Healthy Ageing: The Complete Guide to Staying Strong, Sharp and Independent

By 2030, one in six people in the world will be aged 60 or over, and the number of people aged 80 and older is expected to triple by 2050, according to the World Health Organization. Living longer is one of humanity’s great achievements. But what matters most to most people is not just more years. It is staying strong, clear-headed, connected and independent for as long as possible.

The good news is that much of what happens as we age is not fixed. Muscles can be strengthened at 90, falls can be prevented, the risk of dementia can be reduced, and many problems blamed on “old age” are treatable conditions. This guide explains what you can do, at any age, to age well.

What is healthy ageing?

The World Health Organization defines healthy ageing as the process of developing and maintaining the functional ability that enables wellbeing in older age. Functional ability means being able to meet your basic needs, learn and make decisions, move around, build and maintain relationships, and contribute to society. Healthy ageing does not mean having no illnesses; many people live well with long-term conditions. It means being able to do what you value.

The United Nations declared 2021 to 2030 the Decade of Healthy Ageing, calling for action on ageism, age-friendly environments, integrated care and long-term care.

What changes with age, and what does not have to

Some changes are a natural part of ageing:

• Muscle mass and strength gradually decline, starting from around age 30 to 40 and speeding up after 60 to 70
• Bones lose density, especially in women after menopause
• Joints become stiffer
• Vision changes, particularly for close reading (presbyopia)
• Hearing for high-pitched sounds declines
• Processing speed slows slightly, though knowledge and vocabulary often increase
• Sleep becomes lighter
• Skin becomes thinner and drier
• The body handles medicines differently

But many things often blamed on age are not inevitable. Severe weakness, frequent falls, confusion, incontinence, depression, persistent pain and loneliness are not normal parts of ageing. They often have causes that can be treated or improved.

Strength: the most important thing you can build

Loss of muscle mass and strength with age is called sarcopenia. It increases the risk of falls, fractures, frailty, hospital admission and losing independence. The single most effective thing older adults can do to stay independent is to keep their muscles strong.

Muscles respond to strength training at any age. Studies in people in their 80s and 90s, including nursing home residents, show significant gains in strength, walking speed and balance after just a few months of resistance exercise.

Recommended activity for older adults (WHO)

• At least 150 to 300 minutes of moderate aerobic activity a week, such as brisk walking, swimming or dancing
• Muscle-strengthening activities on at least two days a week
• Balance and strength activities (multicomponent activity) on at least three days a week to prevent falls
• Reducing time spent sitting

If you cannot meet these, do what you can. Some activity is always better than none, and benefits start at any level.

Simple strength exercises at home

• Sit to stand: stand up from a firm chair without using your hands, if possible, and sit down slowly. Repeat 10 times.
• Wall press-ups: stand facing a wall, place your hands on it at shoulder height and bend and straighten your arms.
• Heel raises: holding a chair, rise onto your toes and lower slowly.
• Side leg raises: holding a chair, lift one leg out to the side and back.
• Bicep curls: using tins of food or water bottles as weights.
• Stair climbing with a handrail.

Protein

Muscles need protein to grow and repair. Older adults often eat too little protein, and their muscles respond less efficiently. Experts suggest older adults aim for around 1.0 to 1.2 grams of protein per kilogram of body weight per day (more if unwell), spread across meals. Good sources include eggs, fish, chicken, beans, lentils, milk, yoghurt, cheese, nuts and tofu. People with kidney disease should check with their healthcare provider.

Preventing falls

Falls are the leading cause of injury-related death in older adults worldwide. Around one in three people over 65 falls each year, and the risk rises with age. Falls can cause fractures, head injuries and loss of confidence, leading to reduced activity, more weakness and more falls.

Common causes of falls

• Muscle weakness and poor balance
• Medicines that cause drowsiness, dizziness or low blood pressure, especially when taking several medicines
• Low blood pressure on standing up (postural hypotension)
• Poor eyesight
• Foot problems and unsuitable footwear
• Hazards at home such as loose rugs, clutter, poor lighting and stairs without rails
• Needing to rush to the toilet, especially at night
• Dementia, Parkinson’s disease, stroke and arthritis
• Alcohol
• Fear of falling, which reduces activity

What reduces falls

• Strength and balance exercise programmes, such as Otago exercises, tai chi and group classes, which can reduce falls by around a quarter or more
• Medication review to reduce or stop medicines that increase fall risk
• Home safety assessment, removing trip hazards, adding grab rails, improving lighting and using night lights
• Eye checks and cataract surgery when needed; take care with multifocal glasses when walking outdoors
• Well-fitting, supportive footwear with non-slip soles
• Treating postural hypotension and getting up slowly
• Managing continence to reduce urgent trips to the toilet

What to do if you fall

Stay calm. Check if you are hurt. If you can, roll onto your hands and knees, crawl to a sturdy chair and use it to push yourself up slowly. If you cannot get up, call for help, keep warm with whatever is nearby, and change position to protect your skin. A personal alarm or mobile phone kept on you can be life-saving, especially if you live alone. Always tell a healthcare provider about a fall, even if you were not hurt, as it may be a sign of an underlying problem.

Bone health

Osteoporosis makes bones fragile and more likely to break, often after a minor fall. Hip fractures are particularly serious in older adults. Protect your bones by staying active (especially weight-bearing and strength exercise), getting enough calcium and vitamin D, not smoking and limiting alcohol. Ask about a bone density (DEXA) scan if you have risk factors such as a previous fracture after a minor fall, long-term steroid use, early menopause or low body weight. Effective medicines are available to reduce fracture risk.

Keeping your brain healthy

Some slowing of thinking and occasional forgetfulness, such as briefly forgetting a name, is normal with age. Dementia is not. It is a disease that progressively affects memory, thinking and daily function.

The 2024 Lancet Commission on dementia prevention identified 14 modifiable risk factors that together account for around 45 percent of dementia cases worldwide:

• Less education in early life
• Hearing loss
• High LDL cholesterol
• Depression
• Traumatic brain injury
• Physical inactivity
• Diabetes
• Smoking
• High blood pressure
• Obesity
• Excessive alcohol
• Social isolation
• Air pollution
• Untreated vision loss

This means that controlling blood pressure, staying active, treating hearing and vision loss, staying socially connected, not smoking, limiting alcohol and managing diabetes and cholesterol all help protect your brain.

Keeping mentally active

Learning new skills, reading, puzzles, playing musical instruments, learning languages, volunteering and social activities all challenge the brain. Activities that combine physical, social and mental elements, such as dancing or group walking, may be particularly beneficial.

When to seek help about memory

See a healthcare provider if you or someone close to you notices memory problems that are getting worse, difficulty managing money or medicines, getting lost in familiar places, problems finding words, changes in personality or confusion. Some causes, such as vitamin B12 deficiency, thyroid problems, depression, infection and medicine side effects, are treatable. Early diagnosis of dementia also allows planning and access to support and treatment.

Delirium

Delirium is a sudden onset of confusion, often caused by infection, dehydration, constipation, pain, new medicines or surgery. It is a medical emergency in older people and is often mistaken for dementia. If an older person suddenly becomes confused, drowsy or agitated, seek medical help urgently.

Hearing and vision

Hearing loss affects more than a quarter of people over 60 and becomes more common with age. Untreated hearing loss leads to isolation, depression and is linked to dementia risk. Hearing tests are simple, and hearing aids can make a huge difference. Studies suggest using hearing aids may reduce the risk of cognitive decline in people with hearing loss.

Have your eyes tested regularly, at least every two years, or as advised. Conditions such as cataracts, glaucoma, age-related macular degeneration and diabetic eye disease are common and often treatable, especially when found early. Cataract surgery is one of the most effective and widely performed operations in the world.

Medicines and polypharmacy

Many older adults take five or more medicines (polypharmacy). This increases the risk of side effects, interactions, falls, confusion and hospital admissions. As we age, kidneys and liver clear medicines more slowly, so doses that were once safe may become too strong.

• Ask for a structured medication review at least once a year, and after any hospital stay
• Keep an up-to-date list of all medicines, including over-the-counter products and supplements
• Ask whether each medicine is still needed and whether doses are right
• Be cautious with sleeping tablets, strong painkillers, some antihistamines and medicines with anticholinergic effects, which can cause confusion and falls
• Use a pill organiser or blister packs if remembering doses is difficult
• Never stop a medicine without advice, but do raise any concerns

Nutrition and hydration

Appetite often falls with age, and malnutrition is common but frequently missed, especially in people who live alone, have dental problems, low mood or dementia. Unintentional weight loss is a warning sign.

• Eat regular meals and snacks, with protein at each
• Include fruit, vegetables, whole grains and dairy or alternatives
• Choose nourishing snacks if appetite is small, such as yoghurt, cheese, nuts, eggs or milky drinks
• Drink regularly, about six to eight cups of fluid a day unless advised otherwise; older people feel thirst less, and dehydration can cause confusion, falls, constipation and urinary infections
• Consider a vitamin D supplement, especially if you rarely go outdoors
• Look after your teeth and dentures, which affect eating
• Eat with others when possible

Sleep

Sleep becomes lighter and more broken with age, and many older people wake earlier. Daytime activity, outdoor light, regular routines, limiting long daytime naps and reducing evening fluids and caffeine can help. Sleeping tablets carry high risks of falls and confusion in older adults and are rarely the best answer. Loud snoring with pauses in breathing, or acting out dreams, should be assessed.

Continence

Bladder and bowel problems are common but not a normal part of ageing, and many people suffer in silence. Pelvic floor exercises, bladder training, treating constipation, reviewing medicines and specialist continence nurse services can help many people. Talk to a nurse; there is no need to be embarrassed.

Loneliness and social connection

The World Health Organization’s Commission on Social Connection reported in 2025 that loneliness affects around one in six people worldwide and is linked to an estimated 871,000 deaths each year. In older adults, social isolation is associated with higher risks of heart disease, stroke, dementia, depression and early death.

• Stay in regular contact with family and friends, by phone, video call or visits
• Join a club, faith group, community centre, choir, walking group or class
• Volunteer; helping others gives purpose and connection
• Learn to use technology to stay connected
• Keep in touch with neighbours
• If you are worried about someone, visit, call, invite them out, and encourage them to seek support

Mental health

Depression in older adults is common, often missed and treatable. It may show as tiredness, loss of interest, poor sleep, poor appetite, irritability or physical complaints rather than obvious sadness. Bereavement, loss of independence, chronic illness and loneliness all increase risk. Talking therapies, social activities, exercise and medicines can help. Anyone with thoughts of suicide should seek help immediately; older men have particularly high suicide rates in many countries.

Vaccinations for older adults

• Annual flu vaccine
• COVID-19 boosters as recommended locally
• Pneumococcal vaccine (protects against pneumonia and meningitis)
• Shingles vaccine
• RSV vaccine, now recommended for older adults in many countries
• Tetanus booster if due

Health checks to ask about

• Blood pressure, at least once a year
• Cholesterol and diabetes screening
• Kidney function, especially if you take certain medicines
• Cancer screening according to local programmes (bowel, breast, cervical, lung for some smokers)
• Bone density if at risk
• Eye and hearing tests
• Foot checks, especially with diabetes
• Memory assessment if concerned
• Falls risk assessment
• Annual medication review

Frailty

Frailty is a state of reduced reserve, in which a minor illness or event, such as a urinary infection or new medicine, can cause a big change in health, such as sudden confusion or inability to walk. Signs include unintentional weight loss, exhaustion, slow walking, weakness and low activity. Frailty is not inevitable and can sometimes be reversed or improved with exercise, good nutrition, medication review and support. Comprehensive geriatric assessment by a specialist team can help people with frailty.

Planning ahead

Thinking about the future while you are well gives you control over decisions that matter to you.

• Lasting power of attorney or equivalent: a legal document naming someone you trust to make decisions about your health, welfare or finances if you become unable to
• Advance care planning: discussing and recording your wishes about future care, including where you would like to be cared for and treatments you would or would not want
• A will
• Home adaptations before they become urgent
• Financial planning for care needs
• Conversations with family about your values and wishes

Fighting ageism

WHO reports that one in two people worldwide hold ageist attitudes. Ageism affects health: older people with negative views about ageing live shorter lives and recover more slowly from illness than those with positive views. Ageism in healthcare can mean symptoms are dismissed as “just old age” and treatments are withheld. Expect to be treated as an individual and to receive the same quality of care as anyone else.

The nurse’s role

Nurses in community, primary care, hospital and care home settings lead much of the care that keeps older people well: assessing falls risk, reviewing medicines with pharmacists, spotting delirium and malnutrition, supporting continence, managing long-term conditions, providing vaccinations and supporting advance care planning. Gerontological and older people’s specialist nurses bring expertise in complex needs and frailty.

Making your home age-friendly

Small changes at home can prevent accidents and help you stay independent for longer. Consider an occupational therapy assessment if you are finding everyday tasks harder.

• Install grab rails by the toilet, bath and front door, and handrails on both sides of stairs
• Use bright, even lighting, with switches at the top and bottom of stairs and night lights between bedroom and bathroom
• Remove loose rugs and trailing cables, and keep floors clear
• Store frequently used items between waist and shoulder height to avoid stretching or using step stools
• Use a shower seat, raised toilet seat and non-slip mats
• Keep a phone within reach of where you sit and sleep, or carry a mobile phone or personal alarm
• Fit smoke and carbon monoxide alarms and check them regularly
• Keep your home warm; cold homes increase the risk of heart attack, stroke and chest infections in older people

Staying active with long-term conditions

Many older adults live with conditions such as heart disease, diabetes, arthritis or COPD and worry that exercise might be harmful. For most people, the opposite is true: physical activity improves symptoms and outcomes in almost every long-term condition. Start gently, build up gradually, and ask your nurse or physiotherapist about programmes designed for your condition, such as cardiac rehabilitation, pulmonary rehabilitation or exercise referral schemes. Stop and seek advice if you experience chest pain, severe breathlessness, dizziness or palpitations during exercise.

Frequently asked questions

Is it too late to start exercising at 75?

No. Older adults gain strength and balance at any age, and benefits can be seen within weeks.

Should older people take vitamin supplements?

Vitamin D is often recommended, especially in winter or for people who rarely go outside. Other supplements are usually unnecessary unless there is a deficiency.

Are memory lapses a sign of dementia?

Occasional forgetfulness is normal. Seek advice if memory problems are getting worse or affecting daily life.

How can I stop my parent from falling?

Encourage strength and balance exercise, arrange a medicine review and eye test, make the home safer, and ask about a falls prevention service.

Is it normal to sleep less as you age?

Sleep often becomes lighter and earlier, but persistent insomnia or daytime sleepiness should be checked.

But is it really worth changing my habits at my age?

Yes. The body and brain remain responsive throughout life. Starting to exercise, stopping smoking, treating hearing loss, reviewing medicines and staying socially connected all bring real benefits, often quickly. Every step you take now can add years of independence and quality of life.

Related: Signs an older parent needs help · Frailty and polypharmacy · Hip fracture in older adults · Dementia caregiving guide

Sources: World Health Organization (Ageing and health fact sheet; Guidelines on physical activity and sedentary behaviour; Global report on ageism; Commission on Social Connection 2025), UN Decade of Healthy Ageing 2021–2030, The Lancet Commission on dementia prevention, intervention, and care (2024), World Falls Guidelines (2022).