On August 26, The New York Times ran a piece on intrinsic capacity, a composite measure of how well a person’s mind and body are aging. Looking beyond disease and biological markers, intrinsic capacity is scored across five domains: cognition, locomotion, sensory function, psychological well-being, and vitality. Before you start looking up how you can start using this in your practice, the article clearly states: "You can't ask your doctor to test your intrinsic capacity just yet." Researchers hope physicians will eventually use it to track older patients over time, and some see applications in clinical trials to show that a drug or a lifestyle change slows aging.
Depending on where you are as a clinician in this space, you are either rolling your eyes at another longevity metric you need to learn about, or your spidey-senses may be tingling on a new way to communicate meaningful insights to your patients. The good news is that many of us are already measuring components of intrinsic capacity in our existing workups, and our patients are depending on us to prove to them that they are aging better on our care plans. The rub is now understanding the clinical value of intrinsic capacity before it becomes the next longevity standard, and how to build your practice at the leading edge to start tracking intrinsic capacity.
Researchers are working toward using intrinsic capacity to test whether a treatment slows aging. The World Health Organization made it central to its healthy aging framework in 2015, federal funding is supporting research into that approach, and FDA officials have discussed how aging trials could measure changes in physical and mental function.
For our practices, the question is what those changes can tell us. If a patient’s intrinsic capacity score improves on a care plan, does that mean we are helping them live longer? We don’t have that evidence yet. The researchers’ own consensus statement to the FDA acknowledges that the score has not been validated as a substitute for measuring clinical outcomes. David Furman of the Buck Institute told the Times, “We expect it will, but we don't have the data yet.”
Most practices already cover two of the five domains
In Ultralight's conversations with practices this year, the same assessments keep coming up: grip strength, VO2 max, DEXA, body composition. One physician opening a preventive practice put it simply: "If I want to know their grip strength, their bone density, their VAT levels, those are the things that I like to see." These assessments give us a starting point for tracking locomotion and vitality.
What about the other three domains? Cognitive health is already getting more attention in longevity care, but are hearing and mood getting the same attention? SuperSenses assesses the five senses to help clinicians evaluate sensory changes relevant to brain health. That gives us another way to bring cognitive health into the workup, while making sure hearing, vision, and mood get attention alongside strength and body composition.
Then there is the question of where all these results live. One longevity clinic's operations lead described their function results as "a sheet that we fill out while someone's in clinic." Many practices already collect useful measures across these domains. Recording them consistently in the same place at each review lets us see where a patient’s function is holding, improving, or declining, and use those changes to guide the next care decision.
What it does for the membership
Members pay for proof that their hard work is working. The operations lead at one membership clinic we spoke to described the check-in they want with every patient on a six-month plan: "are you at target, are you not?" Patients can feel a grip score that climbs or a chair rise that gets faster, because those map onto carrying groceries and getting up off the floor. When members can feel the change themselves, the renewal conversation gets easier, because they see the momentum in their activities of daily life.
The evidence backs the instinct, with the usual caveat that these are observational cohorts. In a 2024 meta-analysis of 206,693 adults with an average age between 65 and 85 years, higher intrinsic capacity was associated with a 43% lower risk of death, and people whose capacity held or improved had 63% lower odds of losing independence in daily tasks. For younger members, the PURE cohort of 139,691 adults aged 35 to 70 found each 5 kg lower grip strength was associated with 16% higher all-cause mortality, a stronger predictor than systolic blood pressure.
Testing physical and mental function sits next to biological-age testing. Many of our readers already include epigenetic clocks in their longevity panel of assessments, and the Biomarkers of Aging Consortium counts grip strength, gait speed, and VO2 max as biomarkers of aging next to the ones tested in blood and saliva. Labs and clocks show what is changing inside, and grip and chair rises give patients something they can feel in real life.
The head start
If this measure becomes the longevity standard, practices with a few years of longitudinal function data on each member will already have the baseline. WHO's ICOPE program, as rolled out in France, is designed to rescreen adults over 60 every four to six months and alert on decline. In the first 10,903 people screened, 94% had at least one domain flagged. Vision was the most common flag at 68%, followed by cognition at 60% and hearing at 51%.
In younger members, pass-fail screens may come back normal because they are designed to identify potential impairment in older adults. For our practices, that leaves an important question unanswered: how does their function compare with their own baseline?
Here lies a reason to pay attention before impairment shows up. A UK Biobank analysis of 45,208 adults aged 40 to 69 found that each one-unit higher intrinsic capacity score was associated with 25% lower odds of death. Raising a patient’s score has not yet been shown to extend life. The finding still supports making preserved function a goal of care. For younger members, we can encourage improvements where there is room to improve and help them maintain capacity over time, rather than waiting for a screen to flag a problem.
What to try this week
At your next membership review, establish a baseline across all five domains. For younger members, emphasize measured values and change over time.
Domain | What to assess + chart | Follow-up trigger |
|---|---|---|
Locomotion | • Five chair rises, no arms (seconds) • Grip strength, each hand (kg) • Change from baseline | Unable, or over 14 seconds: assess gait, balance, and strength; consider PT. |
Cognition | • Memory or orientation concerns • Three-word delayed recall (out of 3) • Orientation: today's full date and current location | Incorrect orientation or recall under 3/3: further cognitive assessment. |
Sensory | • Distance vision with usual correction, each eye • Near vision • Hearing concerns and screen result • SuperSenses, if used: composite score and changes | Vision worse than 6/12 (20/40), unable to read N6 near print, or failed hearing screen: focused assessment. Review SuperSenses findings in clinical context. |
Psychological | In the past two weeks: • Feeling down, depressed, or hopeless? • Little interest or pleasure in doing things? • PHQ-9 score, if completed | Either yes: further mood assessment, such as PHQ-9. Self-harm concern: prompt safety assessment. |
Vitality | • Weight and three-month change • Unintentional loss or reduced appetite • Body composition • VO2 max (mL/kg/min) | Over 3 kg unintentional loss in three months, or reduced appetite: nutrition assessment and evaluation of contributing causes. |
Plan | • Domains needing follow-up • Focused assessment, intervention, or referral | Set the repeat assessment date. |
Record results in the same place every time. Keep the values, units, and testing method consistent so comparisons are useful.
Set a retest cadence. ICOPE follows older adults at roughly six-month intervals. For midlife members, consider six months based on clinical need.
Follow each flag with a focused assessment. Confirm the finding and assess contributing factors before choosing an intervention or referral.
Review the changes with the patient. “Here’s what improved, what stayed stable, and what needs a closer look. This is how it affects our plan.”
Be a modern clinician with the help of Ultralight, the AI-native EHR built specifically for functional, integrative, and longevity medicine. We've recently launched wearables integrations and improved AI-native clinical workflows. Get in touch to see the latest updates.
Recap: A Clinician's Masterclass on VO2 Max
On October 6, Brooks Leitner, MD PhD, of VO Health and Sunita Mohanty, CEO of Ultralight, hosted a live session for clinicians on bringing VO2 max into clinical practice. VO2 max sits in the vitality row of this week's table, and the full recording is below.
In the news
Most health systems now use AI to write notes, and far fewer use it to help them think. PHTI's 2026 State of Digital Health Purchasing, updated September 29, found 71% of health systems report some deployment of AI for clinical documentation and ambient scribing, while 18% run AI for clinical decision support at enterprise scale. For a small practice, the next gain from AI sits in reasoning support: reading a panel against a patient's history and checking a differential before the visit.
More than half of adults with no known heart disease already had arterial plaque on imaging. In a NEJM study presented at ESC Congress in late August and worth the late look, imaging of 16,808 adults aged 18 to 70 in Denmark and Spain found atherosclerosis in at least one artery in 57.1%, including about 1 in 13 adults aged 18 to 29. Standard risk scores identified only a small share of them. Plaque on a scan raises risk without making an event certain. For members who want to know where they stand, imaging gives a clearer answer than a risk calculator and a reason to act on apoB and blood pressure sooner.
Low B12 after 50 was linked to a third more fractures. A Scientific Reports analysis of TriNetX health records matched 115,735 adults aged 50 and over with B12 at or below 199 pg/mL against peers with normal levels and found a 33% higher adjusted fracture hazard. The design is observational, and the authors say it does not show that B12 deficiency causes fractures. It is still a cheap reason to keep B12 on the 50-plus panel and read a low result alongside fall risk.
Upcoming Conferences & Events
Oct 8, Beyond the Basics: Advanced AI Prompting for Functional & Longevity Clinicians · Virtual · 11am PT / 2pm ET · Live session hosted by Sunita Mohanty and Karina Tsareva of Ultralight, with panelists Marwa Shoeb, Sheila F. Marshall, and Lyssa Jaye, on advanced prompting with Ultralight AI. Ultralight is hosting!
Oct 8-10, A4M Women's Health Summit · San Antonio, TX · The best clinical education on hormone, metabolic, and midlife women's health you will see this year. The room to be in if you are growing the perimenopause and menopause side of your practice.
Oct 17-18, Roundtable of Longevity Clinics · Buck Institute, Novato, CA · Some 250 longevity clinic leaders, physicians, and researchers working toward shared standards for longevity testing and interventions. In-person and virtual tickets are open. Ultralight will be there!
Oct 21-23, DOC (Living Room Lab) · Sonoma, CA · Salon-style sessions on longevity science and medical AI with faculty from UCSF, Stanford, and the Buck, plus validated diagnostics in the Living Room Lab. Ultralight will be there!
Oct 21-24, NAMS Annual Meeting · San Diego, CA · The single most practice-changing meeting of the year for midlife women's health. Your protocols will look different after this one.
Nov 5-8, Eudēmonia Summit · West Palm Beach, FL · One of the most talked-about longevity gatherings in the U.S. With experientials, hands-on demos, and the best place to try the emerging frameworks your patients will ask you about next year. OvationLab and Ultralight will be there!
Nov 5-7, Private Physicians Alliance Annual Meeting · St. Petersburg, FL · The gathering for independent, cash-pay, and concierge physicians navigating practice independence. Practical and peer-driven. Ultralight will be there!
Nov 8-11, American College of Lifestyle Medicine Conference · Orlando, FL · Lifestyle medicine's main annual event, with evidence-based approaches to behavior change, chronic disease, and healthspan. Growing overlap with the longevity medicine community.
Nov 10-13, Valley Forum 2026 · Napa Valley, CA · Invitation-only forum where healthcare leaders work through the industry's hard problems, AI's role in care among them. Ultralight will be there!
Dec 11-13, A4M Longevity Fest · Las Vegas, NV · The biggest longevity event in the U.S. The room spans clinicians, industry, founders, and the people building next year's platforms, and the connections from this one tend to compound through the rest of your year. OvationLab and Ultralight will be there!
Know of an event we should add? Reply and tell us.
Until next week
What we keep coming back to is how much of this we already measure, and how much more useful it could be if we looked across all five domains over time. It also has us thinking about what we’d learn from doing some of these assessments on ourselves.
We’ll get that chance at Eudēmonia this November, where SuperSenses is included in the ACE Immersion Kit for the first 200 registrants. We’ll also be sharing what we’re seeing with AI in clinical practice and how it’s changing the way we work as we head into 2027. If you’ll be there, come compare notes with us. We’d love to hear what’s been useful in your practice and what you’re still figuring out. We have plenty of those questions ourselves.
See you there,
Sunita & Dr. G