9 - Decades of Positive Lifestyle: A Case Study of a 94-Year-Old’s Path to Wellness and Muscle Strength Maintenance

Abstract

        Healthy aging and the maintenance of physical performance are critical public health priorities, particularly in preventing sarcopenia. Grounded in the six pillars of Lifestyle Medicine, this qualitative study utilized a single-case study and narrative inquiry design to explore the lifestyle practices, shaping factors, and lived experiences of a 94-year-old Thai male. The participant was selected through purposive sampling as an exceptional case due to his extraordinary physical capacity and status as a national master-athlete gold medalist. Data collection involved semi-structured in-depth interviews, family contextual data, field notes, and body composition evaluation via Bioelectrical Impedance Analysis (BIA). Data were analyzed using thematic analysis and narrative interpretation. Methodological trustworthiness was rigorously established through data triangulation, member-checking, researcher reflexive journaling, and the maintenance of an audit trail to ensure consistency.

            The findings revealed that preserving physical fitness into advanced old age is deeply linked to the lifelong accumulation of health capital across six interconnected dimensions: (1) continuous physical activity sustained as a core personal identity, objectively reflected by a skeletal muscle mass index (SMI) of 7.1 kg/m² and a metabolic age of 69 years; (2) nutritional patterns emphasizing traditional whole foods and protein intake while avoiding ultra-processed products; (3) disciplined sleep hygiene averaging 8 hours daily; (4) robust social connection anchored in family and community networks; (5) stress management achieved through emotional resilience and a clear purpose in life; and (6) midlife cessation of smoking and alcohol, heavily reinforced by family values.

            This study suggests that healthy aging is determined by the intersection of long-term health behaviors, psychological resilience, and supportive social environments. These qualitative insights offer empirical evidence to guide community-based health promotion models aimed at sustaining muscle strength and preventing sarcopenia in aging populations.