Academic medical centers across the United States are now treating aging itself as a condition worth slowing down, moving beyond managing age-related diseases to targeting the biological processes that drive aging in the first place. Northwestern University, the University of Texas at San Antonio, Cedars-Sinai Medical Center, the University of Washington, and Albert Einstein College of Medicine have all launched dedicated longevity institutes where researchers conduct comprehensive aging assessments and test medications that might extend both lifespan and healthspan, the years people remain free of disease .

The shift represents a fundamental change in how medicine approaches getting older. Rather than waiting for heart disease, diabetes, or Alzheimer's to develop and then treating those conditions, geroscientists, researchers who study the biological mechanisms of aging, are identifying the underlying processes that make disease more likely in the first place. "We've come to understand that age is the most important risk factor for almost every disease we deal with in adult human beings," explained Douglas Vaughan, MD, director of the Human Longevity Laboratory at Northwestern University Feinberg School of Medicine. "If we can slow down aging even a bit, we can push back the onset of disease and extend the health span of our species" .

What Are These Longevity Labs Actually Testing?

At Northwestern's Human Longevity Laboratory, patients spend up to three hours undergoing a battery of tests designed to measure biological age, a more accurate indicator of aging than the number of years someone has lived. Physicians assess cardiovascular, neurological, and muscular systems, measure body composition using DEXA scanning to quantify fat, muscle, and bone, and analyze blood samples for subtle changes in DNA and thousands of circulating proteins. Artificial intelligence interprets retinal images and heart test data to estimate whether someone is aging faster, slower, or at the expected rate for their chronological age .

The research at these centers has identified roughly 12 interconnected hallmarks of aging that provide targets for drug development and other interventions. These include the shortening of telomeres, chronic inflammation, genomic instability (the accumulation of DNA damage and mutations over time), and cellular senescence, which occurs when damaged cells stop dividing and accumulate in tissues, promoting age-related diseases .

Rather than waiting for new drugs to be developed, many longevity researchers are focusing on medications already approved by the Food and Drug Administration (FDA) for other purposes. Intriguing evidence from animal and epidemiology studies has pointed scientists toward the diabetes drug metformin and the immunosuppressant rapamycin. Based on their effects on multiple body systems, GLP-1 receptor agonists, SGLT2 inhibitors, and bisphosphonates, drugs originally designed to treat osteoporosis, are also viewed as possible candidates for slowing aging .

How Much of Aging Can Lifestyle Actually Control?

Lifestyle and environmental factors account for approximately 80 percent of aging, with the remaining 20 percent attributable to genetics. This means that exercise, nutrition, sleep, social connection, and stress management play an outsized role in how quickly someone ages biologically .

The evidence for specific lifestyle interventions is striking. Taking 10,000 steps a day, equivalent to four and a half to five miles, lowers the risk of early death by 36 percent compared with being sedentary. Sleeping well each night can add as many as five years to the average lifespan . Scientists have also found that following a low-calorie, nutrient-rich diet for five days a month for three months, sometimes called fasting mimicking, appears to mirror the biological effects of calorie restriction, reducing disease risk factors and slowing biological aging in healthy adults .

Steps to Support Healthy Aging Based on Current Research

• Daily Movement: Aim for 10,000 steps per day, or roughly four and a half to five miles of walking, which research shows reduces early mortality risk by 36 percent compared to a sedentary lifestyle.
• Sleep Quality: Prioritize consistent, high-quality sleep each night, as adequate sleep can add as many as five years to average lifespan and supports cellular repair processes.
• Periodic Fasting Patterns: Consider a fasting-mimicking diet, such as eating a low-calorie, nutrient-rich diet for five days per month over a three-month period, which may reduce disease risk factors and slow biological aging.
• Stress Management: Incorporate stress-reduction practices into daily life, as managing life stress is one of the four key lifestyle factors that account for approximately 80 percent of aging.
• Social Connection: Maintain meaningful relationships and social engagement, which research identifies as a critical component of the lifestyle factors that influence aging rate.

The challenge with lifestyle interventions alone is that they require sustained commitment. Extreme calorie restriction, for example, increases longevity in animal models when reduced by 35 to 40 percent, but such restriction is difficult for people to maintain long-term .

Why Are Doctors Prescribing Off-Label Medications for Aging?

Some longevity clinicians are prescribing FDA-approved medications off-label, meaning for purposes other than their original indication, based on emerging evidence that these drugs may slow aging. "It's legal for your doctor to give you any one of these drugs," noted Nir Barzilai, MD, director of the Institute for Geroscience at Albert Einstein College of Medicine . However, many clinicians emphasize that such prescriptions should be considered carefully and in the context of a patient's existing health conditions.

"We want to provide evidence-based care for healthy longevity, but we don't really have the evidence yet. When looking at the individual patients, we should look at the whole package and see what current diseases and conditions they have. Where there are risk factors, then you can act," said Elena Volpi, MD, PhD, director of the Sam and Ann Barshop Institute for Longevity and Aging Studies at UT San Antonio.

Elena Volpi, MD, PhD, Director of the Sam and Ann Barshop Institute for Longevity and Aging Studies at UT San Antonio

SGLT2 inhibitors, which were originally designed to eliminate glucose from the kidneys in diabetes patients, are now shown to improve kidney function and cardiac function and to provide broader health benefits. This discovery illustrates how drugs developed for one purpose may have unexpected benefits for slowing aging across multiple body systems .

The main obstacle to advancing this research is regulatory and financial. The FDA does not recognize aging as a disease, which makes it difficult to design clinical trials that test whether a drug can slow aging. Additionally, drug manufacturers are less inclined to fund studies of inexpensive older drugs, creating a funding gap for the research that could validate these approaches .

"The problem we've got is that in the current environment, the incentive structures are all aligned against getting the data we would all like to see," said Matt Kaeberlein, PhD, founder of the Healthy Aging and Longevity Research Institute at the University of Washington and cofounder and CEO of Optispan, a Seattle-based longevity-medicine clinic.

Matt Kaeberlein, PhD, Founder of the Healthy Aging and Longevity Research Institute at the University of Washington

Despite these challenges, clinical trials are planned or underway at several academic centers. The convergence of improved biological age testing, identified hallmarks of aging, and promising existing medications has created momentum for a new approach to medicine, one that targets aging itself rather than waiting for age-related diseases to emerge .