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We’re living longer, but to enjoy the extra years in good health you need to make smart lifestyle choices.

Ageing expert Dr Hamish Jamieson says a longer life doesn't need to mean eking out an uncomfortable end.

Jamieson, a geriatrician and researcher at Otago University, says every decade people live two years longer.

In the 1950s it was rare for someone to live to 70-years-old. Now it's more common for people to make to 80 or 90.

This age extension has come from improved public health, medicines, nutrition and health awareness, and better treatment for heart disease and some cancers.

It's a common myth that living longer just means facing more years of frailty at the end, says Jamieson.  

Think of a life span as like a rubber band, he says. If this band has been stretched to 80-90, instead of 70, the frail part at the end is only slightly longer and the years spent living well are extended greatly. 

"One of the most important things about ageing is that people can take more responsibility for themselves. Investing in healthy ageing is one of the best investments people can make," he says.

Consistent changes to lifestyle are the key steps:

1. Exercise

It's a well-worn mantra, but Jamieson says exercise has a huge impact on health. "It helps bone strength and reduces the risk of osteoporosis, it helps lower the risk of heart attacks, strokes and diabetes, and it probably helps with cancer risk as well." 

Continuing to move is also an important way to maintain independence. A common trap for older folks is to stop exercising because of a fall or fear of having one. 

This creates a downward spiral where someone loses strength and balance, making an accident more likely.  "Exercising sensibly at a level recommended by your health professional is really important." Walking or gardening is good and weight training can be great. 

2. Eating well

The value of healthy nutrition is becoming more and more obvious. This is the scientifically backed research, not the fad stuff. 

"Probably the strongest evidence is for nuts," Jamieson says. "A handful of nuts, about 30 grams a day, seems to protect against heart disease and lowers the risk of mortality."

Other key foods are vegetables, especially darker-coloured ones, which have the micro-nutrients that help reduce risks of cancer, heart disease and diabetes.

Protein is important for the elderly because it helps fight against the loss of muscle mass that happens with ageing. When muscles shrink, so does strength and balance.

3. Being social

Having someone around can help lessen the impact of things like pain, depression and anxiety, as well as practicalities like having the right food.

Jamieson says isolation is a big problem for people as they get older. When they are in pain, or can no longer drive, they become lonely in their homes.

"Kiwi neighbourhood networks aren't as strong as they used to be. Families don't live near elderly and are busier. Knowing this, it's important to remain a social person and develop networks because contact with others is important to happiness. Retirement villages are a positive thing in this regard.

4. An active mind

This helps lower the risk of dementia, says Jamieson. "If you don't use it, you lose it." Keep mentally active by being social in community groups, doing crosswords, reading, gardening and other mentally challenging activities. Do things you enjoy.

Jamieson says sitting in an armchair watching TV doesn't count as mentally challenging. TV is fun, he says, but it's not a good thing to do all day. There needs to be a challenge. 

5. A good doctor

Jamieson says you need a GP who is proactive about running screening tests for conditions, such as high blood pressure and diabetes, but also one who is good at managing and adjusting medications. Medication needed at 80 can be quite different to what's needed at 60 because so many things have changed.

6. A good weight 

Both weight loss and weight gain are major issues in older people. Frailty and losing the ability to do the things you want to are often linked to weight loss. High protein diets and good nutrition are key to treating that.

Being overweight causes problems in old age for obvious mobility and health reasons. Jamieson suggests thinking of people as being like a car. "A car's life is based on how many kilometres it's run and how much fuel was used. In a human it is how much energy it is using. So a high calorie intake is associated with a reduced lifespan. A normal calorie intake is with a normal life span."

Some studies suggest a lower than normal calorie intake can lead to an extended life, but Jamieson doesn't recommend trying that.

Written by Ewan Sargent. First appeared on Stuff.co.nz.

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