A Simpler Start to Longevity Medicine in Primary Care

By Dr. Silvija Valdonė Alšauskė, MD

Longevity medicine is a rapidly evolving field that draws on cutting-edge science to help people live healthier, longer lives. While the research behind it is often complex, primary care providers don’t need access to advanced technology or expensive testing to begin making a difference. In fact, the journey toward better aging can—and should—start with something much simpler.

Although whole-body imaging or genetic sequencing may offer deep insights, these tools are rarely feasible in everyday practice due to cost, access, and patient-specific factors. Instead, a more realistic and effective approach begins with a core set of evidence-based tests and a structured clinical assessment.

That’s why we’ve developed a practical testing protocol tailored to the realities of primary health care. This “minimum viable” longevity screening strategy combines insights from international guidelines in geroscience, healthy aging, and evidence-based preventive medicine. It’s designed to be straightforward, actionable, and easy to repeat as part of routine care.

By starting with the basics and individualizing the process over time, we can begin to shift from reactive to proactive care. The goal is early detection of risks, targeted interventions to delay aging-related decline, and long-term support for optimizing biological age and extending healthspan.

Longevity medicine doesn’t have to be exclusive or elite. As technology evolves and healthcare systems adapt, there’s a clear path toward broader access and integration into everyday care. To make this vision a reality, we need practical tools, inclusive policies, and a shared commitment to prevention—starting with the first conversation between a patient and their doctor.

1. Initial Patient Assessment

• Comprehensive Medical History:
  • Chronic disease risk factors (CVD, cancer, diabetes, neurodegeneration) and  validated risk-prediction questionnaires (e.g., cardiovascular, frailty)
  • Complaints
  • Family history of age-related illnesses
  • Medication/supplement use, allergies, vaccination history, implemented screening programs
• Lifestyle & Functional Assessment:
  • Physical activity, nutrition, sleep, stress
  • Smoking, alcohol, other substances, social participation
• Psychosocial & Cognitive Screening:
  • Mood/depression (standardized tools and questionnaires)
  • Cognitive impairment (e.g., Mini-Cog, MoCA as available)
  • Social support and loneliness assessment

2. Physical Examination

• Vital Signs:
  • Blood pressure, resting heart rate, respiratory rate, temperature, oxygen saturation
• Anthropometrics:
  • Height, weight, BMI, waist circumference
  • Body composition if equipment available (e.g., BIA)
• Systematic Physical Exam:
  • Cardiovascular, respiratory, abdominal, neurological, musculoskeletal
  • Sensory function: vision, hearing
  • Oral health screen (as often neglected in aging protocols)
• Functional Tests:
  • Grip strength (dynamometer or handgrip tool)
  • Gait speed (timed walk, e.g., 4m or 6m test)
  • Balance tests (if high frailty risk)
  • ECG (if risk factors present)
• Optional:
  • Bone mineral density by risk stratification (if available)
  • Assessment for sarcopenia/frailty (Short Physical Performance Battery, chair rise test)

3. Core Laboratory Panel

Annual baseline (repeat if clinically indicated):

• Metabolic Panel:
  • Fasting glucose and/or HbA1c
  • Lipid profile (total cholesterol, LDL, HDL, triglycerides)
  • Liver function tests (ALT, AST, GGT, bilirubin, albumin)
  • Renal function (creatinine, urea/BUN, GFR)
  • Homocysteine
• Blood Count:
  • Full blood count (CBC), with particular attention to red cell indices (RDW for aging risk signals)
• Inflammatory Markers:
  • hs-CRP (high-sensitivity C-reactive protein) if available
  • Erythrocyte sedimentation rate (ESR)
• Thyroid Profile:
  • TSH, free T4, free T3
• Vitamin D:
  • 25(OH)D level
• Urinalysis:
  • To screen for diabetes, renal disease, infections
• Electrolytes:
  • Sodium, potassium, calcium
• Optional if resources allow:
  • Insulin, C-peptide
  • B12 and folate
  • Sex hormones if symptoms suggestive
  • Ferritin, iron studies
  • Albumin
  • Interleukin-6
  • TNF-alfa
  • Creatine kinase and Lactate dehydrogenase (LDH)

4. Additional/Optional Tests (as resources allow or by risk profile)

• Cardiovascular:
  • Echocardiogram if indicated
• Cancer Screening:
  • Follow guidelines by age/sex (colon, breast, prostate, cervical, skin, etc.)
• Advanced Longevity Markers (typically for specialized settings):
  • Assess methylation (“epigenetic clocks”), telomere length, proteomics—these are not routine in primary care, currently for research/specialty clinics
• Microbiome or advanced nutrition panels (select cohorts/available resources)

 Literature: 

1. Mironov S, Borysova O, Morgunov I, Zhou Z, Moskalev A. A Framework for an Effective Healthy Longevity Clinic. Aging Dis. 2024 Jul 15;16(4):1971-1986. doi: 10.14336/AD.2024.0328-1. PMID: 38607731; PMCID: PMC12221401.
2. World Health Organization. Integrated care for older people (ICOPE): guidance for person-centred assessment and pathways in primary care, 2nd ed. Geneva: World Health Organization; 2024. Available from: https://www.who.int/publications/i/item/9789240103726
3. Department of Health – Abu Dhabi. Healthy Longevity Medicine Clinic Standard. Version 1. Abu Dhabi: Department of Health; 2024. Available from: https://www.doh.gov.ae/en/resources/standards
4. Tavassoli N, de Souto Barreto P, Gillette-Guyonnet S, Rolland Y, Vellas B. Implementation of the WHO integrated care for older people (ICOPE) programme in clinical practice: a prospective study. Lancet Healthy Longev. 2022;3(6):e394–e404.
5. Bischof E, et al. Longevity medicine: upskilling the physicians of tomorrow. Aging Clin Exp Res. 2023;35(4):759–761.