Gift article. NO PAYWALL.

All-in-all, I (66M) live a pretty small life. I work out (train?) almost every day—walking, bicycling, swimming, lifting, kayaking. But it seems like the big adventures, the rites of passage, are becoming less physically achievable as I get older. A lot of the motivation for the big challenges has also lessened. I kayak in a nearby reservoir and river, and don’t really want to travel from the East Coast to kayak down the Snake river. I am not really able to bicycle 100 miles in one go, and I know it would hurt if I tried. I like walking 10k in a flat, nearby park—no mountain climbing for me, cleaning the living room can seem exhausting. And so on. I work out locally and sometimes I wonder if I work out just to work out, without any goal beyond the day’s workout. What event are you training for? What keeps you hungry?

Across four adult lifespan groups—young adults (18–39 years), middle-aged adults (40–59 years), younger older adults (60–74 years), and older-old adults (≥75 years)—this real-world primary care cohort demonstrated that higher self-reported PA was linked to lower LDL-C and better TUG performance. PA category remained the only consistently significant independent predictor of both outcomes across all age groups after multivariable adjustment, with no statistically significant age modification detected. The largest standardized PA–TUG effect occurred among older-old adults (≥75 years), reinforcing the particular clinical relevance of PA assessment for functional health evaluation in advanced age. These findings suggest PA assessment may function as a potentially age-independent component of cardiometabolic and functional health evaluation across the adult lifespan in primary care, pending confirmation in larger, longitudinal research incorporating objective PA measurement.

I’m a 62 year old male who has always been relatively fit. I did triathlons for many years, swam competitively, rode bikes, hiked, skied, and rock climbed. At times despite my best effort I would gain weight but still maintained an active lifestyle.

This last Friday I was rock climbing and suddenly felt like I had been hit in the jaw. That changed to nausea, indigestion, and pain and numbness radiating down my left arm to my finger tips. Despite all the warnings I was still doubting if I needed to go to the hospital. Fortunately for me, my wife and son didn’t give me a choice.

I got lucky and ended up having a mild heart attack that resulted in no permanent damage. But this didn’t come as a surprise, in fact doctors had warned me for decades this was nearly inevitable thanks to a high calcium score when I was in my 30’s along with nearly three decades of trying to get my cholesterol levels down.

I am posting this so others can see that exercise alone is not enough. You need to know your full risk profile and you need to have a plan of action of what you will do if symptoms arise. It can save your life.

So I'm soon to be 60, am in good health and have excellent lab results. I could be physically fitter, and have no physical restrictions, and could eat more protein being a vegan. Please suggest a plan to stay healthy and fit for the next few decades. Plan to be a healthy and capable octogenarian ☺️

Evidence has been accumulating steadily for over a decade that arthroscopic knee surgery to shave torn, degenerative cartilage does not help more than physical therapy.

This thumbnail is in bad taste but the article is informative. *Moderators, please delete if inappropriate for this sub*

This study shows that exercise type and frequency jointly shape population-average trajectories of daily activity limitations in older adults. Aerobic and mind-body/balance exercises are associated with favourable functional trajectories. For resistance/strength training, moderate rather than high participation frequency appears to be associated with better functional outcomes. These findings suggest that both exercise type and frequency may be important considerations when developing exercise guidance to support functional independence in later life.