AI for Primary Prevention and Longevity: From Reactive to Proactive Healthcare Model

Katia Iaccarino, Filippo Ongaro, Luca Di Palma, Saman Fouladi, Isabella Castiglioni, Marco Alì

Primary prevention is essential to reduce disease burden before clinical onset, yet it remains less systematically integrated into care than diagnosis and treatment. Although artificial intelligence (AI) is increasingly used in medicine, most applications have focused on secondary and tertiary prevention, including diagnosis, prognostic stratification, and disease management, while its role in primary prevention remains less defined. This narrative review examines current AI applications across four modifiable lifestyle domains relevant to prevention and healthspan promotion: nutrition, physical activity, sleep, and mental health. We synthesize evidence on machine-learning models, wearable-derived algorithms, computer-vision tools, just-in-time adaptive interventions, and conversational agents used in consumer, community, and hybrid clinical–digital settings. AI applications support postprandial glycemic prediction, automated dietary assessment, meal-planning adherence, sedentary-pattern detection, personalized exercise recommendations, adaptive behavioral nudges, sleep monitoring, circadian-aware recommendations, psychoeducation, stress-management support, and early identification of psychological vulnerability. Collectively, these tools may extend prevention beyond episodic clinical encounters toward continuous, personalized, and context-aware support. However, evidence remains limited by short follow-up, reliance on surrogate or engagement outcomes, digitally literate populations, and insufficient validation in real-world preventive-care pathways. AI is therefore a promising enabling technology for proactive, healthspan-oriented medicine, provided future studies demonstrate long-term effectiveness, equity, safety, and responsible implementation.