A few years ago, almost nobody outside a research lab had heard of NAD+. Today it is on the menu at wellness clinics, med spas and mobile IV services in most American cities, usually described as a way to restore energy, sharpen thinking and slow the effects of aging. Older adults are one of the groups these services market to most directly, and adult children are often the ones asked to help pay, drive or decide.
If someone in your family is considering a course of NAD+ infusions or shots, it helps to separate what is known from what is being promised. The short version is that the biology behind NAD+ is real and interesting, the evidence that injections make older people healthier is still thin, and there are practical safety questions worth asking before anyone rolls up a sleeve.
NAD+, short for nicotinamide adenine dinucleotide, is a molecule found in every living cell. It helps turn food into usable energy inside the mitochondria and supports enzymes involved in repairing DNA and regulating how cells respond to stress. It is made in the body from building blocks that come partly from vitamin B3.
The reason it attracts so much attention is that NAD+ levels appear to fall with age. A widely cited review in Nature Reviews Molecular Cell Biology described declining NAD+ in several tissues as a feature of aging in animals and in people, and linked that decline to a range of age-related changes in metabolism and cell function.1 The logic of the wellness industry follows from there: if levels drop, putting more NAD+ back should help. That step is where the science becomes much less certain.
Most of the human research to date has not tested injections at all. It has tested oral supplements that the body converts into NAD+, mainly nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). In one controlled trial of healthy middle-aged and older adults, six weeks of nicotinamide riboside was well tolerated and raised NAD+ levels in the blood, though changes in health measures such as blood pressure were modest and not conclusive.2 A separate trial in postmenopausal women with prediabetes found that NMN improved how muscle responded to insulin, a meaningful but narrow result in a small group.3
For intravenous NAD+ itself, the published human data is thinner still. A small pilot study that gave NAD+ by six-hour infusion to healthy men mainly tracked how the molecule moved through the body. It also recorded side effects such as nausea, flushing and chest discomfort when the infusion ran faster.4 That is useful safety information, but it is not evidence that repeated drips improve memory, energy or longevity in a 75-year-old.
None of this means NAD+ is worthless. It means the most confident claims you will see on clinic websites run ahead of what has been shown in people, and particularly in older people with existing health conditions, who are rarely the subjects of these studies.
Clinics usually offer NAD+ in one of three ways. An intravenous drip delivers a larger dose slowly over one to several hours. An intramuscular shot, often in the upper arm, is quicker but can sting. A subcutaneous injection goes just under the skin and is sometimes sold as a take-home kit. Each route changes how fast the molecule reaches the bloodstream and how likely side effects are.
For readers who want a plain explanation of those routes, the "NAD+ flush" many people describe, and why product purity documentation matters, independent guides on NAD injections set out the benefits and side effects side by side rather than as a sales pitch. It is worth reading that kind of overview before a consultation, so the questions you bring are specific.
The most commonly reported reactions are flushing, a feeling of pressure or tightness in the chest, nausea, stomach cramps, headache and fatigue. They are usually linked to how fast the infusion runs and tend to ease when it is slowed. For a younger, healthy adult that may be merely unpleasant. For an older adult, chest tightness or dizziness during a drip can be hard to tell apart from something more serious, and that alone is a reason to make sure a qualified clinician is present throughout.
Several groups should talk to their own doctor before trying NAD+ in any form: people with heart disease or heart rhythm problems, anyone with kidney or liver disease, people with a history of cancer, and anyone taking several prescription medicines. IV sessions also involve fluid volume, which matters for people with heart failure. Because research in older adults is so limited, there is simply little data on how NAD+ interacts with common medications for blood pressure, diabetes or blood thinning.
A reputable provider will welcome questions. Families can reasonably ask who oversees the treatment and whether a physician or nurse practitioner reviews medical history first. Ask where the NAD+ comes from and whether it is prepared by a licensed compounding pharmacy, since these products are compounded rather than sold as FDA-approved medicines for aging. Ask how the patient will be monitored during a drip, what happens if they feel unwell, and how the clinic communicates with the patient's regular doctor.
It is also fair to ask about cost in plain terms. NAD+ treatments are generally elective wellness services, are typically paid out of pocket, and are not usually covered by Medicare. Some clinics sell packages of many sessions upfront. A family member who is on a fixed income should never feel pressured into a long contract on the first visit.
The things that most reliably support energy and independence in later life are less exciting than a drip: regular physical activity, strength and balance training, good sleep, enough protein, social connection, and a regular review of medications with a primary care doctor or pharmacist. These are also the areas where the evidence in older adults is strongest.
If a parent or grandparent is curious about NAD+, the best approach is not to dismiss it, but to treat it like any other medical decision. Bring the question to their physician, go in with specific questions, and choose a provider who treats safety as seriously as results. Curiosity about new approaches to aging is healthy. Paying for promises the science has not yet kept is not.
Covarrubias, A.J., Perrone, R., Grozio, A. and Verdin, E. (2021) 'NAD+ metabolism and its roles in cellular processes during ageing', Nature Reviews Molecular Cell Biology, 22(2), pp. 119–141.
Martens, C.R., Denman, B.A., Mazzo, M.R. et al. (2018) 'Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults', Nature Communications, 9, 1286.
Yoshino, M., Yoshino, J., Kayser, B.D. et al. (2021) 'Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women', Science, 372(6547), pp. 1224–1229.
Grant, R., Berg, J., Mestayer, R. et al. (2019) 'A pilot study investigating changes in the human plasma and urine NAD+ metabolome during a 6 hour intravenous infusion of NAD+', Frontiers in Aging Neuroscience, 11, 257.
CHICAGO, Sept. 8, 2026 A new collection of dementia care research is calling for a fundamental shift in how person-centered care is defined, measured and delivered, arguing that the concept must move beyond theory and become a measurable standard across care settings.Published as a special supplement to the Journal of Applied Gerontology, Reconstructing Person-Centeredness was developed through the Leveraging an Interdisciplinary Consortium to Improve Care and Outcomes for Persons Living with Alzheimer's and Dementia (LINC-AD) and led by guest editors, Drs. Sam Fazio and Lauren Stratton at the Alzheimers Association and Dr. Sheryl Zimmerman at the University of North Carolina Chapel Hill. The supplement examines how person-centered dementia care can be more clearly defined, consistently measured and more effectively integrated across health care, long-term care, research and technology.Bringing together researchers, care providers, technology experts and people living with dementia, the supplement explores a concept that is widely embraced but often inconsistently applied across care settings."Person-centeredness is not a fixed destination, but a dynamic and continuously negotiated process," the authors wrote, noting that effective dementia care must balance competing priorities while honoring each person's values, preferences and goals.Among the supplement's key findings:Definitions of person-centered dementia care vary significantly, underscoring the need for a more consistent and comprehensive framework. Common themes include relationships, personhood, empowerment, autonomy, individualization, and attention to psychological and environmental needs.Person-centered care is shaped by factors at multiple levels, including societal systems and policies, organizational culture, leadership, direct care interactions, and family involvement.An international survey identified five core principles of person-centered dementia care: individualized care, caregiver support, individual empowerment, respectful relationships, and a holistic approach to wellness.Person-centered care remains difficult to achieve consistently due to barriers such as stigma, workforce challenges, resource limitations, organizational structures, and regulatory constraints.A major contribution of the supplement is the introduction of the Person-Centered Measure Evaluation Tool (PC-MET), a framework designed to help researchers evaluate whether existing measures, and future measures that will be developed, truly reflect person-centered principles.The tool was developed in response to a growing recognition that person-centered care cannot become a widespread standard unless it can be measured in meaningful and consistent ways. Researchers found that many current assessment tools described as person-centered do not adequately incorporate the perspectives, preferences and experiences of people living with dementia and their care partners."One of the most significant contributions of this work is its focus on measurement, said Sam Fazio, a co-guest editor. If person-centered care is truly a standard we value, we need reliable ways to evaluate and improve it. Tools such as PC-MET have the potential to help researchers and providers better understand whether care and research practices are genuinely reflecting the priorities of people living with dementia and their care partners.Researchers report that PC-MET can reliably assess the person-centeredness of existing research measures while also serving as a roadmap for developing future tools. By providing a practical framework for evaluation, the tool represents an important step toward making person-centered dementia care more measurable, accountable and scalable across dementia research and care delivery.The supplement also examines the growing role of technology in dementia care. Researchers found that technology can enhance engagement and personalization when people living with dementia, caregivers, and providers are involved in its design and implementation. At the same time, the authors caution that technology should enhance human connection, not replace it.A distinguishing feature of the supplement is its inclusion of perspectives from members of the Alzheimer's Association Early-Stage Advisory Group, reinforcing the importance of incorporating lived experience into dementia research and care. Participants emphasized that person-centeredness is rooted in empathy, respect, and meaningful human relationships. One contributor described it simply: Person-centeredness means letting you into my world.The authors conclude that person-centeredness should no longer be viewed as an aspirational philosophy but as an essential and measurable component of quality dementia care. They call for greater collaboration among researchers, care providers, policymakers, technology developers and people living with dementia to establish shared definitions, measurement standards and best practices.The authors conclude that advancing person-centered dementia care will require continued research, stronger measurement tools and sustained efforts to embed person-centered practices throughout health care and long-term care systems worldwide.About the Alzheimer's AssociationThe Alzheimers Association is a worldwide voluntary health organization dedicated to Alzheimers care, support and research. Our mission is to lead the way to end Alzheimer's and all other dementia by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer's and all other dementia. Visit alz.org or call 800.272.3900.
Passions Grow, Passions Bloom: Cultivating Wellness at Willow Valley Communities Among the most popular passions at Willow Valley Communities is gardening. And, Residents here have a wide variety of ways to indulge. Three generous gardens are situated across our sprawling 210-acre campus for Residents to use in a multitude of configurations of their choosing. Willow Valley Communities hardworking Grounds Team tills each garden in the spring and plows them in the fall, making them ready for Residents to dig right in. Whether Residents are experienced pros or novices, gardening is a wonderful way for them to get outside, enjoy nature and each other, and learn new things. Some Residents have been gardening for decades, while others have only started gardening after moving to Willow Valley Communities. In keeping with our Life Lived Forward philosophy, some Willow Valley Communities Residents take their love of gardening to deeper levels. For example, several Residents from across the country have achieved the distinction of Master Gardener. Master Gardeners are certified in their home state, and the program can take six months to a year to complete and includes a minimum of 40 hours of classroom training, a score of 80 percent on the final exam, and 50 hours of volunteer service. In another example, Residents Annabelle Simpson and Susan Kelly worked with the Penn State Extension of the Pennsylvania State University to have one of their gardens certified as an official Pennsylvania Pollinator-Friendly Garden. The stunning garden is well-known for attracting huge numbers of bees, butterflies, insects, and birds, helping our ecosystem to thrive. Residents are also able to partner their gardening skills with their desire to volunteer and give back to the Lancaster community. With the areas rich, fertile soil, and the extra special care and attention the plants receive, Residents often have an abundance of vegetables and donate them regularly. Throughout the growing season, the Solanco Neighborhood Ministries food bank receives a variety of beans, lettuce, kale, peas, carrots, eggplant, cucumbers, peppers, tomatoes, spinach, and much more from Willow Valley Communities Resident gardens. Additionally, every fall, a harvest of hundreds of pounds of sweet potatoes and butternut squash goes to the Lancaster County Food Hub, a community resource for free, nutritious food and gently used clothing. Some Residents maintain gardening plots every year just for this purpose.Annabelle Simpson and Susan Kelly Gardening time is couple time for Residents Mike and Susan Ziegler. Sue is an avid gardener, and Mike loves being outdoors supporting her gardening passion at Willow Valley Communities. They both love being together in nature, and Sue is amazed by how magical gardening can be. Its just a miracle when the seeds come up, she says. Resident Pat Mortensen challenges herself every year by growing something completely different. Once she enjoyed a robust harvest of King Tut Purple Peas, a very rare garden pea said to have been taken out of the tomb of King Tut! Resident and Master Gardener Angela Booker-White is originally from Virginia but has lived all over the country. Her interest in gardening grew as she read and learned more about it. In her plot at Spring Run, Angela grows all sorts of fruits, vegetables, and flowers and always tries something new. She has the most success with seeds she purchases from the dollar store! Angela has also learned how gardening can help during challenging times. She is grateful to her garden, as well as to her fellow Willow Valley Communities gardeners, for helping her during the difficult time of her husbands unexpected passing. Gardeners, and she doesnt know exactly who, would come and help by doing extra work around her plot. Residents just came in and helped, Angela says. Weeding, cutting, trimming, harvesting whatever work needed to be done. Thats the way Residents are here at Willow Valley Communities: very supportive. Resident Keith Yoder, who coordinates the Spring Run Garden, is not at all surprised by the variety of gardeners at Willow Valley Communities or by the reasons they enjoy the activity so much. He agrees that gardening is definitely a hobby that enhances well-being. Though hes known this himself for years, he refers to an article put out by CNBC that states how gardening can add years to your life. And life to your years, Keith adds. Gardening gets you into nature. Its good exercise for your body and your mind plus, you get to eat what you grow!
The Willow Valley Communities Day Spa is a destination for wellness and renewal. Its a critical component of the comprehensive Mind, Body, Spirit approach to wellness of Willow Valley Communities. The Day Spa offers many ways to soothe, calm, invigorate, or rejuvenate. A full range of professional services, all performed by our attentive and inviting staff, allows Residents to create their own regimen for personal well-being and beauty. These services include manicures and pedicures, skin care, facials, revitalizing peels, waxing, tanning, microdermabrasion, and body treatments with a wide range of different massage modalities, wraps, and scrubs. The Relaxation Room, with its beautiful waterfall and Himalayan Salt Wall, is a main feature of The Day Spa. It provides a peaceful and well-appointed environment in which to relax and offers a perfect and welcome respite between services. Himalayan salt rich in negative ions and essential nutrients and minerals offers numerous health benefits for our bodies, such as stress reduction, energy increases, and mood boosts at a biochemical level. Day Spa Manager Diamando Wallace says, Self-care is essential. Although manicures and pedicures are a well-deserved treat, they offer so much more to Residents sense of well-being. You can see the boost in a clients self-confidence as they walk out feeling refreshed. Massages are one of the most popular services requested by Residents, and The Day Spa offers a wide menu of options, including hot stone and aromatherapy. Emily Ransing, Willow Valley Communities Day Spa Massage Therapist, says, Massage is meant to enhance your well-being physically and mentally. I frequently remind my clients that this is their time to focus on themselves to feel healthier. I do all I can to send each client home feeling better than when they arrived. A Willow Valley Communities Resident was asked about her massage as she was leaving The Day Spa one afternoon. She said, After a massage with Emily, your body is so relaxed that you can focus on the things that you often overlook the air is sweeter, the birds are more melodious, the day is brighter. You are better equipped to face the next days, whatever they may bring. As she walked out of the Cultural Center to her car, she added with a smile, Its also a way to take the tension out of your body although theres not much tension at Willow Valley Communities!