How strong do you want to be when you’re 80?

When most of us imagine being healthy at 80, and avoiding major illness.

We hope our blood pressure will be controlled. Our blood tests will look respectable. Our memory will remain clear. We will still be living independently.

But there is another question that deserves to be asked much earlier:

What will your body still be capable of doing?

Will you be able to rise comfortably from a low chair?

Lift a suitcase into the car?

Carry your shopping?

Get down onto the floor and get back up again?

Walk up a flight of stairs without needing to pull yourself along by the handrail?

Strength isn’t just something that matters at the gym. It determines how freely, confidently and independently we can move through everyday life.

Muscle belongs in the health conversation

In her book Forever Strong, physician Dr Gabrielle Lyon presents what she calls a “muscle-centric” approach to health. Her central argument is that medicine and popular culture have spent decades concentrating on reducing body fat while paying far too little attention to preserving skeletal muscle.

It is a useful reframing.

Muscle doesn’t just look good. It allows us to move, protects our joints, supports physical function and acts as an important site for glucose disposal after meals. This helps explain why muscle health and metabolic health are closely interconnected.

That doesn’t mean that healthy ageing can be reduced to a single organ, nor that everybody needs the same exercise program or protein target.

It does mean that strength deserves deliberate attention long before weakness becomes obvious.

Strength matters

Someone can have a perfectly ordinary body weight while gradually losing muscle and strength. Changes in body composition won’t be visible on standard bathroom scales, particularly if muscle is being replaced by fat without a significant change in total weight.

It’s also important not to become overly focused on muscle mass alone.

Modern sarcopenia frameworks place particular emphasis on muscle strength, because strength and physical performance tell us more about future function than a measurement of muscle quantity by itself. 

In other words, what your body can do matters at least as much as what it weighs.

You don’t need to train like an olympian

Strength training can mean lifting weights in a gym, but that is absolutely not the only option.

Depending on your starting point, it could involve:

• Controlled sit-to-stand exercises

• Body-weight movements

• Resistance bands

• Pilates

• Supervised weight training

• Carrying challenging loads

• Hill or stair walking

• Exercises prescribed by a physiotherapist or exercise physiologist

The important ingredients are appropriate resistance, good technique and gradual progression.

Australian movement guidelines now recommend that older adults undertake muscle-strengthening activities on at least two days each week, together with activities targeting mobility, balance and coordination on at least three days.

Encouragingly, the program does not need to be onerous to be useful. Relatively low-volume resistance training can improve physical function in healthy older adults, while resistance training also improves strength and function in people who already have sarcopenia.

The best program is the one that is safe, sufficiently challenging and realistic enough and enjoyable enough to continue.

The protein piece

Exercise provides the stimulus for muscles to adapt. Nutrition provides the raw materials.

Adequate dietary protein becomes particularly important as we age, although the right amount will vary according to body size, activity, appetite, medical conditions and kidney function.

Recent evidence suggests that combining exercise with protein intake is more effective for improving muscle mass, strength and physical function in older adults than relying on either strategy in isolation.

This doesn’t necessarily mean purchasing protein powders or consuming enormous portions of meat.

It begins with looking honestly at each meal:

Does breakfast contain any meaningful protein?

Is lunch substantial enough, or is it mostly toast, crackers or fruit?

Has appetite declined?

Are dental problems, gastrointestinal symptoms, finances or medication side effects making eating more difficult?

Do vegetarian or vegan meals contain a considered protein source?

And are there medical reasons why protein intake needs to be individualised?

A food diary can sometimes reveal far more than a person expects.

What are you preparing for?

A useful healthy-ageing plan shouldn’t begin with somebody else’s idea of fitness.

It should begin with the life you want.

Perhaps your goal is to continue skiing.

Perhaps it is travelling independently and managing your own luggage.

Perhaps it is playing on the floor with grandchildren.

Perhaps you want to garden, sail, play golf, remain at work, or continue living in a home with stairs.

These goals help determine the kind of strength, mobility and balance you need to preserve.

Training becomes far more meaningful when it is connected to something you actually care about.

What happens during a WSD Healthy Aging Appointment?

The WSD Healthy Aging Appointment is designed to move beyond the traditional checklist.

Rather than simply documenting what you can and can’t do today, we want to help you make a practical plan for the years ahead.

Depending on your circumstances, the appointment may include discussion and assessment of:

• Your personal goals for later life

• Current exercise and daily movement

• Strength, balance, mobility and functional ability

• Estimated body composition using biometric scales

• Protein, calcium and overall dietary intake

• Bone density, fracture risk and vitamin D

• Metabolic and cardiovascular health

• Medical conditions that may affect strength or mobility

• Medications that may contribute to weakness, dizziness or falls

• Appropriate referral to an exercise physiologist, physiotherapist, dietitian or other clinician

A biometric scale reading is an estimate rather than a diagnosis. The number becomes most useful when it is interpreted alongside function, medical history and changes over time.

The aim is to understand your starting point. 

Your future strength is being built now

You don’t suddenly become strong, or weak, on your eightieth birthday.

The foundations are laid gradually through the preceding decades: through activity, resistance, recovery, nutrition and the countless small decisions that either challenge the body or allow it to become progressively deconditioned.

Fortunately, it is never too early to begin, and never too late.

Go for progress over perfection. You need a starting point, an appropriate plan and enough consistency to allow your body to adapt.

So perhaps the most useful question isn’t:

How old do you want to live to be?

It’s: How strong do you want to be when you get there?

The WSD Healthy Aging Appointment is available for patients (annually funded by Medicare) who would like a more considered, proactive approach to ageing well.

Appointments can be booked through the Walker Street Doctors Hotdoc Booking platform. 

This article provides general health information. Exercise and nutrition recommendations should be individualised, particularly for people with chronic medical conditions, significant pain, frailty, kidney disease or a recent illness or injury.