Ten frail residents of a nursing home, average age 90, were given a job usually kept for the young: lifting heavy weights. Eight weeks later, the nine who finished were 174% stronger on average. The muscle in their thighs had grown, and they walked a heel-to-toe line 48% faster. The oldest was 96.
Ageing gets pictured as a slow slide we can only watch. The slide is real: strength, balance and speed all fade when nothing asks for them. But how we'll be doing at 80 can be read years ahead from a few plain things, and each of them answers to practice. Ahead: the squeeze of the hand that predicted more than blood pressure did, the ten seconds on one leg that defeated one in five people past fifty, what getting up off the floor says about the years ahead, and what eight months of lifting did for thinning bones.
What's at stake
We're living longer, and only some of the extra years are good ones. On average, about nine years of a life are spent in poor health, roughly a fifth of the whole. The aim is to shrink that stretch, and to keep the years we get worth having.
Genes settle less of this than they get credit for. Among 2,872 pairs of Danish twins, genes explained about a quarter of the difference in how long they lived.
Muscle is where the slide starts. When 468 adults aged 18 to 88 were scanned from head to toe, the noticeable loss began at the end of the forties, and most of it came from the legs. The loss has a name, sarcopenia, put together in 1989 from the Greek words for "flesh" and "poverty".
Strength goes faster than the muscle itself. In 1,880 older adults followed for three years, leg strength fell by about 3% a year, three times as fast as the muscle in their legs. So the mirror and the scales tell us little, and what we can do tells us more.
Some of that is age, and some of it is the chair. Forty athletes aged 40 to 81, who trained four or five times a week, had their thighs scanned and their strength tested. Neither muscle nor strength fell with age. In the people who kept asking, the body kept answering.
1. Keep your grip
How hard you can squeeze says a lot about the rest of you. Grip was measured in 139,691 adults in 17 countries, and they were followed for four years. For every 5 kilos (11 pounds) less in the hand, the risk of dying in that time was 16% higher. Grip predicted it better than blood pressure did.
The hand is standing in for the whole body here: grip is a quick way to measure muscular strength, and it's the strength we're after.
The home version needs only a chair. Rise from it five times without using your arms, as fast as you safely can. More than 15 seconds is the European cut-off for low strength. On a grip meter, the line is 27 kilos for men and 16 for women.
Keeping that strength takes less than we might fear. Across 16 sets of findings, people who did strength work had a 10 to 17% lower risk of dying, and of heart disease, cancer and diabetes. The largest gain sat at about 30 to 60 minutes a week.
Once a week can be enough. When 46 adults aged 65 to 79 lifted weights on one, two or three days a week for 24 weeks, strength rose by 37 to 42% in all three groups, with nothing to choose between them. They got up from a chair faster as well.
Time your five chair rises today. Then carry your shopping in your hands for part of the way home, and swap the trolley for a basket when the list is short. On days with nothing to carry, a gives your hands something to work against.
2. Mind your walking pace
Walking speed turns out to be one of the most telling single measures of how a body is ageing. In 34,485 adults over 65, every tenth of a metre per second faster went with a 12% lower risk of dying over the years that followed. At 75, the chance of living another ten years ran from 19% for the slowest men to 87% for the fastest, and from 35% to 91% in women.
A walk leans on the heart, the lungs, the circulation, the nerves, the muscles and the joints all at once, which is why pace tells so much. The line to remember is a metre a second: ten metres, about 33 feet, in ten seconds at your ordinary pace. People at or above it lived longer than expected for their age.
It matters at the kerb. Pedestrian crossings in the UK are timed for 1.2 metres a second. Among 3,145 people over 65 in England, 84% of the men and 93% of the women walked slower than that, or were unable to do the test safely.
The step count has an answer too. Among 16,741 women with an average age of 72, those taking about 4,400 steps a day were 41% less likely to die over the next four years than those taking about 2,700. The gain kept growing up to about 7,500 steps and levelled off there. The famous 10,000 has little behind it.
The loss comes quickly when we stop. Ten healthy adults of about 72 cut their steps by three quarters, to about 1,400 a day, for two weeks. In that fortnight the lean tissue in their legs fell by about 4%, and their bodies handled sugar less well. Two weeks is the length of a bad cold, or a holiday by the pool.
Sitting has been measured too. In more than a million people, the least active who sat for over eight hours a day had a 59% higher death rate than the most active who sat least. In the most active quarter, the hours of sitting made no difference.
Measure out ten metres, walk it at your usual pace, and time it. Do it again in a month. For the daily count, a clips to a waistband and needs no phone.
3. Stand on one leg
Balance slips faster from the mid-fifties. When 1,702 people aged 51 to 75 were asked to stand on one leg for ten seconds, one in five failed. Over the next seven years, that group was 84% more likely to die than those who managed it, after age, weight and existing illness were taken into account.
It's also what stands between us and a fall, and at least a third of people over 65 fall in any one year. Across 59 tests with 12,981 people, exercise cut the rate of falls by 23%. Programmes that combined balance work with strength work cut it by about a third. Tai chi may cut falls by about a fifth, though the evidence for it is thinner. For walking on its own, the effect on falls is still unclear.
The house plays its part. Clearing the hazards at home, with non-slip strips on steps and less clutter underfoot, cut the rate of falls by 26% across 5,293 people, and by 38% among those already at higher risk.
A fall matters because of what can break. In the three months after a hip fracture, the risk of dying is five to eight times that of people the same age, and it never fully returns to theirs. "Frail" comes from the Latin fragilis, easily broken, the same root as "fracture".
Stand on one leg while the kettle boils, with a hand near the worktop, then change legs.
4. Get down on the floor, and up again
Getting to the floor and back takes strength, balance and flexibility together. In 2,002 adults aged 51 to 80, the move was scored out of ten, with a point lost for every hand or knee used for support. Those with the lowest scores were more than five times as likely to die over the next six years as those with the highest. Each extra point went with 21% better odds.
The reason to practise is plain. Of 313 people aged 72 and over who had a fall without being hurt, 47% were unable to get up without help at least once.
Sit down on the floor once a day and get up again, using as little help as you safely can.
5. Load your bones
The checks show where we stand. The next part is what builds us back up, and bone answers to load the way muscle does. In 101 women past the menopause with low bone density, eight months of heavy lifting under supervision raised the density of the spine by 2.9%. In a comparison group doing gentle exercise at home, it fell by 1.2%. The lifters also grew stronger and steadier on every measure, and the only injury in eight months was one minor back spasm. They even ended a fraction taller, by 0.2 of a centimetre, while the comparison group shrank by the same amount.
Every session in that test was supervised, and that's the part to copy first.
Pills are a weaker bet. Among 25,871 generally healthy adults followed for about five years, a daily vitamin D pill made no difference to the number of fractures, against a dummy pill. None had been picked for low vitamin D or thin bones, so it says little about people who are short of it. The skin makes its own vitamin D in sunlight, and oily fish, red meat, egg yolks and liver carry it too.
If your bones are thin, learn to lift from a trained instructor, and start lighter than you think you need to.
6. Eat enough protein
Muscle is built from protein. Among 2,066 adults in their seventies, those who ate the most protein lost about 40% less lean tissue over three years than those who ate the least.
The picture is less tidy than that sounds. When thigh muscle was measured on scans in 1,561 of the same people over five years, how much protein they ate made no difference, whether it came from animals or from plants.
Where protein clearly earns its place is beside the work. Across 49 tests with 1,863 people, extra protein added to the strength and muscle gained from weight training, with a smaller effect in older people. Food on its own builds little, as the last section shows.
Put meat, fish or eggs at the centre of each meal, which a low-carb, keto or carnivore plate does already, and pair it with something that works your legs.
7. Keep a reason to get up
A reason to get out of bed shows up in the figures too. When 6,985 adults over 50 answered questions about their sense of purpose, those with the weakest sense were 2.4 times as likely to die over the next four years as those with the strongest.
Name one thing this week that someone is counting on you for, and put it in the diary.
8. Start, whatever your age
The checks above are readings. They show who was at risk, and a weak grip can be a sign of illness as much as a cause of anything. The proof that strength itself can be changed comes from tests like the one we started with.
In a larger test, 100 nursing-home residents with an average age of 87 were split into groups. The ones who trained with weights for ten weeks grew 113% stronger, walked faster and climbed stairs with more power. The rest stayed where they were, and a nutrition drink given without the exercise made no difference.
Some people start later still. Fauja Singh took up running in earnest at 89, by his own count of his age, and at 100 ran eight track races in one day in Toronto. Jeanne Calment, the oldest person on record, is said to have taken up fencing at 85, and she rode her bicycle until she was 100.
Sore knees are no reason to sit this out. In 3,537 people with osteoarthritis of the knee, across 44 tests, exercise reduced the pain.
Start light and build slowly. Chest pain, dizziness or a pain that sharpens as you go all mean stop. A sudden drop in strength or pace, or weight falling without trying, is worth having checked soon.
Choose one move that asks something of your legs, like rising from a chair without your arms, and do it every day this week. When that gets easy, a adds load without filling the house with weights.
Never too old to get stronger
The harsh truth about ageing is that the body gives up whatever goes unused. The kinder truth is that it gives it back when asked, at 50, at 70, and at 96.
Stand up from your chair without using your arms, and sit down again slowly. That's the first of five.
Wondering what speeds the clock up? Key Factors That Speed Up Aging (And How to Slow Them Down) — the sun, smoke, sugar, stress and sleep, and how much each one adds.
More worried about your memory than your muscles? Dementia Risk: What It's Linked To, and What You Can Change — hearing, blood pressure, movement and sleep, and when to have your memory checked.
Know someone who has started saying "at my age"? Send them this, and stand on one leg together while the kettle boils.
Disclaimer: This article is general information. For advice about your own health, talk to a qualified health professional.
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