Better health in our 80s and 90s

80s Topics …

• Challenges and preventing problems in our 80s and 90s
• Essentials: exercise, diet and other priorities
• Risks, warning signs and symptoms
• Screenings & check-ups
• Target heart rate when exercising
• Health records and directives
• What to do – today – to improve your health
• Checklist – proactive steps for the 80s
• Your proactive health plan
• Appendix A – Physical health issues
• Appendix B – Disease and illness risks

Challenges and preventing problems in our 80s and 90s

In our 80s, the changes and challenges continue, so it’s important to be more vigilant about identifying early warning signs and more diligent about regular health checks.

Challenges

Preventing health problems

1. Social connection and emotional support
2. Cognitive stimulation and curiosity
3. Light daily physical activity (movement over intensity)

These three factors are strong predictors for people in their 80s of future quality-of-life, but they are not the only ones. There are other proactive practices that are necessary for good health, including diet and nutrition; regular check-ups; good quality sleep and remaining mentally active. A list of these is summarised in the Checklist for the 80s below and explained in the following paragraphs. More information is available by following the links to the resource sections of this guide.

Essentials: exercise, diet and other priorities

Physical activity

Maintaining physical activity is essential for our well-being, despite the aches and pains that we experience more often. Stretching remains important for balance and mobility, particularly joints and muscle groups that are the most important for walking and stability.

Weight-bearing activities should be continued to counter muscle loss and strengthen bones – important in the event of a fall, especially for those people who have osteoporosis.

There are a lot of other activities that are suitable for elder Australians, such as those listed in the guidelines issued by the Australian Department of Health (see Appendix C below) and more information about the importance of regular physical activity can be found in section 3 Physical activity.

Diet and nutrition

Diet still has a very important role to play, which means eating a wide variety of vegetables, legumes, grains and fruits. However, according to the Australian Institute of Health and Welfare, over 91% of Australians over 64 do not meet the recommended minimum consumption of fruit and vegetables.

The right diet will also support your metabolism by keeping your blood pressure, cholesterol, blood sugar and weight within a healthy range. Protein-rich foods will preserve muscle mass and foods with calcium and vitamin D will help support bone health, although sunlight is the best source of vitamin D. If your exposure to sunlight is limited, it is worth considering a vitamin D supplement.

There is a lot of information about the right diet, including foods that contain the necessary vitamins and nutrients, in section 2 Diet and nutrition.

Cognitive engagement – novelty, having a purpose and ongoing learning

To keep our brains sharp, it is important to keep learning – acquiring new skills, or engaging in complex tasks, helps to maintain neural connections. Other important factors for cognitive health include social engagement and purposeful activities such as hobbies, mentoring and creative pursuits that have been shown to enhance mental clarity, and boost motivation: What’s good for your brain.

Positive thinking has many health benefits including preserving cognitive health by lowering stress levels and protecting against anxiety. Mindfulness can also contribute to good mental health – it helps to reduce forgetfulness, improve concentration and increase situational awareness, which is important for reducing the risk of falls: Mindfulness.

The other side of the coin is managing cognitive risks, including loneliness: What’s bad for your brain.

Other priorities for good health

Diet/nutrition, physical activity and cognitive stimulation are not the only factors that are necessary for good health in our 80s. Other factors that need to be managed – Other priorities for good health – include sleep; dental health; stress management and maintaining strong social ties.

reduces stress hormones, supports immune function, and keeps the brain stimulated in ways that solitary activities simply can’t replicate.

Risks, early warning signs and symptoms

It is always important to listen to what our bodies are telling us. This means avoiding the tendency to dismiss any early warning sign as “just ageing”, no matter how minor it may seem – something minor can be an indication of a more serious problem on its way. On the other hand, an early warning sign might be “just ageing”. How do you know the difference?

Have a look at the table below. There is also a table in section 7 with a list of early warning signs and symptoms – Early warning signs – including “what’s normal, and what’s not”. However, many signs or symptoms are indeterminate and can point to different problems, so it is always wise to be sure by checking with your GP. Further reading: What’s normal and what’s not as we age

There is some supplementary information about these risks, and some others, in the appendices at the end of this section.

Health risk	Signs or symptoms	Notes
Arthritis	Pain, swelling and reduced range of motion can affect daily tasks	Both rheumatoid and osteo arthritis can appear for the first time in our 80s.
Cancer	Often no early warning signs	Routine screening (bowel, breast, prostate) usually stops in the late 70s. Cancer risk persists, but detection relies on symptoms rather than screening.
Cognitive decline	Forgetfulness gets worse and memory can show signs of impairment. Difficulty with words increases.	While some cognitive slowing is normal with age, the risk of more significant decline, including mild cognitive impairment, rises sharply in the 80s. Brain regions involved in memory and learning shrink, and blood flow decreases.
Depression	Low mood (including irritability), energy and motivation; poor sleep; withdrawal from social interactions	Loss of loved ones, reduced mobility and loneliness may call for mental health support. Social support and community engagement are important.
Diabetes: Type 2	Being overweight and lack of exercise are early warning signs although often there are often no signs	The risk remains high and is often undiagnosed because the signs can be mistaken for normal ageing. Screening is recommended – blood glucose and kidney function – especially for those with risk factors like hypertension, obesity, or family history.
Dementia	Severe memory loss, disorientation, difficulty recognising people/places	Dementia prevalence rises steeply in the 80s and 90s. Supportive care, routine and caregiver involvement become central.
Falls and fractures	Deterioration in balance and mobility	Hip fractures and hospitalisations rise sharply; osteoporosis exacerbates the danger. Prevention focuses on balance training, home safety, and vitamin D/calcium support.
Frailty & functional decline	General weakness, slower walking, reduced grip strength, difficulty with daily tasks	Frailty becomes a defining risk in the 80s and beyond. It increases vulnerability to falls, hospitalisation, and loss of independence.
Hearing decline	Difficulty picking up words especially in a noisy environment	Hearing problems can contribute to cognitive decline so they should not be ignored
Heart disease, high blood pressure and stroke	Being overweight and breathlessness after mild physical activity are possible indicators but there are not always any pre-warning signs	The risk remains high. Heart disease remains a major cause of death into our 80s. Arrhythmias and heart failure are far more common. Blood testing (cholesterol and blood sugar) and blood pressure should be checked.
Infections and sepsis	Confusion, fever, rapid decline	Older adults are highly vulnerable to urinary tract infections, pneumonia, and sepsis. Even minor infections can cause hospitalisation.
Pancreatic cancer	Usually no early warning signs; symptoms include obesity, type 2 diabetes, smoking and family history of cancer	This risk increases significantly and is one of the more serious health threats in the 80s with a high mortality rate. There is no general screening although people at high risk (family history or relevant mutation) may warrant specialised screening
Respiratory infections	Laboured breathing; shortness of breath; wheezing	Pneumonia, influenza, and COVID-19 are especially dangerous. Vaccination and early treatment are vital.
Vision problems	Cataracts – deterioration in vision clarity; glaucoma – no early warning signs	Increased risk needs to be managed by regular checkups

Further reading: Health risk factors for older Australians

Screenings & check-ups in our 80s and 90s

Test or checkup	Recommendation
Bone health and falls	Forewarning of the degree of risk (by undergoing fall testing and bone density testing) can be helpful
Cancer	Regular skin cancer testing remains advisable; other cancer testing depends on various factors that you need to discuss with your GP
Cardiovascular health	Ongoing blood tests (for cholesterol, blood sugar, etc) and blood pressure checks are helpful for providing information, especially if there are no early warning signs
Diabetes & kidneys	Blood glucose and kidney function tests are recommended for people over 60, especially those with risk factors like hypertension, obesity or family history
General health	Periodic GP visits are recommended for a broad review
Mental health	Screening may be advisable if symptoms warrant
Vaccinations	Shingles and pneumococcal. Regular flu and Covid 19
Vision & hearing	Biannual checks to support safety, mobility and social engagement

Please keep in mind that it may be advisable to get screenings done more regularly if there is either personal or family history of a health issue or relevant symptoms. Section 8.2 – Conditions that require screening – has a long list of available tests.

Target heart rates for exercising

Your target heart rate will depend on your objective, your age and your level of fitness. The first step is to work out your maximum heart rate (MHR) for exercising which can be calculated by subtracting your age from 220. Therefore, if you are 80, your MHR is 140 bpm (beats per minute) although this can vary depending upon level of fitness and state of health, etc. If your goal is gentle walking, the rule of thumb is to aim for 50-60% of MHR i.e. a heartbeat between 70 and 84 bpm. Before embarking upon anything above zone 2, it is wise to consult your doctor.

Goal	Zone	BPM age 80	Activity examples
Light exercise or recovery	Zone 1 (50–60%)	70-84	Gentle walking, yoga, light stretching
Aerobic / Fat burning	Zone 2 (60–70%)	84-98	Brisk walking, steady swimming, light cycling
Cardiovascular endurance	Zone 3 (70–80%)	98-112	Jogging, moderate cycling, swim intervals

Health records & directives

Health records: If you are injured or suddenly fall ill away from home, and need to be treated urgently, your medical records could be critical to the outcome of your treatment. That’s why it’s important to ensure they are accessible online. Talk to your doctor about this: see section 6.11 – Important Health Documents

Why a Will is not enough: If you are in an accident or become very ill, perhaps incapacitated, or even in a coma, who will pay your bills, arrange banking and otherwise manage your affairs?

What to do – today – to improve your health

1. Make a commitment to become more proactive and tell someone close to you about your decision, what you are going to do and when.

2. Make a list of proactive steps you are going to take and when you are going to start on each one.

Below is a brief checklist, and a template for a proactive plan that should be adapted by you for your specific circumstances, level of fitness and state of health. The more you cross-reference the various links in this section about the 80s and 90s to different parts of the Proactive Health Guide, the better your personal plan will be.

Checklist – proactive health for the 80s

• Keep moving – daily – even light activity protects mobility and confidence
• Weight-bearing exercise is essential (e.g. resistance bands)
• Practise balancing to prevent falls (tai chi, single‑leg stands, heel‑to‑toe walking)
• Review medications and supplements for side effects and interactions
• Monitor bone density and fracture risk; address issues early
• Eat enough protein to maintain muscle (often overlooked in this decade)
• Stay hydrated – thirst cues weaken significantly with age
• Protect skin – fragility increases; moisturising and gentle care help prevent tears
• Maintain regular medical checks (heart, eyes, hearing, dental)
• Keep the brain active with learning, creativity, conversation and problem‑solving
• Ideally, have a purpose – engage in purposeful pursuits
• Stay socially engaged to protect mental health
• Prioritise sleep routines to support mood, memory and energy
• Adapt the home environment for safety (lighting, rugs, handrails, clear pathways)
• Use mobility aids confidently – they prevent falls and preserve independence
• Seek support early for mobility, mood or significant memory changes.

Your proactive health plan

Making, and following, a proactive health plan can make a significant difference to your health. The more specific and detailed the plan is, the better. The plan needs to set out what areas of proactivity you intend to focus on and what you intend to do. There is a template set out below that needs to be adapted for your particular needs and current state of health. It should be quite detailed and specific. For example, instead of your list saying “Aim for 2 hours of moderate activity per week”, it is better to say something like “Walk 1.5 km at a brisk pace each Wednesday and Saturday morning”; instead of saying “Maintain a consistent sleep schedule” say “Go to bed at 10 PM and get up at 6:30 AM each day”.

You may want to do this on an Excel spreadsheet so that you can put in the starting date and have a column for each day of the month to keep track of how well you are progressing with your plan. Ideally, each day you will put a tick or a cross against each step that you have decided to embark on. Remember, consistency is the key – it is better to do a little bit every day, and continue doing it until it becomes a habit (see section 9 – Healthy people have better habits) than to do too much and burn out. That means – don’t set your sights too high when you start.

If you also want to track changes to various aspects of your health after embarking on your plan, have a look at section 10.2 – Track your progress

Proactivity focus	Details of what I am going to do	How often	Day 1
Deep breathing – see section 6.3 Breathing	I breathe deeply [in for 4 seconds; hold for 4; out for 4; and hold again for 4] and do it for 1-2 minutes whenever I need a deep breathing boost. The trigger to remind me to do this is … [e.g. when I start to lose concentration OR when I feel tense or under stress OR when I don’t feel happy, etc]	Multiple times throughout the day
Diet & nutrition – see section 2 Diet/Nutrition	I eat a wide variety of vegetables, fruits, legumes and whole grains by adding …. [state specifically what foods you are going to add to your diet]	Daily
	I limit sugar intake, processed foods and salt [be specific what you are going to reduce or eliminate from your diet]	Daily
	I boost my microbiome with probiotic and prebiotic foods [state the specific foods e.g. fermented foods – yoghurt, sauerkraut, etc]	Daily
Exercise – see section 3 Physical Activity	I do 30 minutes of … [e.g. brisk walking] twice per week before breakfast	Tuesday & Friday
	I swim for 30 minutes once per week	Saturday
	I do weights [or use resistance bands] to preserve muscle twice per week	Monday & Thursday
	I do balance exercises (e.g. tai chi, yoga) twice per week	Saturday Wednesday
	I play tennis [or golf, etc] once per week	Sunday
	I do a minimum of 10,000 steps every day	Daily
Medications	I check for interactions or side effects with GP or pharmacist if there are any changes in the way I feel and for any new drug	Insert date
Mental health	I stay mentally active by … (e.g. puzzles, reading) See section 4.2	Daily
	I learn … [e.g. about the 100 years war OR a new language OR a musical instrument]	Daily
	I work on brain health [specify what you are going to do] See cognitive training section 4.2	Insert when
	I work on being positive See section 5.2	Insert when
	I take part in a purposeful activity [ e.g. volunteering or a project such as renovating part of your garden] See section 4.2	Insert date
Mindfulness – see section 5.3 Mindfulness	I engage in mindfulness regularly during each day. The trigger to remind me to do this is … [when I daydream OR when I find my posture is poor OR when I lose concentration OR when I walk through a doorway OR … etc]	Multiple times per day
Screenings & check-ups	Blood test including PSA and blood sugar; Colonoscopy; Mammogram; Skin cancer check; Eye test; Bone density scan, etc	Insert dates (month and year) for each one
Sleep hygiene – see section 6.1 Sleep	I go to bed at 10pm and get up at 6:30am	Each day
	No screens 1 hour before bed	Each day
	Address snoring or sleep apnoea with GP	Insert date
Social connections	I join a community group or interest-based club [be specific about what and when]	Insert date
	I stay engaged with friends and family, or community groups [be specific about what you are going to do and when] See section 4.2	Weekly or monthly
Symptoms & early warning signs	I monitor changes to the way I feel and keep a written record of any signs that I think are unusual. See section 7.2	Ongoing
Vaccinations – see section 6.8 Vaccinations	I get an annual flu and pneumonia shot; I get a Covid 19 booster	Insert date for each one
Other	This is for other issues that may be important for you

APPENDIX A

Physical health issues in our 80s and 90s

• Arthritis: Almost half of Australians aged 75+ live with arthritis, which has a significant impact on mobility, balance and independence. Symptoms may include persistent joint pain, visible swelling and difficulty with stairs or grip strength. Treatment can include tailored exercise programs including strengthening muscles to support joints, and medications like NSAIDs or corticosteroid injections: see section 8.6 – Arthritis.
• Bone health: Maintain calcium (1,200 mg/day) and vitamin D (800–1,000 units/day).
• Cardiovascular: It is helpful to maintain regular aerobic and strength-based exercise (see section 3 – Physical activity) and to monitor blood pressure, cholesterol, and blood sugar annually (section 8.3 Heart disease and 8.4 High blood pressure). See also disease and illness risks below.
• Cognitive changes: Forgetfulness may increase; learning new information becomes harder, partly because of deteriorating connections between the neurons.
• Diet, nutrition and hydration: Focus on nutrient-rich foods, fibre, lean protein and healthy fats. Aim for 6-8 cups per day of fluids: see section 2 – Diet and nutrition.
• Eyesight: testing should be continued for cataracts and glaucoma.
• Falls and fractures: the incidence of falls and fractures increases because of deteriorating balance which makes it important to continue balance exercises; the consequences are more severe if osteoporosis is present
• Hearing: age-related hearing loss continues and needs to be checked – it can exacerbate cognitive decline.
• Mobility and muscular health: Prioritize gentle movement – walking, stretching and balancing exercises – to maintain flexibility and muscle tone. It is also good to do exercises to strengthen your core and stomach muscles to support posture and prevent back pain. Resistance bands will help to offset muscle loss.
• Osteoarthritis: See Arthritis above
• Osteoporosis: See Bone Health above
• Physical activity: Essential for good health to support vitality and resilience: see section 3 Physical activity. However, pain, stiffness and reduced mobility become more common in which case you may want to try a form of exercise that is gentler on your joints such as water aerobics or tai chi.
• Respiratory: Breathing problems, such as chronic bronchitis and emphysema, become more common, and can affect sleep and even lead to fatigue and infections. Asthma may also worsen due to reduced lung elasticity. If breathlessness starts to affect daily activities, it’s important to be test. It is also important to have flu and pneumococcal vaccination is to reduce complications.
• Sleep quality: If ongoing tiredness, consider a sleep assessment to rule out apnoea or other disruptions (see section 6.1 – Sleep). If you feel more than tiredness, and it persists for more than 2 weeks, talk to your GP – it could be fatigue.

APPENDIX B

Disease & illness risks in our 80s and 90s

• Cancer: Different types are listed in the table in section 8.2 Conditions that require screening
• Diabetes (Type 2): Risk remains high so annual tests for blood sugar and kidney function are recommended, particularly if you have a family history, if you start putting on weight or do not do regular exercise.
• Dementia: 1 in 3 people over 85 can be affected by severe cognitive decline
• Depression: Loss of loved ones, reduced mobility and loneliness may call for mental health support
• Heart disease: Heart problems (see section 8.3 – Heart disease) are a major cause of death during the 80s. Blood testing (cholesterol and blood sugar) and blood pressure should be checked, particularly if you have any increased risk factors, such as family history or lifestyle (overweight, sedentary, etc) or symptoms, such as breathlessness or swelling. It is also wise to check for plaque build-up in your arteries – ask your GP about a calcium score to gauge whether there are any blockages that can be present even when cholesterol is within the acceptable range. Your risk will be reduced if you maintain a healthy weight; avoid processed foods, smoking and excess alcohol.
• Medication safety: Some people need to take multiple medications at the same time. This increases the risk of side effects and adverse interactions between drugs so, if they are prescribed by different doctors, it’s very important for your GP or pharmacist to review your medications periodically.
• Mental health: Loneliness, grief and cognitive changes may need to be addressed including the risk of depression, anxiety and dementia. It’s important to continue with social connections and purposeful activities which regulate stress hormones. If you notice any cognitive impairment or mood swings, it’s a good idea to talk to your GP about screening. Consideration should be given to advanced care planning if this has not already been done [see Health Records and Directives above].
• Osteoporosis becomes more common. Bone density scans may be warranted. Management includes calcium, vitamin D, weight-bearing exercise and sometimes medication.
• Pelvic, urinary and sexual health: Urinary incontinence, pelvic organ prolapse and sexual health concerns may become relevant. It may also become advisable to review continence aids and pelvic floor support; consider topical hormone therapies; address sexual wellbeing, relationship and intimacy needs.
• Stroke: Stroke occurs when blood flow to the brain is interrupted, either by a blockage or a bleed. As a test of whether someone has had a stroke, remember the acronym: F.A.S.T.  Face (drooping), Arm (weakness), Speech (difficulty), and Time (to call emergency services – fast!). Other symptoms may include sudden confusion, vision changes, dizziness or severe headache. The risk of having a stroke is highest in our 80s. To reduce risk, regular health checks are essential – particularly for blood pressure, cholesterol and heart rhythm. Lifestyle changes such as quitting smoking, maintaining a healthy weight, staying active and managing chronic conditions like diabetes can dramatically lower stroke risk. If atrial fibrillation (irregular heartbeat) is present, medical management is crucial to prevent clot formation. Over 80% of strokes are preventable with proactive care.
• Thyroid: Thyroid hormones regulate metabolism, so imbalances can lead to symptoms like fatigue, weight changes, mood shifts and temperature sensitivity. The risk of a thyroid disorder increases in our 60s and can be detected by a blood test. Consistent treatment means people can live normal lives but, untreated, it can lead to complications such as heart failure, stroke, infertility or severe depression.

APPENDIX C

Physical activity guidelines (65 and older)

Guidelines have been issued by the Australian Department of Health, Disability and Ageing: https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-older-australians-65-years-and-over