A life well-lived means different things to different people. But as the longevity industry continues to build steam globally, a good life among the moneyed is increasingly measured in health. Where the wealthy may once have been accused of chasing youth, they’ve now largely shifted their focus to chasing health. From pricey annual longevity clinic memberships to exorbitant one-off testing protocols, the adage that health is wealth—or in this case, that wealth equals health—has never rung more true. 

The global longevity market is estimated to reach US $610 billion this year, and global investment in longevity clinics has doubled in the last four years resulting in up to 800 new clinics opening in the U.S., over 40 in Switzerland and 25 in the U.K. in 2023 alone. Even high-end gyms like Equinox are getting into the game with longevity programs that carry a US $40,000 annual membership fee. 

“There’s been an epiphany that aging itself is a disease that can be managed,” says Dr. Jennifer Pearlman, medical director and owner of PearlMD Rejuvenation and a globally recognized expert in regenerative and aesthetic medicine. “We can reprogram the aging process with clinically accessible tools, treatments, technologies, and protocols.” 

In Dr. Pearlman’s clinic, this practice started decades ago with aesthetic injectibles—the original longevity treatment—but she says the pendulum has swung, especially among women who have adopted a more proactive approach to midlife as a critical hallmark in the longevity process. This awareness started with hormonal health and has extended to the gamification of longevity via wearables, an interest in biomarker testing, and the potential for A.I. in precision longevity medicine. Men’s interest has been piqued, too. 

Among the more in-demand longevity tests is the full-body MRI, which can run patients from US $2,000 to US $4,500, says Dr. Mishkat Shehata, a chief medical and longevity officer and founding member and VP of the Emirates Lifestyle and Longevity Medicine Society. Yet it’s only the tip of the iceberg for individuals with unlimited resources. “The usual menu blends advanced imaging and multi-omic biomarker profiling, which includes lab biomarkers,” Dr. Shehata says. MRI, CT, DEXA, and ultrasound scans, whole-genome sequencing, biological-age clocks, extensive biomarker panels, and functional physiological testing are all part of the catalogue. The total cost can run upwards of US $7,000; add on advanced brain and heart protocols, plus GLP-1 drugs, and you could be looking at an additional US $3,000 to upwards of US $25,000. That’s not even taking into account emerging testing in gerotherapeutics like hormone peptide and stem cell therapy, where one potent infusion can cost US $100,000.  

Collectively, these tests can offer wide-ranging intel: from identifying tumours and aneurysms to uncovering information about cellular health and the pace of aging. What’s more, they can be crucial in anticipating cardiovascular events like heart attacks and unstable angina, since they can detect plaque buildup in the coronary arteries. 

Of course, there’s always the question of whether these tests will raise alarm bells over underlying health conditions that are benign. “I would say that technical accuracy is generally high for diagnostics but the uncertainty lies with clinical interpretation of results,” Dr. Shehata says. It’s critical to balance sensitivity and specificity, meaning a test’s ability to accurately diagnose a patient with a condition while minimizing false positives. “The best longevity testing programs use a tiered strategy: highly sensitive tools to screen, followed by more specific, targeted testing to clarify ambiguous findings.”

The research is less conclusive, at least in the case of MRIs. In a systematic review and meta‐analysis published in the Journal of Magnetic Resonance Imaging, researchers found that the benefit of using a whole-body MRI for preventive health screening is “currently not completely clear.” They concluded that MRI findings in asymptomatic patients had a substantial proportion of false-positive findings and that verification data are lacking. 

What it comes down to, says Dr. Pearlman, is ensuring the results are being interpreted by a medical professional with whom the patient has a trusted relationship. “I never hang my hat on a test,” she says. “I always integrate results into a matrix of the patient’s health history, profile, clinical exam, imaging results, and biomarkers. Then over time, I track patterns. Spurious results, lab errors, and false indicators all exist and occur, but it behooves the physician to understand how to mitigate the risk of a false positive while avoiding the false negative.”

Once a clinician has a handle on the results, they may initiate early intervention in the case of detected malignancies or simply offer guidance for personalized lifestyle changes to improve healthspan—arguably the biggest benefit of preventive testing. Depending on what’s flagged, patients might alter their diet, exercise or sleep habits, integrate medications or supplements, or book regular appointments for monitoring. “I advise patients to go slow and take the [test results] one at a time,” Dr. Pearlman says. 

Ultimately, the goal of longevity testing is to find specific actions that allow a patient to be proactive about their health, not reactive because something has gone wrong. Patients can then track to see how well their efforts are working. For example, if a particular inflammation marker drops after a patient has adopted a mediterranean diet, that is a strong indicator that the holistic intervention has beneficial effects for that individual. Along with the guidance of a trusted expert physician, these tailored plans—alongside continued testing—can support patients in their quest for ultimate health.