Don’t Just Add Years; Add Strength

For much of my medical career, we have measured health with numbers.

Blood pressure.

Blood sugar.

Cholesterol.

Creatinine.

Ejection fraction.

Body mass index.

They matter enormously.

But as our patients live into their seventies, eighties and nineties, another set of measurements becomes increasingly important.

Can you get out of a chair?

Can you walk across the room?

Can you climb the stairs?

Can you carry your groceries?

Can you recover after an illness?

Can you still do the things that allow you to live the life you value?

There is something profoundly different between being alive and being able to live independently.

Medicine has become very good at extending survival.

Our next challenge is extending healthspan—the portion of those additional years spent with reasonable health, mobility, cognition and independence.

Muscle belongs at the center of that conversation. We should stop telling older people that weakness is simply their age. Sometimes it is disease. Sometimes malnutrition. Sometimes medication. Sometimes prolonged inactivity.

And sometimes it is a modifiable decline that began so gradually nobody noticed.

We should also abandon the idea that strength training belongs only to young people admiring themselves in gym mirrors.

At 25, strong muscles may improve athletic performance.

At 75, they may help you get off the toilet without assistance.

At 85, they may help prevent a fall.

At 90, they may help you remain in your own home.

The meaning of strength changes with age.

Its importance does not.

So walk.

Lift appropriately.

Practice balance.

Eat well.

Recover actively from illness.

And never assume that because your birthday says you are old, your muscles have been given permission to retire.

The objective is not immortality.

Nor is it to pretend that aging does not exist.

It is something much more realistic and worthwhile: To arrive at our later years with enough strength to continue participating in our own lives.

Because perhaps the finest measure of successful longevity is not simply the number of candles on the birthday cake.

It is still being strong enough to blow them out yourself.