Healthspan and Longevity

Health is not a binary concept, not just health and ill-health but a spectrum. Our goal should be to be at the optimal end of the health spectrum, in other words as healthy as we are able to achieve. This will not only lengthen our lifespan (increase longevity), but also increase our “healthspan”, that is the length of time that we spend in good health.

This may sound obvious, but the healthcare systems of today are not geared for this change but stuck in an old paradigm of disease detection and treatment. Change is coming, though and there is an explosion of interest in this area, ready access to information, testing and easy access to AI that will enable individuals to choose and monitor their healthcare program.

What Is Ageing?

Ageing is a universal biological process, not a disease. Once we have reproduced and nurtured our offspring our genes have no further use for us, actually, we consume resources without benefit to our genes. As a result, evolution has programmed us to age.

Take a hypothetical 70-year-old, who may have trouble getting out of a chair and walking a small distance. To a doctor this may be due to a disease such as Osteoarthritis, or heart failure but big picture, this is due to aging. He or she has probably reached the end of their healthspan, ie they will not regain health again in this lifespan. Their body systems have deteriorated to the point that they are losing the ability to influence their environment and may soon need some sort of care. They may have some friends who have passed away, but, they also have a friend who plays golf four times a week, visits the gym most days and skis with his family living a vibrant life.

These different outcomes for a 70-year-old have little to do with chance, you may have an accident or you may have genes for heart disease and diabetes, but with modern medicine the majority of the difference in outcomes is down to lifestyle. What did a person do to maintain their health in their 40’s, 50’s and 60’s, exercise, diet, sleep etc. By the time a person has lost their health it is too late change lifestyle. The 70-year-old living an active vibrant life did not get there by chance but because of choices that they made up to decades earlier.

Take another hypothetical person, a 45-year-old who has come to a fork in the road, they have high blood pressure, high cholesterol and maybe high blood sugar. Do they choose to take medicines for these problems as proposed by the Doctor or reassess their lifestyle, get advice on how to improve their health through diet and exercise a take a new healthier path? Perhaps they choose a combination of both paths due to their circumstances, but in any case they are far more likely to be a healthy 70-year-old if they choose a healthy path

Unsurprisingly, it turns out that tests that measure physical ability, such as grip strength, VO2 Max (a test of cardiorespiratory fitness as per the chart) and body composition reflect this and are far more predictive of All Cause Mortality than the standard tests in a medical examination, such as Cholesterol. Tests of physical abilities will increasingly be incorporate in to health check.