It is unknown whether the decline in NAD+ and mitochondrial activity with age is due to increased demand, reduced production, or if targeting mitochondria can alleviate associated tissue dysfunction.

“the big question in the field is do you just have an old and sick tissues you have sick mitochondria or will targeting the mitochondria actually somehow alleviate its associated decline in tissue function this is such an interesting question and something that probably until a year ago I don't think I spent enough time to think which is what does it mean to age at the level of the mitochondria and what are the implications of it and perhaps most importantly what can be done to slow the rate of Aging”