Book 01 / Healthspan & evidence
The Longevity Operating System
Mark A. Smith
A Practical, Evidence-Literate Guide to Healthspan, Measurement, and Self-Experimentation
Book 03 of the Longevity Evidence Series / Brain health & prevention
Outrunning Alzheimer’s
What a Global Longevity Community Tested—and What the Evidence Now Says About Protecting Your Brain
By Mark A. Smith
The expanded edition: reporting from public Rapamycin News discussions, refreshed through October 2026 and checked against scientific literature and trial records — including the semaglutide EVOKE trials, blood-pressure prevention evidence, and the arrival of the anti-amyloid antibodies. Evidence is graded by kind, with intervention dossiers, biomarker worksheets, and a watch list rather than a treatment protocol.
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About this book
Outrunning Alzheimer’s follows a global longevity community as it tests dementia-prevention ideas while the research catches up. Drawing on public Rapamycin News discussions — 123 topics and thousands of preserved posts — it traces the threads people pulled on, from “type 3 diabetes” to ketones, GLP-1 medicines, rapamycin, peptides, and the memory drug nobody expected.
This expanded edition is a dated account of evidence checked through October 2026. The first large randomized prevention results have arrived: the semaglutide EVOKE trials, VALAD, LATTICE, and NOPARK returned disappointments for hopes attached to them, and STAREE delivered a split verdict. The subtitle changed because the evidence changed — some ideas gained better support, some met a decisive test and fell short, and many remain open questions.
Every claim is graded by the kind of evidence behind it, from forum account to randomized controlled trial. The book is candid about what the forum got wrong and what the evidence does not prove, and closes with intervention dossiers, a biomarker and trial calendar, three worksheets, and a watch list rather than a treatment protocol.
What’s inside
The question
- The Thread
- What the Trials Now Say
- Knowing Your Risk: APOE4, p-tau217, and the Ethics of a Number
The body under the brain
- A Starving Brain: Ketones, Diets, and Fuel
- Type 3 Diabetes
- The GLP-1 Bet
- The Broken Plumbing
Building reserve
- The Exercise Prescription Nobody Can Patent
- The Night Shift: Sleep and the Glymphatic System
- Signals In: Hearing, Vision, and the Trained Brain
- Hormones and the Critical Window
The forum’s pharmacy
- Refueling the Cell: NAD+, GlyNAC, and Creatine
- Peptides in the Gray Zone
- The Physician’s Protocol
- Rapamycin’s Fast Lane
- The Memory Drug Nobody Expected
- Old Drugs and Old Viruses: Lithium, Vaccines, and Antivirals
- Light, Sound, and the Supplement Shelf
What holds up
- The Antibodies Arrive
- What the Forum Got Wrong
- What This Doesn’t Prove
- Two Lists: What to Do Now, What to Watch
Reference guides
- Reference Guide A: Intervention Dossiers
- Reference Guide B: Biomarkers and the Trial Calendar
- Reference Guide C: Three Worksheets
- Reference Guide D: Three Evidence Files
More from the series
Book 02 / Rapamycin & muscle
mTOR, Metabolism, and Muscle
Mark A. Smith
Rapamycin, Exercise, and the Biology of Longevity Trade-offs
Book 04 / GLP-1 & metabolic health
The Metabolic Frontier
Mark A. Smith
GLP-1 Medicines, Emerging Peptides, Gray-Market Risks, and the Science of Better Body Composition