What Luxury Longevity Clinics Really Offer

Iain Tait is not obsessive about his health. He enjoys a drink and a party; he doesn’t wear a fitness tracker.

But Mr. Tait, 50, does pay more than $20,000 a year for a membership to Hooke, a private health clinic based in London with an emphasis on longevity.

Discovering he had high cholesterol, and the sudden death of a friend from a heart attack, persuaded Mr. Tait, a wealth manager, to take his health more seriously. “Something’s changed to make you feel a little bit vulnerable,” he said, “and then you’re thinking about your own mortality.”

It turns out many people are willing to pay a lot of money to try and stave off feelings of mortality: High-end health and longevity clinics are ballooning. Firm data on the industry is scant, but by one estimate there are as many as 800 such clinics in the United States alone. At some, people pay five-figure annual membership fees to gain access to a barrage of medical tests and personalized health recommendations. At others, à la carte anti-aging treatments can cost thousands of dollars for a single session.

Patients say that they feel rejuvenated by the interventions, and that while the plethora of data can be overwhelming, it ultimately helps them feel more in control of their health. But experts worry that these clinics are capitalizing on people’s fears of aging and death without offering many tangible benefits — because almost none of this is covered by insurance, or proven to prolong one’s life.

It’s almost like ‘being turned inside out.’

The initial step at many longevity clinics is a thorough evaluation, which can include several types of imaging (such as CT, M.R.I. and DXA scans), blood panels, a fitness assessment, cognitive testing and genome sequencing to tell you not just about the state of your health now, but what you might face in the future.

“Our first responsibility to our clients is to make sure you don’t walk off a cliff with something that you had no idea that you had but that’s totally preventable and curable,” said Dr. David Karow, the former president of Human Longevity, a clinic with locations in San Diego and San Francisco. (Dr. Karow stepped down from his role this month.) An annual membership to Human Longevity’s top-tier program costs $19,000 and, in addition to the testing, includes behavioral health recommendations, concierge primary care and treatments like hormone and peptide therapy (an umbrella term for a class of drugs that encompasses everything from collagen supplements to medications like Ozempic).

At Hooke, the tests on Mr. Tait revealed that he had some calcification in the arteries in his neck and a heightened genetic risk for Alzheimer’s disease. Based on his results, the Hooke team drew up a personalized plan centered around improving his diet, exercise and sleep.

They’re not trying “to reassure you that everything’s OK,” Mr. Tait said. “This is almost being turned inside out to look for things that might come at you down the line.”

“And then you just feel this sense of gratitude,” he added, “because, having felt a little vulnerable, you then had this program that’s given you the best chance to address the issue.”

Mr. Tait is representative of many of the people seeking out longevity care, said Kate Woolhouse, the chief executive officer of Hooke. While some are millennial bio-hackers, most are over 50 and often come in because of a health scare, she said. For many, the goal isn’t to live longer, but to maintain their health as they age.

That was the motivation for Joe Nevin, 78, a patient at Human Longevity. Mr. Nevin, who runs a seniors ski program in Aspen, Colo., is dismissive of the word “longevity.” Instead of trying to extend his life span, he said, he wanted an answer to the question: “How do you know you’re healthy?”

“There’s a real difference between what you look like on the outside and what’s going on inside,” Mr. Nevin said.

His first visit in 2017 revealed that he had a tumor on his left kidney. Dr. Karow referred him to an interventional radiologist who removed the growth. Mr. Nevin and his wife have gone back to Human Longevity every year since.

It’s ‘about treating risk, not disease.’

If the testing offered by longevity clinics catches a chronic health condition early, it could help someone live longer. But while thorough health assessments are relatively low risk, some experts say they are largely unnecessary for people without any symptoms or a relevant family history.

Dr. Deborah Korenstein, the senior medical director of Mount Sinai Solutions, a concierge primary care program in New York City, said we often hear “these anecdotes of people who truly believe their lives were saved by these things, and maybe they were. But what we don’t see” is everybody else who had it done and didn’t find anything.

She and other experts also expressed concerns about misleading or unusable results; for instance, the dozens of blood tests that clinics order may not provide practical information that people can act on. And some have questioned whether preventive genome sequencing actually benefits people’s health.

There’s also “no evidence at all that demonstrates that having full body M.R.I.s improved any outcomes, including mortality rates,” said Dr. Catherine Livingston, an associate professor of family medicine at Oregon Health & Science University, who is on the American College of Preventive Medicine’s science and translation committee. But, she added, full-body M.R.I.s do have high rates of false positives. The American College of Radiology and the American College of Preventive Medicine currently recommend against the practice.

Those false positive results can cause people immense stress and anxiety, and even lead to unnecessary procedures or biopsies. In other cases, a real tumor may be identified, but it’s what Dr. Livingston calls an “incidental-oma” — a growth that is benign or would never have progressed enough to affect someone’s health. Yet because it was found, the patient ends up undergoing treatment.

To Dr. Karow, these types of results are not necessarily a bad thing. “Precision medicine is all about treating risk, not disease,” he said.

But, he added, his clinic is careful to avoid unnecessary procedures. “Before we ever stick a needle in somebody or refer somebody for a consult or follow-up, we want to make darn sure it’s something concerning. And by having all of these data, we can do that.”

‘I don’t feel like it’s snake oil.’

When the recommended treatments after these screens are behavioral changes, like improving diet and exercise, they pose little harm, Dr. Korenstein said. But when they start to venture into new — and often unproven — therapies, the situation can change.

At Extension Health, a clinic in Manhattan, such treatments include hyperbaric oxygen therapy, plasma exchange and ozone therapy, as well as a litany of supplements, peptides and hormones.

Craig Linsley, 67 and a retired hairdresser, was initially seen over a decade ago by Dr. Jonathann Kuo, a pain specialist and the founder of Extension Health, for help with his back pain and wrist arthritis. It started with conventional pain management, but as Dr. Kuo’s interests expanded to regenerative medicine and longevity, so did Mr. Linsley’s treatments.

He has now received several rounds of platelet-rich plasma therapy — an experimental treatment that uses a patient’s blood plasma to help heal damaged tissue. He also takes two different peptides that are supposed to help with inflammation and which, according to Mr. Linsley, also improve his skin, hair and nails, as well as his overall stamina. He spends between $5,000 and $10,000 annually on the treatments.

“The things they do are very real,” Mr. Linsley said. “I don’t feel like it’s snake oil at all.”

There are no F.D.A.-approved treatments to target aging, but many of the offerings at longevity clinics are authorized for other conditions and can be used off label at a doctor’s discretion.

For instance, plasma exchange (also called plasmapheresis) is used to treat some blood disorders and autoimmune conditions. The procedure, which costs $12,000 for a single session at Extension Health, involves removing a patient’s blood, separating the red blood cells from the liquid plasma, and then returning the cells and a replacement plasma to the body. It has become popular among bio-hackers and longevity enthusiasts, who claim it can cleanse the blood of toxins. But, Dr. Kuo acknowledged, “there’s no specific F.D.A. approval to use it routinely for longevity purposes or for detoxification purposes.”

That lack of evidence is a red flag to many geriatricians. People are looking for something “that can help them have the passage of time be kinder to them,” said Dr. Alison Moore, the chief of geriatrics, gerontology and palliative care at UC San Diego Health. “I understand the desire, but the evidence base is really not there” for most of the treatments being offered.

Dr. Karow and Dr. Kuo said that they use “biological age” tests at their clinics as metrics to indicate to patients that their interventions are working. But both also acknowledged that these kinds of tests are flawed and have limited accuracy. The doctors insisted, however, that their treatments can make people feel younger.

That has been Mr. Linsley’s experience. “I was starting to feel crickety, like frail,” he said. “And that stuff has gone away.”

“I know I’m not getting younger,” he added, “but I feel like I’m maintaining beautifully.”