Key takeaways
Eight simple tests, from a VO2max estimate to a 10-second one-leg stand, cover fitness, strength, balance, body shape and sleep in under an hour
In 1,702 adults aged 51 to 75, those unable to stand on one leg for 10 seconds had about 84% higher adjusted risk of death
Test once a year under the same conditions, track the trend, and discuss any worrying result with a doctor
Lifespan is how long you live; healthspan is how long you stay active, independent and free of serious disease. There is no single test for it, but a handful of cheap measurements capture the main ingredients: aerobic fitness, strength, balance, body shape, blood pressure and sleep. Here's a checklist you can do at home in under an hour, once a year.
The checklist
| Test | What you need | What it tells you | Evidence |
|---|---|---|---|
| VO2max estimate | Watch, field test or calculator | Aerobic fitness | Strong |
| Resting heart rate | Watch or a 60-second pulse count | Fitness, recovery | Moderate |
| Blood pressure | Validated upper-arm cuff | Heart and artery strain | Strong |
| Waist-to-height ratio | Tape measure | Abdominal fat | Moderate to strong |
| Grip strength | Hand dynamometer | Overall muscle strength | Moderate to strong |
| Sitting-rising test | Floor space | Strength, flexibility, mobility | Moderate |
| 10-second one-leg stand | A wall nearby for safety | Balance | Moderate |
| Sleep | Diary or wearable | Duration and regularity | Moderate |
1. VO2max estimate
Cardiorespiratory fitness is one of the strongest predictors of survival, as we explain in VO2max and longevity. Use the same method each year: a watch estimate, a field test or our VO2max calculator. Then compare with norms for your age or check your fitness age. Remember that watch values have an error margin (see how accurate is watch VO2max?), so look at the trend rather than one number.
2. Resting heart rate
Measure it on waking, before coffee, or use your watch's weekly average. A meta-analysis of 46 studies (Zhang et al., 2016) linked every 10 beats per minute higher resting heart rate to about 9% higher all-cause mortality. It's affected by sleep, alcohol, stress and illness, so use averages. More in resting heart rate and HRV.
3. Blood pressure
Use a validated upper-arm monitor. Sit quietly for five minutes, back supported, arm at heart level, and take two or three readings on several mornings and evenings. Blood pressure has some of the best trial evidence of any marker: each 10 mmHg lower systolic pressure was linked to 13% lower all-cause mortality in a large meta-analysis (Ettehad et al., 2016). Ask your doctor which target applies to you.
4. Waist-to-height ratio
Measure your waist midway between your lowest rib and the top of your hip bone, after breathing out normally, and divide by your height in the same units. A meta-analysis of studies with more than 300,000 adults (Ashwell et al., 2012) found this ratio detected cardiometabolic risk better than BMI or waist alone. The UK's NICE suggests keeping your waist to less than half your height (a ratio under 0.5). See also VO2max and body weight.
5. Grip strength
A hand dynamometer costs about the same as a pair of running shoes. Take the best of three squeezes with each hand. In the PURE study (Leong et al., 2015), each 5 kg lower grip strength was associated with about 16% higher all-cause mortality. Grip is a proxy for overall strength, so train your whole body, not just your hands (see strength training for runners).
6. Sitting-rising test
Stand barefoot, then sit down on the floor and stand up again, using as little support as you can. Start at 5 points for sitting and 5 for rising, and subtract one point for each hand, knee, forearm or other support. In 2,002 adults aged 51–80 (Brito, Araújo et al., 2012), lower scores were linked to higher mortality, and each extra point was associated with 21% better survival. Skip it if you have joint problems or a high fall risk.
A simpler alternative is the 30-second chair stand: count how many times you can stand up fully from a chair with arms crossed. Track your own trend year to year.
7. Ten-second one-leg stand
Stand on one leg, the other foot resting behind the standing calf, arms by your sides, eyes forward, for 10 seconds. Have a wall or chair nearby. In 1,702 adults aged 51–75 (Araújo et al., 2022), about one in five could not do it, and they had 84% higher adjusted risk of death over about seven years. Balance can be trained, and it matters for preventing falls.
8. Sleep
Keep a one-week sleep diary or use your wearable's averages. A meta-analysis of 1.4 million people (Cappuccio et al., 2010) found both short sleep (relative risk 1.12) and long sleep (1.30) were linked to higher mortality, though long sleep may partly reflect existing illness. Aim for regular timing and enough sleep to feel rested (see VO2max and sleep).
How to track it yearly
- Same month, same conditions. Rested, not after a hard session or illness.
- Write it down in a simple spreadsheet: one row per year, one column per test.
- Focus on direction. A falling VO2max estimate, rising blood pressure or a failed one-leg stand matters more than where you stand against a chart.
- Add lab tests with your doctor: ApoB or a lipid panel and HbA1c are the most useful. See longevity biomarkers and, if you train hard, blood tests for athletes.
What this checklist can't do
These tests are screening tools, not diagnoses. Most of the evidence is observational: people who score well also tend to be healthier in other ways. Still, nearly every item responds to training, which makes them useful targets. For the latest research on how changes in fitness relate to risk, read our 2025–2026 research update.
Discuss your results with a doctor, particularly high blood pressure, chest pain or breathlessness on exertion, or a sudden drop in any score.
Frequently asked questions
How do you measure healthspan?
There is no single healthspan test. A practical approach combines measures of aerobic fitness, strength, balance, body shape, blood pressure, resting heart rate and sleep, repeated yearly so you can see trends.
What is the sitting-rising test?
You sit down on the floor and stand up again using as little support as possible. Each hand, knee or other support costs a point from a maximum of 10. In a Brazilian study of adults aged 51 to 80, lower scores were linked to higher mortality.
What waist-to-height ratio is healthy?
The UK's NICE advises keeping your waist to less than half your height, a ratio below 0.5. A ratio of 0.6 or more indicates high central fat and further increased health risk.
How often should I check my healthspan markers?
Once a year is enough for most tests. Check blood pressure more often if it is raised, and retest sooner if you start a new training plan or notice a decline. Share results with your doctor.
Sources
- Zhang D, Shen X, Qi X. Resting heart rate and all-cause and cardiovascular mortality in the general population: a meta-analysis. CMAJ, 2016;188(3):E53-E63.
- Ettehad D, Emdin CA, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet, 2016;387(10022):957-967.
- Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev, 2012;13(3):275-286.
- National Institute for Health and Care Excellence (NICE). Keep the size of your waist to less than half of your height, NICE recommends. News release, April 2022.
- Leong DP, Teo KK, Rangarajan S, et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet, 2015;386(9990):266-273.
- Brito LB, Ricardo DR, Araújo DS, Ramos PS, Myers J, Araújo CG. Ability to sit and rise from the floor as a predictor of all-cause mortality. Eur J Prev Cardiol, 2014;21(7):892-898 (published online 2012).
- Araujo CG, de Souza e Silva CG, Laukkanen JA, et al. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. Br J Sports Med, 2022;56(17):975-980.
- Cappuccio FP, D'Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep, 2010;33(5):585-592.