Two Fitness Tests Your Doctor Might Do Soon (start now!): Fitness is a Vital Sign

Fitness is a vital sign and this episode may completely change how you think about aging after 40.

If you’re listening carefully, we don’t have a fat problem: we have a muscle problem. With greater strength, power, VO2 max entering menopause women have fewer vasomotor issues and less chance of developing dementia and heart disease. Until fitness is a vital sign, exercise may still feel optional. And… the exercise absolutely is better than nothing but if you want it to really be doing the most good, you measure if it’s working. Because now more than ever, fitness is a vital sign.

In May I taught a brief demonstration to physicians of how to administer two fitness assessments – that can be done and interpreted in less than 3 minutes. These are directly related to sarcopenia. (Defined as significant loss of muscle and strength) Important, right? Some of these functional tests I’ll describe have a stronger relationship with your longevity than your blood pressure, yet that’s never missed in an appointment. 

If your doctor’s visits got an upgrade to the pace of science truly keeping you thriving, this would be it.

How Fitness is a Vital Sign Doctors May Soon Start Testing Routinely

Given the time you spend with a physician is often short, I chose these two tests because they predict so much and don’t just take time, they give you real feedback about the value of your exercise. I want them in your hands (pun intended when you hear what one is) so you can essentially take the pre-test and ace the quiz should your doctor ever start. 

And if not, you’ve got it to take matters into your own hands. 

So let’s go. 

I’m going to start though with a quiz. If you’re walking or driving, hold your fingers up to score. There are only a few questions. I’ll give you the grading scale at the end.

SARC-F Screen for Sarcopenia: Component Question Scoring

Strength: How much difficulty do you have in lifting and carrying 10 pounds?

• None 0
• Some 1
• A lot or unable 2

Assistance in walking: How much difficulty do you have walking across a room?

• None 0
• Some 1
• A lot, use aids, or unable 2

Rise from a chair: How much difficulty do you have transferring from a chair or bed?

• None 0
• Some 1
• A lot or unable without help 2

Climb stairs: How much difficulty do you have climbing a flight of 10 stairs?

• None 0
• Some 1
• A lot or unable 2

Falls: How many times have you fallen in the past year?

• None 0
• 1ess than 3 falls 1
• 4 or more falls 2

Data suggests that a SARC-F score of ≥4 best predicts the need for further, more comprehensive evaluation

Midlife Women Need Strength Training Because Fitness is a Vital Sign

Two Functional Tests

1. Five-Time Chair Stand Test (Strength): Measures how quickly a person can stand up from a seated position five times without using their arms. A time >15 seconds indicates probable sarcopenia. 12-15 increased risk of falls. 
2. Handgrip Strength Test (Strength): Uses a handheld dynamometer to measure muscle strength. Cut-offs for probable sarcopenia are <27 kg (59.5 lbs.)for men and <16 kg (35.2 lbs.) for women. 
   
   

Key Takeaways

• Fitness should be treated as a vital sign alongside blood pressure and heart rate.
• Muscle strength and power are major predictors of longevity and independence.
• Sarcopenia risk increases with age, especially during and after menopause.
• Weight loss without preserving muscle can harm metabolism and long-term health.
• Functional tests like chair stands and grip strength provide valuable insight into aging health.
• Grip strength reflects overall body strength—not just hand strength.
• Strength training is essential for healthy aging, mobility, and recovery.
• Preparing physically today helps you handle future illness, surgery, or setbacks more successfully.
• Functional fitness matters more than appearance alone.
• Measuring progress is critical if you want exercise to support longevity.