10.2 Living Longer vs Living Well
Lifespan represents the total number of years a person lives, a measure most people think of when they consider longevity. For example, a person who lives to 80 has a longer lifespan than someone who lives to 78. Healthspan, however, refers to the number of years one remains in good physical and mental health, active, and free from serious disease or disability. An individual who lives to 80 but spends the last 5 years in chronic pain or is incapacitated will likely have a shorter healthspan than someone who lives to 78 and passes away suddenly with minimal decline in function.
Wellness is a process involving making choices that are likely to increase both lifespan and healthspan in the future, thus optimizing both present and future well-being. Many people place tremendous focus on living longer, but without also working to maintain or enhance healthspan, extra years may be spent dealing with discomfort, dependence on others, and chronic illness.
When individuals fail to prioritize healthspan early on, aging and disease progression naturally lead to a steep decline in quality of life. This decline does not necessarily shorten lifespan, as demonstrated by those who live many years with pain or disability. At that stage, some will pursue treatment in an attempt to buy a better quality of life. This reactive approach may only help with acute illnesses and has a limited impact on chronic conditions. While it can extend lifespan, it often falls short of significantly improving healthspan and, in some cases, it can even worsen it.
By contrast, a healthspan-focused approach is proactive (Chapter 3). It prioritizes disease prevention, lifestyle adjustments, and ongoing care at the forefront to maintain strength, independence, and cognitive function for as long as possible. It is not just about adding years to your life but about making those years feel strong, capable, and independent.
Watch: Healthspan versus Lifespan
Video: “What is Longevity? | Peter Attia, M.D.” by Peter Attia MD [3:59] is licensed under the Standard YouTube License.Transcript and closed captions available on YouTube.
In his video, Dr. Peter Attia explains the relationship between healthspan and lifespan under three different scenarios:
- No intervention (white line): Healthspan gradually declines over time, with a sharp drop toward the end of life, indicating both a deteriorating quality of life and a relatively shorter lifespan.
- Treatment-based approach (blue line): Healthspan follows a slightly improved trajectory compared to no intervention, but still shows a noticeable decline before the end of life. This reflects reactive healthcare—treating disease after it arises.
- Healthspan-focused approach (red line): Healthspan is maintained at a higher level for a longer period, with a more gradual decline. Lifespan is also extended. This approach emphasizes proactive strategies like prevention, lifestyle changes, and optimizing overall health to delay the onset of chronic disease and disability.
A Preventative Focus is Key
Focusing on proactive, healthspan-centred interventions not only extends lifespan but also compresses morbidity, allowing individuals to maintain a high quality of life until near the end of life. Notice how those who try to intervene with a treatment-based or reactive approach are often too late.
