Many of us aspire to live a long life so we can spend more time with loved ones, enjoy enriching experiences, and see more of the world. But what good is that extra time if you’re in poor health? Your cognitive, mental, and physical health can significantly affect the quality of those additional years.
That distinction highlights the key difference between healthspan and lifespan.Lifespan tells us how many years you live. Healthspan reflects how many of those years you spend in good health, with the physical, cognitive, cardiovascular, and metabolic function needed to maintain your quality of life.
Living longer doesn't always translate to living healthier. Research suggests there’s a meaningful gap between lifespan and the years people spend in good health. One estimate puts the healthspan-lifespan gap at roughly nine years, meaning a significant portion of later life may be spent managing disease or disability. [1]
At Biograph, the goal is to help members improve their healthspan within their lifespan. This starts with establishing where your health stands today, identifying risks before they substantially affect your quality of life, and tracking the measures we can improve over time.
Why healthspan matters more than living longer
Over the past century, advances in medicine, sanitation, nutrition, and public health have helped people live longer. But, as mentioned above, extending lifespan without delaying the onset or reducing the severity of chronic disease can also increase the number of years people live with illness or disability, widening the healthspan-lifespan gap.
Closing that gap means shifting some of our attention from treating disease once it’s established to identifying risk earlier and preserving the many bodily systems that keep us healthy. Protecting healthspan early on means:
Protecting cardiovascular health before a heart attack occurs
Maintaining muscle and bone before mobility declines
Improving metabolic health before diabetes develops
Addressing cognitive and neurologic risk before function is substantially affected
The earlier we identify potential health risks, the more opportunities clinicians have to intervene.
What determines your healthspan?
There isn’t a single test, biomarker, or behavior that determines your healthspan. Genetics and family history can play a role in healthy aging, but other important factors include your cardiovascular and metabolic health, physical fitness, body composition, sleep, nutrition, mental health, preventive care, and other modifiable factors. We break down the significance of each here:
Cardiovascular fitness and VO2 max
The link between cardiorespiratory fitness and healthy aging is strong. VO2 max measures how effectively your body can take in and use oxygen during intense exercise. Higher cardiorespiratory fitness is strongly associated with better long-term health outcomes, while low fitness is a predictor of mortality risk. [2]
But it’s important to note that cardiorespiratory fitness is modifiable, meaning you can improve it with appropriate physical activity-based interventions. This can support your ability to walk, climb stairs with ease, travel, exercise, and care for yourself as you age. Among returning Biograph members who began with low VO2 max:
About 65% improved enough after working with our exercise team to reduce their age-adjusted mortality risk by an estimated 50%
Members who started with the lowest fitness levels improved their VO2 max by nearly 15% on average during their first year
Studies suggest these improvements are associated with an estimated 14-16% reduction in all-cause mortality risk
Metabolic health and insulin sensitivity
Metabolic dysfunction can develop gradually, sometimes years before someone receives a diagnosis of type 2 diabetes.
Blood glucose and HbA1c are important measures, but a broader, more comprehensive assessment may also include insulin-related markers, blood pressure, triglycerides, body composition, visceral fat, liver health, and cardiovascular biomarkers such as ApoB.
At Biograph, nearly half of members who entered with prediabetes returned to normal blood sugar levels within their first year. Similarly, nearly 89% of members with elevated ApoB successfully lowered this key marker of cardiovascular risk.
Muscle mass, mobility, and bone density
Muscle mass and bone health are key components of healthspan. Muscle supports strength, balance, glucose regulation, and mobility. Bone density helps protect against fractures that can dramatically affect independence later in life. Both can decline with age, making resistance training, adequate nutrition, and appropriate monitoring increasingly important. [3]
But your body weight alone can’t tell clinicians whether you’re maintaining muscle, accumulating harmful visceral fat, or losing bone mineral density. That’s why a DEXA scan can provide additional context by measuring your lean mass, fat mass, visceral fat, and bone mineral density.
Cognitive health and stress resilience
Healthspan also encompasses the ability to think clearly, make decisions, maintain relationships, and engage meaningfully with the world around you.
Your cognitive health can be influenced by many of the same factors that affect the rest of your body, including cardiovascular health, physical activity, sleep, metabolic health, and stress.
Sleep is especially important for maintaining cognitive health and helping other bodily systems function properly. Research has found that persistent short sleep during midlife is associated with a 30% increased risk of dementia later in life. [4]
Stress and mental health can also affect your ability to get deep, restorative sleep at night, as well as your physical activity, daily nutrition, cardiovascular function, and other healthy behaviors.
Cognition isn’t separate from your cardiovascular, metabolic, and psychological health. These systems are interconnected and collectively influence healthy aging.
How can you improve your healthspan?
The fundamentals of good health remain some of our most powerful tools.
Regular aerobic and resistance exercise supports cardiovascular fitness, muscle, mobility, and metabolic health. Nutrition matters, too. Research has linked dietary patterns such as the Mediterranean diet with better cardiovascular outcomes, while the DASH diet has been shown to lower blood pressure and the MIND diet has been associated with better cognitive function. [5] [6] [7]
Adequate sleep, stress management, meaningful social connection, avoiding tobacco, and appropriate preventive care also contribute to healthy aging.
But personalization matters, which is why it’s so important to get comprehensive testing and work closely with a physician who can translate that clinical context into action.
Whether you need to improve your VO2 max, reduce ApoB, address insulin resistance, or all three, a general plan may not improve these markers as effectively as a strategy tailored to your individual health needs will.
How Biograph helps protect healthspan
Our physician-led assessments zoom in on individual health markers while also looking at the bigger picture of your overall health, including:
Cardiovascular screening
Advanced blood work
VO2 max
Body composition
Bone health
Cognitive assessment
Sleep
Imaging
Nutrition
We then track those measures longitudinally because your health changes over time. What matters is whether your cardiovascular fitness, metabolic health, muscle mass, bone mineral density, cognition, and other key measures are being maintained or improved as you get older.
Among returning Biograph members, 96% report measurable progress toward their health goals. More than 70% of members who began with elevated cholesterol lowered their LDL by Year 2, and nearly three out of four members who entered within the highest cardiovascular risk category moved into a lower-risk category during their first year.
The goal isn’t just to live longer. It’s to preserve your ability to live well for as much of that time as possible.
What is healthspan?
Healthspan refers to the years of life spent in good health, with physical, cognitive, and functional capacity largely intact. It considers the quality of the years you live during those years, not just the quantity.
Can healthspan be longer than lifespan?
No. Healthspan occurs within your lifespan.
What is a good healthspan goal?
There isn’t a universal number of healthy years everyone should target. A better goal? Preserve physical function, cognition, metabolic and cardiovascular health, mobility, and independence for as much of your lifespan as you can.
Is healthspan genetic?
Sure, genetics can influence your healthspan, but they aren’t the only factor. Exercise, nutrition, sleep, metabolic and cardiovascular health, smoking, stress, preventive care, and other modifiable factors can all influence healthy aging.
What tests help track healthspan?
There isn’t a single test that determines your healthspan. Depending on your individual risk, helpful measurements may include VO2 max, blood pressure, advanced blood biomarkers, DEXA body composition and bone density, cardiovascular screening, cognitive testing, sleep evaluation, and medical imaging, such as a whole-body MRI, when necessary.
Dr. Michael Doney is Biograph’s Executive Medical Director, with over 20 years of experience leading clinical care and advancing a more proactive, data-driven approach to medicine.
Clinical references
Garmany A, Yamada S, Terzic A. Longevity leap: mind the healthspan gap. npj Regenerative Medicine. 2021;6(1):1-7. doi:10.1038/s41536-021-00169-5
Lundy L, Reilly RB, Fleming N. VO2max ageing and all cause mortality in a global cohort of multi marathoners. Scientific Reports. 2026;16(1). doi:10.1038/s41598-026-52475-x
MedlinePlus. Aging changes in the bones - muscles - joints. MedlinePlus. 2022. Accessed August 31, 2026. https://medlineplus.gov/ency/article/004015.htm
Sabia S, Fayosse A, Dumurgier J, et al. Association of sleep duration in middle and old age with incidence of dementia. Nature Communications. 2021;12(1):2289. doi:10.1038/s41467-021-22354-2
Shikany JM, Safford MM, Soroka O, et al. Mediterranean Diet Score, Dietary Patterns, and Risk of Sudden Cardiac Death in the REGARDS Study. J Am Heart Assoc. 2021;10(13):e019158. doi:10.1161/JAHA.120.019158
CONLIN PR. The Dietary Approaches to Stop Hypertension (DASH) Clinical Trial Implications for Lifestyle Modifications in the Treatment of Hypertensive Patients. Cardiology in Review. 1999;7(5):284-288. doi:10.1097/00045415-199909000-00013
Dhana K, James BD, Agarwal P, et al. MIND Diet, Common Brain Pathologies, and Cognition in Community-Dwelling Older Adults. , ed.Gardener H. Journal of Alzheimer’s Disease. 2021;83(2):683-692. doi:10.3233/jad-210107
