What prescription‑based guideline would you recommend for a generally healthy adult seeking to maximize health‑span and reverse aging?

No Evidence-Based Prescription Guideline Exists for "Reversing Aging"

There is no validated prescription-based guideline for reversing aging in healthy adults, and current medical evidence does not support the concept that any medication can reverse the aging process itself. 1, 2

Why This Question Cannot Be Answered as Asked

The Fundamental Problem

• Aging cannot be reversed by prescription medications according to current scientific understanding—no intervention has been shown to slow, stop, or reverse the aging process in humans 1
• The concept of "anti-aging medicine" as it relates to reversing chronological aging is not supported by rigorous clinical evidence 1
• While some computational models (aging clocks) suggest certain interventions may affect predicted "biological age," these findings require rigorous clinical validation and do not represent actual age reversal 2

What the Evidence Actually Addresses

The provided guidelines focus exclusively on:

• Medication rationalization in elderly patients with established cardiovascular disease and multimorbidity 3, 4
• Deprescribing potentially harmful medications in older adults to reduce adverse drug reactions and improve quality of life 3, 4
• Managing polypharmacy complications rather than prescribing new agents for health optimization 3, 4

What Evidence-Based Medicine Actually Recommends for Healthy Adults

Focus on Disease Prevention, Not Age Reversal

• The European Society of Cardiology emphasizes that prescribing decisions should prioritize prevention of age-related diseases (cardiovascular disease, diabetes, cancer) rather than attempting to reverse aging itself 3
• Treatment goals should focus on preserving functional independence, maintaining quality of life, and preventing morbidity—not reversing chronological age 3

The Deprescribing Paradigm for Older Adults

For older adults (the only population addressed in the provided guidelines), the recommendation is actually the opposite of adding prescriptions:

• The American Geriatrics Society recommends systematic deprescribing of medications when potential harm outweighs benefit, particularly for preventive medications in those with limited life expectancy 3, 4
• High-priority targets for removal include anticoagulants, antidiabetic agents, opioids, anticholinergics, antiplatelets, and NSAIDs when risks exceed benefits 3, 4
• Polypharmacy itself increases risk of adverse drug reactions, drug-drug interactions, falls, cognitive impairment, and mortality 3, 4

Critical Caveats About "Anti-Aging" Claims

Research vs. Clinical Reality

• Preliminary research on metformin, rapamycin, resveratrol, and NAD+ precursors shows theoretical promise in animal models but lacks rigorous human clinical trials demonstrating actual age reversal or mortality benefit in healthy adults 2, 5, 6
• Aging clocks that measure "biological age" are computational models whose clinical significance remains unclear—lowering their outputs does not necessarily translate to improved morbidity, mortality, or quality of life 2
• Disease and disuse are far more likely explanations for functional decline than "true" aging, making lifestyle modification more important than prescription medications 7

The Harm of Inappropriate Prescribing

• Adding medications to healthy adults without clear disease-specific indications increases risk of adverse drug reactions, drug-drug interactions, and prescribing cascades 3, 4
• The European Society of Cardiology warns that attempting to reach multiple disease-specific targets through polypharmacy can lead to adverse outcomes (e.g., blood pressure lowering causing falls and instability) 3
• Chronological age alone should never be the basis for prescribing decisions—functional status, cognitive status, life expectancy, and patient goals must guide therapy 3, 4

What Actually Matters for Healthspan

Evidence-Based Approach for Healthy Adults

Rather than prescribing medications for "age reversal," the evidence supports:

• Lifestyle interventions including caloric restriction, plant-based diet, regular physical activity, high-quality sleep, and stress management show more promise than pharmacological approaches 2
• Prevention of pathological aging through management of cardiovascular risk factors, maintaining physical activity, and avoiding environmental toxins—not through prescription medications for healthy individuals 7
• Compression of morbidity by shortening the period of functional decline, making "health span" match life span through disease prevention rather than age reversal 7

When Medications Are Appropriate

• Only prescribe when clear disease-specific indications exist (hypertension, diabetes, hyperlipidemia, etc.) with proven mortality or morbidity benefit 3, 4
• Time-to-benefit must be considered—preventive medications should only be used when estimated life expectancy exceeds the drug's time-to-benefit 3
• Patient-centered goals including functional independence and quality of life should drive prescribing decisions, not chronological age or theoretical "anti-aging" effects 3