Researchers are moving toward human trials of treatments designed to slow biological aging, but no clinical trial evidence yet shows that changing aging biology can extend people’s healthy years. Longevity clinics now offer expanded testing and personalized interventions; the link between proposed biological markers and longer healthy lives, however, remains unproven.
The Evidence Gap
Daniel Belsky, associate professor of epidemiology at the Columbia University Mailman School of Public Health and the Robert N. Butler Columbia Aging Center, said researchers haven’t tested the hypothesis in humans. “We don’t know yet whether we can really do this. But we do have an alignment of evidence to argue this is possible. And we now have a mobilization of resources to actually test it,” he said.
Nir Barzilai, director of the institute for aging research at Albert Einstein College of Medicine in New York City, described aging as a biological process that can contribute to multiple diseases. “Aging has biology. This biology drives diseases.” Rather than wait for diabetes, cardiovascular disease or cancer to emerge and treat each separately, Barzilai said, medicine could eventually target processes associated with aging.
Laboratory studies have changed aging biology in organisms from roundworms to mice. Belsky said medicines, exercise, calorie restriction and other interventions can slow cellular changes associated with aging and extend animals’ lives. Human trials are getting closer. But evidence that these interventions can extend human health span isn’t yet available.
Researchers are also testing ways to measure biological aging, rather than relying only on chronological age. One approach examines epigenetics: changes in how genes are regulated without altering the underlying DNA sequence. Belsky said chemical tags called methyl groups bonded to DNA “could track the passage of time in a human body.”
Belsky’s Finding Aging Biomarkers by Searching Existing Trials (FAST) project collects multi-omic data, including proteins, metabolites and epigenetic marks on white blood cells. Researchers aim to find indicators that respond to interventions and could measure their effects on aging biology. But researchers haven’t shown that changing those biomarkers extends healthy lifespan, Belsky said.
Clinics and Regulation
Researchers are examining whether biomarkers could serve as “surrogate endpoint[s]” in clinical trials. Trials could use these measures if they reliably indicate that an intervention is likely to prevent disease or extend healthy lifespan. The connection between biomarker changes and those outcomes remains unsettled.
Longevity clinics are opening with standard medical assessments and wider testing intended to build a detailed picture of a person’s health. Mayo Clinic launched its Healthy Longevity Clinic in 2023. Singapore’s National University Health System has established a similar program, pairing detailed assessment with personalized lifestyle or medical interventions. Some scientists have warned that the field needs better regulation as clinics become more common.
In October 2024, Abu Dhabi’s Department of Health introduced a licensing framework for Healthy Longevity Medicine Centers. The department called the framework the first of its kind globally; it defined a clinical category and set standards for facilities. It licensed the Institute for Healthier Living Abu Dhabi as the world’s first state-designated specialized Healthy Longevity Medicine Center.
Allan Boston, the institute’s chief operating officer, said, “All your cells are aging constantly. In the past, we thought that was just an inevitable stage of life. It’s not inevitable. There are things we can now start to do about that. That changes the whole concept of medicine.” Boston said a deeper understanding of cellular activity could help researchers design therapies, drugs, immunotherapies and technologies to alter, slow or potentially reverse aging pathways.
Sleep, exercise, community and diet can influence aging biology, Belsky said, without advanced medical innovations or specialist clinics. “The thing we know works is available in some form to most of us,” he said. “We can add healthy years to our lifespan even without these new drugs.”