We need to talk about getting older. Not in that vague, someday sort of way, but practically.
With advancing age, people accumulate more health conditions. Functioning declines. Alzheimer’s rates climb steadily—the numbers are stark if you look at them. Musculoskeletal frailty creeps in, making movement harder. And with that can come the heartbreaking loss of independence.
For many people, the thought of a nursing home is genuinely frightening. But even for those living independently, there’s another quiet crisis unfolding: social isolation.
People retire and lose the social networks that came with work. We’ve become increasingly insular as a society. Where previous generations participated in community groups and associations, we’re now more disconnected than ever. Depression, isolation, and loneliness in older age have become a genuine public health crisis. But here’s the thing—and this matters—there’s actually a lot that can be done.
When we talk about healthy aging, we’re talking about a lifelong process. At our practice, we’ve chosen the mid-forties as the time to really focus on this, though not arbitrarily. It’s when rates of chronic diseases and cancers start to rise. It’s when people need to start thinking seriously about the decades ahead and their eventual transition out of work.
Perhaps most importantly, we know that lifestyle choices in your forties have a hugely outsized effect on your risk of dementia and frailty later. It’s also when preventive screening becomes relevant—cholesterol checks, bowel cancer screening, breast screening.
But even more significant than screening? How you actually live.
Despite the mental image many of us carry—that fitness and strength training are for the young—they actually become more critical as you age, not less.
Strength-based training has remarkable benefits for mobility, independence, and overall health. Balance exercises are vital for preventing falls, one of the biggest threats to older people’s wellbeing. Cardiovascular exercise remains essential for being able to do the things you want to do.
And here’s the paradigm shift that’s been happening in medicine: we know that taking up exercise even in your nineties produces real benefits.
There’s an old saying: when’s the best time to plant a tree? Ten years ago. When’s the second best time? Right now.
Nutritional needs change as you age, and generic advice doesn’t cut it. What your body needs at 75 isn’t what it needed at 45. Adequate protein becomes crucial for maintaining muscle mass. Calcium and vitamin D for bones. The right balance to support cognitive function and energy.
This isn’t about restriction or chasing some ideal. It’s about fuelling your body appropriately for where you are now and where you want to be.
Genetic profiling is going to transform clinical care in the coming years—the emerging data is genuinely exciting. Being able to identify specific risk factors early and tailor interventions more precisely to each person’s unique biology has real potential.
We’re committed to employing this technology as it matures, but safely and judiciously. New isn’t always better, and we’re not interested in novelty for its own sake.
First, we acknowledge reality: we’re all aging, and we’re all going to die one day. Living in denial of that doesn’t serve anyone—not patients, and not doctors either. Sometimes we clinicians have our own blind spots about this.
What we need is a holistic approach tailored to where you are in your life course. Not generic advice from a textbook, but genuine consideration of your circumstances, your goals, and what actually matters to you.
Our practice is involved with the Centre of Excellence for Healthy Ageing, which is led by Dr Suzanne Williams, with Dr Jamie Nuttall also contributing. They’re working to translate research into practical clinical tools and models of care that will make a difference in the decades ahead.
Part of the motivation is demographic reality: the population is getting older, and there’s a significant shift happening. Unless we change the determinants of health now, we’re heading toward an untenable situation in terms of disease burden among older people. That’s not scaremongering. It’s facing facts so we can do something about it.
We’re passionate about this work. We want to see people who are interested in shaping their life course toward health, thriving, and vitality—whatever age they’re at now.
Whether you’re in your mid-forties just starting to think about this, or in your eighties wanting to maintain your independence, there are interventions that matter
This isn’t about denying mortality or chasing eternal youth. It’s about living as fully as possible for as long as possible. Maintaining independence and quality of life. Stacking the deck in your favour with the things we know actually work.
