Many people think healthy ageing only becomes important after retirement.
In reality, healthy ageing begins much earlier – often decades before old age arrives.
The findings from the 2025 National Health and Morbidity Survey (NHMS) Older Persons Health report clearly show that many of the health problems affecting older Malaysians today develop gradually over many years.
These conditions, including frailty, diabetes, hypertension (high blood pressure), depression, sarcopenia, dementia and loss of independence, do not suddenly appear at the age of 70 or 80.
They are often the result of long-term lifestyle habits, chronic stress, inactivity, poor nutrition and uncontrolled medical conditions accumulated throughout adulthood.
This means that adults below the age of 60 still have a valuable opportunity to influence how they will age in the future.
One of the most important lessons from the NHMS report is that living longer does not necessarily mean living healthier.
Many adults are surviving into old age, but experiencing poor mobility, dependence, frailty, so- cial isolation, memory problems and multiple chronic diseases.
Therefore, the goal should not simply be longevity, but healthy longevity, i.e. maintaining physical function, mental sharpness, emotional well-being, independence and quality of life for as long as possible.
Keep it moving
Physical activity is one of the most powerful tools for healthy ageing.
Modern lifestyles have become increasingly sedentary.
Many adults spend long hours sitting at desks, driving, using smartphones or watching screens.
Unfortunately, prolonged inactivity contributes to obesity, diabetes, hypertension, poor cardiovascular (heart) health, muscle loss and declining fitness.
The 2025 NHMS findings regarding frailty and sarcopenia among older adults should therefore serve as an important warning sign.
Frailty and muscle loss do not occur overnight.
They often begin silently during middle age when physical activity decreases and muscle mass gradually declines.
Exercise should not be viewed merely as a way to lose weight or improve appearance.
It is an investment in future independence.
Regular physical activity improves cardiovascular health, muscle strength, balance, mood, sleep, bone health and cognitive function.
Adults should aim to remain consistently active through activities such as brisk walking, cycling, swimming, jogging, dancing, hiking or sports.
Strength training deserves particular emphasis.
Many people focus heavily on aerobic exercise, but neglect muscle health.
However, muscle is essential for mobility, balance, metabolism and resilience in older age.
Building and maintaining muscle earlier in life helps protect against frailty later.
Simple resistance exercises using body weight, resistance bands or weights can help preserve muscle mass and strength.
Importantly, strength training is beneficial not only for men, but also for women, especially after menopause when muscle and bone loss accelerate.
Eat and sleep
Nutrition also plays a major role in determining how people age.
Dietary habits developed during adulthood often continue into older age.
Frequent intake of sugary drinks, processed foods, excessive salt, unhealthy fats and excessive calories increases the risk of obesity, diabetes, hypertension, stroke, heart disease and kidney disease.
The 2025 NHMS report showed high rates of chronic diseases among older Malaysians, highlighting the importance of prevention much earlier in life.
A healthy diet should include adequate vegetables, fruits, whole grains, healthy fats and sufficient protein intake.
Many people underestimate the importance of protein for maintaining muscle health.
Adequate protein intake supports muscle maintenance, recovery, immunity and healthy ageing.
At the same time, healthy ageing is not about extreme dieting or unrealistic body image goals.
Crash dieting and excessive weight loss may actually worsen muscle loss and reduce long-term health.
Sleep is another pillar of healthy ageing that is often neglected, especially among working adults.
Many people sacrifice sleep because of work demands, social commitments or excessive screen time.
However, chronic sleep deprivation affects mood, memory, concentration, immunity, blood pressure, metabolism and emotional well-being.
Poor sleep habits established during midlife may contribute to higher risks of obesity, diabetes, cardiovascular disease, depression and cognitive decline later in life.
Feeling and thinking
Mental health is equally important.
The 2025 NHMS report highlighted significant levels of depression among older adults, reminding us that emotional well-being must not be ignored throughout life.
Chronic stress, anxiety, burnout, loneliness and untreated mental health problems during middle age may have long-term consequences.
Unfortunately, many adults normalise unhealthy levels of stress as part of modern living.
Constant exhaustion, emotional burnout, irritability and poor work-life balance are often overlooked until serious physical or emotional consequences develop.
People should feel comfortable seeking support for emotional difficulties.
Mental health care is not a sign of weakness.
Emotional resilience is an important component of healthy ageing.
Strong social relationships also influence long-term health outcomes.
Humans are social beings, yet modern life can become increasingly isolating.
Work demands, relocation, smaller family sizes and digital lifestyles may gradually weaken social connections.
Many older adults become socially isolated after retirement because their social identity was previously centred around work.
This is why maintaining friendships, family relationships, hobbies and community involvement throughout adulthood is so important.
Social engagement supports emotional well-being, cognitive health, and even physical health.
People who remain socially connected often experience lower risks of depression, loneliness and cognitive decline.
Cognitive health should also be prioritised long before memory problems develop.
The 2025 NHMS finding that one in 10 older adults have dementia is deeply concerning.
Although not all dementia can be prevented, many risk factors are modifiable.
Regular physical activity, good blood pressure control, diabetes management, smoking cessation, social engagement, hearing care and lifelong learning may all help reduce dementia risk.
Keeping the brain active is important.
Reading, learning new skills, solving problems, playing musical instruments, learning languages, engaging in hobbies and intellectual curiosity all help maintain cognitive reserve.
Prevent and stop
Preventive healthcare should never be neglected.
Many adults avoid medical check-ups because they feel healthy.
However, conditions such as hypertension, diabetes and high cholesterol may remain silent for years before complications develop.
Regular screening allows earlier intervention and better long-term outcomes.
Detecting problems early often prevents serious complications later.
Vaccination is another important, but sometimes overlooked, aspect of healthy ageing.
Adults should remain updated on recommended vaccines such as influenza, pneumococcal, shingles and Covid-19 where appropriate.
Preventing infections becomes increasingly important with advancing age.
Smoking cessation remains one of the most important health decisions people can make.
Smoking damages nearly every organ system and significantly increases the risk of stroke, heart disease, lung disease, cancer, frailty and dementia.
Excessive alcohol intake also contributes to liver disease, falls, cognitive impairment and multiple chronic illnesses.
Money and identity
Financial health also affects healthy ageing.
Financial insecurity contributes to chronic stress, delayed healthcare, poor nutrition and reduced quality of life.
Planning for retirement, insurance, healthcare costs and future caregiving needs earlier in life can reduce future burden on both individuals and families.
Importantly, people should also think realistically about future caregiving expectations and living arrangements.
Malaysia’s family structure is changing.
Smaller families, migration and urbanisation mean that not every older adult will have children or relatives available to provide caregiving support in the future.
Planning early allows families to prepare more realistically and avoid crisis situations later.
Another important, but often overlooked, aspect of healthy ageing is maintaining purpose and adaptability.
Many people define themselves heavily through work.
When retirement eventually arrives, some struggle with loss of identity, loneliness or emotional distress.
Developing hobbies, volunteer roles, friendships, spiritual life and community involvement before retirement helps create a smoother transition into older age.
Technology literacy is also becoming increasingly important.
Future healthcare systems, communication platforms, banking and social services will continue becoming more digital.
Adults who remain adaptable and comfortable learning new technologies may maintain greater independence later in life.
Beyond the individual
Workplace culture also plays an important role in future ageing outcomes.
Many middle-aged adults experience chronic stress, long working hours, poor sleep, irregular meals and little physical activity because of demanding work environments.
Over time, these unhealthy patterns contribute to obesity, hypertension, diabetes, burnout and mental health problems.
Employers therefore have an important role in supporting healthier ageing through workplace wellness programmes, mental health awareness, healthier work environments, preventive health screening and better work-life balance.
Communities and governments also shape how populations age.
Safe parks, walkable neighbourhoods, accessible healthcare, recreational facilities, community activities and age-friendly infrastructure encourage healthier lifestyles throughout life.
Healthy ageing should therefore not be viewed solely as an individual responsibility.
Society itself must create environments that support healthier living across the lifespan.
Consistency is key
Most importantly, healthy ageing does not require perfection.
Small consistent habits practised over many years often have the greatest impact.
Regular exercise, healthier eating, adequate sleep, strong social relationships, stress management, preventive healthcare and lifelong learning all accumulate benefits over time.
The 2025 NHMS findings should therefore not simply alarm younger adults.
Instead, they should motivate earlier action.
The choices people make in their 30s, 40s and 50s strongly influence how they will live in their 70s and 80s.
Successful ageing begins long before old age arrives.
The goal is not merely to live longer, but to remain physically active, mentally sharp, emotionally resilient, socially connected and functionally independent for as long as possible.
Dr Tay Hui Sian is a consultant geriatrician and internal medicine physician. This is the last in a three-part series on ageing healthily. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
