According to the World Health Organization, the global average life expectancy is 71 years. However, while some individuals live longer, others do not experience the advantages of a long and healthy life. Many older adults face age-related health issues and are afflicted by serious diseases like Alzheimer’s disease, Parkinson’s disease, and even accelerated ageing diseases.
Researchers in the field of ageing are working diligently to address some pressing questions: How can we promote healthy ageing? And how can we prevent or at least slow down the progression of these age-related diseases??
Central to this research is a small molecule known as NAD? (Nicotinamide Adenine Dinucleotide, oxidized form), which is garnering much attention.
An expert perspective on NAD? and ageing
An international group of experts has summarised and analysed the existing preclinical and clinical research on the subject, providing clear recommendations for future studies.?
“NAD? may hold the key to healthier ageing and could protect us against diseases like Alzheimer's disease and Parkinson's disease,” says Evandro Fei Fang-Stavem, an associate professor at the University of Oslo.?
“However, we need further research on how to effectively utilise NAD? in patient treatment,” he adds.
Fang-Stavem leads a team of NAD+ experts from over 20 institutions and presents this expert opinion-type review published in Nature Aging.?
NAD? levels decline with age
NAD? exists in every cell of the body and plays a critical role in various vital processes.?
“We need NAD? to survive. Without NAD?, it is speculated that we may die within a couple of minutes,” Fang-Stavem explains.?
As we age, many individuals experience a decline in NAD? levels. Indeed, several studies have indicated that patients with Alzheimer's disease exhibit notably low levels of NAD?.?
Increasing NAD? levels may mitigate age-related diseases
In the world of research, studies build upon one another, much like building blocks.
Fang-Stavem and his colleagues have systematically reviewed the findings from studies examining the effects of increasing NAD? levels, including both animal studies and clinical trials involving patients.?
These clinical studies have explored various ways to increase NAD? levels among patients suffering from age-related diseases, often by giving patients special vitamin-like compounds such as nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN).?
What findings have emerged from these studies? What do we know, and what remains uncertain??
Several clinical trials suggest that increasing NAD? might be an effective strategy for mitigating the effects of ageing and combatting age-related diseases.?
“When we review the various studies, it appears that augmenting NAD? levels in individuals with deficiencies may be a promising approach to facilitate healthier ageing and treat or at least slow down the development of a range of diseases,” says Fang-Stavem.?
Identifying patients who could benefit from NAD? treatment
However, there are also studies indicating that elevating NAD? levels does not necessarily lead to improved patient outcomes. Researchers believe multiple factors may influence the efficacy of such treatments.?
“We must investigate which types of supplements are effective, the appropriate dosages for patients, and the duration of treatment,” he clarifies, adding:?
“Moreover, we need to consider whether the specific age-related disease a patient has, its progression, and individual differences affect the impact of NAD? augmentation. For instance, genetic factors and other conditions may also play a role.”?
Awaiting results from ongoing clinical trials?
Numerous clinical studies are currently in progress, both in Norway and in other countries.?
“More research is needed to develop safe and effective NAD? treatments. New studies are essential to comprehend why increasing NAD? levels are beneficial for some patients while being ineffective for others,” emphasises Fang-Stavem.?
The interest in the small molecule NAD? is considerable, even among the general populace.
“Many are curious whether supplements that can elevate NAD? might also provide preventive benefits and promote healthy ageing,” he explains.?
“It may take some time before we can confidently assert whether the promising results observed in animal studies also apply to humans,” the researcher concludes.?
The expert perspective is useful for all involved in NAD? research
Professor and co-author Torbj?rn Omland, who leads Campus Ahus where Fang-Stavem's research group is based, believes that the summary provides a solid foundation for further research on NAD?.?
“There is a knowledge gap on NAD? and its clinical effects to basic researchers and clinicians, and this review paper provides the latest expert opinion to those who are interested in and are working in the field NAD? research,” he states.?
“This review will also provide relevant information to many NAD?-based clinical trials across a wide spectrum of clinical conditions, including neurological and cardiovascular disease.”
Contact
Reference
Zhang, J., Wang, H. L., Lautrup, S., Nilsen, H. L., Treebak, J. T., Watne, L. O., ... & Fang, E. F. (2025). Emerging strategies, applications and challenges of targeting NAD+ in the clinic. Nature Aging, 1-28. The article can be accessed here.
Grants
This project was supported by HELSE S?R-?ST (#2020001, #2021021, #2023093), the Research Council of Norway (#262175, #334361), NordForsk Foundation (#119986), the Civitan Norges 澳门葡京手机版app下载sfond for Alzheimers sykdom (#281931), the Rosa sl?yfe/Norwegian Cancer Society & Norwegian Breast Cancer Society (#207819), HORIZON-TMA-MSCA-DN (#101073251), and the Alzheimer’s Association (PTC-Gene-25-1439553). ??
Conflict of interests?
Fang-Stavem is a co-owner of Fang-S Consultation AS (Organization number 931 410 717) and NO-Age AS (Organization number 933 219 127); he has a CRADA arrangement with ChromaDex (USA) and an MTA with GeneHarbor (Hong Kong) Biotechnologies Limited; he is a consultant to AgeLab (Vitality Nordic AS, Norway) and the Hong Kong Longevity Science Laboratory (Hong Kong).