Healthier approaches to ageing mean “the 70s are the new 50s”. Here’s how to increase your own healthspan.
In 44BC, the great Roman orator Cicero wrote On Old Age, an essay to reassure his friend Atticus that retirement was nothing to fear. He praised exercise, gardening, lively conversation, friendship and a good diet.
Cicero got a lot right, including the importance of keeping our brains sharp.
Men can “retain their powers of mind, if they keep their interest and their application to study and to learning”.
Two thousand years on, healthy ageing is now the domain of scientists – and it seems we’re in better shape than ever. The International Monetary Fund’s 2022 annual report, which analysed data from 41 countries, found that widespread healthier approaches to ageing mean “the 70s are the new 50s”. On average, a 70-year-old in 2022 had the same cognitive ability as a 53-year-old in 2000.
Professor Eric Brunner of UCL’s Institute of Epidemiology and Health Care leads the influential Whitehall II study, which has tracked more than 10,000 civil servants since 1985. The research has yielded insights into everything from the links between high sugar intake and depression to the impact of stress on heart health. Brunner is now exploring the connection between dementia and lifestyle. “We are getting smarter and staying smarter for longer,” he says.
Sir Muir Gray, visiting professor in the Nuffield Department of Primary Care at the University of Oxford and a long-standing adviser on healthy ageing policy, is unequivocal. The author of numerous books on the subject – including Sod 70! – he insists at 82 that “70 need not be old. Ageing is a normal biological process that should not cause many problems until your 90s.”
According to the Office for National Statistics, today’s average 70-year-old woman has a one-in-10 chance of living to 100. “But don’t focus on longevity,” says Gray. “It’s all about healthspan – how long we enjoy a good quality of life.”
Gray believes writing a longevity plan should be a standard part of pre-retirement preparation. His own Oxford Personalised Plan to Live Longer Better, created with a team of experts, encourages people to approach ageing as carefully as they do their finances. “Why wouldn’t you set about it with a plan, like you would with money?” he says. With the right approach, many years of active, fulfilling life can lie ahead.
And who better to advise on that than the academics who have devoted their careers to studying ageing? So what do the professors recommend?
Know your blood pressure and other risk factors
Eric Brunner, honorary professor of social and biological epidemiology at University College London, says we should all be tracking our risk factors: “measurements that are acknowledged good indicators of how well a person is ageing and their risk of the commonest causes of disease and death: blood pressure, cholesterol, blood sugar levels (HbA1c), kidney function (eGFR); for men: regular prostate cancer checks; and women: breast cancer screening. If you can afford it, a DEXA scan is useful and especially for women who tend to lose bone density.
“We used walking speed, hand grip strength, and what’s called the sit-to-stand test in the Whitehall II study, as they are useful, easy to perform and raise warning flags – if you can’t do those things, then your physical function is deteriorating. What’s exciting is that physical functional symptoms are reversible and the same is true of Type-2 diabetes. In short, don’t smoke, do exercise, restrict drinking to moderate quantities on social occasions, keep a healthy BMI and have regular checks on hearing and vision.”
Brunner cautions against over-testing, however: “They’re only useful for researchers and for people wanting to make money. A wiser investment is joining a gym or going on an activity holiday. I’m 72, and I had some issues with knee pain. After only five days in Spain doing yoga three times a day, they’re completely fine.”
Put walking at the centre of your life
The benefits of exercise are “accepted and overwhelming”, says Gray. “A 2015 Academy of Medical Royal Colleges’ report described exercise as the ‘miracle cure’.”
Exercise improves the rate at which blood delivers oxygen and nutrients to muscles and organs, including the brain, while also clearing harmful waste. Preserving muscle protects against both physical and mental frailty.
“Our daily movement patterns are the strongest predictor of our mortality risk from all conditions, including those people fear the most: dementia, frailty and the need for social care.”
A leisurely daily stroll, however, is only half the picture. In his book, Walking Cure, Gray recommends “a ‘walking plus’ programme: 30 minutes of walking a day for stamina and 10 minutes of exercises for strength, suppleness and skill. A set of weights and a session with a trainer is a far better 70th birthday present than a bottle of wine, and women especially should take action to increase the strength of both bones and muscle.”
The goal is to build a movement habit that increases in both time and intensity. “Build fitness, and bridge ‘the fitness gap’: how fit you are versus how fit you can be. The aim is to walk briskly and notice an increase in breathing rate and measure your progress.”
To get started, Gray suggests logging your height, weight, BMI, resting pulse rate, any existing health conditions and age. Then, track the number of steps you take over seven days. A simple notepad will do, but wearable health trackers are becoming more affordable – Apple Watch, Google Pixel, the Whoop wristband, Ultrahuman rings or Garmin for keen walkers.
“I just use the NHS Active 10 app on my phone, which will soon be prescribed to everyone,” he says.
“I’ve gone from 31 minutes a day of brisk walking in my sixties, to 32 minutes in my 70s, and 33 minutes in my 80s. I increased my plank from 80 seconds to 81 seconds this year, and when I hit 82, I will put another second on.”
Develop an easy repertoire of nutrient-rich dishes
Dr Emily Leeming, author of Genius Gut, is a microbiome specialist, registered dietitian and research fellow at the Department of Twins Research and Genetic Epidemiology, King’s College London.
“The crucial thing is to have wholesome meals up your sleeve (not literally) that you can prepare without any effort or thought,” she says. “An easy breakfast, say, is nutty muesli with fruit and creamy Greek yoghurt – though my grandmother is in her 90s and just pours cream on her cereal. Before I became a nutritionist, I’d have been horrified, but as we age nutrition becomes a lot more nuanced. The appetite often wanes, meaning we unintentionally eat less, so we need to focus on preserving a healthy weight and the muscle mass to protect against frailty.”
This becomes especially important from our 70s onwards, when muscle loss and frailty can accelerate.
“Ensure you eat sufficient protein to preserve muscle mass – that’s not just about eating meat; protein is in plant foods too. Make a big batch of chilli or a cottage pie and throw in some tinned green lentils. It’ll freeze well into meal-sized batches. Or roast a chicken at the weekend and eat the leftovers all week to ensure you’re hitting 1.2–1.4g of protein per kilo of bodyweight.”
Take up a sociable sport and make your socialising face-to-face
To keep both brain and muscles in shape, you could do worse than a game of boules or tennis.
Behnam Sabayan, assistant professor of neurology at the University of Minnesota School of Medicine and a leading voice in preventive neurology, puts it simply: “To keep your brain healthy, you have to stay both physically active and connected socially. People don’t grasp that brain health is about exposing yourself to lots of things that stimulate social interactions.”
Mixing physical and social activity, he explains, maximises neuromuscular health beyond “just plugging in your ear buds and going to the gym”. That could mean exercising with friends, joining a team sport or simply prioritising a face-to-face visit over a phone call.
“Half my patients have a history of stroke or dementia in their family, and having seen a sibling or a parent suffer, they come to me to prevent going the same route. I always recommend they do physical activity with a friend or a group.”
And for even greater benefits?
“Add meaning and purpose,” he says. “Whether that’s helping other people, walking to church or running a marathon for a charity. The evidence is that we get even more from an activity if it is active, social, and has a sense of purpose; in fact, even just anticipating doing an enjoyable and meaningful activity has some benefits.”
Boost your immune defences to reduce inflammation as you age (inflammaging)
“Everyone aged 50 and over should get all the vaccines recommended for their age group,” says Laura Haynes, professor of immunology at the University of Connecticut and an expert in how ageing influences immune responses.
“What we are starting to see is that vaccines have multiple protective effects on health.”
Recent studies have linked the shingles vaccine with a lower incidence of dementia, while the Hepatitis B vaccine has been shown to reduce the risk of liver cancer. Haynes explains that vaccines preserve wider health because the body isn’t confronted with the inflammatory impact of fighting viruses.
“Inflammaging is a real thing. We know inflammation increases with age, and it is thought to drive many age-related diseases. Vaccines are an important part of keeping our exposure to inflammation down, along with exercise, sleep and diet.
“Here in the US, we are seeing a resurgence of infectious diseases like measles in the young that we could have eliminated,” she says. In older populations, studies show that vaccine hesitancy is clearly linked with increased risk of death from flu, pneumonia and Covid-19.
“With age, our ability to respond to vaccines diminishes, but vaccines still provide decent protection, although it isn’t as robust as that seen for younger adults,” says Haynes. Hence it’s really important that older adults keep up with regular boosters and consider doubling up Covid and flu jabs in the same appointment.
“Some people with autoimmune issues or other medical concerns might need to be conservative with getting one or more vaccines at the same time, and I’m guessing that they know who they are and can weigh the pros and cons. For the rest of us, even if the day after reaction is not very pleasant, I say get them both and stay in bed for a day. Think of it like a hangover, but better, one with a small period of suffering for big gains.”
Be smart about sleep
Professor Russell Foster, director of the University of Oxford’s Sir Jules Thorn Sleep and Circadian Neuroscience Institute and author of Life Time: the New Science of the Body Clock, and How It Can Revolutionise Your Sleep and Health, warns that ageing flattens our “circadian drive for sleep”.
The best way to reset the body’s natural 24-hour clock, he says, is to “Get outside. Get that photon shower in the morning light, which is consolidating signals to the clock that sets the sleep-wake cycle.”
A 2020 Swedish study found that moderate to severe sleep disturbance in later life strongly predicts health issues such as arthritis and dementia. Foster emphasises lifestyle solutions as the key. “To stabilise sleep and circadian rhythms: wind down before bed, have a robust exposure to natural light, and try to move throughout the day. If you sit all day and have swollen ankles, the accumulated fluid will have to be integrated when you lie down, which will raise blood pressure and mean you have to pee out up to a litre of fluid as urine.”
Shortcuts can backfire. “Naps will push back ‘sleep pressure’, meaning you can nod off at night, but can’t stay asleep.” Anything beyond occasional use of sleeping pills or antihistamines is “not helpful, they are not a mimic for sleep. They can not just further disrupt the sleep-wake cycle but also contribute to cognitive decline.”
He is “not a fan” of melatonin and warns that “alcohol disrupts sleep-wake cycles, impairs memory formation and contributes to cycles of caffeine dependency that further disrupts sleep”.
Learn about sleep science, Foster advises, but don’t obsess about it. “Sleep has become a whole industry, with the sergeant majors of sleep screaming so loud we are frightened of it. Stay calm. Waking up in the night is not a disaster; it’s a default pattern of human sleep. Relax, read a bit and then let sleep resume naturally.”
Clear cortisol with movement
Stress is normal and necessary to all aspects of human existence, but it isn’t just about work and it doesn’t end on retirement. Dr Marie-Josée Richer, a lecturer at the Institute of Mental Health at the University of Montreal and author of two new studies on stress in older age, explains: “As we get older, we are vulnerable to new kinds of stress, including health and finances, as well as ‘emotional contagion’ in which we are more prone to mirror the stress felt by people around us. This is twinned with a less efficient physiological ability to clear the stress hormone, cortisol, from the body.”
Cortisol – the so-called stress hormone – is useful, giving a surge of energy to get up in the morning and deal with periods of adversity. “But you don’t want it hanging around; that’s when it becomes chronic stress and that is harmful.”
Fear not, though, or rather stress not. “Learn to have an awareness of what stress feels like and then act to clear the cortisol from the body with movement. Any movement will work: walking, physical exercise, dancing, or a simple breathwork method like belly breathing, also called diaphragm breathing, singing, saying prayers, reciting a poem, or chanting. Any of these will signal to the brain that it’s not stressful out there any more.”
So, if you have a silly argument, go for a walk, sing, or take three deep breaths and notice a calming effect.