Healthspan, Not Just Lifespan - Rethinking Longevity
- Gary Moller
- 1 day ago
- 5 min read
Living longer is not necessarily the same as living well. The real achievement is reaching old age strong, capable, independent and still enjoying life.
There is an enormous amount of interest these days in longevity. We are surrounded by books, podcasts, supplements, drugs, hormones, testing programmes and increasingly elaborate technologies promising to slow ageing and extend life. The Internet is awash with longevity gurus, most of them many years younger than myself and many jacked to high heaven on all kinds of hormones and other so-called life-extending drugs and therapies - some which I predict will come back and bite these people and their followers on the bum, and very painfully so. Some of this work is fascinating and may eventually prove very useful, much of it, however, will be discarded to the dustbins of medical folly.
The objective is not to look 25 when we are 75. It is to be remarkably capable for 75
After more than fifty years working in health, rehabilitation, nutrition and sport, I keep coming back to a much simpler question: what is the point of adding years to life if those extra years are spent weak, dependent and heavily medicated?
I am much more interested in healthspan than lifespan. I want people to remain strong enough to carry their groceries, climb stairs, work in the garden, travel, play with their grandchildren and get themselves off the floor. I want them to retain their marbles, their independence, their friendships and a reason to get out of bed in the morning. Ageing is inevitable, but frailty is not an inevitable consequence of getting older. That principle sits at the heart of my approach to healthy ageing.
The body remains remarkably adaptable
One of the great mistakes we make is treating the ageing body as though it is simply wearing out. Of course, biological ageing brings changes that cannot be avoided, but we remain adaptable creatures throughout life. Muscle responds to resistance. Bone responds to loading. The cardiovascular system responds to exercise. Balance can be trained. Nutritional deficiencies can often be corrected. Skills can be learned and the brain continues responding to stimulation.
I see the same principle when dealing with bone health. Bone is not inert scaffolding. It is living tissue that is continually being broken down, rebuilt and remodelled according to the demands placed upon it. Muscles and bones work together, which is one reason maintaining strength becomes increasingly important as the years pass.
This is why I have never been particularly attracted to the idea of "anti-ageing". We cannot stop ageing. What we can influence, sometimes considerably, is how we age. The objective is not to look 25 when we are 75. It is to be remarkably capable for 75.
The arithmetic changes as we get older
There is another aspect of longevity that receives surprisingly little attention. When doctors recommend preventive treatments, particularly medications that may need to be taken for many years, benefits are commonly expressed over a five-year, ten-year or even longer time horizon. Yet the relevance of that time horizon changes considerably depending upon the age and health of the person sitting in front of us.
This is why I constructed the conditional survival chart for New Zealand (above) that accompanies my white paper. Life expectancy at birth tells us relatively little about the person who has already reached 60, 70, 80 or 90. Conditional survival asks a more useful question: having reached this age, what is the probability of still being alive at a particular future age?
This idea of investing well ahead becomes especially important when considering preventive medicine. A treatment may produce a statistically significant benefit over ten years, but that does not automatically tell us whether it represents a worthwhile trade-off for a particular older person. We also need to consider absolute benefit, time-to-benefit, adverse effects, competing health risks, quality of life and the person's remaining probability of living long enough to receive that benefit.
Don't get me wrong: Modern medicine can be extraordinarily valuable and, when appropriately prescribed, medicines can prevent suffering and extend life. It is an argument for proportion and perspective.
What is the point of adding years to life if those extra years are spent weak, dependent and heavily medicated?
We should be building stronger people
As people grow older, I think, instead of injecting another wonder drug, the emphasis should increasingly be upon building reserve. The emphasis should be on improving and maintaining true functional health, rather than merely controlling numbers. Muscle strength, aerobic capacity, balance, mobility, good nutrition, sleep, meaningful relationships and purpose provide something no laboratory number can adequately describe: resilience.
These foundations are remarkably uncomplicated. Eat nourishing, nutrient-dense food. Keep moving. Maintain muscle. Challenge the cardiovascular system appropriately. Spend time outdoors. Sleep properly. Maintain friendships and family connections. Keep learning. Have something worthwhile to do tomorrow. These principles also sit at the centre of the FreeRangers approach to ageing.
None of these things guarantees longevity. Nothing does. Genetics, accidents, infections and plain bad luck remain part of life. But these foundations improve the odds of arriving at later life with something far more valuable than another birthday: the physical and mental capacity to enjoy it.
The aim is not merely to live longer. It is to arrive at old age strong, healthy, useful, independent and still thoroughly engaged with life.
My white paper on health and longevity
I have brought these ideas together in a white paper because I think we need a more mature conversation about longevity, preventive medicine and healthy ageing. Rather than asking only, "Can this intervention reduce my statistical risk?", we should also be asking:
How large is the benefit for someone of my age and circumstances? How long before that benefit is likely to appear? What are the costs and possible harms along the way? And what else could I be doing that improves not merely my chance of survival, but my strength, independence and enjoyment of life?
Those are particularly important questions as we enter our seventies, eighties and nineties. The aim should never be to deny ageing or death. It should be to make the most of the years we have, while doing everything reasonably within our control to remain strong, healthy, useful and independent.
That, to me, is what longevity should really be about.
Medical Disclaimer
This information is provided for educational purposes only and is not intended as personal medical advice, diagnosis or treatment. Always consult an appropriately qualified healthcare professional regarding your individual circumstances, medications and health conditions.
Comments