Overview

• An expert opinion in Nature Aging from more than 25 scientists consolidates evidence on targeting NAD+, a central metabolic cofactor that declines with age.
• Early human studies using precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) report encouraging signals in memory, movement, and metabolism.
• The authors call for larger, longer, and better-controlled trials to establish effective doses, routes and frequency of administration, long-term safety, and interindividual response differences.
• Multiple clinical trials are currently underway worldwide, and the review outlines a research roadmap to guide ongoing studies and potential clinical use.
• With a fast-growing supplement market and unresolved questions about efficacy and translation from animal models to patients, the authors note confusion in the field and disclose relevant conflicts of interest.