10/19/2025
Did you get your 7,000 steps in today? Number of daily steps proposed as 5th vital sign. When you go to a doctor the traditional 4 vital signs are blood pressure, pulse, respiratory rate and weight. Famed physician, Dr. George Lundberg, now age 92 proposes that steps per day be the 5th vital sign. In 2019 he wrote about "How To Be Elderly and Not Frail." (https://www.medscape.com/viewarticle/912106). At that time he focused on the common thread of physical exercise as a core element of aging. What do we mean by exercise? All of it. Strength, balance, coordination, flexibility, and aerobic exercises like walking. Dr. Lundberg has focused on the target of 7,000 steps a day although he practices resistance exercises 3 days a week also.
For years we've focused on walking and other aerobic activities believing that our aerobic fitness level is the best predictor of how long we are going to live. In recent years, right along side of that, we see that our strength and our muscle mass are the best predictor of how well we are going to live. I've found that those who are strong and active in their older years have continued that habit for decades. But I also celebrate those who have become more fit even as they age.
Traditionally in medicine, when you get weak and fall we engage physical therapy to try to address the needs of the frail only to find it does not work well. What does work well is avoiding becoming frail in the first place. If this 92 year old man can get his 7,000 steps in every day I suspect most of us could as well.
