The Arising · Care & Connection

THE ARISING · LONGEVITY & HEALTHSPAN SUNDAY, OCTOBER 18, 2026 IN THIS EDITION · LONGEVITY & HEALTHSPAN 1 ACOG Now Recommends Hormone Therapy for Many Women With Hot Flashes 2 Cardiologists Urge Doctors to Prescribe Exercise as Routine Heart Care 3 Fasting and Autophagy in Humans: Summary Calls Link Unproven 4 Gut Supplements May Modestly Improve Cognition in Adults Over 60, Review Finds 5 Higher Ultra-Processed Food Intake Linked to Silent Brain Damage on MRI 6 Higher VO2 Max Linked to Lower Depression and Anxiety Risk in UK Biobank 7 Bonn Lab Study Shows Blood Cells From Older Donors Lose Epigenetic Age in a Dish 8 Longer Sleep Linked to Kidney Disease Risk in Type 2 Diabetes LONGEVITY & HEALTHSPAN · WEEKLY READ · 2 MIN AMERICAN COLLEGE OF CARDIOLOGY Cardiologists Urge Doctors to Prescribe Exercise as Routine Heart Care You may not need 10,000 steps a day to protect your heart. A new statement from the American College of Cardiology says the biggest gains come when inactive people start moving at all. This is an expert scientific statement that synthesizes existing evidence, not a new trial, and it is written mainly as guidance for clinicians. he statement, published online October 15, 2026, in JACC, asks doctors to treat exercise as a foundational part of routine cardiovascular care. It coversT both preventing heart disease and managing it. The writing committee was chaired by Jonathan N. Myers, PhD. Its central message is simple. "Some activity is better than none," Myers said. According to the statement, the greatest benefit comes when people move from inactivity to regular physical activity. More activity, and more intensity where clinically appropriate, is linked to further benefit. THE ARISING · OCTOBER 18, 2026 PAGE 6 What counts as enough? The statement points to growing evidence that meaningful benefits come well below 10,000 steps a day. About 5,000 to 7,000 daily steps is associated with lower cardiovascular and all-cause mortality for many adults. That is an association seen in studies of populations. It does not prove that walking that amount is the cause of the lower risk. This is the weakest part of the argument: the step-count evidence is observational. "Patients do not need to become athletes to improve their cardiovascular health," Myers said. "Small increases in physical activity can produce meaningful benefits, particularly for those who are currently inactive." Strength work gets a place in the plan too. The statement says resistance training should complement aerobic exercise for most adults. Aerobic exercise is walking, cycling or anything that raises your heart rate for a sustained period. Resistance training means lifting weights, using bands or doing bodyweight exercises. The statement recommends doing both. The statement also says exercise should be individualized. A plan should reflect a person's heart condition, functional capacity, symptoms, goals and preferences. A person recovering from a heart event needs a different plan than someone with no symptoms who is trying to stay healthy. On testing, the statement says routine exercise testing is not required before starting exercise for most people who have no symptoms or whose conditions are stable. Testing can still provide useful information for shaping a prescription when it is clinically appropriate. For many people with known heart disease, cardiac rehabilitation remains first-line treatment, the statement says. Access to it should be expanded. Insurance reimbursement is still a barrier for many. Patients with known heart disease who cannot take part in a formal program should still receive an individualized exercise prescription. The statement also says wearable devices and virtual or home-based programs may help people keep exercising over time, especially alongside structured programs. Myers said exercise is one of the most effective therapies for preventing and managing cardiovascular disease, yet it remains underutilized in routine care. The statement calls for more exercise counseling in routine visits, better clinician training and expanded access to rehabilitation. THE ARISING · OCTOBER 18, 2026 PAGE 7 Exercise is not a replacement for medical care. Do not start, stop or change any treatment, including medications or a prescribed rehabilitation plan, without your clinician. The statement is written for clinicians, so questions about how it applies to you belong with your own care team. The statement also calls for more research on long-term adherence, clinical outcomes, diverse populations and scalable ways to deliver exercise programs. Watch for whether those studies follow, and whether insurers move on cardiac rehabilitation coverage. Source: American College of Cardiology (JACC) THE ARISING · OCTOBER 18, 2026 PAGE 8

The Arising H E A L T H I N T E L L I G E N C E SUNDAY, OCTOBER 18, 2026 · MARKETS & STRATEGY DESK IN THIS EDITION · MARKETS & STRATEGY 1 Major Hospitals Open Longevity Clinics, and STAT Asks Whether They Work 2 PPIC Projects California's 65-Plus Labor Force Will Reach 1.8 Million by 2040 3 FDA Approves Viatris' Ryzumvi Eye Drops for Presbyopia in Adults 4 Wyden Seeks Input on Medicare or Medicaid Universal Home Care Benefit 5 Atrogi's Oral Muscle Drug Linked to 13% Power Gain in Small Study 6 Over 90% of US Nursing Homes Staff Below Acuity-Based Expected Level, LTCCC Says MARKETS & STRATEGY · WEEKLY READ · 2 MIN COMPETITIVE LANDSCAPE · STAT Major Hospitals Open Longevity Clinics, and STAT Asks Whether They Work Large hospitals are now opening longevity clinics, according to STAT, which asks a basic question about them: what are people paying for, and does it work? The page we reviewed does not state prices or payment terms, and it offers no evidence that the services work. ccording to STAT, longevity clinics are popping up in major hospitals across the country. STAT's biotech podcast, The Readout LOUD, devoted its Oct. 16A episode to the trend. The hosts are Elaine Chen, Adam Feuerstein and Allison DeAngelis. Their guest was STAT reporter Sarah Todd, who visited one of the clinics. The market is described as very large. STAT says longevity medicine is "estimated to be a multitrillion dollar industry." The episode page does not say who made that estimate or how it was calculated. Readers should treat the figure as an unverified claim. THE ARISING · OCTOBER 18, 2026 PAGE 25 STAT's page does not spell out why hospitals are entering this field, so we do not offer a view on their motives. STAT's headline for the episode calls longevity clinics "Hospitals' next lucrative bet." That is STAT's description, and it is a bet, not a proven result. The page does not name which clinic Todd visited, and it does not list the services offered or what patients pay. It points readers to a separate piece for more on her experience, which we did not have. The page's web address mentions Northwestern, but the text does not say where Todd went. We therefore make no claim about the institution, the tests or the cost. The competitive picture is largely unknown. The source does not provide data on how many clinics exist, what they earn, who else operates in the field, or how patients are choosing among providers. The central question is whether the services work. The episode asks, "what are people paying for, and does it work?" The page presents no evidence that any testing or program leads to longer life or better health. This is the weakest point in the whole story: a large market estimate with no stated source, and no outcome data. A clear answer would matter either way. If the programs show real benefit, hospitals may have found a durable new business line. If they do not, the model could invite scrutiny. Regulatory impact is not addressed in the STAT page. No rules, enforcement actions or oversight plans are described, so any view on that point would be speculation. Readers considering longevity testing or programs should consult a clinician before acting. WHAT TO WATCH NEXT Whether hospitals publish outcome data for these clinics, and whether STAT's follow-up reporting clarifies what the services are, what they cost and whether they work. Source: STAT THE ARISING · OCTOBER 18, 2026 PAGE 26

THE ARISING · MARKETS & STRATEGY SUNDAY, OCTOBER 18, 2026 IN THIS EDITION · MARKETS & STRATEGY 1 Major Hospitals Open Longevity Clinics, and STAT Asks Whether They Work 2 PPIC Projects California's 65-Plus Labor Force Will Reach 1.8 Million by 2040 3 FDA Approves Viatris' Ryzumvi Eye Drops for Presbyopia in Adults 4 Wyden Seeks Input on Medicare or Medicaid Universal Home Care Benefit 5 Atrogi's Oral Muscle Drug Linked to 13% Power Gain in Small Study 6 Over 90% of US Nursing Homes Staff Below Acuity-Based Expected Level, LTCCC Says MARKETS & STRATEGY · WEEKLY READ · 2 MIN NEWSWEEK Wyden Seeks Input on Medicare or Medicaid Universal Home Care Benefit A senior Senate Democrat is asking for public feedback on options to expand home care coverage for older Americans and people with disabilities. Sen. Ron Wyden has put that question to the public, and the answer could reshape a market that now sits largely outside Medicare. yden is the ranking Democrat on the Senate Finance Committee. According to Newsweek, he released a request for information seekingW feedback on how to overhaul long-term care. It is not a bill. It lays out options rather than one finished proposal. Two routes stand out. One would create a new Medicare home care benefit. The other would use Medicaid to build a universal home care benefit. The document also covers nursing-home quality and the long-term care workforce. The gap he is targeting is well defined. Medicare covers certain skilled nursing, therapy and home health aide services for eligible people. Aide coverage is available only when the person also receives qualifying skilled services. Medicare does not pay for custodial care when that is the only care needed. It also does not pay for 24- hour home care or home meal delivery. THE ARISING · OCTOBER 18, 2026 PAGE 31 Medicaid fills much of that space. According to KFF, as cited by Newsweek, it is the country's main payer for long-term services and supports and accounts for more than half of U.S. long-term care spending. Families who need ongoing help but do not qualify for Medicaid often face large bills. The costs are sizable. CareScout's 2025 Cost of Care Survey puts the national median for a non-medical caregiver at $35 an hour. At 44 hours a week, that is $80,080 a year. Assisted living has a median of $74,400 a year, and adult day health care $24,700. For the market, the strategic question is substitution. A public home care guarantee could take over spending that families now cover from savings or private policies. It could also change demand for the products built around that spending. The source does not say how any benefit would be designed, so these effects are interpretation, not findings. Kevin Thompson of 9i Capital Group, quoted by Newsweek, said many private insurers have exited the market or sharply cut coverage because the financial risks became too great. He said cost is the biggest obstacle to a universal program. Michael Ryan, a finance expert, framed the open questions as who pays for universal care and where the caregivers will come from. He also said families should not expect relief soon, because this is a request for input, not legislation. The request builds on a May initiative Wyden launched with 16 other Senate Democrats. That effort listed three priorities: affordable home care, better nursing- home care and a stronger long-term care workforce. In the May statement, the senators called for a home care guarantee for people with Medicare. For now, nothing changes for Medicare recipients. Wyden said he wants responses from across the country. Watch for the feedback his committee receives, and whether any of the options turns into a bill with a funding plan attached. Source: Newsweek THE ARISING · OCTOBER 18, 2026 PAGE 32