Longevity research has shifted from theoretical gerontology to pharmacological intervention. Dr. David Sinclair at Harvard Medical School estimates that aging research funding has increased 400% since 2015. Dr. Nir Barzilai, director of the Institute for Aging Research at Albert Einstein College of Medicine, is leading some of the most ambitious human trials. Multiple compounds that extend lifespan in animal models are now in clinical testing.
Rapamycin extends lifespan by 10-25% in mice through mTOR suppression, which activates autophagy — the cellular recycling process. A 2024 Phase 2 trial at the University of Washington (n=150, ages 55-75) is testing low-dose rapamycin (1 mg, 3 times weekly) for immune function improvement in healthy older adults. The Dog Aging Project, tracking 32,000 companion dogs, is expected to report rapamycin data within two years.
Senolytics selectively eliminate senescent cells that accumulate with age and secrete inflammatory factors (the senescence-associated secretory phenotype, or SASP). Dr. James Kirkland at Mayo Clinic pioneered the dasatinib-quercetin combination. A 2024 Phase 2 trial (n=48) is now testing senolytics for idiopathic pulmonary fibrosis, with preliminary results showing improved 6-minute walk distance by 21.5 meters.
NAD+ precursors are the most commercially advanced, with an estimated 3 million Americans currently supplementing. Human studies show NMN supplementation at 250 mg daily increases blood NAD+ levels by 38-45% within 2 weeks. The gap: no human trial has demonstrated improved healthspan or lifespan outcomes, and a 2023 review in Aging Cell (k=18 trials) concluded that functional benefits remain unproven.
Metformin is being tested in Dr. Barzilai's TAME (Targeting Aging with Metformin) trial — the first FDA-approved trial targeting aging itself as an indication (n=3,000, ages 65-79). Observational data from a 2014 Diabetes, Obesity and Metabolism study (n=180,000) suggests diabetic patients on metformin live 15% longer than matched non-diabetic controls. Results are expected within 3 years.
The current evidence-based longevity protocol remains unremarkable: 150 minutes of moderate exercise weekly reduces all-cause mortality by 31% (2022 British Journal of Sports Medicine meta-analysis, n=196,000). Sleep 7-9 hours. Eat a mostly whole-food diet. Maintain social connections — loneliness carries a mortality risk equivalent to smoking 15 cigarettes daily, per a 2023 WHO advisory. Manage blood pressure below 130/80 and fasting glucose below 100 mg/dL.