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NAD+ levels decline with age : 40-year-old adults have ~50 % of the NAD+ levels of 20-year-olds 60-year-old adults have ~25 % of younger NAD+ levels The decline is visible in all tissues , muscle, liver, brain, skin, blood The mechanism of decline is multifactorial : Increased CD38 activity , the enzyme that breaks NAD+ down

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Int J Gynaecol Obstet 1999;64:121-7