A good baseline takes two days and a handful of tests. Most of what longevity clinics add on top is expensive noise. Here is the short list.
Preventive medicine has a marketing problem: the useful tests are cheap and boring, and the useless ones are expensive and exciting. A longevity check-up is worth doing from around forty, earlier with family history, and the value lies almost entirely in a dozen measurements and a plan. Everything else is optional.
The core list
Blood: a full lipid panel including apolipoprotein B, which counts the particles that actually cause arterial disease; fasting glucose and HbA1c; kidney and liver function; a full blood count; thyroid; vitamin D; ferritin; and, once, lipoprotein(a), an inherited risk factor that does not change. Blood pressure, measured properly, several times. Body composition by DEXA scan, which separates fat, muscle and bone and picks up early bone loss. Cardiorespiratory fitness by a VO2max test or at least a submaximal estimate. Grip strength. A resting ECG and, depending on age and risk, a coronary calcium scan. Age-appropriate cancer screening: colonoscopy or stool test, mammography, cervical screening, skin check. A sleep and mood questionnaire.
The numbers that predict most
Four stand out. VO2max, because fitness predicts mortality better than any blood test. Apolipoprotein B, because it is the best single lipid measure of cardiovascular risk and it can be lowered. Grip strength and muscle mass, because they predict independence and survival. And blood pressure, because it is the most treatable risk factor there is. If a clinic does not measure these four, choose another clinic.
What to be sceptical about
Full-body MRI without a specific question finds harmless things that lead to worrying investigations. Broad genetic panels change little that the core list does not already tell you. Micronutrient panels, hormone optimisation, intravenous vitamins, stem cell infusions and proprietary biological age tests range from unproven to expensive theatre. A clinic that leads with these is selling, not measuring.
Using the results
The point is the plan. Every result should map onto one of six pillars: movement, food, sleep, stress, connection and environment, plus medication where the numbers justify it. Then re-test in twelve months. A single check-up is a photograph; two are a direction, and the direction is what you can change.
Where to do it
A good general practitioner can order most of the core list. Clinics on the Costa del Sol, in the Engadin and South Tyrol add the fitness testing, the interpretation and a setting that helps you start. The clinic journey explains the week; the Vitality Score is the free approximation you can do tonight.
Try it
Vitality ScoreSleep, steps, strength, plants, alcohol, friends, purpose, stress, daylight and breath.Retreat BudgetChoose a destination, the nights, the level of stay, how often you eat out, how many treatments and whether flights are included.Frequently asked questions
How often should I have a check-up?
Every one to two years from forty, annually from sixty or with known risk factors. More often changes little unless you are treating something.
Are biological age tests worth it?
Not yet. Epigenetic clocks are interesting research tools with wide error margins for individuals. Fitness, blood pressure and lipids tell you more, and they are cheaper.
