What Makes a 97-Year-Old Man Cycle 5,000 km a Year?
Background: The nature versus nurture debate is one of the oldest issues in the study of longevity, health and successful aging. Objective: We present a 97-year-old man (I.K.) as an example of the effects of habitual exercise on the aging process. Methods: Extensive assessments included medical examinations, interviews, musculoskeletal structure, performance characteristics, cognitive function and gut microbiota composition. Results: I.K. suffers from iatrogenic hypogonadism, prostate cancer, hypothyroidism and a history of deep popliteal thrombosis. Notwithstanding, he cycles up to 5,000 km a year and participates in competitive sports. His musculoskeletal properties, athletic performance, cognitive function and gut microbiota are outstanding. Some traits even exceed those seen in middle-aged men. Conclusions: His long-term physically and intellectually active lifestyles combined with extensive social interactions have most likely contributed to his exercise capacity, despite his medical history.