Keys to longevity for older adults: how to age well

From ‘Blue Zones’ to alcohol use and supplements, here is what you need to know to age well.
Aug. 1, 2024
older woman doing yoga. exercise is one of the keys to longevity as you age.
Adding activities like yoga can enhance balance and help with a well-rounded approach to physical fitness, an important key to longevity. Photo: Getty Images.

Older adults often tell their doctors that longevity is their No. 1 goal.

“Patients say ‘I want to get to 100,’” says Dr. Thomas Johnson, a specialist in geriatric medicine at the UCHealth Seniors Clinic on the Anschutz Medical Campus.

But what does longevity actually mean?

Johnson doesn’t view longevity as a number per se or living to a particular age. Rather, he encourages patients to focus on achieving the greatest quality of life during the years they have left.

“I ask them, ‘What does living to 100 mean to you?’”

To help older people make the most of their later years, we quizzed Johnson on frequently asked questions about longevity.

When you talk to your patients about longevity, how do you define it?

“I like to think of longevity in terms of ‘health span’ rather than ‘lifespan,’’’ said Johnson, who is also an assistant professor of medicine in geriatrics at the University of Colorado School of Medicine.

“We used to think about studies exclusively in terms of mortality and wanting people to live longer, but we also want to emphasize quality of life aspects as they age,” he said.

Johnson encourages people to think about specifics such as:

  • Do you want to age in place and stay in your home as you get older?
  • What makes life meaningful for you?
  • What are your values as you age?
  • What are your hobbies; are they important to you?
  • Do you want to be active?
  • What kind of diet do you have, and are you willing to make changes for your health?
  • What role does exercise play in your life?
  • Are you engaged with your community, a church, family and friends?

“We know that some of the effects of aging start as early as 30. We’re all aging, so we should all be thinking about how to age in a healthy and active way,” Johnson said.

How key is exercise and fitness in keeping us healthy as we get older?

As we age, managing chronic conditions is very important, but controlling diabetes and blood pressure are just small parts of staying fit.

Focus on preventing injuries by driving safely, wearing helmets when skiing or cycling, preventing falls by avoiding unsteady ladders and holding rails on steps.

One of the best physical activities we can do as we age is to walk. But it’s important to add other forms of exercise since walking helps with aerobics. Many older focus on aerobic activities but don’t get enough of two other key forms of physical activity: resistance and balance training.

“We need to be doing exercises that build our muscles since they decrease in quality and quantity as we age. That includes using weights and doing squats, lunges, and practicing getting in and out of chairs,” Johnson said.

He recommends yoga, tai chi, dancing, swimming, stationary cycling and water aerobics, among other activities.

Talk to your primary care provider about an exercise plan that will work for you, especially if you have lung and heart issues, Johnson said.

Experts at the U.S. Centers for Disease Control and Prevention encourage adults to get at least 150 minutes of moderate intensity aerobic exercise per week (you should be able to have a conversation while doing it) or 75 minutes of high-intensity exercise when you are out breath.

Johnson also encourages people to add strength and balance exercises three days a week.

“Don’t limit yourself by saying you can’t do it. Talk to your primary care provider about what you can do. I have patients well into their 70s who are skiing, dancing and running multiple miles. We can work on modifying activities that you love to make them safe for you,” he said.

What role does nutrition play in living longer?

It’s never too late to work on nutrition, Johnson said.

“We know there are certain areas in the world called Blue Zones, where people are living longer.”

Blue Zones are places around the world that have 10 times as many residents living to 100 compared to similar-sized cities. What they have in common is active lifestyles and Mediterranean diets rich in plant-based foods including:

  • Vegetables, fruits and legumes
  • Whole grains, nuts and seeds
  • Olives and olive oil
  • Fatty fish like sardines, salmon and anchovies
  • Herbs such as oregano, rosemary and basil
  • Greek yogurt

“The Mediterranean diet is one that people can enjoy wherever they live,” Johnson said.

He encourages patients to not view their diets as “all-or-nothing” scenarios.

“I love telling people not be too hard on yourself. It’s important to give ourselves a break and have a little cake and ice cream once in a while. It’s OK to make exceptions on special occasions,” he said.

Should I be eating less as I get older or practice fasting?

While it’s true that our metabolism slows down over time, and we might not be as hungry as we once were, Johnson encourages patients to eat full and balanced meals, especially with certain medications that must be taken with food.

As far as fasting and time-restricted eating, which happens to be a popular topic on social media now, he cautions against jumping on that bandwagon as there is no definitive data on whether these practices work, especially in older adults.

“If you’re interested in exploring an idea like this, work with your medical provider because there are certain circumstances where it would not be recommended, for instance if you have insulin-dependent diabetes.”

No smoking is a given, right? What if I smoked earlier in my life?

Yes. Cigarette smoking and nicotine use directly undermine longevity and healthy aging, Johnson said.

He advises patients to avoid nicotine altogether. That means no smoking, chewing or vaping.

“If your goal is to maximize your life span, then your goal is to not to use nicotine,” he said.

But hope is not lost for those who had a previous nicotine habit. If you gave up smoking, the  payoff is big, as the longer you go without smoking the more your risk of developing lung cancer declines. After 15 years, your risk of cancer approaches the level of someone who has never smoked.

(And free help is available for people who want to quit smoking. And many older adults who smoked in the past can also get screened for lung cancer.)

What about drinking in moderation?

Alcohol use is a very interesting topic, Johnson said.

“To me, it’s a values-based decision. It depends upon how it matters to that person, to their beliefs and their culture. I let patients decide what is important to them,” he said.

With conflicting studies saying a glass of red wine is healthy and others saying any amount of alcohol is detrimental, Johnson said he informs patients about the research and encourages them to make educated decisions. He does discuss the dangers of drinking too much when it comes to driving and falling. (Learn the truth about alcohol consumption.)

Should I take vitamins or supplements? 

Before taking vitamins or supplements, talking to medical provider is a must, Johnson said.

“Vitamins and supplements can have side dramatic effects and interact with medications you are taking, as well as upcoming procedures, and could be detrimental to current conditions you are dealing with. It’s important that people include this in their entire health picture when they talk with their doctor.”

Learn why annual medication reviews are so important.

Research on multi-vitamins is mixed on whether they are beneficial, he said.

And while some supplements could play a role in your nutritional regimen and have some efficacy, he cautions against too-good-to-be-true promotions that promise to take years off your life or advertise a fountain of youth in a pill. Many are not regulated by the U.S. Food and Drug Administration (FDA).

Cost is also an issue with these products. Johnson encourages patients to try and get most of their nutrients from healthy eating.

What about so-called longevity drugs?

While trials investigating certain anti-aging pharmaceuticals are ongoing, the jury is still out on whether it’s possible to slow down the aging process with drugs.

For instance, rapamycin has gained a following among online trendsetters and celebrities to extend longevity. Despite it only been approved by the FDA for use in transplant patients to help them tolerate new organs, it is being prescribed by some physicians for older patients, while other health care professionals caution that more research is needed.

Johnson said that drugs like these cannot substitute for a healthy diet and lifestyle, as well as another influencer at play that we cannot control: Genetics.

“We know that genetics is definitely a factor, as it influences diseases you are predisposed to, and that can impact the quality and quantity of your life. But even though you may be at risk for something, it doesn’t mean it’s 100% going to happen to you, and there are many behavioral changes you can take to minimize those risks.”

Are there ways to keep my mind young?

Two very important parts of longevity are promoting cognitive health and mental/social health.

“The more we grow our baseline cognitive health in our younger years, the greater the buffer will be to losing it as we age,” Johnson said.

Should I do crossword puzzles? Learn an instrument? Take up a foreign language? Will it make a difference?

“I think those are positive things and it may help your cognitive function While it hasn’t proven to absolutely prevent cognitive decline, they are still good thing to try,” Johnson said.

“As we get older, it’s important to take up new hobbies and adopt mindsets of continual learning. I encourage people to stay engaged, join social groups and ones that are of interest to you. Volunteer. The big thing is to take an active role in the world around you.”

Everything is linked when we live a healthy lifestyle: Exercising, getting proper sleep, maintaining mental health, finding meaningful activities and doing things that matter to you. Developing a relationship with your primary care provider to help treat issues that arise — including depression and anxiety — is also important.

“Healthy aging is a lifestyle we choose, and all of these things you do can add up to a big improvement in the quality of the years we have.”

About the author

Mary Gay Broderick is a Denver-based freelance writer with more than 25 years experience in journalism, marketing, public relations and communications. She enjoys telling compelling stories about healthcare, especially the dedicated UCHealth professionals and the people whose lives they transform. She enjoys skiing, hiking, biking and traveling, along with baking (mostly) successful desserts for her husband and three daughters.