Longevity Table: Evidence for Interventions That Affect Lifespan and Healthspan
The open access Longevity Table evaluates 152 “longevity interventions” using evidence on lifespan, health, and risk
On September 1, the author of Recto and Verso published the open access Longevity Table. It evaluates 152 supplements, drugs, procedures, tests, and habits separately according to evidence on lifespan, preservation of health and everyday function, and risk.
The phrase “extends life” often combines distinct claims. A drug may reduce the risk of death in people with a disease, yet be offered to healthy people for a different purpose. Exercise may improve physical function, while a blood test measures a biomarker, which is an indicator of how the body is functioning. Each outcome requires its own supporting research.
In the Longevity Table, each row asks a specific question: who receives the intervention, what they receive, what it is compared with, and which outcome is measured. Metformin for a person with type 2 diabetes and metformin for a healthy person therefore occupy separate rows. Changing any of these conditions changes the question that the research must answer.
The evidence hierarchy is based primarily on human data and the outcome that was measured. The highest tier requires two independent trials in which participants were randomly assigned to groups and deaths from all causes were counted, or one very large study conducted at several clinical sites and supported by corroborating evidence. A study of a biomarker or physical function answers a question about that marker or function. A conclusion about lifespan requires data on all-cause mortality.
The table contains 152 rows. Under its classification system for lifespan, 131 rows are labeled “unproven,” seven “ineffective,” five “possibly effective,” and nine “probably effective.” Among the nine rows labeled “probably effective,” the author identifies four behavioral practices and five drugs used in people who have the diseases that these drugs treat. This group contains no supplements.
The author distinguishes between two outcomes. The label “unproven” applies when an appropriate study has not yet been conducted. A row is labeled “ineffective” when a study with enough participants measured the relevant outcome and found no effect. On the methodology page, the author describes the ratio of 131 to 7 as a finding produced by this classification system.
The author describes the table's creation as a debate between two models. One selected publications and assigned a rating, while the other checked whether the selected tier was appropriate, whether the evidence was current, and whether the rules had been followed. The same check can be performed without the table: specify the person, intervention, comparison, and outcome, then determine whether the study actually measured that outcome.