Longevity has become a marketing word, attached to supplements, scans and programs with large price tags. The evidence points somewhere less glamorous and more useful. Most of what helps people live longer and stay independent is well known: fitness, strength, sleep, steady blood pressure, sensible screening and a doctor who follows the numbers over time.

This article lays out a practical plan for the year, built around an annual physical and the conversations that follow it.

Start with a thorough yearly visit

A good annual visit is more than a checklist. It is the time to look at trends: weight and waist, blood pressure at home and in the office, cholesterol, blood sugar and kidney function, compared with last year and the year before. Our article on your annual physical covers the screenings the evidence supports by age.

If you have Medicare, it helps to know the difference between visits. Medicare Part B covers a yearly wellness visit once every 12 months, which Medicare describes as a conversation-based visit to create a personalized prevention plan. Medicare is clear that it is not a routine physical exam.

At Legacy Medical, the annual executive physical includes lab work and an ECG, with time afterward to go through the results together.

Fitness and strength: the two strongest levers

Cardiorespiratory fitness is one of the best predictors of how long people live, and strength is what keeps them independent. The federal guidelines for older adults call for at least 150 minutes a week of moderate aerobic activity, at least two days of muscle strengthening, and balance activities.

  • Set one fitness goal for the year, such as walking briskly for 30 minutes most days.
  • Add strength training twice a week. See strength training after 50.
  • Track something simple, such as how long a familiar walk takes. See VO2 max and fitness.

Know your numbers, and the ones worth adding

Blood pressure, LDL cholesterol, A1c and kidney function do most of the work in predicting heart attack, stroke, diabetes and kidney disease. Beyond those, a few tests can add useful detail for some people: a one-time lipoprotein(a), an ApoB, or a coronary calcium score when a treatment decision is close. Our article on ApoB and lipoprotein(a) explains when they help.

More testing is not automatically better. Each test should answer a question that would change what you do. Tests that are not backed by screening guidelines can turn up incidental findings that need further tests of their own. If you are considering one, ask Dr. Shtern whether it makes sense for you.

Sleep, alcohol, medicines and vaccines

The National Institute on Aging notes that older adults still need seven to nine hours of sleep a night, and that sleep problems become more common with age. Ongoing sleep deficiency is linked by NHLBI to heart disease, high blood pressure, diabetes and other conditions. Alcohol deserves a fresh look too, since current federal guidance simply advises drinking less.

Once a year, go through every medicine and supplement you take with your doctor, including over-the-counter products. Some may no longer be needed, some doses may need adjusting as kidney function changes with age, and some combinations raise the risk of falls or confusion. Vaccines belong in the same review, since recommendations for adults change with age.

A sample year

  • Annual physical: labs, ECG, screenings due, medicine review, and vaccines checked against the CDC adult immunization schedule.
  • A month later: a follow-up to settle any open questions from the results and agree on two or three goals.
  • Every three to six months, as needed: a check-in on blood pressure, blood sugar or a new medicine, often by video.
  • Before hurricane season and before travel: refill timing, an updated medicine list and copies of key records.
  • Any time something changes: a same or next business day visit rather than a wait.

Why continuity is the real advantage

The strongest feature of any longevity plan is a doctor who knows your baseline. A creatinine that edges up each year, a home blood pressure average that drifts, a new medicine that does not sit well with an old one: these are easy to miss in a rushed system and easy to catch when one physician follows them.

That is how Dr. Shtern practices at Legacy Medical: one patient at a time, labs and ECGs in the office, specialist coordination, and phone access around the clock for members. If you would like to build a plan like this with her, start with a complimentary meet and greet.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.