A randomized placebo-controlled trial of nicotinamide riboside in older adults with mild cognitive impairment

Orr ME, Kotkowski E, Ramirez P, Bair-Kelps D, Liu Q, Brenner C · GeroScience

Blood NAD+ rose 2.6-fold with no excess adverse events. Cognition on the MoCA and every other neurocognitive measure was unchanged. Cerebral blood flow in the default mode network fell on NR — a finding that would not survive correction for multiple comparisons. Exploratory methylation analysis showed a modest reduction in epigenetic age by PhenoAge and GrimAge clocks.

Population

Older adults with mild cognitive impairment

Intervention

Nicotinamide riboside escalated to 1,000 mg/day for 10 weeks

Comparator

Placebo

Limitations

Twenty participants, ten weeks, explicitly a pilot. The epigenetic-age result is exploratory and uncorrected — the closest thing this literature has to a biological-age finding, and far too thin to build on.