The longevity guru

It's never too late to enjoy an active old age, says a road-to-Damascus doctor who believes healthcare should prioritise prevention over treatment.

- NICKY PELLEGRINO

Anyone who has ever visited a nursing home will have seen them, trapped in their recliners, mouths open and eyes blank, being fed liquids from sippy cups: elderly people who are entirely dependent on their carers. Some look close to death; arguably, their quality of life is so diminished they may as well be. It can be difficult to see these people. None of us want to envisage ourselves spending our final years that way.

But we ought to be envisaging it, says Canadian-American doctor and longevity expert Peter Attia. He believes we should be spending more time with those who are in their final 10 years - what he terms "the marginal decade" - and thinking about what we want for that time in our own lives. We need to focus on our endgame, says Attia.

"I ask every single one of my patients what they want to be doing in their marginal decade," he explains. "The answers are usually quite ambitious. They might say they still want to be able to ski, for example. And so, I make them reverse engineer, and examine what they need to be doing now so that they have the strength, the lateral stability, the cardiovascular fitness, to still be skiing then. I'm not going to tell them they can't do it. But if they are 50 and still skiing with ease now then they need to build up their resources to cope with the next decade or two of decline. Because decline is coming and it's actually quite nonlinear. It really starts to hit us when we're 75."