Can you really reverse ageing? UAE doctors cut through the longevity hype and what extends lifespan

At this point, you might just believe that ageing is sold in bottles. A pharmacy can almost feel like a enchanted apothecary, with colourful bottles promising to reverse your biological clock. Hello boosters, powders, supplements and everything that sounds like it belongs on a chemist’s roster.

It all comes under the increasingly popular term ‘longevity’. But speak to doctors and the picture is a little less glamorous. Before you buy into the idea that longevity comes down to miracle molecules, it has a lot more to do with blood pressure cuffs, treadmill tests and a good night’s sleep.

Doctors may not agree on every nuance of the fast-moving field of longevity, but they do converge on the fundamentals.

The first myth to fall is the simplest one: Longevity medicine is a quest to squeeze more candles onto the birthday cake.

As Dr. Birjis Shaikh, a specialist in internal medicine at Aster Cedars Hospital & Clinic in Jebel Ali, explains: "Longevity is not simply living longer; it is about living longer in good health. The goal is to increase health span; years of life with good physical, mental and functional capacity."

Dr. Ksenia Butova, founder and CEO of Longevium, frames the same idea through the lens of a specific scientific theory. "In clinical terms, longevity medicine is about healthspan, the years a person remains physically active, cognitively healthy and free from major chronic disease or disability," she says.

Her aim, she explains, is to identify and modify the biological and clinical factors that contribute to cardiovascular, metabolic, musculoskeletal and neurodegenerative disease before significant functional decline occurs, an approach rooted in what researchers call the geroscience hypothesis: the idea that tackling the shared mechanisms behind multiple age-related diseases may beat treating each one separately after the fact. As she puts it, the idea is not only, to add years to life, but to compress morbidity and extend the years lived in good health.

It is also about extending the number of years a person can remain physically and mentally healthy, independent and able to enjoy a good quality of life. Dr. Joseph Youssef, a specialist in internal medicine at Medcare Royal Speciality Hospital Al Qusais, warns that someone may live to an advanced age but spend many of those years managing chronic disease or disability precisely the outcome longevity medicine is meant to prevent.

He argues the field should ideally focus on reducing preventable risks and preserving function rather than simply chasing a particular number on a biological-age report.

There is no single definitive test, however sophisticated, however expensive, that can hand you a number for how fast you're ageing.

"Biological-age tests, including DNA-methylation and telomere testing, provide estimates; but routine measures such as blood pressure, cholesterol, HbA1c, kidney function, body composition and fitness are often more clinically useful," Shaikh says.

What most people forget, adds Butova, whose clinic specialises in exactly this kind of testing, is that ageing occurs across multiple biological systems," so her practice assesses it across several complementary domains."

This means building a layered picture: Clinical and phenotypic biomarkers such as glucose, insulin, lipids and inflammation; cardiorespiratory fitness; body composition and muscle strength; cognitive assessment; and, at the molecular level, epigenetic clocks with names like GrimAge and DunedinPACE. “VO₂max, in particular, is ‘one of the most consistently validated predictors of long-term health and mortality’, she says, adding that the integrated ability of the cardiovascular, respiratory and muscular systems to deliver and use oxygen.

Even telomere length, long the poster child of anti-ageing science, gets a reality check. It's biologically associated with ageing, Butova says, "However, its usefulness as a stand-alone measure of an individual's biological age remains limited because of substantial individual variability and methodological differences between tests."

For the layperson, the takeaway is straightforward: Different biological-age tests can produce different results because they measure different aspects of ageing, and there is still no universally accepted definition of biological age. Youssef's verdict on the commercial versions of these tests is measured: "These tests can be interesting from a research and risk-assessment perspective, but they should not be treated as a definitive measurement of someone's overall health or future lifespan."

Well yes and no. Yes, some ageing biomarkers respond to lifestyle change. No, that doesn't mean you've bought yourself extra years of life.

Certain controlled trials have reported measurable changes in epigenetic-age scores following structured interventions involving diet, exercise and other lifestyle factors," Dr Butova says.

However, she is careful to draw a line: "An improvement in an epigenetic-age score does not necessarily mean that a person's lifespan has been extended. These biomarkers are associated with risk, but they are not yet proven surrogate endpoints for longevity."

She sees biological-age testing primarily as an additional tool for risk assessment and longitudinal tracking, the trajectory over time, she believes, matters more than any single number.

Youssef, meanwhile, is rather cautious about the idea of reverse ageing. "We should be cautious about interpreting this as literally making the body younger," he says. "A lower biological-age score does not necessarily mean that a person has reversed ageing or reduced their risk of every age-related disease."

The more useful question, in his view, is often whether a person's health, fitness and disease-risk profile are improving, rather than whether they have managed to reduce a number on a test.

Strip away the branding, and the interventions come down to what you've been told since childhood, rather than anything you'd read on a biohacking forum.

"Exercise, healthy nutrition, avoiding smoking, maintaining a healthy weight, adequate sleep and controlling cardiovascular risk factors have the strongest human evidence," says Shaikh. "Many supplements, IV therapies, NAD products and anti-ageing medications remain investigational."

Butova is equally emphatic that the fundamentals do the heaviest lifting: exercise to maintain muscle and cardiorespiratory fitness, healthy nutrition and body composition, good sleep, avoiding smoking, vaccination, preventive screening, and appropriate treatment of cardiovascular and metabolic risk factors.

Rather than handing everyone the same anti-ageing protocol, she argues that interventions should target the individual's actual risk profile.

Perhaps the most consistent warning concerns money, specifically, how easily it can be spent chasing reassurance rather than health.

"Be cautious about expensive tests and treatments that promise to 'reverse ageing' without evidence that they improve meaningful health outcomes," Shaikh says. "For most people, investing in exercise, nutrition, sleep, preventive healthcare and evidence-based screening is far more valuable."

Dr Butova applies a simple filter before recommending any advanced test to a patient: "Will this result actually change what we do?" As she puts it, a single biological-age result is not a diagnosis, and advanced testing should never replace established preventive medicine.

Advanced genetic and multi-omics testing has its place, she says, but the results "need to be interpreted in context rather than treated as isolated numbers."

Her summary of the discipline could double as its mission statement: "The goal is not to perform the greatest number of tests or treatments. It is to identify meaningful risks early... and intervene while there is still an opportunity to alter the health trajectory."

Ask three questions before paying for a test or treatment: "What exactly does this test measure? Is the result clinically validated? And will the result change what I or my doctor do?" As Youssef warns, a sophisticated-looking report does not necessarily mean the result has been clinically validated or that acting on it will improve health outcomes.

Where the doctors diverge slightly is on the frontier science. Dr Butova is open to emerging fields, pointing to considerable research into gerotherapeutics, senolytics, NAD-related pathways, peptide-based interventions — while insisting that we still lack large, controlled, long-term human trials demonstrating that they extend healthspan or lifespan in otherwise healthy people.

Youssef names specific examples in that same investigational bucket, including metformin, rapamycin and NAD-related products, and offers a line that could serve as the whole field's disclaimer: A treatment showing an effect on a biological marker does not automatically mean it helps people live longer or healthier lives.

It's a field racing forward on multiple scientific fronts, epigenetic clocks, multi-omics profiling, senolytics, peptide therapies and yet none of it outperforms the basics.

Move more. Eat well. Sleep properly. Don't smoke. Know your blood pressure, your cholesterol, your glucose. Build muscle before you need it. That remains, for now, the most evidence-backed anti-ageing protocol available.