Aging Well: What Is Peakspan—and What Do You Want to Keep Doing?
Take a moment and picture yourself at 75 or 85.
Don’t just picture a birthday cake with a slightly alarming number of candles. Picture an ordinary Tuesday.
Where do you wake up? Who is there with you? What are you looking forward to?
Maybe you’re heading outside to tend your garden. Maybe you’re meeting friends for lunch, packing for a trip, or picking up your grandchildren. Perhaps you’re wandering through a museum, volunteering, or making dinner for a house full of people you love.
Imagine the details. Can you walk as far as you want to? Carry your suitcase? Hear the conversation around the table? Get down on the floor—and back up again—without needing a committee?
What do you want to remain able to do?
Keep that picture in mind. Because when we talk about longevity, it’s easy to get caught up in years, lab results, and the latest supplement with an ambitious price tag.
But the future most of us want is much more personal: enough strength, energy, clarity, and independence to keep participating in a life we enjoy.
The retirement story that breaks my heart
Most of us know someone who spent years looking forward to retirement.
There were plans. Travel. Hobbies. More time with family. Finally having a calendar that belonged to them.
Then a major health problem changed everything.
Whenever I hear a story like that, I feel such sadness for the person—and for the life they had been waiting to enjoy.
Of course, not every illness is preventable. A serious diagnosis does not mean someone failed to take care of themselves. Even excellent preventive care cannot give us guarantees.
But those stories remind me why planning for the future needs to include our health alongside our finances.
We ask, “Will I have enough money to do the things I want?”
I also want us to ask, “What can I do now to support the health and abilities those plans will require?”
That brings us to a newer idea in aging research: peakspan.
What is peakspan? Lifespan, healthspan, and capability
Here’s the distinction:
· Lifespan: How long you live.
· Healthspan: The years you live without major disease or disability.
· Peakspan: The period when a particular ability stays close to your personal best.
In a 2026 perspective paper, researchers proposed defining peakspan as the age interval during which someone maintains at least 90% of their peak performance in a specific physical or cognitive domain. [1]
That last part matters. Strength, endurance, and different thinking skills do not all follow the same timeline. Your body does not send a group email announcing, “Everyone, we peaked on Thursday.”
Peakspan is an emerging research framework, not a validated clinical score we can calculate from routine bloodwork. Most of us also lack measurements of our lifetime best.
Still, it raises a useful question: Are we paying enough attention to function before disease or disability develops?
You can have reassuring lab results and still notice that stairs are harder, your balance feels less dependable, or you’ve started declining invitations because the activity feels like too much.
Those changes deserve attention.
And no, this does not mean competing with your 25-year-old self. Aging well can include chronic illness, disability, and adapting your activities. The goal is to support the life that matters to you, with the body you have.
A marathon runner taught me something important
One of my medical school classmates was a marathon runner.
He also had a heart attack during medical school.
He had familial hypertriglyceridemia—an inherited condition involving elevated triglycerides—that he hadn’t known about.
That experience stayed with me. Someone could be young, highly active, and still have an important risk that exercise alone did not reveal or eliminate.
Please keep exercising. It is one of the most valuable things you can do for your health.
But being able to run a marathon is not a complete cardiovascular evaluation.
And this subject is personal for me, too.
My family history showed up in my kitchen
My dad had a heart attack in my kitchen.
Twice. A few weeks apart.
Thankfully, we got him straight to the hospital, and he recovered well. But those experiences brought our family’s cardiovascular risk into very sharp focus.
I know I have a very high level of lipoprotein(a), often shortened to Lp(a). This is a largely inherited cardiovascular risk factor that isn’t included in a standard cholesterol panel. Healthy habits remain important, but they generally have little effect on the Lp(a) level itself. [2]
So I pay close attention to the factors I can influence, including cholesterol and blood pressure, alongside my other preventive care.
I’ve also had a coronary artery calcium scan, and my score was zero.
That is reassuring. It means the scan did not detect calcified plaque in my coronary arteries. But it does not rule out all plaque or give me a lifetime exemption from heart disease. [3]
I appreciate the good news, and I keep planning.
Knowing my risk helps me decide where to focus my efforts.
Prevention should fit your risk
You and I may have very different family histories, blood pressure readings, cholesterol levels, and medical backgrounds. Our prevention plans should reflect those differences.
Doctors call this risk stratification. It means putting the relevant pieces together to decide what level of prevention makes sense for you.
That starts with your personal and family history, blood pressure, cholesterol, blood sugar, tobacco exposure, and other relevant factors.
Current cardiovascular guidelines recommend measuring Lp(a) at least once. Depending on the situation, we may also use longer-term risk estimates, selected additional blood tests such as ApoB, or a coronary artery calcium scan to help guide decisions. [4]
These tools have different purposes. A calcium scan looks for calcified plaque; it does not replace evaluation of symptoms. Genetic testing is useful for selected questions, rather than something everyone needs simply because they want to age well.
When a family history suggests an inherited condition, targeted testing and genetic counseling can help us decide what the findings would mean for screening or treatment. [5]
The question before ordering a test is: Would the result change what we do?
Sometimes the plan involves lifestyle changes. Sometimes it involves medication. Often it involves both.
If treatment for cholesterol or blood pressure is appropriate, taking it is not a failure of healthy living. It is another way to protect the future you’re working toward.
Train for your future Tuesday
Now return to the day you imagined at the beginning.
What will it ask of your body?
Travel might mean long walks and stairs. Gardening involves bending, lifting, and getting up from the ground. Grandchildren have a remarkable ability to turn a quiet afternoon into an agility assessment.
Different activities require different abilities.
One useful takeaway from Dr. Stacy Sims’s writing on exercise and aging is that even a consistent exercise habit can leave gaps. The activities we love may develop some capacities more than others. [6]
Walking is wonderful for endurance. We still need to challenge our muscles. Strength training is valuable. Our hearts and lungs need work, too.
A balanced approach includes:
· Aerobic activity for endurance: brisk walking, cycling, swimming, dancing, or other activities you enjoy.
· Resistance training for strength: weights, bands, machines, or appropriately challenging body-weight exercises.
· Balance and mobility practice to help you move confidently.
General guidelines recommend at least 150 minutes of moderate aerobic activity each week and muscle-strengthening activity on at least two days. You can work toward that gradually. Small amounts count. [7]
Power—the ability to produce force quickly—also matters for everyday tasks and responding to a stumble. How you train it should fit your current abilities, joint and bone health, and medical history.
No one needs to start by leaping onto a box because someone on the internet said it was “non-negotiable.”
The useful question is: What can you safely build from where you are today?
Feed the future you’re building
Imagine you’ve started strength training, but breakfast is coffee, lunch is whatever you find between appointments, and dinner is mostly an apology to yourself.
Your muscles would like a word.
Nutrition for aging well needs to support strength and activity while also supporting cardiovascular and metabolic health.
My starting point is familiar: include protein, add colorful fruits and vegetables, and build meals around mostly minimally processed foods.
Protein sources might include fish, eggs, poultry, yogurt, tofu, beans, or lentils. Fiber-rich foods—vegetables, fruit, legumes, and whole grains—also deserve regular space on the plate. [8]
Enough nourishment matters. If you’re losing weight, particularly when your appetite is reduced, we need to pay attention to what you eat and how your strength is holding up.
The scale can report that you’re smaller. It cannot tell us whether you’re better prepared to lift your suitcase.
Protein needs and weight goals should be individualized, especially when kidney disease or other conditions affect the plan.
And your meals should be enjoyable. A plan for a better life ought to leave room for dinner you actually want to eat.
Aging well through midlife and menopause
For women, perimenopause and menopause make this conversation especially timely.
Estrogen helps protect bone. As levels decline around menopause, bone loss accelerates—often without symptoms. You generally cannot feel your bone density falling, which is why risk assessment and bone-density testing matter. [9]
This is a good time to review strength training, nutrition, calcium and vitamin D needs, fracture risks, and whether treatment is appropriate.
It is also a time to reassess sleep, symptoms, and cardiovascular risk.
If hot flashes repeatedly wake you up or vaginal discomfort affects intimacy, those problems deserve treatment. “Welcome to midlife; please lower your expectations” is not a care plan.
For women and men alike, new fatigue, reduced strength, or changes in sexual function deserve thoughtful evaluation. Hormones may be part of the picture, but we should not assume they explain everything.
Midlife gives us a chance to respond to changes and plan ahead while there is still much to build and protect.
Your brain—and your people—belong in this picture
In your imagined future, were you alone with a perfect cholesterol panel?
Probably not.
There were people. Conversations. Places to explore. Things to learn.
Aging well includes caring for sleep, mood, hearing, vision, and the medical conditions or medications that may affect thinking and daily function. It also includes staying engaged with other people and meaningful activities. No hobby or puzzle app guarantees protection from dementia, and physical health and mental engagement deserve attention. [11]
Learn something unfamiliar. Play music. Join a group. Try a recipe complicated enough to require reading the instructions twice.
Sleep deserves its own attention. Many adults need around seven to nine hours. Persistent insomnia, loud snoring, or daytime sleepiness should prompt a conversation rather than an escalating relationship with caffeine. [12]
And remember the less glamorous preventive work: appropriate cancer screening, vaccinations, and routine care.
It may not make an exciting social media reel. It can still make a meaningful difference.
Give your future self something to work with
Return to that ordinary Tuesday at 75 or 85.
Write down three things you want to remain able to do. Be specific.
“I want to travel” is a start. “I want to walk around a new city without sitting out half the afternoon” gives us something to plan for.
Then ask:
· What abilities will those activities require?
· What symptoms or limitations are getting in my way now?
· What risks should I understand?
· What is one realistic step I can take this week?
At Focused Health & Wellness, I want to help you connect those goals with a practical plan: movement, nutrition, symptom care, appropriate testing, risk reduction, and treatment when it makes sense.
We can follow laboratory trends and blood pressure, but also how you sleep, how far you can comfortably walk, and whether you feel stronger and more capable.
We cannot promise exactly what the future will bring. We can take meaningful steps to support it.
Your future self may want to carry a suitcase, plant tomatoes, or dance at a family wedding. Let’s give that person something to work with.
Ready to build a personalized plan for aging well? Contact Focused Health & Wellness to schedule a visit. In-person care is available in Jefferson City, with telehealth for patients located in Missouri.
Sources
1. Peakspan: Defining, Quantifying and Extending the Boundaries of Peak Productive Lifespan. Aging and Disease (2026). Read source
2. American Heart Association. Lipoprotein(a). Read source
3. American Heart Association. More than 40% of adults with no known heart disease had fatty deposits in heart arteries. Read source ; Mehta et al. Independent Association of Lipoprotein(a) and Coronary Artery Calcification With Atherosclerotic Cardiovascular Risk. JACC (2022). Read source
4. American Heart Association. Top Things to Know: 2026 Guideline on the Management of Dyslipidemia. Read source
5. National Human Genome Research Institute. Genetic Counseling FAQ. Read source
6. Dr. Stacy Sims. Exercise and Aging: What Active Women Need to Know (2026). Read source
7. U.S. Department of Health and Human Services. Physical Activity Guidelines: Questions & Answers. Read source
8. National Institute on Aging. Healthy Meal Planning: Tips for Older Adults. Read source
9. Endocrine Society. Menopause and Bone Loss. Read source
10. The Menopause Society. 2022 Hormone Therapy Position Statement. Read source ; USPSTF. Hormone Therapy for Primary Prevention of Chronic Conditions. Read source
11. National Institute on Aging. Cognitive Health and Older Adults. Read source
12. National Institute on Aging. Sleep and Older Adults. Read source
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