I have a slightly unusual goal for my patients. I want you to get old. Really old.
I want you to be 85 years old with places to go and things to do. I want you traveling, gardening, playing with grandchildren, going out with friends, carrying your own groceries, and getting down on the floor and, perhaps more importantly, getting yourself back up again. I want you to be the 95-year-old whose family occasionally wonders what exactly you are getting up to.
Because getting older isn't something I'm trying to prevent. Getting older is the goal. What I care about is how we get you there.
I care about your healthspan
We talk a lot about lifespan in medicine: How many years will you live? But there's another concept I think is even more important, and that's healthspan. How many of those years can you spend feeling well enough to actually live your life?
Simply adding years isn't quite the goal. I want to preserve your independence, your mobility, your strength, your cognition, your relationships, and your ability to do the things that make your life feel like yours. That means some of the decisions we're making together in your 40s, 50s, and 60s aren't really about today. We're taking care of the person you're going to be twenty or thirty years from now.
Muscle becomes incredibly important
If there's one thing I wish more people understood about healthy aging, it's that muscle isn't just about appearance. Muscle is functional reserve. It helps you climb stairs, carry groceries, get out of a chair, catch yourself when you stumble, recover from illness, and maintain your independence.
As we age, maintaining muscle becomes harder. That's one reason you'll hear me talk increasingly about protein, movement, and strength training as you get older. I'm not trying to turn everyone into a bodybuilder. I'm trying to make sure 80-year-old you can still open the pickle jar.
Our bones matter too. Strong muscles aren't terribly useful if the scaffolding underneath them becomes fragile, so we pay attention to bone health. We think about nutrition, activity, menopause, medications, family history, and other risk factors, and when appropriate, we screen for osteoporosis. The goal isn't a beautiful bone-density report sitting in your medical chart. The goal is you remaining capable and independent.
We're playing the long game
This is also where some of the decidedly less glamorous parts of preventive medicine become incredibly important: blood pressure, cholesterol, blood sugar, smoking, exercise, sleep, and nutrition.
These aren't numbers I'm trying to make perfect so I can give you a gold star at your next appointment. We're managing risk over decades. A statin today may be about preventing the stroke that could change your independence twenty years from now. Treating high blood pressure isn't about pleasing your doctor. It's about protecting your heart, brain, kidneys, and blood vessels so they can continue doing their jobs for a very long time.
This is long-game medicine.
And your brain is part of that plan. I care about your sleep. I care about your mood, anxiety, and depression. I care whether you have meaningful relationships, whether you have things that challenge your brain, and whether you have things that bring you joy. I care whether you're lonely. We aren't trying to preserve a collection of organs. We're trying to preserve you.
Not everything is “just getting older”
There is one other part of healthy aging that I think deserves more attention. Sometimes patients tell me about a symptom and then immediately dismiss themselves: “Well, I'm getting older.”
Yes. You are. So am I.
Some changes are normal parts of aging, but getting older doesn't mean you should automatically accept feeling terrible. Pain that keeps you from doing things matters. Exhaustion matters. Significant changes in memory matter. Depression matters. Loss of strength matters. Sexual health matters. Sleep matters. Your quality of life still matters at 50, 70, 85, and 95.
We may not be able to fix everything. Aging is real, and medicine has limits. But “you're getting older” should not be the end of the conversation.
I am not trying to keep you young
There is an enormous industry devoted to convincing us that aging itself is the enemy. I don't believe that. Wrinkles are allowed. Gray hair is allowed. Bodies change. Life leaves evidence.
I'm much more interested in what your body can do than whether it looks like it did when you were 25.
So no, my goal isn't to keep you young. My goal is to help you build a body and a life capable of carrying you as far as possible. We'll maintain the machine. We'll protect the muscle and strengthen the scaffolding. We'll manage the risks we can manage. We'll treat problems when they arise. And we'll keep adjusting the plan as the years go by.
Because I don't want to help you avoid getting older. Getting older is the goal.
I want to help you get really, really good at it.
Dr. Kristy Mount, MD, PhD, FAAFP
Deserving of Joy
A quick note: This letter is for educational purposes only and is not a substitute for individualized medical advice. Every person's health history, risks, and treatment needs are different. Please talk with your physician or healthcare professional about what is appropriate for you.