Goal: living longer
Evidence by Goal: Living Longer
Every graded record measured on death from any cause, survival or longevity, including the ones that failed. A letter here describes the human trial evidence for that use; it is not advice.
47 graded uses, grouped by what the trials measured, highest letter first within each group. Every letter is copied at build time from the record that owns it, and records graded D, tested without benefit or not yet tested, are listed with the rest.
Measured on deaths and disease events
Trials that counted deaths, heart attacks, strokes, fractures, falls, cancers or other clinical events.
- AHard clinical endpointProtocol · Individual-participant and trial-level meta-analyses A study that pools the numbers from several trials into one combined estimate. of randomized trials, and large randomized trials of intensive against standard targetsGrade for: Lowering blood pressure in people with high blood pressure, against placebo An inactive substitute made to look like the real treatment, so participants cannot tell which one they received. or less treatment: major cardiovascular events and death
- AHard clinical endpointProtocol · Individual-participant meta-analyses and randomized outcome trials; genetic (Mendelian randomization A method that uses gene variants people are born with as a natural experiment, to test whether a factor causes an outcome.) studies are listed as excluded evidence and carry no letterGrade for: Heart attack, stroke and death, lowering LDL Low-density lipoprotein cholesterol, the cholesterol fraction most closely tied to plaque in the arteries. cholesterol in people with established vascular disease or after an acute coronary syndrome
- AHard clinical endpointProtocol · Individual-participant meta-analyses and randomized outcome trials; genetic (Mendelian randomization) studies are listed as excluded evidence and carry no letterGrade for: Heart attack, stroke and cardiovascular death, lowering LDL cholesterol in people without vascular disease who are at raised risk
- AHard clinical endpointPrescription · Randomized controlled trials People are assigned to the treatment or a comparison by chance, so the groups differ only in what they received. It is the design that can show cause and effect.Endpoint The outcome a trial measures to decide whether the treatment worked, such as heart attacks, blood pressure or a symptom score.: Cardiovascular death, heart attack and stroke in people with cardiovascular disease or type 2 diabetes
- AHard clinical endpointPrescription · Randomized controlled trialsEndpoint: Cardiovascular death, heart-failure hospitalization and kidney-failure progression
- AHard clinical endpointPrescription · Randomized controlled trials and individual-participant meta-analyses of randomized trialsGrade for: Death and major cardiovascular events in people with coronary heart disease or other established vascular disease
- AHard clinical endpointPrescription · Randomized controlled trials and individual-participant meta-analyses of randomized trialsGrade for: Heart attack, stroke and cardiovascular death in people without cardiovascular disease who are at raised risk
- BHard clinical endpointProtocol · Meta-analysis of randomized trialsEndpoint: Disease-free survival and overall survival after curative-intent treatment for non-metastatic cancer, structured exercise program against health education or usual care
- CHard clinical endpointSupplement · Randomized trials and meta-analyses in Japanese surgical patients, mixedEndpoint: Overall survival after curative resection of colorectal or gastric cancer, PSK added to chemotherapy
- CHard clinical endpointProtocol · Meta-analyses of randomized trials (mixed/modest)Endpoint: Cardiovascular events, including coronary death
- CHard clinical endpointProtocol · Randomized controlled trialEndpoint: Death, heart attack and stroke in coronary heart disease
- CHard clinical endpointProtocol · Observational Research that watches what people already do rather than assigning a treatment. It can show that two things travel together, not that one causes the other. synthesis for the headline; randomized trials and pooled analyses on blood pressure and atrial fibrillationGrade for: All-cause mortality in middle-aged men with heavy drinking, screening with an intervention to drink less
- CHard clinical endpointProtocol · Meta-analyses of randomized trials of loneliness programs and one randomized trial with mortality; cohort studies An observational study that follows a group of people over time and compares what happens to them. described, not gradedGrade for: Mortality in lonely older adults, psychosocial group rehabilitation
- CHard clinical endpointProtocol · Cochrane meta-analyses of randomized trials of quit-smoking medicines, and two randomized trials of quit programs with mortality; cohort studies described, not gradedGrade for: Death from any cause, a quit-smoking program, middle-aged smokers
- CHard clinical endpointDevice or therapy · Large randomized trials of low-dose CT screening against chest X-ray or no screeningGrade for: Death from any cause, current and former heavy smokers
- DHard clinical endpoint · Not yet testedSupplement · Randomized controlled trial, single small trial per useGrade for: Longevity, healthspan or mortality
- DHard clinical endpoint · Not yet testedSupplement · RCT Randomized controlled trial: people are assigned to the treatment or a comparison by chance, so the groups differ only in what they received. It is the design that can show cause and effect. + observational meta-analysisGrade for: Cardiovascular events and all-cause mortality
- DHard clinical endpoint · Tested, no benefitSupplement · RCTs + meta-analyses (use-specific)Grade for: All-cause mortality (older adults not selected for vitamin D status)
- DHard clinical endpoint · Not yet tested; tested, no benefitSupplement · Animal + observational for aging (D Route 1 No human randomized trial has been run, so the record rests on animal or mechanistic evidence only. One of the two routes to the lowest letter on EBL's scale.); randomized trial null for memory (D Route 2 Human randomized trials have been run and did not show benefit on the stated outcome. One of the two routes to the lowest letter on EBL's scale.); pharmacokinetic trialsGrade for: Aging, longevity, mortality
- DHard clinical endpoint · Not yet tested
- DHard clinical endpoint · Not yet testedSupplement · Small randomized trials, narrow postoperative indications onlyGrade for: Systemic inflammation, cardiovascular or longevity useEndpoint: Any systemic or long-term health outcome
- DHard clinical endpoint · Not yet testedSupplement · One placebo-controlled trial; other studies small, dose-order or uncontrolledGrade for: Mortality, frailty and longevityEndpoint: Mortality, frailty, longevity
- DHard clinical endpoint · Not yet testedSupplement · Randomized controlled trials, mixedGrade for: Longevity, healthspan or mortality, taken by mouth
- DHard clinical endpoint · Tested, no benefitProtocol · Cochrane meta-analysis of randomized trials (found no mortality benefit → D)Endpoint: All-cause, cardiovascular and cancer mortality in adults unselected for disease
- DHard clinical endpoint · Tested, harm foundProtocol · Randomized controlled trialEndpoint: Disability-free survival in healthy adults aged 70 and over
- DHard clinical endpoint · Not yet testedProtocol · Randomized controlled trials and meta-analyses of randomized trials (LDL cholesterol, HbA1c A blood test that reflects average blood sugar over the previous two to three months.); cohort evidence only for events and mortalityGrade for: Heart attack, stroke, mortality and longevity
- DHard clinical endpoint · Tested, no benefitProtocol · Randomized controlled trial (scheduled phlebotomy in peripheral artery disease); natural-experiment and cohort evidence only in healthy donorsEndpoint: All-cause death; death, nonfatal heart attack or stroke
- DHard clinical endpoint · Not yet testedProtocol · Randomized controlled trials and a Cochrane review (recurrent C. difficile); randomized trials and meta-analyses on metabolic markers (metabolic syndrome and obesity); no completed randomized trial on an aging outcomeGrade for: Aging, frailty and longevity in older or healthy adults
- DHard clinical endpoint · Not yet testedProtocol · Meta-analyses of randomized trials and randomized trials (meaning, purpose, distress, physical and cognitive tests); population studies of purpose with death, dementia and heart disease are listed as excluded evidence and carry no letterGrade for: Death, dementia and heart disease
- DHard clinical endpoint · Tested, no benefitProtocol · Meta-analyses of randomized trials and randomized trials; population studies on heart disease, dementia and death are listed as excluded evidenceGrade for: Heart attack, stroke and death, periodontal treatment
- DHard clinical endpoint · Not yet testedProtocol · Randomized trials of disclosing APOE results and a meta-analysis of trials of DNA-based risk results (found no benefit on behavior or risk factors, D); risk estimates for e4 carriers come from genetic and population studies and are listed as excluded evidenceGrade for: Dementia, heart disease and death after learning the APOE result
- DHard clinical endpoint · Tested, harm foundProtocol · Individual-participant meta-analyses and randomized outcome trials; genetic (Mendelian randomization) studies are listed as excluded evidence and carry no letterGrade for: Heart attack, stroke and death, raising HDL cholesterol with CETP inhibitors, niacin or apolipoprotein A1 infusion
- DHard clinical endpoint · Tested, no benefitProtocol · Individual-participant meta-analyses and randomized outcome trials; genetic (Mendelian randomization) studies are listed as excluded evidence and carry no letterGrade for: Heart attack, stroke and cardiovascular death, lowering triglycerides with a fibrate added to a statin
- DHard clinical endpoint · Tested, no benefitProtocol · Meta-analyses of randomized diet trials, recovered data from two 1960s and 1970s randomized trials, and randomized feeding trials of blood lipids and inflammatory markers; cohort studies and a non-randomized hospital trial are listed as excluded evidence and carry no letterGrade for: All-cause mortality when linoleic-acid oils replace saturated fat
- DHard clinical endpoint · Not yet testedDevice or therapy · Meta-analyses of randomized trialsGrade for: Longevity / mortalityEndpoint: no RCT
- DHard clinical endpoint · Not yet testedDevice or therapy · Small RCTs + meta-analysis (aesthetic/dermatology)Grade for: Systemic or intravenous administration for longevity, healthspan or anti-aging
- DHard clinical endpoint · Not yet testedDevice or therapy · No randomized outcome trial; pooled observational yield data onlyEndpoint: Cancer mortality or all-cause mortality in asymptomatic screened adults
- DHard clinical endpoint · Tested, no benefitDevice or therapy · Randomized trials and meta-analyses of CPAP against usual care, sham A fake version of a procedure or device used as the comparison, so participants cannot tell which one they received. CPAP or inactive controlGrade for: Heart attack, stroke and cardiovascular death in adults with moderate to severe obstructive sleep apnea, mostly without daytime sleepiness
- DHard clinical endpoint · Tested, no benefitDevice or therapy · Population randomized trials of an invitation to screening against usual care, and their pooled analysisGrade for: Colorectal cancer deaths and death from any cause, an invitation to screening colonoscopy, adults aged 55 to 64
- DHard clinical endpoint · Tested, no benefitDevice or therapy · Meta-analyses of randomized trials of mammography screening against no screeningGrade for: Death from any cause, women invited to mammography screening
- DHard clinical endpoint · Tested, no benefitDevice or therapy · Large randomized trials of PSA screening against usual careGrade for: Death from any cause, men invited to PSA screening
- DHard clinical endpoint · Tested, no benefitPrescription · Randomized controlled trials and individual-participant meta-analyses of randomized trialsGrade for: Disability-free survival (living without dementia or persistent physical disability) in adults aged 70 and over without cardiovascular disease
Measured on function, or by a blinded clinician
Trials that measured performance with an instrument, or used a scale scored by a clinician who did not know the treatment.
- CMeasured functionProtocol · Randomized controlled trialEndpoint: A cognitive score (HDS-R) in mild cognitive impairment
- DMeasured function · Tested, no benefitProtocol · Observational harm-association study; no deprescribing Reducing or stopping a medication under a prescriber's supervision. RCT demonstrates benefitEndpoint: Cognition, falls, quality of life and mortality
- DMeasured function · Tested, harm foundPrescription · Randomized controlled trialsEndpoint: Muscle and mitochondrial gains from exercise training in healthy older adults
Measured on a blood marker or other stand-in
Trials that measured a number standing in for the outcome, such as blood pressure, LDL cholesterol or HbA1c. These letters stop at B.
- CSurrogate biomarkerProtocol · One pilot randomized controlled trial, maker-fundedEndpoint: DNA methylation age, an epigenetic clock A test that estimates biological age from chemical marks on DNA (DNA methylation).
- CSurrogate biomarkerProtocol · Umbrella review and meta-analyses of randomized trials + epilepsy RCTsGrade for: Longevity and cardiometabolic markers in adults
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