1: “What do you want to be doing in your later decades?”
“What is your plan for the rest of your life?”
These are the questions Dr. Peter Attia asks his clients to answer in his terrific book Outlive: The Science and Art of Longevity.
He wants them to reflect. To sketch out their future.
Most of us have watched our parents or grandparents getting older. Beginning in their seventies, they often undergo a steep physical decline. In the final decade of their lives, many cannot participate in the activities they love to do. In some cases, there is unfortunate pain.
Peter’s insight?
“My patients rarely expect this decline to affect them,” he writes.
“We almost expect this to happen to our elders, and even with this knowledge, relatively few of us take measures that might help ourselves avoid that fate.”
2: Which is why he asks his clients to reflect on how they want to live as they age. He wants them to focus on their endgame, which most of us might prefer to avoid thinking about.
“I ask them to be very specific about their ideal future,” he writes. “What do they want to be doing when they are older?”
What’s surprising?
“It’s striking how rosy their predictions tend to be,” Peter observes. “They feel supremely confident that they will still be snowboarding or kickboxing, or whatever else it is they enjoy doing now, when they’re in their seventies and eighties.”
Peter stops them. He explains: “Look, in order to do that, you will need to have a certain level of muscular strength and aerobic fitness at that age. But even right now, at age fifty-two (for example), your strength and your maximum volume of oxygen uptake (VO2 max) are already barely sufficient to do those things, and they are virtually certain to decline from here.”
3: One tool Peter uses he calls “the Centenarian Decathlon”.
Think of it “as the ten most important physical tasks you will want to be able to do for the rest of your life,” he writes.
“Some of the items on the list resemble actual athletic events, while some are closer to activities of daily living, and still others might reflect our own personal interests. I find it useful because it helps us visualize, with great precision, exactly what kind of fitness we need to build and maintain as we get older. It creates a template for our training.”
Peter begins by providing his patients with a list of more than fifty physical tasks. He asks them to select those items they want to be able to perform in their ninth, or better yet tenth, decade. Items on the list include:
1: Hike 1.5 miles on a hilly trail.
2: Get up off the floor under our own power, using a maximum of one arm for support.
3: Pick up a young child from the floor.
4: Carry two five-pound bags of groceries for five blocks.
5: Lift two twenty-pound bags of groceries for five blocks.
6: Have sex.
7: Do thirty consecutive jump-rope skips.
So which ones do they choose?
“All of them, typically,” he notes. “They want to be able to hike a mile and a half, or carry their own groceries, or pick up a great-grandchild, or get up if they fall down. Or play eighteen holes of golf, or open a jar, or fly somewhere in a plane. Of course they do.”
Now it’s time for some mathematics.
The future grandchild will weigh around thirty pounds. “That’s basically the same as doing a squat while holding a thirty-pound dumbbell in front of you. Can we do that now, at age forty?
“Most likely. But now let’s look into the future. Over the next thirty or forty years, our muscle strength will decline by about 8 to 17 percent per decade—accelerating as time goes on.
“So if we want to pick up that thirty-pound grandkid or great grandkid when we’re eighty, we’re going to have to be able to lift about fifty to fifty-five pounds now. Without hurting ourselves. Can we do that?”
Let’s say we want to hike that hilly trail. It will require a VO2 max of roughly 30 ml/kg/min. Assume we are 40. If we score 30 currently, we’re average for our age.
“But I’m afraid that’s not good enough,” Peter writes, “because our VO2 max is also going to decline. So we’re going to have to go ahead and cross that hike off our list. We can pull it off now, but we likely won’t be able to do it when we’re older.”
Eventually, Peter’s patients understand.
“Together, we come up with a list of ten or fifteen events in their personal Centenarian Decathlon, representing their goals for their later decades. This then determines how they should be training.”
It is not about mindless “exercising.”
Instead, he recommends training with a particular purpose in mind: “To be kick-ass one-hundred-year-olds. . . By fixing our aim at the Centenarian Decathlon, we can make every decade between now and then better as well.”
The real purpose of the Centenarian Decathlon is to help Peter’s patients “redefine what is possible in our later years and wipe away the default assumption that most people will be weak and incapable at that point in their lives.”
More tomorrow.
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Reflection: What do I want to be doing in my later decades? What’s on my list for my “Centenarian Decathlon”?
Action: Journal my answers to the questions above.
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