The longevity field has reached an inflection point: practitioners can extend lifespan, but the real clinical challenge lies in preserving the function and capacity that make those years worth living. Cognitive decline, muscle loss, and metabolic dysfunction are just a few of the conditions widening the gap between lifespan and healthspan as patients age without sustainable physiologic resilience.
Against this backdrop, LongevityFest 2025 unfolded December 12-14 at the Venetian Expo and Convention Center in Las Vegas. Over three intensive days, more than 9,000 healthcare practitioners engaged with 170+ leading experts across 220+ specialized sessions. This year’s record-setting gathering created a vital nexus for exploring the interventions that preserve brainspan, build metabolic resilience, and protect the physiologic systems that determine how patients age.
The following insights represent a fraction of what attendees learned and are implementing in 2026, including the frameworks, tools, and intervention strategies emerging from the world’s largest longevity medicine event that translate directly to patient care and practice success, putting them way ahead of the curve.
5 Takeaways From LongevityFest 2025 For 2026 And Beyond
1. Longevity Is Not The Goal: Healthy Brain Aging Is
One of the most consistent and perhaps shocking messages that rang out across sessions and tracks was the reframing of “success” in longevity medicine. Rather than focusing on abstract concepts, the shared target was clear: patients who can remember, plan, and decide well into their 90s, demonstrating sustained memory, executive function, and autonomous decision-making across decades.
Multiple experts underscored the need to address brain aging as a downstream pathology, with cognitive decline reflecting upstream biology, including inflammatory signaling, circadian dysregulation, accumulated exposure, and more. These determinants manifest years before the clinical presentation of cognitive impairment and neurological disease, establishing intervention points that practitioners can leverage before neurodegeneration becomes irreversible.
Nutritional Dark Matter: The Future of Brain Longevity — Austin Perlmutter, MD
Dr. Austin Perlmutter, New York Times bestselling author and brain health expert, introduced the takeaway that echoed throughout the weekend when he boldly proclaimed, “Longevity misses the mark,” to a room full of longevity practitioners. Yet, rather than devaluing the collective mission, what he offered instead was thought-provoking clarity: that the prevailing focus on extending lifespan has overlooked preserving cognitive capacity, and that oversight represents measurable clinical failure, evidenced by the current downturn in population mental and brain health.
His presentation reframed food as a daily physiologic input extending far beyond macronutrients. Every meal delivers microbial metabolites, micronutrients, plant bioactives, and modern contaminants that accumulate as a result of biological pressure over time. He quantified the scale: approximately 139,000 chemicals exist in the modern food supply. That exposure load directly affects metabolic state, neuroinflammation, and brain resilience – the upstream systems determining whether patients maintain cognitive function or drift toward decline. Dr. Perlmutter positioned polyphenols and flavonoids as the protective exposure class practitioners can leverage immediately.
Key Insights:
Nutrition counseling becomes more actionable when framed as exposure management rather than as preference or morality.
Polyphenols and flavonoids function as a meaningful “protective exposure class,” with long-term observational data associating higher intake with materially lower dementia and Alzheimer’s risk.
The signal is pattern-driven, not supplement-dependent. He highlighted a meaningful intake delta (roughly +1,000 mg/day) between low- and high-polyphenol patterns.
The current patient diet includes modern residues and contaminants (e.g., pesticides, PFAS, plasticizers, microplastics, disinfection byproducts), which reframes nutrition as a vital part of brain risk reduction.
Polyphenols are linked to upstream systems that map cleanly to brainspan: metabolic regulation, immune modulation, microbiome signaling, and gene expression effects.
Longevity Lesson:
Brainspan is built through cumulative exposures. Food is one of the most frequent and most steerable inputs shaping that exposure load, especially via polyphenol density and modern contaminant burden.
Winning Your Brain War – The Pivotal Role of Immunometabolism in All Neurodegenerative Diseases — David Perlmutter, MD
Board-certified neurologist and author of the #1 New York Times bestseller Grain Brain, Dr. David Perlmutter, followed his son on stage to expand the brain health framework into immunometabolic territory. Dr Perlmutter positioned neurodegeneration as a systems failure, the brain expressing the body’s metabolic and inflammatory reality in real time.
His central mechanism: microglia function as the clinical bridge between body state and brain outcome. Microglial metabolism mirrors systemic metabolism, meaning insulin resistance and chronic inflammation translate into brain vulnerability years before clinical diagnosis. This connection makes metabolic health a neuroprotective imperative.
Key Insights:
Neuroinflammation produces structural brain damage. Chronic microglial activation impairs phagocytosis, destabilizes the blood-brain barrier, triggers synapse elimination, reduces neurogenesis, and accelerates amyloid and tau aggregation. These changes represent measurable tissue injury.
Environmental exposures compound metabolic risk. Air pollution (PM2.5), pesticides, heavy metals, endocrine disruptors, and microplastics function as additive stressors that increase inflammatory load over time. Modern exposure burden is directly tied to worsening cognitive outcomes.
The prevention ceiling is higher than assumed. In a 2024 review, The Lancet Commission concluded that modifying 14 risk factors may prevent or delay nearly half of dementia cases, positioning early metabolic intervention as high-yield neuroprotection with substantial population-level impact.
Longevity Lesson:
Treat metabolic dysfunction and exposure reduction as foundational neuroprotective strategies. Address insulin resistance, sleep quality, chronic inflammation, and environmental burden before microglial activation becomes structurally entrenched. Cognitive decline becomes preventable when practitioners intervene at the metabolic level, before neuroinflammation progresses to irreversible tissue damage.
Future Ready: 2025’s Boldest Ideas for Brain Health and Longevity — Ken Sharlin, MD
Dr. Sharlin, a board-certified neurologist specializing in brain health and cognitive longevity, defined brainspan in functional terms as the years of sustained executive function, memory, and emotional stability. His session addressed a gap many practitioners face: the need to wait for diagnostic criteria to justify intervention when functional decline begins five to ten years earlier. This window represents the period when protocols can alter disease trajectory and transform patient outcomes. Dr. Sharlin emphasized functional markers and trajectory measurement tools that enable practitioners to identify decline early and track intervention response over time.
Key Insights:
Brainspan measures capacity, not the absence of disease. Functional preservation of sustained cognition, emotional regulation, and independent decision-making should define the target endpoint of longevity medicine.
Cognitive decline operates on a preclinical timeline. Measurable deterioration precedes diagnosis by 5-10 years, expanding the window for practitioners to intervene before symptoms reach diagnostic thresholds.
Balance functions as an accessible resilience assessment. Inability to maintain a one-legged stance is associated with an 84% higher 10-year mortality risk. Mortality rates differ substantially: 17.5% in those unable to complete the test versus 4.6% in those who can.
Trajectory measurement supersedes chronological age. Epigenetic clocks and pace-of-aging tools like DunedinPACE track aging rate and intervention response longitudinally, providing actionable data beyond static age or late-stage diagnostic labels.
Longevity Lesson:
Deploy functional markers alongside biological age measurement to identify cognitive decline during the preclinical window. Balance testing offers an immediate, no-cost assessment of neurologic resilience. Epigenetic clocks establish a baseline aging rate and track the efficacy of interventions over time. Early detection enables practitioners to implement neuroprotective protocols when they can still alter the trajectory, before neurodegeneration becomes symptomatic and structurally entrenched.
Neuroprotection Across the Lifespan: Evidence-Based Interventions for Cognitive Longevity — David Barzilai, MD, PhD
Dr. David Barzilai, founder and CEO of Barzilai Longevity Consulting and lecturer at Harvard Medical School, positioned cognitive decline as a preventable continuum rather than an inevitable endpoint. His session quantified how standard cardiometabolic risk factors translate directly into brain vulnerability and emphasized that midlife intervention carries disproportionate protective value.
Key Insights:
Cognitive decline progresses along a measurable continuum. The path from normal aging to mild cognitive impairment to dementia follows predictable progression rates: MCI advances to dementia at 4-7% annually compared with 1-2% in controls without impairment.
Cardiometabolic risk functions as a quantifiable cognitive risk. Hypertension is associated with a 40-60% higher dementia risk. Diabetes is associated with a 50% higher risk. Meanwhile, obesity and smoking are each correlated with a 30-40% elevated risk.
Blood pressure management protects cognition. SPRINT-MIND trial data showed intensive blood pressure control reduced mild cognitive impairment risk by approximately 19%, establishing hypertension treatment as a direct neuroprotective intervention.
Cognitive reserve provides measurable clinical protection. Reserve functions as resilience against pathology, built through education, cognitively complex work, leisure activities, and sustained social engagement. These factors delay the expression of underlying neuropathology.
Longevity Lesson:
Cardiometabolic risk management is brain preservation. Therefore, it is important to treat hypertension, diabetes, obesity, and smoking as modifiable cognitive risk factors requiring early, intensive intervention. It is vital to build cognitive reserve through deliberate engagement strategies, especially once the protective window opens in midlife and before functional decline becomes apparent.
Advance Your Cognitive Longevity Toolkit | January 15-17, 2026 | Orlando, FL
To continue this brain-first momentum and delve deeper into groundbreaking protocols for brainspan preservation, join Drs. Austin and David Perlmutter, Terry Wahls, Ken Sharlin, and other experts at Cognition360: Where Innovation Meets Brain Health, from January 15 to 17 in Orlando, FL. This event promises three days focused on the latest assessment and implementation tools. Learn more about the training transforming functional longevity medicine practices nationwide and secure your spot by clicking here.
2. Muscle Is Medicine: Survival Of The Strongest
The LongevityFest 2025 agenda dedicated multiple sessions to the question of what determines whether patients maintain function as they age. Another dominant theme that emerged was skeletal muscle and physical fitness. Across presentations addressing muscle physiology, movement prescription, and bone health, the message was consistent: strength is the infrastructure that determines whether patients recover from illness, preserve independence, or decline with each passing year.
When patients lose muscle (or fail to build it), every other intervention becomes more difficult to implement.
Why Muscle Is Medicine: The History, Science, and Future of Strength — Gabrielle Lyon, DO
Board-certified family physician, founder of Muscle-Centric Medicine®, and LongevityFest 2025 keynote speaker, Dr. Gabrielle Lyon, took to the Main Stage to reframe body composition entirely. Dr. Lyon positioned obesity and skeletal muscle function as “two sides of the same coin”, both central factors at play in modern metabolic disease. Her main argument was that longevity care can’t stay anchored to “what patients need to lose.” The constructive approach should be anchored to what patients can build instead, including strength, tissue quality, and muscle capacity.
Key Insights:
Muscle functions as protective tissue. Skeletal muscle serves as the primary site for glucose disposal, a major driver of lipid oxidation, and the body’s amino acid reservoir. During illness, injury, or extended bed rest, muscle provides “body armor” and metabolic reserve that support immunity, wound healing, and recovery capacity.
The GLP-1 era requires muscle protection. Predictable high-risk populations, including older adults, post-menopausal patients, inactive individuals, face consequences from rapid body mass loss: compromised immunity, impaired wound healing, increased infection susceptibility, reduced healing capacity, and elevated mortality at extremes. Dr. Lyon’s directive is operational: pair weight-loss interventions with resistance training and higher-protein intake, including essential amino acids and branched-chain amino acids as part of the clinical strategy.
Musclespan is the missing healthspan metric. The keynote introduced “musclespan” as the duration patients maintain strength, capacity, and the physiologic resilience that muscle provides.
Longevity Lesson:
Skeletal muscle is a primary organ system requiring direct clinical intervention. In patients facing illness, aging, injury, or pharmacologic weight loss, muscle determines whether they recover or decline. Treat muscle preservation as foundational clinical infrastructure.
Movement is the Multiplier: How Physical Activity Amplifies the Pillars of Lifestyle Medicine — Melissa Sundermann, DO
Dr. Melissa Sundermann, a double board-certified physician in internal and lifestyle medicine, reinforced the keynote’s strength framework by linking population-level movement data to morbidity and mortality.
Key Insights:
Sedentary behavior is a quantifiable risk factor for mortality. Each additional hour of daily television viewing is associated with an 11% higher risk of all-cause mortality.
Movement benefits appear at attainable thresholds. Meta-analysis data show meaningful health outcomes at around 5,000-7,000 steps per day. Patients achieving approximately 7,000 steps per day (compared with 2,000) demonstrate lower all-cause mortality, improved cardiovascular outcomes, reduced dementia risk, fewer depressive symptoms, and lower fall rates.
Longevity Lesson:
Prescribe step count as the accessible entry point for muscle preservation. Start by reducing sedentary time, then establish a baseline activity threshold (5,000-7,000 steps daily) that supports strength-training protocols and long-term functional capacity.
How to Use Bone Health as a Biomarker of Longevity — Douglas Lucas, DO
During his afternoon lecture, osteoporosis specialist Dr. Douglas Lucas proposed “durability” as an essential longevity target. His session spotlighted bone health as a marker of patients’ ability to remain load-bearing over time and revealed how muscle preservation builds the musculoskeletal system that keeps patients upright, mobile, and independent as they age.
Key Insights:
The Bone Optimization Pyramid places exercise and nutrition as the foundation. Dr. Lucas structured skeletal integrity as something built through consistent action rather than addressed as an afterthought or pharmaceutical intervention alone.
Protein aligns bone protection with muscle preservation. Adequate protein intake is explicitly included in the nutritional foundation, positioning bone and muscle health as interconnected structural requirements rather than separate concerns.
Longevity Lesson:
When bone density is the presenting concern, treat the intervention plan like engineering work. Strength training and adequate protein intake are non-negotiables for maintaining patients’ load-bearing capacity over time.
3. Human First: The Provider-Patient Relationship, Trust, And AI
The provider-patient relationship faces unprecedented pressure in 2026. With artificial intelligence tools generating medical advice and social media influencers selling protocols, misinformation spreads faster than evidence. In this environment, trust becomes the variable that determines whether patients follow through on treatment, return for follow-up, or abandon care entirely in favor of the next trending solution.
LongevityFest sessions addressing this reality positioned trust as something practitioners must actively build and protect. The human element of care – characterized by presence, clinical judgment, and honest communication – determines patient outcomes more than the sophistication level of any protocol. While AI can enhance practice efficiency, marketing can improve visibility, and digital tools can streamline workflows, these technologies function as amplifiers when used correctly and can become liabilities if they replace human connection.
A Conversation: Emerging Wellness Trends and Bridging the Gap Between Lifestyle and Medicine — Will Cole, DC; Erika Schwartz, MD
On the LongevityFest Main Stage, Dr. Erika Schwartz, a preventive and regenerative medicine pioneer and bestselling author, and Dr. Will Cole, a leading functional medicine expert and bestselling author, discussed the current healthcare landscape and what practitioners must understand to deliver “human-first” care in an oversupplied wellness market.
They evaluated popular longevity trends and positioned tools and measurements as trust supports only when they reduce burden and help patients see progress, encouraging practitioners to choose interventions that feel manageable, establish baseline metrics, and track improvement.
Key Insights:
Design for capacity first. If the protocol increases overwhelm or dread, simplify it. Early restraint protects trust and follow-through more effectively than comprehensive plans patients abandon within weeks.
Treat adherence as a systems problem, not a character flaw. When patients struggle with consistency, adjust the plan architecture. Don’t escalate complexity or blame the patient.
Use tools only if they lower the burden. Any technology, including AI, should make care easier to follow. If it adds steps to an already overloaded patient’s day, it compromises adherence.
Translation and communication drive adherence. Cole and Schwartz identified a recurring pattern: patients arrive after spending significant out-of-pocket money on “one cure after another,” often shaped by social media rather than prioritization. The provider’s role is to translate complexity into executable plans and communicate clearly enough that patients understand what matters, what to ignore, and how to measure progress.
“Editing” functions as an essential skill. Patients present with “supplement graveyards” and overwhelming stacks. Practitioners build trust by filtering noise, clarifying priorities, and defining realistic success metrics.
Prioritize testing that determines protocol. Favor health history first, then order tests that actually change treatment decisions. Avoid information gathering that expands complexity without improving execution or outcomes.
Longevity Lesson:
In an oversupplied wellness market, practitioners build trust by translating trends into prioritized action. Edit the plan down to what’s relevant and sustainable. Explain the rationale and use targeted metrics to help patients visualize progress. This approach turns lifestyle medicine into something patients can follow with consistency rather than abandon in frustration, driving improved outcomes across health and satisfaction.
The AI-Enhanced Practitioner: Clinical Skills for the Next Generation of Longevity Medicine — Alexis Gonzales, ND; Sunjya Schweig, MD
During this afternoon session, Drs. Alexis Gonzales and Sunjya Schweig presented a model for integrating artificial intelligence into longevity practice without compromising patient trust or clinical judgment. Their lecture explicitly named patient-facing trust as a competency, requiring practitioners to “demonstrate transparent AI use through effective patient communication.”
Key Insights:
“Friction Mapping” identifies where AI adds value. The framework locates points where fragmented data, cognitive load, and administrative strain create workflow drag, then positions AI to reduce that friction without inserting itself into patient-facing interactions.
“Context switching” without losing presence. Practitioners must shift between clinician-only thinking and AI-assisted workflows without compromising rapport or clarity in the room. This transition functions as a direct trust signal.
Clear role boundaries: “AI holds the data. You hold the patient.” AI assembles patterns across labs, wearables, and patient history into coherent summaries. Practitioners validate, interpret, and translate that information into treatment decisions.
Transparent AI use builds trust. The session positioned transparency as a learnable skill. When AI contributes to clinical decision-making, practitioners should make that contribution visible to patients. Secrecy erodes confidence faster than imperfect tools.
Longevity Lesson:
Use AI for synthesis, not authority. Position AI as the tool that organizes complex data into usable patterns, then apply clinical judgment to validate and translate those patterns into patient-specific recommendations. Transparency about AI’s role preserves trust.
Staying Visible in the Era of AI: Simple Shifts… so Your Ideal Patients Can Find You Tomorrow — JJ Virgin, CNS
Celebrity nutritionist, fitness expert, and New York Times bestselling author JJ Virgin addressed trust signals and patient acquisition in an increasingly AI-filtered market. Her session examined how generative AI reshapes patient search behavior and practice visibility, positioning trust as something built through consistent presence across multiple touchpoints rather than one-time discovery.
Key Insights:
“The Great Decoupling” changes the way patients are discovered. Generative AI tools answer queries directly through “zero-click search,” reducing traffic to practice websites even when those websites power the AI’s answer. Practitioners lose visibility even though they produce the content patients consume.
Trust becomes a content cadence problem. Virgin framed authority as something built through repeatable “nurture” assets: newsletters, workshops, patient assessments, blog content, and success stories. Credibility develops over time through consistent, patient-readable touchpoints that demonstrate expertise and outcomes.
AI becomes the new front desk. If AI summaries shape first impressions, practitioners benefit from maintaining clear, consistent, patient-readable content that AI can surface: services offered, clinical approach, outcomes narratives, and accessible explanations of complex topics.
Longevity Lesson:
Expect AI to mediate patient discovery. Build visibility by consistently delivering content that demonstrates expertise, explains your approach, and shares patient success narratives. Trust develops through repeated positive experiences and exposure to credible, helpful information.
4. At The Root: Metabolic-Immune-Gut Triad
The 2025 LongevityFest program identified the biological foundation underlying accelerated aging, chronic dysfunction, and disease progression: the metabolic-immune-gut triad. This interconnected system determines the success of brain health interventions and muscle preservation protocols. The microbiome operates as an upstream control system. Microbial metabolites shape immune tone. Barrier integrity governs inflammatory signaling. The resulting metabolic load manifests as dysfunction years before patients identify digestion as the problem.
Sessions addressing this triad provided practitioners with concrete assessment tools that translate abstract concepts into measurable physiological markers. Specific metabolites, permeability markers, and metabolic flexibility measurements reveal the system’s capacity for resilience. These markers expose the biological foundation supporting brain protection, muscle preservation, and functional longevity. Upstream dysfunction, as revealed by these assessments, predicts which downstream interventions will succeed and which will fail before practitioners invest time and resources.
The Inflammation Equation: Gut Diversity, Hormonal Harmony, & Longevity – Dushyant Viswanathan, MD
Dr. Dushyant Viswanathan, dual board-certified in internal medicine and integrative medicine and founder of The Columbia Center for Integrative Medicine, positioned microbial processes as the drivers of immune tone. His session mapped the specific mechanisms through which gut ecology governs systemic inflammation and metabolic function. The framework identified short-chain fatty acid production, microbial metabolite balance, and barrier integrity as determinants of whether patients develop immunosuppression or a chronic inflammatory burden.
Key Insights:
Microbes drive immune tone. Immunologic mechanisms are driven by microbial processes. Vagus activation and short-chain fatty acid (SCFA) production serve as core mechanisms that favor immunoquiescence over inflammation. The microbial environment determines systemic immune behavior.
Metabolic drift begins with SCFA depletion and the accumulation of toxic metabolites. Dr. Viswanathan’s metabolic syndrome framework starts with a loss of SCFAs and a buildup of toxic microbial metabolites, alongside an environmental chemical burden. This shift precedes clinical metabolic dysfunction.
Longevity phenotype requires specific structural and metabolic characteristics. The protective phenotype includes tight junction integrity, LPS non-dominance (irrelevance), robust bile acid metabolism with secondary bile acid production, and preserved mitochondrial health. These markers define the biological foundation supporting extended healthspan.
Longevity Lesson:
Treat gut ecology as the upstream variable determining immune tone. When SCFA capacity declines and lipopolysaccharide (LPS) becomes dominant, the downstream consequences are predictable: immune dysregulation and metabolic decline. These changes manifest years before gastrointestinal symptoms become the presenting complaint. Address microbial balance early to preserve the metabolic-immune foundation supporting brain health and muscle preservation.
The Gut Microbiome & Aging: Unraveling The Microbial Pathways To Longevity — Julia Malkowski, ND
Dr. Malkowski, a naturopathic physician with dual doctorate degrees in naturopathic and chiropractic medicine, translated the metabolic-immune-gut triad into trackable clinical metrics. Her session addressed the assessment gap practitioners face: how to monitor gut ecology, immune burden, and metabolic risk using specific biomarkers that connect microbial health to systemic outcomes.
Key Insights:
Permeability functions as a systemic disease amplifier. Intestinal permeability and zonulin elevation associate with inflammatory diseases and aging-related conditions. Barrier compromise propagates immune activation beyond the gut.
Zonulin links barrier status to metabolic syndrome metrics. Higher zonulin correlates with increased waist circumference, elevated diastolic blood pressure, and higher fasting glucose. Impaired fasting glucose associates with increased serum lipopolysaccharide and zonulin, establishing permeability as a metabolic risk marker.
The assessment framework provides actionable monitoring tools. Dr. Malkowski outlined practical categories: abundance and phyla shifts, diversity indices (Shannon, Simpson), dysbiosis index, key taxa profiling, plus serum and fecal zonulin for permeability assessment. These markers translate gut ecology into quantifiable data.
Dietary interventions produce measurable immune outcomes. Fermented foods, particularly low-sugar options, are associated with increased diversity and reduced levels of inflammatory proteins, including interleukin-6.
Longevity Lesson:
Use zonulin, diversity indices, and dysbiosis signatures as the monitoring framework that transforms gut health from subjective complaint into quantified immune load and metabolic risk assessment. These biomarkers provide trackable endpoints that indicate whether interventions address the biological foundation supporting brain health and muscle preservation.
5. Spotlight On: The Nervous System
Brain health, muscle preservation, patient-provider relationships, and metabolic-immune-gut integrity established what practitioners need to protect. Meanwhile, the nervous system was revealed as the variable determining whether patients can execute the protocols, preserving those systems. Sessions on autonomic function, stress physiology, and nervous system regulation converged on a single reality: when the nervous system operates in chronic sympathetic dominance, the downstream consequences are predictable and consequential. Sleep disruption, impaired focus, loss of emotional regulation, elevated blood pressure and heart rate, and low heart rate variability – all of which pose important opportunities for intervention.
The Neuroscience of Stress: Leveraging AI, Devices, and Psychedelics for Optimal Brain-Body Health — David Rabin, MD, PhD
Dr. David Rabin, a board-certified psychiatrist and neuroscientist and co-founder of Apollo Neuroscience, addressed stress physiology and autonomic nervous system regulation on the LongevityFest Main Stage. His research focuses on chronic stress resilience and non-invasive interventions for treatment-resistant conditions, including PTSD and substance use disorders. The session positioned autonomic state as an upstream determinant of whether patients can sustain the sleep quality, metabolic function, and cognitive capacity required for functional longevity.
Key Insights:
Chronic stress trains the autonomic nervous system into sympathetic dominance. Prolonged exposure to stress conditions the nervous system to maintain fight-or-flight activation, suppressing parasympathetic rest-and-digest function. The clinical presentation is consistent: poor sleep quality, impaired focus, impaired emotional regulation, elevated blood pressure and heart rate, and reduced heart rate variability.
Improved parasympathetic tone functions as a measurable intervention target. Restoration of parasympathetic function produces observable clinical improvements: improved emotional regulation, better sleep quality, enhanced focus, decreased blood pressure and heart rate, and improved heart rate variability. These metrics provide trackable endpoints for nervous system interventions.
Interventions span from accessible behavioral tools to technology-assisted protocols. Dr. Rabin presented a toolbox with scalable entry points: biofeedback, deep-breathing protocols, mindfulness practices, movement meditation (including yoga), soothing touch, sound and music therapy, vagal nerve stimulation, empathic listening, and wearable technology such as Apollo Neuro vibration therapy. The range allows practitioners to match intervention intensity to patient capacity and preference.
Longevity Lesson:
Autonomic state operates upstream of sleep, focus, and emotional regulation. When sympathetic dominance becomes baseline, patients lose the physiologic capacity to execute longevity protocols regardless of their sophistication. Heart rate variability, resting heart rate, and blood pressure provide accessible metrics for assessing autonomic balance. Parasympathetic restoration becomes a defensible intervention objective, with tools ranging from breathing protocols and movement practices to vagal stimulation and device support. Address nervous system regulation before expecting patients to sustain complex treatment protocols.
The Neuroplasticity Revolution: Pathways to Healing the Nervous System — Terry Wahls, MD
Dr. Wahls, clinical professor of medicine and author of The Wahls Protocol, has personally recovered from progressive multiple sclerosis using the functional medicine approach she now teaches. Her session addressed neuroplasticity as the mechanism through which the nervous system functions, either improves or deteriorates, based on repeated exposure patterns. The framework positioned nervous system change as trainable rather than fixed, with direct implications for practitioners working to restore function in patients with chronic conditions or prevent decline in aging populations.
Key Insights:
Neuroplasticity is work-shaped. Dr. Wahls stated: “Our nervous system is shaped by work.” Nervous system change occurs through repeated inputs and consistent practice. Function improves or degrades based on what the system experiences repeatedly over time.
Resource allocation follows a use-it-or-lose-it principle. Any part of the body or brain not actively engaged will have its resources diverted elsewhere. Dr. Wahls linked bed rest to muscle atrophy and bone demineralization as examples of this reallocation pattern. The nervous system prioritizes maintaining the function that receives consistent demand.
Metabolic capacity determines nervous system resilience. The brain consumes approximately 22% of total ATP production. Insufficient ATP results in neurodegeneration. This metabolic burden explains why systemic energy production capacity directly affects nervous system outcomes and why the metabolic-immune-gut triad matters for neurologic function.
Plasticity operates in both directions. Dr. Wahls described negative neuroplasticity following chronic injury such as multiple sclerosis or stroke: disuse patterns inhibit muscle activation, accelerate atrophy, and establish incorrect movement patterns that complicate rehabilitation efforts. She presented neuromuscular re-education, physical therapy, and slow, precise, targeted movements as interventions to restore the brain-to-spinal-cord-to-muscle connection.
Longevity Lesson:
The nervous system adapts to repeated exposure. Recovery requires more than symptom management. Practitioners must prevent negative plasticity by maintaining function through consistent engagement and providing the metabolic foundation supporting neuroplastic change. This means addressing ATP production capacity through the metabolic-immune-gut interventions discussed earlier and prescribing specific, repeated movement patterns that reinforce desired neural pathways. Disuse accelerates decline. Targeted practice rebuilds capacity
The Autonomic Deregulation Theory of Aging — JP Errico
JP Errico, a prolific inventor and scientist, explored the autonomic nervous system in depth as a central mechanism in aging biology rather than as a peripheral stress factor. His session reframed autonomic dysfunction from a symptom to the driver of the biological aging process itself. Errico’s framework positioned parasympathetic activation as a protective force across the hallmarks of aging.
Key Insights:
The autonomic nervous system functions as a rate-setter for aging biology. Errico’s framework positioned autonomic tone as an upstream control input that simultaneously affects multiple aging mechanisms. Chronic sympathetic overactivation sits upstream of symptom burden and accelerates aging biology. Parasympathetic activation stabilizes systems, creating the physiologic conditions allowing other longevity interventions to hold.
Hallmarks collapse into three clinically legible categories. Errico organized aging hallmarks into energy (mitochondrial dysfunction, cellular senescence, stem cell exhaustion), information (genetic instability, telomere attrition, epigenetic drift), and homeostasis (intracellular and extracellular proteostasis, autophagy, nutrient sensing, plus inflammation, dysbiosis, and altered communication).
Clinical reality precedes rejuvenation hype. Errico opened with the rejuvenation landscape, including cellular reprogramming and technology investment, then reframed the conversation around near-term intervention. Practitioners who ignore autonomic balance keep the accelerator down while pursuing advanced protocols. Address the rate-setter first.
Longevity Lesson:
The autonomic nervous system determines aging rate across multiple biological systems simultaneously. Sympathetic overactivation accelerates hallmark processes while parasympathetic activation stabilizes them. Practitioners cannot successfully intervene on energy metabolism, genetic stability, or homeostatic balance in a nervous system operating in chronic fight-or-flight. Autonomic regulation becomes a prerequisite for other longevity interventions. Assess autonomic tone using heart rate variability, resting heart rate, and blood pressure variability. Prescribe parasympathetic activation interventions before expecting metabolic, immune, or mitochondrial protocols to produce lasting results.
Standout LongevityFest Sets New Records
These were our notes from fifteen sessions out of over 200 lectures delivered at LongevityFest 2025. The remaining agenda covered mitochondrial therapeutics, senolytic protocols, practice management systems that actually protect your clinical time, cardiovascular assessment frameworks that catch disease progression years earlier, and immune dysfunction treatments that address the root cause rather than suppress symptoms. Practitioners left Las Vegas with protocols they implemented the following Monday, ranging from specific supplement sequences and lab interpretation criteria to patient communication approaches that improve adherence rates.
LongevityFest delivered clinical frameworks designed for immediate integration, and the practitioners applying these protocols throughout 2026 will deliver measurably different patient outcomes than colleagues still working from 2024 knowledge.
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