The State of Longevity
Science: 2026

Executive Summary

2026 was a year of large, careful trials, and several important ones were negative. Two phase 3 trials found that oral semaglutide does not slow early Alzheimer’s disease.² In long-term follow-up of the Diabetes Prevention Program, metformin did not lower the risk of developing multiple chronic diseases, while lifestyle change did.³ The first large statin trial in healthy adults aged 70 and older cut major heart events but did not extend life free of dementia or disability.¹

At the same time, GLP-1 weight-loss drugs arrived as pills, a 2026 cholesterol guideline replaced the 2018 one,¹³ and in June the first partial-reprogramming therapy was given to a person, in a safety trial for an eye disease (Life Biosciences). The pattern is the same across the year: the interventions with the strongest evidence remain the familiar ones, and new drugs are being tested more rigorously than the marketing around them.

The Trials That Mattered

STAREE: statins for healthy adults over 70

In 9,971 adults aged 70 and older without heart disease, diabetes or dementia, atorvastatin lowered major cardiovascular events by 30% over about six years (hazard ratio 0.70) but did not lengthen survival free of dementia or disability.¹ For older adults, the trial turns “should I start a statin?” into a question about preventing heart attacks and strokes, not about living longer in good health.

EVOKE and EVOKE+: semaglutide does not slow Alzheimer’s

Two phase 3 trials randomized 3,808 people with early, amyloid-confirmed Alzheimer’s disease to oral semaglutide or placebo; the drug did not slow clinical decline.² The hope had come from observational data in people with diabetes, and the trials show how such signals can mislead.

Metformin: two more null results

Decades after the Diabetes Prevention Program, adults with prediabetes assigned to lifestyle change had a lower risk of multimorbidity (hazard ratio 0.79), while metformin made no difference (0.91, not significant).³ In the DEMFOS trial, adding metformin to an intensive lifestyle program did not improve physical function in older adults with obesity.⁴ The large TAME trial of metformin against aging has still not announced full funding or enrollment as of October 2026 (AFAR).

Lifestyle programs for the aging brain

In US POINTER, 2,111 older adults at risk of dementia improved global cognition more with a structured, higher-intensity lifestyle program than with a self-guided one.⁵ LatAm-FINGERS, run in 11 Latin American countries, found the same direction of effect for a systematic program versus flexible health advice.⁶

PEARL: low-dose rapamycin in healthy adults

Over 48 weeks, adverse events were similar with weekly low-dose rapamycin and placebo, and visceral fat, the main outcome, did not change; women taking 10 mg gained lean tissue mass and reported less pain.⁷ It is a safety signal and a modest secondary finding, not evidence that rapamycin slows human aging.

Insomnia therapy and an aging clock

In a secondary analysis of a randomized trial, older adults who received cognitive behavioural therapy for insomnia showed a slower pace of aging on the DunedinPACE clock than a sleep-education group, with no significant difference on GrimAge or PhenoAge.⁸ It is a small biomarker signal, but it comes from a randomized design.

Weight-Loss Drugs Become Pills

In December 2025 the FDA approved a semaglutide tablet for weight management (Novo Nordisk); in its trial in adults with obesity, weight fell 13.6% over 64 weeks versus 2.2% with placebo.⁹ On April 1, 2026, the FDA approved orforglipron (Foundayo), a non-peptide pill (Eli Lilly); in the ATTAIN-1 trial the highest dose reduced weight by 11.2% over 72 weeks versus 2.1% with placebo.¹⁰ In people with type 2 diabetes and heart or kidney disease, orforglipron was non-inferior to insulin glargine for major cardiovascular events (hazard ratio 0.84).¹²

The triple agonist retatrutide produced 18.8% weight loss at 80 weeks on its top dose, versus 5.1% with placebo, in the first phase 3 trial published in full,¹¹ and Lilly plans to file for FDA approval in early 2027 (Lilly). Not every cardiometabolic drug succeeded: in September 2026, Ionis reported that pelacarsen, which lowers lipoprotein(a), missed the primary endpoint of its outcomes trial (Ionis SEC filing).

Guidelines and Regulation

Cholesterol. The 2026 ACC/AHA dyslipidemia guideline replaced the 2018 cholesterol guideline and covers high LDL cholesterol, high triglycerides and elevated lipoprotein(a).¹³ Our ApoB and Lp(a) articles were updated to it.

Menopause hormone therapy. In November 2025 the FDA asked manufacturers to remove cardiovascular disease, breast cancer and probable dementia from the boxed warning on menopausal hormone therapy, keeping that information elsewhere in the label (FDA); the first updated labels were approved in February 2026 (FDA). The underlying trial evidence did not change.

Peptides. In July 2026 an FDA advisory committee recommended six peptides for the list pharmacies may compound from and rejected one; the votes are not binding, and the FDA had not acted on them as of October 2026 (our Wire report).

What We Are Watching

For every registered longevity trial and its current status, see our Clinical Trial Tracker.

Claims the Evidence Still Does Not Support

Nothing published this year changed our assessment of these popular interventions. Each link goes to our full, sourced review.