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Key Takeaways NAD+ is a critical cellular coenzyme that declines sharply with age, with tissue levels falling to roughly half of young-adult levels by middle age and driving mitochondrial dysfunction, compromised DNA repair, and many of the cognitive and metabolic symptoms patients chalk up to "just getting older." The clinical evidence base is genuinely early-but-promising: strong mechanistic rationale and preliminary human studies showing safety and efficacy signals, but no large-scale randomized trials yet to support claims of dramatic age reversal in healthy adults

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[DOI] [PMC free article] [PubMed] [Google Scholar] 130.Shen Y., Li X., Dong D., Zhang B., Xue Y., Shang P