By around the age of 65, things start to shift. That’s often when people begin thinking about retirement, or at least stepping back a bit. You’re in your comfort zone at work – not pushing yourself as much, not learning new things – and that lack of challenge accelerates ageing.
But far from being too late, your sixties might actually be the perfect time to consider your health.
63-year-old GP and longevity expert Dr Sabine Donnai explains that we don’t age gradually – we age in jumps. “There are three main ‘age jumps’: around 50, around 65, and again around 80.”
At 50, the shift is mainly hormonal; at 65, it’s neurological – to do with the brain, mindset and lifestyle; and at 80, the changes are largely metabolic (metabolism slows and muscle loss speeds up). Understanding these shifts means you can prepare for them.
So how do we slow down the ageing process at 65?
“It really comes down to what you want from life,” says Dr Donnai. “Not everyone chooses to be truly healthy – and that’s fine – but most people underestimate how much control they actually have. If I told you that you could only ever have one car in your life – even if it were the most expensive car on earth – you’d take care of it meticulously. That’s how you should treat your body.”
This is where hard data can make all the difference. “If I show someone that their blood sugar levels are dangerously high and explain the potential consequences, like heart disease, that often sparks change – not because they’re scared, but because it makes sense. Most people are logical. They just need the information clearly presented.”
A firm believer in the power of a healthy lifestyle to off-set unhealthy genes, Donnai points to what she calls “the wellderly” – people who make it to their 80s without major illnesses like cancer, heart disease or dementia. Contrary to what many believe, genetics plays a surprisingly small role in who joins their ranks.
“Only about 10 to 20 per cent of illnesses are directly related to genetics,” she explains. “The vast majority come from epigenetics – our lifestyle, environment and mindset. You can’t simply blame your genes. Genes load the gun; lifestyle pulls the trigger.”
The key is understanding that health improvements have immediate benefits, not just future ones.
Dr Donnai’s approach centres on four interconnected pillars: activity and exercise, stress and sleep, nutrition and detoxification. Get these right and you’re giving yourself the best possible chance at a vital, independent old age.
Keep on moving: climb stairs and carry shopping bags
“That’s my mantra. Movement keeps you strong, flexible and mentally alive,” she says. From fifty onwards, your muscle mass starts to decline quickly unless you challenge it – and you can’t maintain muscle with walking alone.
“You need resistance training. Does that mean joining a gym? Ideally, yes, but not necessarily. Carry your shopping bags, climb stairs, play golf and pull your own cart. Travel without relying on others to lift your luggage.”
She’s emphatic about this: “The single most important thing you can do is maintain muscle mass and strength. If you lose muscle, you lose metabolic flexibility (the ability to switch burning carbs and fat for energy), resilience and independence. It’s the foundation of everything else.”
The statistics back this up powerfully. “When you go from unfit to fit, the difference in your survival from any illness increases by 80 per cent. Equally if you stay unfit, you increase your risk of dying from any illness in the next 10 years by 80 per cent.” Even moving from completely unfit to moderately fit makes a huge difference.
“Within a week of daily movement, your blood pressure, mood and sleep will all improve,” says Dr Donnai. “Within a month, cholesterol, insulin and inflammatory markers start to normalise, testosterone and growth hormone levels increase, and blood vessels begin to repair.” After six weeks, mitochondria multiply, visceral fat shrinks and measurable changes appear in brain volume (especially in the hippocampus). As such, you’ll feel sharper and more focused thanks to increased brain proteins (BDNF), and emotional balance and sexual function will improve.
Balance training is equally crucial. “If you can’t stand on one leg for thirty seconds, it’s a sign your stability needs work. Practise that daily. Try standing on one leg while brushing your teeth.” Falls are one of the biggest causes of hospitalisation in older adults, so this simple practice could be life-saving.
Dr Donnai’s own exercise routine is efficient and purposeful. For cardio and strength, she uses a cross trainer and rebounder doing interval training in an extensive home gym. “I don’t particularly enjoy the gym, but the Educogym circuit keeps my mind busy. You get two exercises in one, and the machine pushes you further. You only do each exercise for one minute, so in 25 minutes I have worked all my muscle groups.” She also does flexibility exercises, including 10 minutes of yoga each morning, and uses an infrared sauna twice a week.
It sounds intensive, but she insists the key is efficiency, not perfection. “I don’t do anything that’s time consuming.”
Stress and sleep: The overnight housekeeping service
“Sleep is absolutely critical – it’s when your brain clears out toxins and performs what I call its ‘overnight housekeeping,’” explains Dr Donnai. During deep and REM sleep, your brain’s lymphatic system drains away waste products, including the proteins linked to dementia.
“You cannot cheat sleep. You might get away with it in your thirties, but after fifty, it catches up with you.” Aim for seven to eight hours of meaningful, restorative sleep.
One of the most underdiagnosed issues she sees? Obstructive sleep apnoea. “It’s a major risk factor for cardiovascular disease, and around sixty per cent of cases go undiagnosed. If you snore, wake up tired or your partner notices you stop breathing briefly in your sleep, get tested.”
If you’re struggling with insomnia or stress, deep, slow breaths can lower your heart rate and help you drop off, while Dr Donnai meditates twice a day using Transcendental Meditation. “I have a mantra. I never voice it – you repeat it in your brain. I do it sitting on the train.”
Reduce your toxic load: use vinegar instead of bleach
“Every day we’re exposed to chemicals, plastics, pesticides and pollutants – there’s nowhere on earth completely free from them,” says Dr Donnai. Over time, this toxic load contributes to virtually every chronic illness.
Take Parkinson’s disease, for example. “It’s very linked to environmental toxins,” she explains.
“People who live within a one-mile radius of a golf course have a 126 per cent higher risk of Parkinson’s. Golf courses are heavily sprayed with chemicals to keep weeds down.” Farmers face even greater risks due to pesticide exposure – “from a health perspective, farming is one of the most dangerous professions.”
Where possible, Dr Donnai eats organic and has eliminated all non-natural products from her home. “I am very aware of toxicity because that is not good for inflammation. So I usually opt for natural cleaning products – vinegar instead of bleach – and avoid microwaving in plastic. Choose clean toothpaste and shampoo, and skincare without SLS or PFAS (per- and polyfluoroalkyl substances that are indestructible within the environment and potentially in humans also).” Even dental floss can be coated with these “forever chemicals.” Dr Donnai uses Kingfisher toothpaste, as well as Keeko dental floss and interdental brushes.
“It takes around thirty years for PFAS to leave your body once they’re in, so prevention matters,” she explains. She also recommends donating blood regularly – not only are you giving blood to someone who really needs it, but “It’s an easy, affordable way for you to reduce heavy metals and chemicals because the body regenerates new, cleaner blood.”
Nutrition: Cook from scratch and snack on nuts and boiled eggs
“We should aim to eat up to a hundred different foods a week,” says Dr Donnai. “That sounds like a lot, but it’s easy when you use herbs and spices, and eat different cuisines. One day Thai, the next Italian – each introduces new bacteria to your gut.”
The biggest nutritional mistake people make as they age? “Most people actually eat less protein when they should be eating more,” she warns. As we get older, our metabolism slows but our protein requirements increase because we lose muscle mass faster. For a healthy, moderately active 70kg person at 60 years of age, aim for a target of 70-84 g/day, while at 80 you need a target of 85-105g day. This is roughly 25-35g of protein per meal, the amount required to hit the leucine trigger of 2.5-3g leucine (an essential branched-chain amino acid (BCAA) that is crucial for protein synthesis, muscle repair and preventing muscle breakdown even when anabolic signalling declines).
“A slice of toast and jam or a light salad won’t cut it. Snack on boiled eggs, nuts, hummus or a piece of chicken instead.”
When it comes to nutrition, Dr Donnai practises what she preaches – rigorously. She starts her day with fresh, antioxidant-rich matcha, which she grinds herself in her matcha maker (no coffee, because it doesn’t agree with her digestion). “I make my own green juice; it stays fine for two days, so I only do it three times a week.” She freezes cubes of turmeric and ginger to add to it. For protein, she makes her own almond milk, avoiding dairy which she finds inflammatory. “I’m from Belgium – food is important for the whole family. I do enjoy cooking.”
The non-negotiables
If you take away nothing else, Dr Donnai emphasises three things: maintain muscle mass through resistance training, know your numbers through regular testing, and live with purpose. “Test, don’t guess. Data gives you insight, and insight gives you power. You can’t change what you don’t measure.”
She recommends checking your HbA1C (blood sugar), LDL cholesterol, inflammation markers, vitamin D and thyroid function from about 40 onwards. A DEXA scan for bone density and muscle mass is also valuable. As long as you have no significant lifestyle changes, annual testing is sufficient. If any of the markers are “off” then retest after three months, and then every six months until they are under control.
But perhaps most importantly: “Live with purpose. It doesn’t have to be grand – it just has to mean something to you. Whether that’s learning something new, helping others or simply finding joy in daily rituals, purpose keeps you alive longer – both biologically and emotionally.”
This means staying engaged and challenged. “Many people tell me they do a crossword every day. I say, ‘That’s lovely – but your brain already knows how to do that.’ To keep the brain young, you need to learn something new and a little difficult.” She suggests ballroom dancing, table tennis or playing an instrument.
“The biggest mistake people make in their sixties and seventies is withdrawing from life. You must stay engaged. Keep moving, keep laughing, keep learning – those are the true markers of longevity.”
Her final message cuts through all the complexity: “You shouldn’t accept ageing as a given; it’s entirely in your hands. Getting older, yes, but ageing, no. There are things you can do at any age. It’s not a lot you need to do to counterbalance it.”
As she puts it: “Longevity isn’t about adding years, it’s about adding life to the years you already have.”
Telegraph Media
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By elocal magazine