What is a longevity check-up?

A longevity check-up is an in-depth medical assessment that quantifies measurable risk factors for age-related conditions — cardiovascular disease, cancer, metabolic disorders and neurodegenerative processes — and derives an individual prevention plan from the results, before symptoms appear.

The statutory Check-up 35 in Germany covers blood pressure, blood glucose, cholesterol and a basic medical history. A longevity check-up goes considerably deeper: 87 to 230+ biomarkers, whole-body MRI, spiroergometry (VO2max), vascular ultrasound, cognitive testing, and optionally genetics and liquid biopsy. The aim is not only to identify acute disease but to quantify your biological age and your risk trajectory.

Six domains are usually covered: 1) a comprehensive blood panel with inflammatory markers, hormones, metabolic parameters and nutrient status, 2) cardiovascular diagnostics with ECG, echocardiography and vascular ultrasound, 3) lung function and spiroergometry, 4) imaging, usually as whole-body MRI, 5) neurocognitive testing, 6) optionally genetics, epigenetics, microbiome and multi-cancer liquid biopsy. The specific scope varies between providers.

Chronological age in years says little about how fast your body is actually ageing. Biological age is estimated using validated biomarkers: epigenetic clocks such as DunedinPACE and GrimAge, telomere length, inflammatory markers and organ function parameters. A longevity check-up measures these values and shows whether you are biologically younger or older than your year of birth would suggest. That information makes interventions verifiable.

The individual components are very well established. Risk factors such as ApoB, Lp(a), HbA1c, VO2max and blood pressure are considered robust predictors of morbidity and mortality. Whole-body MRI has been validated in studies as an early detection tool (for example Lancet 2023). Epigenetic clocks are methodologically well established. The overall effect of a combined check-up on life expectancy is currently being investigated in long-term studies. A serious longevity provider makes no promises of cure here, but works with the best evidence currently available.

For most adults between 35 and 65, an annual or biennial rhythm makes sense. Biomarkers change gradually, and only longitudinal data reveals reliable trends. Interventions such as dietary change, a training plan or medication need 3 to 12 months before an effect becomes measurable. For higher-risk patients, or following an intervention, shorter intervals can be appropriate.

The latest sensible starting point is the mid-thirties. At that stage measurable changes begin in ApoB, insulin resistance, vascular elasticity and lung function. Many of these values still respond well to intervention at that age. With a family history of early heart attacks, cancer or dementia, a check-up is defensible from the mid-twenties onwards.