Dr Mike MacDonald

A longevity audit: The starting point to optimizing your lifespan and healthspan

Health and longevity

Table of Contents


You are going to die! Unfortunately, it is the only certainty in life.

At some point, we all start to think about our own mortality. Maybe it is prompted by a health scare? or maybe you have kids or grandkids and you would like to see them grow up?

You start to ask the question “How can I live a longer and healthier life?”.  In this short article I will describe how I broadly think about this question.

You need to think about longevity as made up of 2 key concepts:

  1. Lifespan – The total duration of your life
  2. Healthspan – The period of life spent in good health, free from chronic disease.

There is no point in living to 120 if you develop heart failure at the age of 60 and can’t walk 2 steps for 60 years! 

The starting point of improving both healthspan and lifespan is to examine where you are now – “A Longevity Audit”. 

Makes it sound kind of boring…. :-)) But with this structure, you can start looking at yourself with a more objective lens.  Once you have done the groundwork you can then look at areas that need work.

A longevity audit can be structured in 4 stages:

  1. Family history
  2. Disease screening
  3. Lifestyle screening
  4. Current state


Stage 1 – Family history

Family history of disease tells you about your own genetics. For example, if you have a man in your family having a heart attack at the age of 50, it is a real red flag.

You need to go deep on this one, extending into at least second-degree relatives. Often people don’t really know what disease their relatives have or had so you need to ask your parents and siblings about all their disease and their parents.

You can extend this part with formal genetic testing for example ApoE4 for Alzheimers risk.

Stage 2 – Disease screening – Do you have any disease or any risk factors for disease?

The key disease areas that cause early death and early incapacity and morbidity are:

  1. Cardiovascular disease (including heart attacks and strokes)
  2. Cancer
  3. Alzheimers/dementia
  4. Metabolic disease

Most diseases have a pre-clinical period where early detection allows early treatment. Coronary artery disease starts as a teenager, and plaques can be detected in the arteries years before they cause angina or a heart attack.

In its most simplistic form, this will be taking simple blood tests like kidney function,  blood glucose, and cholesterol, in addition to physiological measures such as body weight, waist circumference, and blood pressure. There are, however, extensive disease screening strategies available using advanced biomarkers, imaging, and liquid biopsies for cancer.

Stage 3 – Lifestyle screening

Lifestyle screening is arguably the most important part of the audit. Deficiencies in your lifestyle, can lead to disease and shorten lifespan.

The key areas to look at are:

  1. Nutrition – What you eat, when you eat
  2. Exercise – Type, intensity, frequency, duration
  3. Sleep – Amount, quality

For this stage data collected from biometric devices can be useful such as fitness and sleep trackers.

Stage 4 – Current state

What is your current cognitive, physical and mental function? Ideally, you need to collect as much objective data here as possible. The data you collect will form your baseline and you will set targets for improvement.

  1. Cognitive – Fatigue, mental agility, memory
  2. Physical – Grip strength, muscle mass, VO2 max, flexibility
  3. Mental – Mood, anxiety depression, social groups, friends, networks

Putting it all together

After your audit, you will have a picture of your future risks, current disease, lifestyle, and current functional status. With the help of your physician, you can structure a plan utilizing the latest evidence about disease prevention and management. 

From there you can set short and long-term goals, and reach your targets by optimizing areas of your lifestyle or utilizing medications if necessary. Each stage can go very deep, and utilize newer technologies. But you will get a lot from doing this on a basic level, even with just simple blood work and blood pressure. Live long and prosper!  


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