If you want to stay strong, sharp, and full of energy as you age, you may need more than the standard annual checkup. The latest research on longevity and preventive medicine shows that certain tests and health metrics can predict your future health trajectory and allow you to make early lifestyle or medical changes, long before symptoms appear.
This isn't about waiting for problems to arise. It's about active health optimization. Staying in your peak physical and mental shape, protecting your energy, and extending your healthspan (the number of years you live in good health).
Christophe has been exploring the most advanced, science-backed checkups to consider around age 45, especially if you already lead a healthy lifestyle and want to stay ahead of aging, and here are his findings.
Why Longevity Checkups Matter for Optimal Health
Most traditional health checkups focus on detecting diseases after they appear. Longevity medicine takes a proactive approach:
- It aims to prevent disease before it develops
- It identifies early warning signs at a molecular and metabolic level
- It optimizes physical performance, cognitive health, and energy levels
- It personalizes recommendations based on your unique biology, lifestyle, and health goals
In other words, it's about creating a personalized health dashboard: a comprehensive monitor and roadmap for how your body is aging and how to intervene early for maximum benefit.
Essential Annual Blood Tests and Vital Signs for Longevity
These foundational tests provide the cornerstone of your health tracking. Ideally, you should check them every year (or even 2x a year if optimizing for longevity).
Cardiovascular and Metabolic Health: Your Heart, Arteries, and Energy Systems
Your cardiovascular and metabolic health determines how well your body uses energy and oxygen. These biomarkers are critical predictors of healthy aging:
Advanced Lipid Profile Testing
Go beyond basic "good" and "bad" cholesterol measurements. Include:
- Apolipoprotein B (ApoB): measures the number of atherogenic particles that can clog your arteries; more precise than LDL cholesterol alone for cardiovascular risk assessment
- Non-HDL cholesterol: another accurate marker of cardiovascular disease risk
- Lipoprotein(a) (Lp(a), one-time test): a genetically influenced particle linked to higher heart attack and stroke risk
Blood Sugar and Insulin Sensitivity Markers
Stable glucose levels are fundamental for sustained energy and longevity:
- Fasting glucose: your blood sugar level after an overnight fast
- HbA1c (Hemoglobin A1c): your average blood sugar over the past 3 months
- Fasting insulin: measures how well your body manages glucose; elevated insulin can signal early metabolic dysfunction
- Oral Glucose Tolerance Test (OGTT): optional but valuable for assessing how your body handles a glucose load
Blood Pressure Monitoring
Aim for readings below 120/80 mmHg. Even slightly elevated blood pressure accelerates aging of the heart, brain, and kidneys. Consider a 24-hour ambulatory blood pressure monitor for the most accurate baseline assessment.
Inflammation Biomarkers
High-sensitivity C-reactive protein (hs-CRP) reveals low-grade systemic inflammation, which is directly linked to accelerated aging, cardiovascular disease, and decreased energy levels.
Organ Function and Nutrient Balance Assessment
Healthy organ function supports optimal aging. Key annual evaluations include:
- Liver panel: ALT, AST, GGT, and bilirubin: detects silent liver stress and dysfunction
- Kidney function: Creatinine and estimated Glomerular Filtration Rate (eGFR), plus urine albumin-to-creatinine ratio (UACR): provides early warning for kidney damage
- Thyroid function: Thyroid Stimulating Hormone (TSH) and, if indicated, free T3 and T4: essential for metabolism and energy regulation
- Essential nutrients: Ferritin (iron stores), vitamin B12, folate, and vitamin D levels
Baseline Health Tests: One-Time or Infrequent Assessments
Some diagnostic tests don't require frequent repetition but provide invaluable insights into your long-term health trajectory and risk factors.
Advanced Cardiovascular Imaging
Coronary Artery Calcium (CAC) Scan
This low-dose CT scan measures calcium buildup in your coronary arteries:
- A score of zero indicates excellent heart health
- Higher scores reveal increased cardiovascular risk and guide personalized prevention strategies
- Typically performed once every 5-10 years unless risk factors change
Body Composition and Physical Performance Testing
DEXA Scan (Dual-Energy X-ray Absorptiometry)
This comprehensive scan measures:
- Body fat percentage and distribution
- Visceral fat levels (fat around internal organs)
- Lean muscle mass
- Bone mineral density
Optimal muscle mass and low visceral fat strongly correlate with longevity and healthy aging.
VO₂ Max Testing
This assessment measures your maximum oxygen uptake capacity during exercise. It is widely considered the single best predictor of cardiovascular fitness and overall health resilience.
Functional Strength Assessment
Surprisingly, grip strength is one of the strongest predictors of healthy aging, independence, and longevity. Regular strength testing provides valuable insights into your functional capacity. The best grip strength test is simply the dead hang. If you last 2 minutes or more, this is excellent (Christophe still struggles above 1 minute, he needs to work out more!).
Advanced Liver Health Evaluation
- FIB-4 index: a simple calculation using standard blood test results to assess liver scarring risk
- Transient elastography (FibroScan): specialized ultrasound to measure liver stiffness; recommended only if FIB-4 is abnormal or risk factors are present
Essential Cancer Screening After Age 45
Cancer risk increases with age, but early detection dramatically improves outcomes. At 45, prioritize these screenings:
- Colorectal cancer: Begin screening now: colonoscopy every 10 years, or less invasive stool-based tests annually
- Breast cancer (women): Mammogram every 1-2 years starting at age 40
- Cervical cancer (women): HPV testing every 5 years or Pap smear every 3 years
- Prostate cancer (men): Discuss baseline PSA (Prostate-Specific Antigen) testing, especially with family history or risk factors
- Lung cancer: Low-dose CT screening for adults 50+ with smoking history
- Skin cancer: Annual full-body dermatological examination, particularly with sun damage or family history
Sleep Quality, Cognitive Function, and Mental Health Assessment
Sleep and cognitive health are frequently overlooked in standard medical checkups but are absolutely essential for sustained energy and longevity:
Sleep Quality Evaluation
If you experience snoring, wake up feeling unrefreshed, or have persistent fatigue, consider a home sleep study to rule out sleep apnea and other sleep disorders.
Cognitive Baseline Testing
Establish cognitive benchmarks using simple screening tools like the Montreal Cognitive Assessment (MoCA) to detect subtle changes early and track cognitive health over time.
Stress and Emotional Balance Monitoring
Chronic stress accelerates cellular aging. Consider monitoring:
- Heart rate variability (HRV): indicates autonomic nervous system health and stress resilience
- Cortisol levels: helps assess adrenal function and chronic stress impact
Continuous Health Monitoring and Lifestyle Metrics
Your health is dynamic, so continuous tracking helps you maintain a proactive approach:
Wearable Technology Integration
Track key metrics including:
- Resting heart rate trends
- Heart rate variability (HRV)
- VO₂ max estimates
- Daily step count and activity levels
- Sleep patterns and quality metrics
At-Home Health Monitoring
- Home blood pressure monitoring: take quarterly readings to identify early trends
- Continuous Glucose Monitoring (CGM): a 10-14 day trial can reveal hidden glucose spikes and help personalize your nutrition strategy
Advanced Longevity Testing: Cutting-Edge Health Insights
If you're working with a longevity-focused physician or have access to advanced testing, consider these powerful assessments:
Epigenetic Age Testing
Measures your biological age versus chronological age using DNA methylation patterns. This revolutionary testing can show how lifestyle interventions are affecting your aging process at the cellular level.
Polygenic Risk Scores
Analyzes your genetics to predict predisposition to conditions like heart disease, diabetes, or certain cancers, allowing for ultra-personalized prevention strategies.
Microbiome Analysis
While still emerging, gut microbiome testing is increasingly relevant for optimizing digestion, immune function, and metabolic health.
Creating Your Personal Health Dashboard
To make this actionable, think of your test results as a comprehensive personal health dashboard. Here's your annual monitoring framework:
Annual Priority Testing
- Cardiometabolic health: track ApoB, fasting glucose, HbA1c, fasting insulin, and hs-CRP
- Organ health: monitor liver, kidney, thyroid function, and essential vitamin levels
- Cancer screening: stay current based on your age, sex, and family history
Biannual or As-Needed Testing
- Body composition and fitness: DEXA scan and VO₂ max testing every 1-2 years
- Cognitive and sleep assessment: establish baselines and monitor changes as concerns arise
Continuous Monitoring
- Utilize wearable devices for daily health metrics (Christophe is not a fan of wearables but it works well)
- Conduct quarterly home blood pressure checks
- Consider periodic CGM trials for metabolic insights
Key Takeaways for Optimal Longevity
- Longevity checkups focus on optimization and prevention, not just disease detection
- At 45, prioritize monitoring: cardiovascular health, metabolic function, body composition, cancer screening, cognitive performance, and sleep quality
- Building a personal health dashboard helps you identify concerning trends before they become serious health problems
- The ultimate goal: Not just living longer, but living better with sustained energy, strength, and mental clarity
Your Next Steps to Better Health
- Schedule a comprehensive baseline checkup covering the essential tests outlined above
- Begin tracking daily health metrics using wearables and reliable at-home monitoring tools
- Consult with a longevity-focused healthcare provider who can interpret your results and personalize your health optimization strategy
- Create your annual testing schedule and set reminders to stay consistent with your health monitoring
Remember: The best time to start optimizing your health was yesterday. The second-best time is today. It's like investing for retiring: the sooner you start, the more it compounds before you need it. Investing in comprehensive health monitoring at 45 can add decades of vitality to your life.
Where to Get Your Advanced Longevity Checkup
While many traditional healthcare providers can perform basic testing, cutting-edge longevity assessments require specialized clinics with advanced equipment and expertise. Here are some of the world's leading destinations for comprehensive health optimization checkups:
Europe's Leading Checkup Centers
Zoī offers one of Europe's most comprehensive 360° health checkups. Their annual membership costs €3,600 and includes a complete longevity assessment with ongoing health monitoring and personalized recommendations. Located close to Place Vendôme in Paris, Zoī features state-of-the-art facilities, and clients adore the experience (which is remarkable for a health checkup!).
American Hospital of Paris - Checkup Center provides comprehensive executive health screenings combining French medical excellence with international standards. Their programs include advanced cardiovascular imaging, metabolic assessments, and cancer screening protocols typically ranging from €2,000-4,000 depending on the package selected.
AYUN specializes in personalized longevity medicine with cutting-edge healthcare treatments led by world-class specialists focusing on proactive and preventive care. Their comprehensive assessments integrate advanced diagnostics with personalized intervention strategies. AYUN in in Zürich, Switzerland.
YEARS represents the forefront of German precision medicine, offering detailed biomarker analysis, metabolic profiling, and personalized longevity protocols. Their scientifically-rigorous approach combines traditional German medical excellence with innovative longevity research. YEARS is in Berlin in Germany.
Neko Healthrevolutionizes health screening with AI-powered technology. Their £299 Neko Body Scan takes just 10 minutes and uses 70 sensors to collect 50 million data points, screening for skin cancer, cardiovascular disease, and metabolic abnormalities. Co-founded by Spotify's Daniel Ek, they have locations in Stockholm and two centers in London (Marylebone and Spitalfields).
Checkups during Medical Wellness Retreats
Palazzo Fiuggi offers comprehensive longevity assessments. Their "Longevity Full Body Check" integrates advanced diagnostics with their therapeutic wellness programs.
Clinique La Prairie pioneered genetics testing and epigenetics, and all their programs integrate their legendary comprehensive health assessments. Every stay begins with an in-depth health checkup analyzing over 300 markers.
Chenot Palace Weggis offers the Body Insights and Optimization program that combine their renowned detox methodologies with comprehensive health assessments. Their diagnostics include 12 in-depth assessments: epigenetic testing, metabolic analysis, body composition, biomarker profiling, stress response evaluations, strength tests, and more.
Clinique Nescens was founded with preventive medicine and longevity at its core. It's no surprise that their "Cure Reset" program includes comprehensive health assessments, in-depth testing and personalized intervention protocols.
Asia-Pacific
The checkup approach at Chi Longevity at Four Seasons Singapore is interesting both for its exhaustivity and its integration of longevity perspectives at its core. It represents the pinnacle of longevity medicine in APAC at the moment. Their health assessments use advanced diagnostic tools and include blood tests, cognitive testing, and genetic profiling depending on the package chosen. "Vital Start" is the flagship checkup of Chi Longevity at the moment, it includes biological age testing, metabolic and cardiovascular assessments, and comprehensive performance markers. Key parameters measured include VO2 max, lung function, hormone levels, and detailed body composition analysis.
We also love the quality of the medical checkups at RAKxa, which is known for the quality of its integrative medicine. RAKxa is in Bangkok, Thailand.
North America
The Executive Health Program at Mayo Clinic (Rochester, Minnesota) offers gold-standard comprehensive health assessments with prices typically ranging from $5,000-8,000. Their programs include advanced cardiac imaging, metabolic profiling, and personalized risk assessment. Mayo Clinic is amongst the world's leaders in longevity medicine.
The Executive Health offer at Cleveland Clinic (Ohio & Florida) provides world-class preventive medicine programs with comprehensive longevity-focused assessments, typically priced between $4,000-7,000 depending on the selected package.
And many of our clients like to go to SHA Wellness Clinic in Mexico to have their in-depth health assessments. The experience is above and beyond, the quality of the check-up is excellent, and obviously, the results directly inform the treatments to design personalised medical wellness programs and optimise longevity and performance.
Choosing the right clinic for you: consider factors such as geographic convenience, specific expertise areas (cardiac, metabolic, cognitive), technology integration, and whether you prefer a medical clinic setting versus a wellness resort environment. Many clients combine these comprehensive checkups with wellness retreats for a complete health optimization experience. Ask us if you need any help, we are happy to guide you.
