What Does the Phrase “Aging Well” Really Signify in Terms of Strength and Independence?

The short answer is that the World Health Organization states that healthy ageing means developing and maintaining the functional ability which allows for a good quality of life in older age; in simple terms, this means remaining able to be and do the things you value. Strength is essential in almost all of these activities, whether it’s getting up from the floor, carrying your own bag or catching yourself when you trip. And, unlike your genes, it is something you can train at any age.

A better definition of aging well

It is not a matter of having no wrinkles or even of being free from disease to age well. The World Health Organization defines functional ability as comprising the skills which enable people to meet their basic needs; to learn, grow and make decisions; to be mobile; to establish and maintain relationships; and to contribute to society (WHO).

The World Health Organization also points out that there is no such thing as a typical older person; while some people in their eighties have a physical and mental capacity similar to that of individuals in their thirties, others of the same age require assistance with dressing and eating. Much of this difference has developed over the course of decades and therefore the decisions you take when you are fifty or sixty are important.

Why strength is the foundation

A clear indication of this comes from a study led by Canada. The PURE study, which was carried out at McMaster University, assessed grip strength in 139,691 adults aged between 35 and 70 years in 17 countries, one of which was Canada. For every 5 kg less grip strength there was a 16 per cent increased risk of dying from any cause, and grip strength was a better predictor of death than systolic blood pressure (Leong et al., Lancet 2015, via Healio).

Here are two honest reservations. While grip strength is an indicator of general physical strength rather than a magical solution, pressing a stress ball will not affect your future. Moreover, the study was observational in nature, and the researchers themselves have suggested that trials should be carried out to determine whether increasing strength reduces these risks. That said, it is in line with a substantial amount of evidence which connects muscle-strengthening exercises to longer and healthier lives.

Falls: the independence threat nobody plans for

Falls are the situation which most suddenly results in a loss of independence. In Canada they account for 89 per cent of hospitalisations among adults aged 65 and over because of injury. Nearly two-thirds of these hospitalisations are among women and more than one third involve a hip fracture. The number of deaths caused by falls in this age group increased by 51 per cent between 2017 and 2022 (Public Health Agency of Canada, 2025).

The good point is that falls are one of the most preventable of the outcomes in the study of aging.

Exercise prevents falls, but the type matters.

The gold standard for summarising evidence on health matters, a Cochrane review, examined the effects of exercise in preventing falls among adults aged 60 and over who live in the community. The findings it reached are as follows (Sherrington et al., BJSM 2020, abridged Cochrane review; summary):

That final point is important and explains why this series stresses ‘strength and balance’. Weight lifting develops the engine, while balance training teaches your body how to use it over time. The Osteoporosis Canada guideline of 2023 makes the same recommendation, advising balance and functional training at least twice a week (Morin et al., CMAJ 2023).

Bone: strength training can help, done right

For many years it was advised that women with low bone density should avoid heavy lifting. This was challenged by the LIFTMOR trial, which randomly assigned 101 postmenopausal women who had low bone mass and an average age of 65 to either eight months of twice-weekly, 30-minute supervised high-intensity resistance and impact training or to a low-intensity exercise programme carried out at home. Spine bone density increased by 2.9% in the group that did the lifting and decreased by 1.2% in the group that did the home exercises, and the lifting group also showed improvements at the hip (Watson et al., JBMR 2018; full text). A single mild adverse event took place during the training and there were no fragility fractures (Watson et al., 2018).

The caveat is that the participants underwent screening and were under close supervision. If you have osteoporosis, it is advisable to gradually increase your lifting with the help of a qualified professional rather than doing so on your own.

What aging well looks like in real life

Independence can be understood in terms of the various daily tasks, as shown in the following breakdown.

How I’d apply this: a 58-year-old who travels and doesn’t want fitness to be her job

She is 58, travels frequently, and her greatest fear is not wrinkles but becoming a person who is unable to travel alone. Here is the way I would present her training.

Begin with her current state at 80 years of age; I’ll ask her to put down three things that she would still like to be doing when she reaches that age. These are travelling alone, lifting her own carry-on luggage and getting down on the floor with her grandchildren. These three points then form the basis of all the exercises and are more important than any reading on a scale.

In each session you should include a period of balance training—spending two to three minutes at the end of every strength session on exercises such as single-leg stands, heel-to-toe walking, and stepping in different directions. The Cochrane evidence makes it clear that this is an aspect which is not covered by strength training alone.

Keep practicing how to get up from the floor. Once a week, do this slowly and if necessary use a chair for support. It is the ability that people most frequently fail to retain without realising it and the one that is most important following a fall.

You should ask your doctor about your bone health. The guidelines produced by Osteoporosis Canada state that postmenopausal women who are 50 years of age or older should be evaluated for fracture risk factors (guideline appraisal). Once you know your bone condition, this will determine how heavily we proceed and how quickly.

Once a year, on her birthday, carry out a re-test consisting of the five-rise chair test, single-leg balance, a floor get-up, and her heaviest carry. If these tests either remain stable or show improvement from year to year, then she is aging well, no matter what the calendar indicates.

Frequently asked questions

Sources

1. 1Fischbacher M, Weeks BK, Beck BR. The influence of antiresorptive bone medication on the effect of high-intensity resistance and impact training on osteoporotic fracture risk in postmenopausal women with low bone mass: protocol for the MEDEX-OP randomised controlled trial. BMJ Open. 2019;9(9):e029895. Griffith repository
2. 2Leong DP et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet. 2015;386(9990):266–273. Healio summary
3. 3Morin SN et al. Clinical practice guideline for management of osteoporosis and fracture prevention in Canada: 2023 update. CMAJ. 2023;195(39):E1333–E1348. CMAJ; appraisal
4. 4Public Health Agency of Canada. Falls among older adults in Canada: data blog, November 2025. Health Infobase
5. 5Sherrington C et al. Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review. Br J Sports Med. 2020;54(15):885–891. PDF
6. 6Watson SL et al. High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: the LIFTMOR randomized controlled trial. J Bone Miner Res. 2018;33(2):211–220. Journal
7. 7World Health Organization. Healthy aging and functional ability (Q&A). who.int