Four terms that get muddled. Three of them on purpose.

Prevention aims to avert or detect a specific condition early. It has defined targets, guidelines and programmes whose effect on patient-relevant endpoints has been assessed. Longevity aims further: not at one condition but at ageing as the common denominator of several conditions, and at the number of healthy years rather than merely avoiding an event. The overlap is large. What works in prevention works in longevity too: not smoking, aerobic fitness, blood pressure, lipids, sleep. The difference lies at the edges, where longevity uses procedures for which no endpoint data exists. That edge is the source of most mistaken expectations.

No, and the confusion harms the serious part of the field most. In the market, anti-aging mostly denotes offerings that promise to reverse or slow ageing: infusion therapies, stem cell and exosome offerings, plasma exchange, high-dose preparations. For none of these is there evidence on patient-relevant endpoints in healthy people. Longevity as a research field studies mechanisms of ageing and, in clinical application, works with the same factors as prevention. We do not offer anti-aging: no infusion therapies, no stem cells, no exosomes, no plasma exchange, and no promise to slow or reverse ageing.

Preventive medicine is the medical discipline; prevention is its subject. The discipline covers three levels: primary prevention before the condition, secondary prevention as early detection at a symptom-free stage, tertiary prevention against progression and relapse. Some authors add quaternary prevention, protection against overtreatment. In Germany a substantial part of this is standard care with specifications from the Federal Joint Committee. When a clinic describes itself as preventive, that says nothing yet about the scope of its offer: the term is not protected and ranges from an extended basic check-up to programmes with imaging and sequencing.

Preventive medicine within a longevity framing, and we state where the line between them runs. The core is conventional: lipid diagnostics with ApoB and Lp(a), blood pressure, metabolism, cardiac and vascular ultrasound, spiroergometry with directly measured VO2max, cancer screening. That is guideline-based preventive medicine. Above it sits a second layer that we explicitly label research-adjacent: whole-body MRI as screening, liquid biopsy, epigenetic clocks, microbiome analysis. For that layer we state that no diagnosis and no treatment follows from it. We use it because the longitudinal data we want to build does not yet exist.

Outside medicine, and that is a placement rather than a judgement. Biohacking describes self-experiments with wearables, supplements, cold, heat and fasting protocols, mostly without medical supervision and without a control group. Individual elements are well studied, such as endurance training and sleep regularity; others barely at all. The problem is not the experiment but the inference from one’s own course to an effect: without a comparison there is no separating what the protocol did from what would have happened anyway. We sell no supplements and take no commissions, and we make no remote diagnoses from wearable data.

By what it says about its own limits. Five checkable points. First: is evidential weight declared openly per procedure, or is everything sold with equal conviction? Second: is it stated that guideline-based early detection is not replaced? Colonoscopy, mammography and skin screening remain independently indicated. Third: does overdiagnosis come up before the examination or only afterwards? Fourth: is there a personal medical consultation after the report and coordination of onward care? Fifth: are preparations sold from which the provider earns? Anyone who answers all five clearly is more reliable than one with the larger equipment inventory.