Step 91: Honor Your Neck

As a doctor who takes care of a lot of old people, I see that the neck is under-recognized as a source of trouble, and therefore worth particular attention. Headaches, numb hands and dizziness are the three main symptoms of a bum neck. Whenever I hear any of these complaints, I immediately focus my exam on the neck. The nerves and blood supply to the head and arms all run through the neck.

The neck is a series of seven small vertebrae, on the top one of which rests the skull. I compare the neck to an accordion that has a certain amount of play in it. When there is injury or inflammation, the muscles that hold the neck in place contract just like an accordion, and the nerves, muscles and arteries get pinched. Headaches and numb hands result when the nerves are pinched, and dizziness and lightheadedness occur when the arteries are knuckled. Often these symptoms are worse in the morning, because during the night you sleep with your chin on your chest, and the neck muscles tend to get like gelatin. As you waken and stretch out the spasm, the kinks in the nerves and arteries are relieved, and the symptoms subside.

The Neck As Stress Zone

The neck is what I call an organ of response. Think of a lioness for a moment. When she is alarmed, her neck is tight, her ears are up, her eyes stare and her shoulders tense as she readies herself for any emergency. Your anatomy is not so obvious as the lion's, but when you are on the alert, your neck and shoulder muscles tighten, and your stare and posture are fixed and vividly attentive. In contrast, when everything is calm, you tend to hold your head in different attitudes, shifting easily and frequently, relieving tension. So the neck is a major seat of stress.

Exercise for Pain Relief

The first approach to a tight, painful neck is not a collar, traction or referral to physical therapy, but exercise. The mischief that injuries and stress can cause your neck are well addressed by keeping your neck strong and supple. You can keep it strong by pushing your head forward and then back against your cupped palm for a count of 10 alternately several times a day. You can keep it supple by gently moving it forward, backward and sideways. Perform these exercises gently; therapists generally advise against rotating the neck.

Bottom Line Advice

Look at the horizon, not at the ground. Keep your chin up and in. Keep your shoulders back. Keep your head high. Stand tall. See over the hill. Be proud, look proud. Respect your neck.

Step 92: Keep Breathing

Two hundred years ago Joseph Priestley discovered oxygen. His discovery led him to speculate that this common and vital element was both life-giving and hazardous at the same time. His suspicion has proved correct. We can't live without it, but it also causes mischief along the way.

Does Exercise Accelerate Aging?

The question then immediately arises: If oxygen is a bad actor, why should you exercise, which results in breathing and puffing along the way and thereby subjects you to increased risk of oxygen-caused damage? The accelerated traffic in oxygen does result in increased generation of potentially harmful free radicals, the same free radicals that are widely held to be responsible for the deteriorating changes associated with the aging process. So, does exercise accelerate aging? No!

The explanation probably resides in the fact that the systems your body has developed to get rid of these free radicals are also increased by exercise. These scavenger devices clearly go up in trained people. People with higher oxygen transport capacity (VO2 max) not only generate more free radicals, but they also get rid of them faster.

Don't Fear Free Radicals

In a sense, this system is like the old argument about heartbeats and exercise. If every heart has only so many beats in them, why use them up by exercising? Well, it is true that exercise increases pulse rate. But the resting pulse is substantially slower in fit than in unfit persons. A fit person's resting pulse is 48 instead of the usual 70. Sure, his pulse goes up to 120 or 130 during exercise, but the rest of the time it beats at a stately and efficient pace. This means that the net result is fewer beats a day.

I don't fear free radicals. I count on fitness to manage them. But what if you want a booster? Can antioxidants, such as vitamin E or vitamin C, help? There are a number of experiments in animals and people that have been designed to determine whether these compounds can either boost exercise performance or decrease oxygen damage created during exercise. The results vary, but so far there is no evidence that vitamin E improves exercise performance.

To Supplement or Not?

Personally, I don't take antioxidant supplements, although many of my colleagues do. I am ready to be persuaded that they are of real value, but I do not feel that we yet know enough to make this blanket recommendation. On the other hand, physical exercise has multiple, unambiguous credentials as a keystone strategy in reaching 100.

Step 93: Use Your Brain -- Exercise

You know that exercise is good for your bones, your muscles, your heart, your cholesterol, etc., but what about that organ that sits between your ears, your brain? After all, your brain is you. A surgeon can transplant any other part of your body, and you would still be you. But if you received a new brain, you would become someone else.

What happens to your brain when you exercise? We know that on any exertion, blood is shifted from the unessential parts of the body -- such as the intestine and kidneys -- to the arms and legs, where the work is going on. The brain, however, is spared this diversion, so adequate blood supply is constantly assured. It continues to receive its pint and a half of blood every minute. As we study the evolutionary chain, the brain grows in proportion to the complexity of the movements the animal makes. Predatory animals have bigger brains than prey animals, and this brain is associated with more intricate lifestyles. Fit people have faster nerve conduction, in accord with the "use it or lose it" principle. It makes sense, then, that the more you practice some movement, the more efficient the muscles, circulation and nerves become.

Grow Your Brain

Whatever part of the brain is involved in an activity will grow, just as a muscle does when it is used. Neuroscientist Marian Diamond showed that Albert Einstein's parietal lobes, the associative part, were huge. In a similar way, violinists, bakers and car mechanics each have brains that reflect parts of the brain they use most.

Growth and development require several things: an energy flow, growth factors, circulatory support and adequate nutrition. All of these elements are provided by exercise. Exercise prompts the release of adrenaline, a very potent brain stimulant. We are more alert when adrenaline is present; sleep occurs in its absence.

Exercise Increases IQI was thrilled when I read a research paper by Bob Dustman in Salt Lake City. He selected a group of older people and tested them before and after an exercise protocol. Not only did all the predicted other benefits ensue, but the IQs of these people went up as well. A more recent experiment reported from North Carolina showed that a six-week brisk walking program increased the cognitive abilities of older people 7.5 percent. Wow! Exercise increases IQ! That's something, but on reflection it makes sense that it should be true.

Bottom Line: MoveSo we learn another benefit of an exercise program. It is reported that smart people exercise more. Do they exercise because they are smart, or are they smart because they exercise? As you age, you are at risk for loss of brainpower. Most of this loss is not due to age, but is instead the result of pulling back from the business of being fully alive. Think, move, think, move. Your brain will thank you for it.

Step 94: Chase the Blues

Movement is good for you. Every organ, tissue and cell in your body works better when it is active. Movement is good for your body, and it is good for your spirit. Even thinking about movement makes you feel brighter. A frolicking colt, a tumbling puppy, a romping child bring smiles. It is hard to conceive of feeling bad after a roller coaster ride, a downhill ski run or a merry-go-round spin. A jet plane, a race car or a speedboat creates excitement. Movement is an upper.

Physical Exercise as Therapy

Sitting is a downer. For a long time there has been a suspected relationship between inactivity and depression. The very idea of a caged animal is depressing, but as I've said before, all of us are zoo animals. Our culture has placed us in inactivity cages. Maybe the only ones who aren't depressed are those of us who are active. It has been asserted that no depression can withstand a 10-mile run. Psychologists and psychiatrists have embraced the notion that physical exercise is an important form of therapy for depressed people.

How could exercise help depression? The chemical modulator of the many body adaptations that accompany physical exercise is adrenalin. One of the various effects of adrenalin is to act as a stimulus for the release of endorphins in the brain. The endorphins are chemicals that nature has created to make us pain insensitive. The evolutionary advantage to being resistant to pain, while engaged in the survival strategy of fight or flight, is obvious. Wounds don't hurt until the battle is over. A fellow ran almost the entire Boston Marathon with a broken leg. He didn't feel it until the race was over. Together, adrenalin and endorphins are uppers. Depressed people have less of both. The preferred way of treating depression is to restore the deficiency in adrenalin and endorphins. Nature's way is prescribing exercise.

Don't Slow Down

As you dare to be 100, losses occur along the way. Being physically fit allows you better to bear the burden those losses thrust upon you. There is an inevitable tendency to slow down as you age; the very thought of having to keep up with the trail of grandchildren is daunting. But the better able you are to do it, the less chance you will have of becoming depressed. The last of life should not be lived with a sad expression. It should be lived with a bright and optimistic outlook. A physical exercise program is a central part of maintaining that attitude. A walk to the store, the library or the post office is better medicine than anything I have in my black bag.

Step 95: Be Sexy, Be Fit

As sex is identified as a major quality-of-life issue, it is appropriate to inquire whether being physically fit enhances late-life sexuality. There have been only a few studies that addressed the topic. Dr. Jim White at the University of California in San Diego selected 95 sedentary middle-aged men who exercised briskly for one hour three times a week for nine months. Those men who worked hardest at the workouts reported more frequent sexual activity, a more reliable function during sex and a higher percentage of quality orgasms. The control group reported no such changes. No pain, no gain.

Exercise Helps Circulation

The penis is a vascular organ. Exercise is a potent stimulator of circulation (although erections during physical activity would seem unlikely). Exercise is an effective technique in correcting erectile difficulties. How much of the benefit derives from a tune-up of the vascular system and how much derives from an increased sense of self-esteem (the active exercise group also lost 19 percent of body fat) is unknown. But everyone acknowledges that the brain is the most important sex organ. Anything that improves the brain's image of self is bound to improve sexuality.

Several years ago my son Walter and I did a survey of the sex habits of the men over 70 who belong to the Fifty-Plus Fitness Association. Of 38 members, average age 75, 58 percent still rated their sex lives as good or very good, another 23 percent fair, and only 19 percent reported their sex lives as poor. The original 1948 Kinsey Report recorded that 55 percent of 75-year-old men were impotent. Our small survey would indicate that an active group does far better.

Healthful Living Leads to Good Sex

What about women? It is clear that physical exercise is a wonderful assistance to some of the changes associated with menopause. Fitness evens out many of the bumps and also adds immeasurably to older women's sense of confidence, health and independence. For a large number of women, the quality of their sexual lives improves after menopause. Being physically fit helps. Exercise mandates a continued body awareness, which is a further health and sex benefit. Continued engagement in all aspects of healthful living leads to good sex.

Good sex is good for your health. Good health is good for your sexuality. Be fit and sexy -- hopefully until 100.

Step 96: Avoid the Big C -- Exercise

Does taking a walk help prevent cancer? There is increasing evidence that cancer is not just a random event -- that it really has a strong relationship to how we live our lives. The linkage between cigarette smoking and lung and bladder cancers is the prime example. But if it is so obvious that how we live causes cancer, isn't there similar evidence that how we live helps to prevent it? Yes.

Keep Illness at Bay

More and more researchers are finding that physical fitness helps us prevent cancer. No one suggests that being fit eliminates the risk of cancer altogether, but numerous studies strikingly illustrate lower rates of the disease in people who exercise. Some forms of cancer seem particularly responsive to an active lifestyle, colon cancer among them. It has been known for some time that the length of time it takes food to transit your intestinal tract from entrance to exit is considerably shorter in active people. Without question, diet, too, has a lot to do with cancer. The inference then is that if some cancer-provoking material stays in contact with the lining of the colon for longer, it provides an increased risk of colon cancer. Whether this is the explanation for its protective role or not is uncertain, but the lower rate of colon cancer in active people is unassailable.

Special Benefits to Women

The other principal types of malignancy that have been shown to react to an actively lived life are the reproductive organ cancers: breast, uterus and ovary for women, and prostate for men. The possible mechanism behind such protection is the same for both sexes, involving a lowering of tissue exposure to levels of the sex hormones estrogen and testosterone. For women it is clear, particularly in those young elite athletes whose menstrual patterns are disrupted by their intense pursuit of fitness, that fitness and low body fat content dramatically lower estrogen levels. Consequently, those organs that are targets for estrogen will not be bathed in decades of higher estrogen amounts and consequently have less potential for malignancy.

Reduced Risks for Men, Too

For men, the story is the same. Exercise lowers testosterone levels, and the prostate is clearly sensitive to testosterone. Men with prostate cancer have been reported to have higher levels of testosterone than others. Often the first treatment for prostate cancer that has spread is castration. Such a step drops testosterone levels virtually to zero and frequently results in a marked reduction of the spread of the tumor. If your prostate gland is exposed to a lower testosterone level over the lifetime, the risk decreases dramatically. Other cancers, such as lung cancer, are also low in fit people, but this is felt to be due to the fact that few fit people smoke.

Cancer is such an evil villain that I feel every one of us should be doing everything we can to prevent it. Cure is still too rare, so prevention is vital. Being physically fit has excellent credentials as a vaccine we should all be using regularly.

Step 97: Walk Away From Infection

As with resistance to cancer, fitness also provides protection against infections. The ability to ward off the threats posed by the sea of bacteria and viruses in which we live is dependent on elaborate and still not totally understood mechanisms. In the last 10 years we have discovered dozens of body chemicals that protect us, and physical exercise has been shown to provide higher levels of many of these defense compounds. Fit people get colds less often. The Centers for Disease Control in Atlanta found that those people who jogged 25 miles a week had one or two respiratory infections per year compared to the general index population of three per year.

Find the Right Balance

Of course, it was also found that 13 percent of the people who ran in the Boston Marathon in 1987 came down with flu or colds within a week of the race, compared with only 2 percent of the spectators. British Olympic gold medalist Sebastian Coe failed to qualify for the 1988 games because of a debilitating cold. Why? Overtraining not only fails to increase resistance to infection, but it also probably lowers it.

How does exercise increase immunity? The link is not fully established, but we do know that physical exercise is accompanied by an outpouring of adrenalin, the compound that makes the heart pump faster and produces sweating and metabolic adaptations such as high blood sugar. It also makes the body temperature go up, such as during infection. Adrenalin causes the spleen to release immune substances and the number of infection-fighting white blood cells to go up as well. It is also possible that adrenalin provides benefit to allergy sufferers as well. Many allergy medications have as their primary ingredient adrenalin or a related compound.

When exercise is extreme, however, the stress state results. Stress is accompanied by higher levels of cortisone. Cortisone, unlike adrenalin, produces a decreased resistance to infection and is potentially the component that puts competitors straining at the edge of their abilities at risk.

Regular, Sustained Exercise Is Key

A clear marker of older people is a reduced immune response. But we must ask again whether the decreased response is due to aging or inactivity. We haven't recruited enough 100-year-old athletes to answer this question definitively, but it seems likely that the reason older people seem prone to infection is that they are often frail -- not only in bone and muscle, but in antibody response as well. The logical proposition, then, is to offset the supposed decline in resistance to infection as we age. You need to retain fitness over the lifetime, not as a weekend warrior who puts yourself constantly at risk by overdoing and putting a stress on your body systems, but with a planned, regular exercise program in which all body systems participate in a meaningful way.

This does not mean that you should continue to exercise when you are really sick with an infection. If you have fever or general symptoms such as muscle aches or headaches, you should lie low for a few days. But don't let a runny nose alone interrupt your active lifestyle.

Step 98: Know That Aging Is Incurable

Five years ago the wire services were clogged with reports that human growth hormone, as advocated by a group of workers at the University of Wisconsin, was the answer to the deteriorations of aging. I cringe when I hear such news, because I know that soon the phone will be jangling with crowds of patients wanting to get on the bandwagon. To this day, I see advertisements in popular magazines of clinics near or below the Mexican border where rejuvenation therapy with a youth hormone (HGH) is provided. Such ballyhoo is not unique. Youth farms have flourished for centuries, largely in Europe, where flocks of the hopeful converge in the search for renewed energies and childhood retrieved.

To Supplement or Not?

Like other schemes, rejuvenation therapy has some rationale behind it. Certainly muscle strength is lower in older people, and this muscle weakness translates into bundles of clinical problems. It is also true that older people have lower levels of growth hormones in the blood than younger people. Hence the suggestion that restoration of HGH levels to normal will restore the lost strength of youth.

It now appears that growth hormone use is loaded with problems. The important research group at Washington University in St. Louis reported their experience with HGH in older people. Half of their group of subjects stopped the use of the treatment within two to eight weeks of its initiation, due to symptoms of arthritis and fluid retention. This high percentage of side effects occurred despite low doses of the drug. Further, those subjects who were able to complete four months of treatment failed to exhibit substantial increases in muscle strength. Other reports of side effects secondary to growth hormone use include induction of diabetes and cancer.

No Salvation in a Bottle

The reason older people's muscles grow weak and their HGH levels are low is not due to the fact that they are old. Their muscles are weak and their hormone levels are low because they have stopped exercising. The answer to this problem lies not at the drugstore but in the walk to and from the drugstore. Such treatment is effective, safe, devoid of side effects and cheap. HGH treatment costs in the range of $15,000 per year.

Nevertheless, Americans seem destined to continue to seek salvation in a pill bottle. Technology appeals to us. Easy-fix solutions are par, but muscles don't yet know that. The way to keep older muscles fit is to use them, not jack them up with anabolic steroids.

The Real 'Cure' Is Exercise

It is still possible that growth hormone injections may have a useful role in medical care, such as following a severe injury or stroke, but your aging remains yours to manage, with little help on the horizon from your friendly pharmacist. To keep your growth hormone levels up and your bones and muscles strong, start by taking a walk.

Step 99: You Don't Have to Win

One of the treasures of my life was my friendship with George Sheehan. We ran together, joked together, philosophized together. His wonderful writing nourished me. His view of the integration of exercise and living was brilliant, and his book "Running and Being" remains one of my top favorites. George died after a long bout with prostate cancer. We talked often toward the end. He was a terrible patient, as most doctors are. I did my best to keep his spirits and energy up.

You Win at Life by Placing Last

We were soul brothers except for one thing. George wanted to win. His life strategy was to be first. Probably not as intense as Vince Lombardi's, his insistence in beating the other fellow was nevertheless a constant. In contrast, my ego survives being passed by all the time. It doesn't bother me one bit to come in last, as long as I come in. I love the saying, "Life is the one game you win by coming in last." I am practicing that approach.

My analysis of exercise is to pay no attention to time. The rest of my life is so driven by 15-minute increments that when I jog or do any exercise, I want to do it without having to finish in any particular time. Who is going to remember who came in first anyway?

Don't Let Competition Create Barriers

The idea of competition and winning is part of the lure of sports for many people, but it is also a major barrier for others. In competing, the likelihood of losing -- after all, there can be only one winner, and a whole lot of losers -- is intimidating and therefore a negative feature in encouraging people to exercise. But exercise isn't about winning. It is about participating, doing something, anything.

The process of aging, slow as it is, dictates that you are going to lose if you insist on competing with the you of yesterday. Yet you can be the best for today by being active and retaining your best function and form.

The need for physical exercise is a remnant of millions of years of walking. Such a pace has sustained our existence on this earth, and it is how we came to understand our surroundings. In our lifelong journey, speed and winning have little relevance. Being a part of nature -- not dominating it -- is the issue.

Life Is Not a Spectator Sport

But just because the idea of winning is not the reason for exercise, it doesn't mean that you can sit around and watch. Someone wisely said that life is not a spectator sport. It has to be played and engaged. Growing older is a slow process, but it can become much faster if you don't participate.

The difference between activity and inactivity, when multiplied by years of living, is the major determinant of how your later life will be lived. If you race at the start and don't pace yourself, you will lose. If you don't even start -- or halt along the way -- you will lose. Keeping the pace, staying the course, is the master strategy. If you offered me fast, first, strong or steady, I would always choose steady.

Step 100: Just Do It

OK, I lied. There aren't just 99 steps to 100. In fact, the 100th step sums up all the others.

Just Keep Moving

Golf, like bowling, is a wonderful recreation, but it just isn't enough push to qualify as quality exercise. To do my body good, movement must have some pace to it. Walking is clearly the form of exercise that is most universally available and could be a boon to our nation's fitness profile -- if we would only remember individually and collectively how to walk. As it is now, we cluster around elevators to go up one floor. The airport is also a challenge -- when an escalator, horizontal or vertical, is available, nearly everyone uses it. Stairs become nearly obsolete. In public buildings, they are often built in unfriendly corners where rubbish accumulates. I would favor prohibiting elevators for ascents of fewer than six floors.

Aim for Heart-Pounding, Panting Exercise

Other athletic endeavors, such as tennis, basketball, baseball, football, biking, skiing, etc., are all qualified by how the sport is played. I know tennis players who are either so skillful or so lazy that they rarely move from the center of the court. Other sports are the same. If you play with a level of intensity that causes the heart to pound and the breath to pant, that's when health benefits accrue. But even some football players are in lousy shape. Just being strong isn't enough. You can be strong as a bull and still be in poor condition. I delight in the stories of body builders who flunk the physical exams for such-and-such a job position because they are in poor condition.

To be successful, an exercise program should have an element of recreation and renewal in it. Exercising just because it is good for you isn't enough for most people. It should be fun, too. If the exercise is perceived as work, chances are you won't sustain it. For some people this means group activities, for others it means a solo experience. For some it must be done in the morning, for others the evening. There are lots and lots of ways to be fit.

Aim for Balance

But be more than body fit, be whole person fit -- body, mind, spirit all in harmony, balance, vitality. This is the ideal. It takes guts and smarts. It takes involvement. The key is to do it, just do it.

Anti-Aging Advice: 99 Steps to 100 by Walter M. Bortz, M.D.

Enjoy a healthy retirement with Dr. Walter Bortz's anti-aging strategies. This leading aging expert offers 99 simple steps for longevity that show how Diet, Attitude, Renewal, and Exercise can help you control your body's change, growth and repair.

DIET
Step 1: diet and nutrition
Step 2: read well to eat well
Step 3: know when to eat
Step 4: your body's need for calories
Step 5: fat alert
Step 6: count cholesterol
Step 7: push carbos
Step 8: protein pros and cons
Step 9: don't dry up
Step 10: slash the salt
Step 11: keep your fiber up
Step 12: vitamin care
Step 13: calcium matters
Step 14: a coffee break for longevity
Step 15: alcohol: anti-aging foe or friend?
Step 16: chemical cuisine?
Step 17: beware free radicals
Step 18: cancer-fighting diet

ATTITUDE
Step 19: believe in longevity
Step 20: be necessary
Step 21: find meaning
Step 22: be an optimist
Step 23: take risks
Step 24: stay in control
Step 25: maintain the creative spark
Step 26: seek wisdom
Step 27: be a responsible ager
Step 28: have options
Step 29: be a good neighbor
Step 30: cherish experience
Step 31: get high on helping
Step 32: learn to learn
Step 33: don't kill yourself
Step 34: keep your senses sharp
Step 35: train your brain
Step 36: build memory
Step 37: keep order
Step 38: be attractive
Step 39: recognize that sex is for life
Step 40: stay in touch
Step 41: take rx pet
Step 42: keep family strong
Step 43: don't take yourself so seriously
Step 44: work with stress
Step 45: have time sense
Step 46: know your primary doctor
Step 47: pamper your glands
Step 48: be a good loser
Step 49: stay in tune
Step 50: stay on the road
Step 51: recognize depression
Step 52: die well
Step 53: have guts

RENEWAL
Step 54: recharge yourself
Step 55: stay in flow
Step 56: renew your health
Step 57: cherish your world
Step 58: think travel
Step 59: think when, where, and why retire
Step 60: make your last nest your best
Step 61: beware of retirement myths
Step 62: afford retirement
Step 63: have a life money plan
Step 64: be wealth fit--save
Step 65: keep working
Step 66: spend it all
Step 67: lobby for yourself
Step 68: use leisure
Step 69: re-learn, re-think, re-educate
Step 70: sleep enough
Step 71: keep in rhythm
Step 72: steps for the woman
Step 73: steps for the man

EXERCISE
Step 74: take the first step
Step 75: know how hard, how Long, how often to exercise
Step 76: realize it's never too late
Step 77: make time for exercise
Step 78: when tired, exercise
Step 79: don't fear exercise
Step 80: it's ok to be sore
Step 81: watch your fuel gauge
Step 82: learn with what and when to fuel the exercise
Step 83: keep your oxygen tanks full
Step 84: make exercise your circulation's best friend
Step 85: be strong
Step 86: stay loose
Step 87: stay balanced
Step 88: stand straight
Step 89: work dem bones
Step 90: respect your back
Step 91: honor your neck
Step 92: keep breathing
Step 93: use your brain -- exercise
Step 94: chase the blues
Step 95: be sexy, be fit
Step 96: avoid the big C -- exercise
Step 97: walk away from infection
Step 98: know that aging is incurable
Step 99: you don't have to win
Step 100: just do it

The DARE Philosophy

"DARE to Be 100" is based on Dr. Bortz's "DARE" philosophy: Diet, Attitude, Renewal and Exercise.

Diet. Regarding diet, Dr. Bortz focuses on variety and activity, likening inactive people to zoo animals: "When you're a zoo animal, you must be carefully fed, but wild animals can eat anything." Through exercise, you can boost your metabolism and help slow the aging process. "The most important step is to stay physically active," says Dr. Bortz.

Attitude. This is a crucial and sometimes overlooked category. "Believe in 100," Bortz challenges. If you want to become a centenarian, you must believe you can. Set goals for your retirement, develop a plan and remain optimistic.
Renewal. "Recharge, keep working and stay in the mainstream," says Dr. Bortz. Remain resilient because "it's not how many times you fall -- because age brings losses -- but how many times you stand up" that's important.

Exercise. The anti-aging benefits of aerobic exercise are clear. However, Dr. Bortz cautions us to be strong, stay loose and stay balanced. "The most important organ in an older person is not the heart or lungs but the legs." Legs are what give a person an active, independent lifestyle.