Fig. 4 |. Therapeutic approaches to restore NAD⁺ levels and their impact on health.

Ageing is associated with decreased nicotinamide adenine dinucleotide (NAD⁺) levels that promote or exacerbate ageing-related diseases. Thus, restoring NAD⁺ levels has emerged as a therapeutic approach to prevent and treat ageing-related diseases and to restore health and vigour during the ageing process (part a). Some potential strategies that boost NAD⁺ levels include lifestyle changes, such as increasing exercise, reducing caloric intake, eating a healthy diet and following a consistent daily circadian rhythm pattern by conforming to healthy sleeping habits and mealtimes. Another approach is the use of small-molecule inhibitors or activators to boost NAD⁺ biosynthesis and the use of dietary supplements, including NAD⁺ precursors, such as nicotinamide mononucleotide and nicotinamide riboside. All of these approaches promote tissue NAD⁺ levels and are beneficial for health. These include improved tissue and organ function, protection from cognitive decline, improved metabolic health, reduced inflammation and increased physiological benefits, such as increased physical activity, which may collectively extend patient healthspan and potentially lifespan (part b).