Guide
In your 70s and beyond
The goal shifts to maintaining function, avoiding falls and hospitalisation, and preserving independence. Many "longevity" interventions optimised for midlife adults make less sense here. The pivot is to interventions that preserve mobility, cognition, and social engagement.
Top priorities
- Resistance training. Even in 80s and 90s, measurable strength gains are achievable and reduce fall/fracture risk substantially. See exercise.
- Adequate protein— 1.2–1.6 g/kg/day to preserve muscle. See protein.
- Avoid hospitalisations via vaccine adherence (flu, pneumococcal, RSV, shingles), fall prevention, sleep apnea treatment, BP and glucose stability.
- Polypharmacy review annually. Many drugs accumulated over decades are no longer net-beneficial; some actively cause cognitive impairment, falls, or hypotension.
- Hearing, vision, dental: all under-treated; all predict outcomes.
- Social engagement and purpose: see social connection, purpose & meaning. Loneliness is medically dangerous in this decade.
What changes in lipid management
Primary-prevention lipid lowering in adults >75 with no prior ASCVD becomes a more individual decision. Secondary prevention (after a CV event) remains strongly indicated. Discuss with the clinician who knows your full picture.
What changes in blood-pressure management
Target BP becomes individualised. Aggressive lowering can precipitate falls and acute kidney injury in some older adults. Orthostatic measurement matters. See hypertension.
What to measure (less is more)
- Function: gait speed, chair-rise, grip strength.
- Cognitive screen (MoCA) annually.
- Basic labs: CBC, CMP, HbA1c, lipid panel, eGFR with cystatin C.
- Vitamin D, B12.
- Hearing and vision.
- Sleep apnea if not already evaluated.
What to stop or reduce
- Aggressive screening with low yield (whole-body MRI in low-risk).
- Off-label drug stacks not tailored to your specific situation.
- Restrictive diets that compromise protein intake.
- Endurance-only exercise without resistance work.