Listen on: Apple Podcasts | Spotify | Amazon Music | Podcast Index | Overcast | YouTube

We all want to live long and well. But how much time do we really have—and how many of those years will be good ones?

It’s a question that’s both deeply personal and wildly complex. And it’s one I’ve been thinking about more often lately—not just as a physician, but as someone who’s seen aging touch my family and friends in profound ways. My dad’s good years ended abruptly at 56 after a multiple myeloma diagnosis. And several friends have recently faced cancer diagnoses that changed everything. These moments make you wonder: how many good years do you have left?

So, what exactly is a “good” year? For some, it’s peak performance—competing, solving complex problems, or setting personal records. But for most of us, it’s simply being able to move with ease, live pain-free, and enjoy life’s pleasures without restriction.

Let’s explore what science, experience, and a little bit of introspection can tell us about that question—and what you can do with that information.

Step One: Estimate Your Remaining Years

We start with the basics: actuarial life tables. These centuries-old tools use population data to estimate life expectancy based on your age and sex. At birth, American men average 73 years and women 79—but if you’ve already reached age 55, your expected years jump. For men, it’s now 79; for women, 82. You can find your own estimate using this Social Security life table.

Want something a bit more personal? Try the Framingham Heart Study’s cardiovascular risk calculator. By plugging in your age, cholesterol, blood pressure, and lifestyle factors, you can estimate your 10-year risk for heart disease. I calculated mine at 4.7%.

There’s even emerging research around combining clinical risk with genetics—called polygenic risk scores—which may offer more precise insights into your longevity. While this remains largely a research tool for now, its promise is intriguing (Nature Medicine, 2023).

And yes, sharing these scores can spark change. A meta-analysis of 28 studies found that people who receive personalized risk data often make meaningful lifestyle improvements.

Step Two: Assess Your Physical Resilience

Longevity isn’t just about living longer—it’s about staying functional. And that’s where strength and mobility tests come in.

Take the Brazilian Sit-Stand Test, which evaluates your ability to get up from the floor without using your hands or knees. Each point lost correlates with a 20% increase in mortality over six years. A score below 8? You’ve doubled your risk.

Or try testing your grip strength. A study across 17 countries found that every 5 kg drop in grip strength corresponded with a 15% increased risk of death.

These tests don’t just reveal physical capacity—they serve as mirrors for future vulnerability. Fortunately, strength and aerobic fitness are highly trainable. If you’re unsure where to start, check out my earlier episodes on exercise basics and advanced fitness strategies.

Step Three: Consider the “Good Years” Framework

This is where it gets trickier. While we can predict years of life with some accuracy, determining quality of those years is far more elusive. Tools like the SF-36 assess current physical function, but they don’t project how long that function will last.

Still, there are patterns worth noting. Most of us lose 1–2% of muscle mass each year after age 30, and aerobic fitness drops about 10% per decade—up to 20% per decade after 70 (Journal of Gerontology). So if you’re able to lift 40 pounds now or run a mile in 10 minutes, think about how that might change in 10–20 years unless you intervene.

It’s also helpful to consider current risk factors: heart failure affects 1 in 4 Americans, and conditions like arthritis, depression, and low back pain are among the most common sources of long-term disability (Journal of Cardiac Failure). Taking stock of your physical and emotional health today can give you clues about your future trajectory.

Step Four: Prepare for the Wild Cards

Accidents and unexpected illness are part of life. While rare events like lightning strikes or shark attacks are outliers, falls are not. For those over 65, one in four will experience a serious fall each year—resulting in over 38,000 deaths in the U.S. annually (National Council on Aging).

Vision loss doubles fall risk, and untreated hearing loss triples it. The good news? Hearing aids can cut that risk by half. Building resilience—bone strength, flexibility, balance—isn’t just a wellness trend; it’s an insurance policy. See my episode on resilience and strong bones.

Final Thoughts: Take Action, Don’t Panic

No tool or test can predict your future with certainty. But they can offer a powerful nudge toward action.

Try one of the physical tests. Plug your data into a risk calculator. Reflect on what you can control: your strength, your relationships, your diet, your mindset. Aging isn’t just decline—it’s also a shift in intelligence, from fluid (problem-solving) to crystallized (wisdom). As Arthur Brooks writes in From Strength to Strength, your value doesn’t fade; it transforms.

So here’s my takeaway: do what you can, enjoy what you can, and accept that some things are out of your hands. But many more aren’t. You have the power to shape not just how long you live, but how well.