMA Network Open, 2018). In the PURE study of 139,691 adults in 17 countries, each 5 kg lower grip strength was associated with a 16% higher risk of death over a median of 4 years (Leong et al., Lancet, 2015). These are associations, not proof that raising either number extends life.
- Body composition. Some programs list a DEXA scan on their menu to estimate fat and lean mass. Our sister publication Metabolic Media covers body composition testing in depth.
- “Biological age” tests. Epigenetic clocks estimate age from chemical marks on DNA.
Biological age tests deserve a caution. They are research tools, not diagnoses. Different clocks use different algorithms and training data, and they often disagree with one another. A September 2026 Stanford Medicine overview noted that many epigenetic clocks carry roughly three years of built-in error, so a result showing you are three years “older” could reflect noise. A 2025 peer-reviewed review likewise described technical variability and limited ability to forecast healthspan. A single score is not a verdict on how well you are aging.
Which interventions are evidence-backed and which are still experimental?
This is the most useful distinction a reader can make.
Supported by strong human evidence. The 2019 American College of Cardiology and American Heart Association guideline on primary prevention of cardiovascular disease lays out the core: regular physical activity (the guideline cites at least 150 minutes a week of moderate activity or 75 minutes of vigorous activity for adults), a diet emphasizing vegetables, fruits, whole grains, nuts, and fish, not using tobacco, managing blood pressure, and clinician-guided cholesterol treatment based on overall risk. None of this is new, but it remains the foundation any credible longevity program is built on.
Common program focuses where the evidence is largely observational. Many programs also emphasize sleep and social connection. The 2025 Cell review notes that a lack of social support is considered a marker of poor health and proposes psychosocial isolation as a hallmark of aging. That framework is still being tested, and it does not show that a program’s sleep or social coaching changes how people age.
Still experimental. Several interventions attract attention because of animal research, but human evidence for slowing aging is missing or early:
- Rapamycin extended median and maximum lifespan in genetically diverse mice in the National Institute on Aging’s Interventions Testing Program, even when started late in life (at about 600 days of age). Based on age at 90% mortality, lifespan rose about 14% in females and 9% in males (Harrison et al., Nature, 2009). Human data on aging are limited.
- Metformin is an established diabetes medicine. Its role in aging is still an open question: the TAME trial has been designed and discussed since 2015 but, as of September 2026, its sponsor describes it as still needing funding to launch, so no results exist.
- NAD+ precursors (such as NMN and nicotinamide riboside) raise NAD+ levels in blood, but a rise in a biomarker is not the same as a longer or healthier life. Randomized trials, including a one-year NMN study in middle-aged and older adults listed on ClinicalTrials.gov, are still underway.
- Senolytics, drugs that clear senescent cells, have shown effects in mice. No senolytic is FDA-approved for aging.
Mouse results are never evidence that something works in people. When a program presents an experimental option, it is fair to ask what human data exist and how large those studies were.
Some programs also list peptides on their menus. For background on what peptides are and how they are regulated, see The Peptide Report’s peptide profiles hub.
Concierge vs telehealth models
Longevity programs generally come in two forms.
Concierge or in-person clinics usually offer extended visits, on-site testing such as fitness or imaging, and direct access to a clinician. They tend to cost more, and availability depends on where you live.
Telehealth programs handle visits by video or messaging and send patients to a local lab or use at-home collection kits. They are often less expensive and easier to access, but hands-on assessments are limited, and prescribing depends on the clinician being licensed in your state.
Neither model is better for everyone. The right fit depends on what you want tested, how much follow-up you want, and your budget. Our care models and cost hub collects our coverage of both.
Questions to ask before joining
- Who are the clinicians, and are they licensed in my state?
- Which tests are included, and what does each one add beyond standard care?
- How are results explained, and how often is follow-up?
- Which recommendations rest on human trials, and which are experimental?
- If a medication is prescribed, which pharmacy fills it, and is it an FDA-approved product or a compounded preparation?
- What is the total yearly cost, including labs and add-ons?
- Will the program share results with my primary care clinician?
Clear answers to these questions are a good sign.
FAQ
What kind of clinicians practice longevity medicine? Clinicians in the field usually come from internal medicine, family medicine, cardiology, or sports medicine. It is worth asking about a clinician’s training and licensure before joining a program.
Can a longevity program slow my aging? No test or treatment has been shown in human trials to slow aging itself. What strong evidence does support is lowering cardiovascular risk, staying active, and following standard preventive care, which many programs emphasize.
Are biological age tests accurate? They are useful in research but inconsistent for individuals. Different clocks can give different answers, and results can carry roughly three years of error, according to a Stanford Medicine overview.
Does insurance cover longevity programs? Memberships are usually cash-pay. Some individual lab tests may be covered when ordered for a medical reason, so check with your insurer.
Is longevity medicine a replacement for my regular doctor? No. It works best alongside primary care, not instead of it.
Sources
- López-OtÃn C, Blasco MA, Partridge L, Serrano M, Kroemer G. “Hallmarks of aging: An expanding universe.” Cell. 2023;186(2):243-278. PMID 36599349. https://europepmc.org/article/med/36599349
- López-OtÃn C, Kroemer G, et al. “From geroscience to precision geromedicine: Understanding and managing aging.” Cell. 2025;188(8):2043-2062. PMID 40250404. https://www.cell.com/cell/fulltext/S0092-8674(25)00284-3
- Arnett DK, Blumenthal RS, et al. “2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease.” Circulation. 2019. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000678 (Executive summary: https://pubmed.ncbi.nlm.nih.gov/30879339/)
- Barzilai N, Crandall JP, Kritchevsky SB, Espeland MA. “Metformin as a Tool to Target Aging.” Cell Metabolism. 2016;23(6):1060-1065. PMID 27304507. https://pubmed.ncbi.nlm.nih.gov/27304507/
- American Federation for Aging Research. “TAME: Targeting Aging with Metformin.” Accessed September 28, 2026. https://www.afar.org/tame-trial/
- Stanford Medicine. “Biological age versus chronological age: What the science says.” September 2026. https://med.stanford.edu/news/insights/2026/09/biological-chronological-age.html
- “Epigenetic Clocks: Beyond Biological Age, Using the Past to Predict the Present and Future.” PMC review, 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12539533/
- ClinicalTrials.gov. “Intervention of Nicotinamide Mononucleotide in Middle-aged and Elderly People” (NCT06592859). https://clinicaltrials.gov/study/NCT06592859
- Mandsager K, Harb S, Cremer P, Phelan D, Nissen SE, Jaber W. “Association of Cardiorespiratory Fitness With Long-term Mortality Among Adults Undergoing Exercise Treadmill Testing.” JAMA Network Open. 2018;1(6):e183605. https://doi.org/10.1001/jamanetworkopen.2018.3605
- Leong DP, Teo KK, et al. “Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study.” Lancet. 2015;386(9990):266-273. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62000-6/abstract
- Harrison DE, Strong R, Sharp ZD, et al. “Rapamycin fed late in life extends lifespan in genetically heterogeneous mice.” Nature. 2009;460:392-395. PMID 19587680. https://doi.org/10.1038/nature08221
Longevity Index publishes educational content only. It is not medical advice. Regulatory status is stated as of September 2026.