These 4 M’s are the key to successful aging, expert reveals

Alexa Mikhail

America is in the midst of a seismic demographic shift.&nbsp;<div class="paywall-selector"></div><div class="paywall">



The number of people​​ 65 and older is on track to double by <a href="https://www.urban.org/policy-centers/cross-center-initiatives/program-retirement-policy/projects/data-warehouse/what-future-holds/us-population-aging">2040</a>, reaching 80 million. By <a href="https://www.census.gov/library/stories/2019/12/by-2030-all-baby-boomers-will-be-age-65-or-older.html">2030</a>, all baby boomers will be 65 or older, and the number of family caregivers is dramatically increasing to meet the demand.&nbsp;



As the population ages, gerontologists have pointed to the <a href="https://fortune.com/well/2023/04/15/healthspan-may-be-more-integral-to-your-well-being-than-lifespan-how-to-lengthen-it/">health span–life span gap</a>—the difference between how long someone lives and how long someone lives in good health. The gap, which is wider for <a href="https://fortune.com/well/2025/02/20/halle-berry-respin-menopause-lonegvity-care/">women</a> than for men, means people are spending their last years in poor health, often in need of caregiving services and support. However, there are ways to prioritize your <a href="https://fortune.com/well/2025/02/06/more-men-than-women-believe-they-will-see-life-span-increase-survey/">aging trajectory</a> now to minimize the gap and look forward to a longer life. Public health strategies for aging well are key to helping people age independently and relieving health care strain on the system.&nbsp;



Terry Fulmer, PhD, is the president of the John A. Hartford Foundation, which invests in helping older adults thrive. Fulmer, also a geriatric nurse practitioner, participated in a meeting in 2017 convening health care systems, scholars, and experts to outline the pillars that lead to healthy aging as part of an initiative to create<a href="https://www.johnahartford.org/grants-strategy/current-strategies/age-friendly/age-friendly-care"> age-friendly health systems</a>. The scientific meeting gave birth&nbsp;to the <a href="https://altarum.org/news-and-insights/aaad-snp-care-coordination-and-integration-using-age-friendly-health-systems-4ms">“Age Friendly Health Systems’ 4Ms Framework.”&nbsp;</a>



“I’d like people to anticipate their future with some level of comfort,” Fulmer tells Fortune. She hopes to help others “maximize your capacity as you grow older.”&nbsp;



Here are the 4 M’s to successful aging:&nbsp;



<h2 class="wp-block-heading">Matter</h2>



To age well, you must reflect on your goals and preferences before you think of anything else. “If your goal is to ensure that you are as strong as possible for an upcoming event, then you&#8217;re going to really focus on that, and if your goal is to eliminate pain, you&#8217;re going to focus in a different way,” Fulmer says. “What matters really drives the plan of care.”



Fulmer says that when people share what matters most with their family and health care providers, it helps others support them with their goals. Many share that they do not want to lose their memory like their father may have, which may help them prioritize strengthening their brain, such as maintaining strong social connections, eating well, and trying new things to stimulate the brain.&nbsp;



Focusing on what matters is important for clinicians, too, says Fulmer, because it helps them avoid seeing older adults as a monolith.&nbsp;



“When you come into a clinical visit, you don&#8217;t want to say what&#8217;s the matter with you,” Fulmer says. “You want to say, ‘What matters to you?’ It&#8217;s a very different way of talking to patients when you put it in their hands to tell you their goals and preferences.”



This reflection can shape the rest of the 4 M’s.&nbsp;



<h2 class="wp-block-heading">Medications</h2>



As the risk for chronic conditions increases with age, older adults are more likely to visit a range of providers, from a primary care physician to a cardiologist. Therefore, keeping track of medications and symptoms in one place is critical.&nbsp;



“Not all providers are aware of the other medications you&#8217;re taking,” Fulmer says. “This is super important, to talk to your clinical team and say, ‘Okay, here&#8217;s my list of medications. I want to make sure they&#8217;re safe, that I&#8217;m not taking too many, that I’m taking the right dose, [and] that there aren&#8217;t any interactions.”&nbsp;



Fulmer points to the “<a href="https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18372">Beers Criteria</a>,” a widely used industry checklist for ensuring older adults are not taking harmful medications whose side effects may outweigh the benefits or those that don’t interact well with each other.&nbsp;



<h2 class="wp-block-heading">Mobility</h2>



Mobility is being able to move with ease. It is an essential ingredient to staying active and healthy as you age. To increase mobility, be conscious about moving regularly, getting up when sitting for a while and walking. It’s also important to prioritize strength training to counter age-related muscle loss. You can also work on mobility even if you use a cane or walker, Fulmer says. 



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Older adults are at a higher risk for falls and experience age-related muscle loss. However, Fulmer says these risks alone “created a scenario where people were afraid to move.”&nbsp;



“They were self-limiting, or others were limiting their mobility, and therefore, you have muscle wasting,” she says. “Keep yourself as physically mobile as possible because what do people fear? They fear dependency.”&nbsp;



<h2 class="wp-block-heading">Mind</h2>



As people age, many&nbsp;fear normal age-related cognitive changes. 



“You will have cognitive changes, but talk to your primary care provider about it and tell them what you&#8217;re thinking, and don&#8217;t be embarrassed,” she says.&nbsp;



Keeping the mind healthy at any age by reducing stress, staying connected, sleeping well, and more can help reduce the risk for dementia.&nbsp;



Fulmer hopes the framework will highlight that it&#8217;s never too late to play a more active role in aging.&nbsp;



“It’s celebrating aging, celebrating that longevity, and making sure that we stay in communication with our providers and our families,” Fulmer says. “I want the 18-year-olds out there to think about it when they&#8217;re with their grandparents. We want the 90-year-olds out there to say, ‘There are things I can personally be doing for my own quality of life right now.’”&nbsp;



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“I’d like people to anticipate their future with some level of comfort.”


These 4 ‘Ms’ are the key to successful aging, expert reveals

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