Lifestyle Medicine and Healthy Ageing in Viet Nam: Preserving Function, Reducing Frailty Risk and Supporting Independence

Lifestyle Medicine and Healthy Ageing in Viet Nam: Preserving Function, Reducing Frailty Risk and Supporting Independence

Last reviewed: 23 September 2026

Viet Nam is ageing rapidly. Within about a decade, more than one in five people in the country is projected to be over the age of 60. This is an important achievement of development: people are living longer, with life expectancy now estimated at 74.7 years. Yet healthy life expectancy is estimated at 65.4 years, leaving a gap of more than nine years during which many people may live with illness or functional limitations. Population ageing therefore raises a question that goes well beyond longevity: can people continue to move, think, communicate, participate in family and community life, make their own decisions and remain as independent as possible as they grow older? [3]

Lifestyle Medicine has an important role in that discussion, but its role needs to be understood carefully. It is not an anti-ageing treatment, it does not stop biological ageing, and it should not be presented as a substitute for geriatric medicine, rehabilitation, appropriate medication, surgery, long-term care or social support. Its contribution is more practical: addressing modifiable behaviors and environments that can influence chronic disease, physical and mental capacity, muscle health and the ability to function over time.

Healthy ageing is about function, not simply the absence of disease

The World Health Organization defines healthy ageing as the process of developing and maintaining the functional ability that enables well-being in older age. Functional ability depends on a person's intrinsic capacity, meaning their physical and mental capacities, the environment in which they live and the interaction between the two. It includes the ability to meet basic needs, learn and make decisions, be mobile, maintain relationships and contribute to society. Importantly, being free of disease is not a requirement for healthy ageing. Someone can live with hypertension, diabetes, osteoarthritis or another chronic condition and still maintain substantial independence and well-being when their health is appropriately managed. [1]

This distinction matters because chronological age and the number of diagnoses tell us only part of the story. One older person may have several well-controlled chronic conditions and remain active and independent, while another person with no single severe diagnosis may experience progressive weakness, impaired mobility, social isolation, cognitive decline or difficulty performing everyday activities. Healthy ageing therefore needs to consider function, autonomy, participation and quality of life, not only laboratory values, diagnoses or years lived.

This perspective is also central to the World Health Organization's updated Integrated Care for Older People guidance. The second edition, published in 2025, describes a person-centered pathway beginning with basic assessment, followed when needed by more detailed assessment, development of a personalized care plan, and implementation and monitoring. It considers intrinsic capacity across cognition, mobility, vitality, vision, hearing and psychological capacity, together with social support, caregiver needs and other health concerns. [2]

Lifestyle Medicine can complement this approach because nutrition, physical activity, sleep, stress, social connection and avoidance of risky substances influence several dimensions of health across the life course. The relationship should remain complementary, however. Lifestyle Medicine is one part of healthy ageing, not a replacement for comprehensive care of older people.

Viet Nam's ageing transition is already a health-system issue

Under Viet Nam's Law on the Elderly, an older person is a Vietnamese citizen aged 60 years or older. The current consolidated text, No. 23/VBHN-VPQH dated 26 February 2026, retains this definition and establishes rights relating to healthcare and opportunities to participate in cultural, educational, physical, recreational and social activities. [4]

Population ageing is increasingly reflected in national policy. The National Strategy on Older Persons to 2035, with a vision to 2045, approved by Decision No. 383/QĐ-TTg in February 2025, provides a national framework for protecting, caring for and promoting the role of older people as Viet Nam adapts to population ageing. [5]

The policy direction became more concrete in June 2026. Decision No. 1116/QĐ-TTg amended the Programme on Health Care for Older Persons to 2030. The programme states that, from 2026, older people should receive a free periodic health examination or screening at least once each year and have individual health records established for monitoring and management. By 2030, it targets at least 90% of older people being detected, treated and managed for major noncommunicable diseases, including cancer, cardiovascular disease, hypertension, diabetes, chronic obstructive pulmonary disease and dementia. It also sets targets for community-based care, volunteer networks, daytime care models and geriatric services. [6]

On 3 September 2026, the Government also approved the Programme on Strengthening International Cooperation on Older Persons for 2026–2031. Its priorities include healthy ageing, long-term care, old-age security, development of the care workforce, data and digital transformation, age-friendly environments and the development of products and services for older people. [7]

This policy context matters for Lifestyle Medicine. Healthy ageing should not become another stand-alone wellness program operating outside the health system. It should connect with primary care, geriatrics, rehabilitation, clinical nutrition, mental health, community health, chronic disease management and the developing system of long-term care.

Frailty, sarcopenia and muscle health are related, but not the same

One of the most useful concepts in healthy ageing is frailty. Frailty describes reduced physiological reserve and increased vulnerability, meaning that a relatively modest stressor such as an infection, hospitalization, fall or medication change can result in a disproportionately large decline in health or function. [8] Frailty should not be used as another word for “old”. Many people remain active and independent well into later life, while vulnerability can vary substantially among people of the same chronological age.

Frailty is also not necessarily a fixed, one-way state. Appropriately designed exercise, nutrition support and comprehensive care can improve frailty-related outcomes and physical function in some older adults, although effects vary and not every person's frailty can be prevented or reversed. A 2024 systematic review and meta-analysis of 28 randomized trials involving 4,857 frail older adults found that multicomponent exercise improved frailty status and several measures of physical function, including muscle strength, gait speed, balance and functional performance. [9]

Sarcopenia overlaps with frailty but is not the same condition. It focuses more specifically on deterioration in skeletal muscle health, while frailty is a broader state of vulnerability involving multiple domains. The Asian Working Group for Sarcopenia 2025 Consensus Update represents an important shift for Asian populations. It extends sarcopenia assessment into middle age, including adults aged 50–64 years, simplifies diagnosis around the concurrent presence of low muscle mass and low muscle strength, and treats physical performance as an important outcome. More broadly, it reframes the discussion from detecting sarcopenia late in life toward promoting muscle health across the life course. [10]

This is highly relevant to Viet Nam. Preparing for population ageing cannot begin when people turn 60. Muscle strength, physical activity, nutrition, obesity, diabetes, smoking, alcohol exposure and cardiovascular health develop across decades. The responsible goal is therefore reducing frailty risk, recognizing decline early, preserving muscle health and supporting function, not promising to “reverse ageing”.

Movement matters, but “walk more” is not enough

Physical activity is one of the strongest connections between Lifestyle Medicine and healthy ageing. Aerobic activity supports cardiovascular and metabolic health, but maintaining independence also depends on strength, balance and mobility. World Health Organization guidance recommends that older adults undertake regular physical activity, including 150–300 minutes of moderate-intensity aerobic activity, or 75–150 minutes of vigorous-intensity activity, or an equivalent combination each week. Muscle-strengthening activities involving major muscle groups are recommended on at least two days each week, while varied multicomponent physical activity emphasizing functional balance and strength training is recommended on three or more days each week to enhance functional capacity and help prevent falls. [11]

These numbers are useful population-level guides, but they should not become rigid prescriptions for every older person. Someone who is healthy and active may be able to combine walking, cycling, resistance training and balance exercises. Someone living with frailty, significant osteoarthritis, neurological disease, cardiovascular disease, recent falls or functional impairment may require assessment, gradual progression, adaptation or supervised rehabilitation.

For this reason, physical activity in later life should not be reduced to a target for minutes or steps. Some of the outcomes that matter most are highly practical: Can the person rise from a chair? Climb stairs? Carry groceries? Recover balance? Walk safely outside? Continue doing the activities that matter to them? Those abilities may depend as much on muscle strength, balance and mobility as on aerobic fitness.

Nutrition and weight management should protect muscle and function

Healthy eating remains important throughout life, but nutrition in older adults should not simply mean applying increasingly restrictive diets. The current international core definition of Lifestyle Medicine includes a whole-food, plant-predominant eating pattern among its evidence-based therapeutic lifestyle interventions. [12]

Older adults, however, may also face reduced appetite, chewing or swallowing difficulties, unintended weight loss, loss of muscle, chronic disease, financial constraints or difficulty purchasing and preparing food. In these situations, preventing undernutrition and maintaining adequate energy and protein intake may become a more immediate clinical priority than pursuing an idealized dietary pattern.

Exercise and nutrition also interact. A systematic review and network meta-analysis published in August 2026 found that adding protein or protein-related supplementation to resistance or functional exercise may provide additional benefit for some measures of grip strength and appendicular skeletal muscle mass in older adults with sarcopenia or at high risk. However, the evidence network was sparse and certainty was generally very low, so the study could not establish one supplementation strategy as clearly superior. [13]

The practical principle for Viet Nam should therefore be individualized rather than commercial. Diet, nutritional status, health conditions, medications, kidney function where relevant, the ability to chew and swallow, food access and financial circumstances should all be considered before major dietary changes or additional nutritional products are recommended. Food should remain central. Supplements may have appropriate clinical roles, but they should not become the defining feature of healthy ageing.

Weight management deserves similar nuance. Obesity remains clinically important in older adults, and intentional weight reduction may improve cardiometabolic health and mobility in selected people. But weight loss can also include loss of lean tissue, so an older adult who becomes lighter while simultaneously becoming weaker has not necessarily achieved a better overall health outcome.

This issue has become more relevant as pharmacological obesity treatment expands. A 2026 scoping review focused on glucagon-like peptide-1 receptor agonists in older adults concluded that weight loss can be accompanied by muscle-mass loss, while evidence on muscle indices and physical performance remains limited and inconsistent. A separate 2026 narrative review found that direct evidence specifically in older adults remains scarce: only four of 21 included studies specifically examined adults aged 65 years or older, making age-specific conclusions uncertain. [14,15]

This does not mean that these medicines should be avoided in older adults when clinically indicated. It means that treatment goals should extend beyond body weight alone. Muscle preservation, strength, nutritional adequacy, mobility, comorbidities and the person's priorities should be considered alongside cardiometabolic benefit.

Sleep, mental health and social connection also shape functional ageing

Healthy ageing is not only about muscle and metabolism. Sleep problems, depression, anxiety, cognitive decline, loneliness and social isolation can influence physical activity, nutrition, medication adherence, motivation and the ability to live independently. Sleep should therefore be assessed rather than assuming that every older person simply needs to “sleep more”. Insomnia, obstructive sleep apnea, chronic pain, nocturia, medication effects and changes in circadian rhythms may require very different responses.

Recent evidence also links sleep and frailty, although causality remains uncertain. A 2025 systematic review found associations between poor sleep quality, abnormal sleep duration and frailty, while another 2025 meta-analysis of observational studies found both short and long sleep duration to be associated with a higher prevalence of frailty. Because much of this evidence is cross-sectional or observational, these findings should not be interpreted to mean that changing sleep duration alone will prevent frailty. [16]

Social connection deserves similar attention. Relationships, community participation, meaningful roles and opportunities to contribute can support well-being and help people remain engaged in everyday life. Viet Nam already has community assets relevant to this area. United Nations Population Fund-supported Intergenerational Self-Help Clubs, for example, combine basic health monitoring, peer support, livelihood activities, social participation and mutual assistance. These clubs should not automatically be labelled Lifestyle Medicine interventions, but they illustrate an important principle: healthy ageing can be supported through communities and social relationships as well as through clinical care. [3]

Multimorbidity and the environment change what is realistic

Older adults commonly live with more than one chronic condition. A person may simultaneously have hypertension, diabetes, chronic kidney disease, osteoarthritis, osteoporosis, sleep problems and several regular medications. This makes Lifestyle Medicine potentially valuable because improvements in physical activity, nutrition, sleep or smoking can influence several conditions at the same time. But it also makes care more complicated.

Significant changes in diet, body weight or activity can alter blood pressure, glucose levels, symptoms and sometimes medication needs. Frailty, falls risk, kidney disease, cardiovascular disease or other conditions may affect how physical activity should progress or what nutritional intervention is appropriate. Tobacco and harmful alcohol use also remain relevant in later life, particularly because dependence, multimorbidity and medication interactions may require more than brief lifestyle advice.

Lifestyle Medicine in older adults should therefore connect with medication review, nutritional assessment, falls prevention, rehabilitation and disease-specific clinical care where indicated. “Lifestyle first” should never be interpreted as “lifestyle only.” The aim is not simply to improve isolated risk factors, but to improve health and function while minimizing unnecessary treatment burden and harm.

The physical and social environment also matters. An older person may be advised to walk every day but live in an area without safe sidewalks. Another may be encouraged to improve dietary quality but depend on someone else to shop and prepare meals. Someone may need rehabilitation but have difficulty reaching a facility. The World Health Organization includes environmental factors explicitly in its concept of functional ability because housing, transport, neighborhood design, health and social care, relationships, income and public policy all interact with individual capacity. [1]

This is particularly relevant in Viet Nam. United Nations Population Fund analysis reports that around 99% of older people rely on family care, with women carrying approximately 72% of caregiving responsibilities, while formal integrated long-term care remains underdeveloped. The same analysis highlights important inequalities affecting older women, rural residents, ethnic minority populations and people without adequate income security. [3]

Good Lifestyle Medicine practice should recognize these realities rather than interpreting difficulty following recommendations as a failure of personal responsibility.

What should healthcare organizations measure and do differently?

Healthy ageing provides an opportunity to move beyond disease-by-disease care toward a more functional and person-centered model. Primary care and outpatient services can consider incorporating assessment of mobility, nutritional status, cognition, psychological well-being, sensory impairment, social support and falls risk when clinically appropriate. Hospitals can pay closer attention to mobility, nutritional decline and deconditioning during and after admission. Rehabilitation services can connect recovery with longer-term physical activity and behavior support, while community programs can help maintain participation after formal clinical care ends.

The World Health Organization's Integrated Care for Older People framework offers a useful international structure for this work. It should be adapted to the Vietnamese context rather than copied mechanically, and it needs to operate alongside Vietnamese clinical guidance, professional roles, available resources and local referral pathways. Lifestyle Medicine can add value by strengthening the lifestyle, behavior-change and chronic-disease components of this broader model. The two approaches share an important principle: care should be organized around the person and their function, not only around individual diagnoses. [2]

Healthy ageing also changes what counts as a meaningful outcome. Blood pressure, glucose, lipids and body weight remain important where clinically relevant, but they do not capture everything that matters to an older person. Depending on the setting and individual needs, meaningful measures may also include muscle strength, mobility, balance, falls, nutritional status, activities of daily living, quality of life, social participation and the person's own priorities.

Someone who can again walk to the local market, prepare a meal, participate in family life or remain independently at home may have achieved an important health outcome even if no laboratory result has changed dramatically. This is consistent with the broader World Health Organization approach to healthy ageing and its 2025 monitoring framework for the United Nations Decade of Healthy Ageing, which emphasizes systematic measurement and stronger national monitoring and evaluation systems. [17]

Professional boundaries still matter

Healthy ageing is inherently multidisciplinary. Physicians, nurses, clinical nutrition practitioners, rehabilitation professionals, clinical psychologists, pharmacists, social-care professionals and community workers may all contribute, but they do not perform the same functions.

Under Viet Nam's current Law on Medical Examination and Treatment, reflected in Consolidated Document No. 26/VBHN-VPQH dated 26 February 2026, individuals who perform medical examination and treatment are generally subject to applicable licensing, practice registration and scope-of-practice requirements. The law expressly prohibits medical examination and treatment without meeting the applicable conditions or outside the authorized professional scope, except in circumstances specified by law. [18]

Lifestyle Medicine education or certification does not, by itself, create a new Vietnamese healthcare profession, practice licence or expanded scope of practice. Clinical assessment, diagnosis, prescribing and treatment must therefore remain within the lawful professional authority of the person providing them. Educational, community-based and social-care activities likewise need to comply with the legal and professional requirements applicable to the services actually being provided.

The same distinction applies to sarcopenia. The Asian Working Group for Sarcopenia 2025 Consensus is an important contemporary scientific reference for Asian populations, but it should not be presented as a Vietnamese legal or regulatory standard unless it is incorporated into applicable Vietnamese professional guidance. For education, the most useful approach is to strengthen recognition, evidence appraisal, appropriate assessment, interdisciplinary collaboration and referral while maintaining clear professional boundaries.

Healthy ageing starts long before old age

Perhaps the most important lesson is that healthy ageing should not begin at age 60. Muscle reserve, cardiovascular and metabolic health, smoking exposure, dietary patterns, sleep, social relationships and physical activity develop across decades. By the time significant frailty or disability becomes apparent, many opportunities for earlier prevention may already have been missed.

This life-course perspective is one reason the Asian Working Group for Sarcopenia now extends its muscle-health framework into middle age. It also fits naturally with Lifestyle Medicine: interventions that reduce chronic disease risk at 40 or 50 may help preserve capacity at 70 or 80. The practical message is not that ageing can be avoided. It is that the trajectory of ageing can be influenced by health, behavior, disease management and environment across the life course. [10]

What this means for Viet Nam

Viet Nam's ageing transition should not be framed only as a future burden on healthcare, families or social protection. Longer life is an achievement of development. The challenge is to ensure that additional years of life can include as much health, dignity, participation and independence as possible.

Lifestyle Medicine can contribute because many factors associated with chronic disease and functional decline are potentially modifiable. It will be most useful, however, when connected with geriatrics, primary care, rehabilitation, clinical nutrition, mental health, community services and social policy rather than developed as a parallel system.

For Viet Nam, several practical priorities follow. Health professionals need stronger capability in healthy ageing, physical function and muscle health. Functional decline, frailty and nutritional risk should be recognized earlier when appropriate. Resistance and balance training need greater visibility alongside aerobic activity. Lifestyle assessment can be integrated with chronic-disease and older-person care. Referral pathways between primary care, specialist care, rehabilitation, clinical nutrition, mental health and community services need to become clearer. Outcomes should include function and quality of life, not simply biomarkers.

Local research will also be essential. Viet Nam needs better evidence on frailty and sarcopenia, nutrition and muscle health, community-based models, integrated care, social connection, long-term care and the ways socioeconomic and geographic conditions influence functional ageing. These priorities align increasingly well with national policy, including the National Strategy on Older Persons, the revised Programme on Health Care for Older Persons to 2030 and the 2026–2031 Programme on Strengthening International Cooperation on Older Persons. [5–7]

The goal is not to defeat ageing

Healthy ageing should not be marketed as a promise to remain young. Ageing is a normal part of life. Disease, frailty and loss of independence are not synonymous with ageing, and people of the same chronological age can have very different capacities, circumstances and priorities.

The contribution of Lifestyle Medicine is therefore not to “reverse age”. It is to help create conditions in which people can preserve physical and mental capacity, reduce avoidable disease burden, remain connected to others and continue doing what matters to them for as long as possible.

For Viet Nam, this may become one of the most important applications of Lifestyle Medicine over the coming decade. The question is not simply how many additional years people can live, but how much function, independence, connection and meaning can be preserved within those years.

References and further reading

1. World Health Organization. Healthy ageing and functional ability. World Health Organization.

2. World Health Organization. Integrated Care for Older People (ICOPE): Guidance for Person-Centred Assessment and Pathways in Primary Care. Second edition. 2025.

3. United Nations Population Fund Viet Nam. Population Ageing in Viet Nam: From Demographic Transition to Development Opportunity. 10 February 2026.

4. Office of the National Assembly of Viet Nam. Consolidated Document No. 23/VBHN-VPQH dated 26 February 2026, Law on the Elderly.

5. Prime Minister of Viet Nam. Decision No. 383/QĐ-TTg dated 21 February 2025 approving the National Strategy on Older Persons to 2035, with a vision to 2045.

6. Prime Minister of Viet Nam. Decision No. 1116/QĐ-TTg dated 22 June 2026 amending and supplementing Decision No. 1579/QĐ-TTg approving the Programme on Health Care for Older Persons to 2030.

7. Prime Minister of Viet Nam. Decision No. 1702/QĐ-TTg dated 3 September 2026 approving the Programme on Strengthening International Cooperation on Older Persons for 2026–2031.

8. Morley JE, Vellas B, van Kan GA, et al. Frailty Consensus: A Call to Action. Journal of the American Medical Directors Association. 2013;14(6):392–397. doi:10.1016/j.jamda.2013.03.022.

9. Yang X, Li S, Xu L, et al. Effects of multicomponent exercise on frailty status and physical function in frail older adults: A meta-analysis and systematic review. Experimental Gerontology. 2024;197:112604. doi:10.1016/j.exger.2024.112604.

10. Chen LK, Hsiao FY, Akishita M, et al. A Focus Shift from Sarcopenia to Muscle Health in the Asian Working Group for Sarcopenia 2025 Consensus Update. Nature Aging. 2025;5(11):2164–2175. doi:10.1038/s43587-025-01004-y.

11. World Health Organization. WHO Guidelines on Physical Activity and Sedentary Behaviour. Geneva: World Health Organization; 2020.

12. Rea BL, Cheema S, Lanza S, Makinde MT, Matthews S, Palma M, Kadosh MA, Lapsa-Lešinske A, Karlsen MC. Governance and Update Process for Lifestyle Medicine Core Competencies and Definitions. American Journal of Lifestyle Medicine. 2026;20(7):1116–1123. doi:10.1177/15598276261424740.

13. Yang B, Chen X, Yuan G, Zhang X, Lu D. Comparative effectiveness of protein or protein-related supplementation combined with resistance or functional exercise for sarcopenia in older adults: a systematic review and network meta-analysis. Frontiers in Nutrition. 2026;13:1892302. doi:10.3389/fnut.2026.1892302.

14. Simsek H, Ucar A. GLP-1 Receptor Agonists for Obesity Management in Older Adults: A Scoping Review on the Risk of Sarcopenia and Sarcopenic Obesity. Current Nutrition Reports. 2026;15:55. doi:10.1007/s13668-026-00777-x.

15. Jagasia K, Pfeiffer AM, Vitale K. GLP-1 receptor agonist therapy and skeletal muscle: A narrative review synthesizing adult evidence with implications for older adults. The Journal of Aging Research & Lifestyle. 2026;15:100083. doi:10.1016/j.jarlif.2026.100083.

16. Liu HM, Xue YJ, Tang KW, et al. Association between sleep duration and frailty in older adults: Systematic review and meta-analysis of observational studies. Archives of Gerontology and Geriatrics. 2025;137:105949. doi:10.1016/j.archger.2025.105949.

17. World Health Organization. Measuring the Progress and Impact of the UN Decade of Healthy Ageing (2021–2030): Framework and Indicators Recommended by the WHO Technical Advisory Group. 2025.

18. Office of the National Assembly of Viet Nam. Consolidated Document No. 26/VBHN-VPQH dated 26 February 2026, Law on Medical Examination and Treatment.

Clinical and regulatory note: This article is intended for professional education and discussion. It does not provide individual medical advice or establish a clinical protocol, Vietnamese professional scope of practice or regulatory standard. Frailty, sarcopenia, nutritional risk, cognitive decline, falls and other health concerns in older adults may require individualized assessment and multidisciplinary management. Lifestyle interventions should be adapted to the person's health status, functional capacity, treatment plan and professional guidance.

Privacy Policy and Personal Data Protection Notice

Terms and Conditions

VLMA is operated by Vietnam Lifestyle Medicine Alliance Company Limited, Enterprise Registration Number 0318902666.

VLMA is a Sister Organization of the Lifestyle Medicine Global Alliance and a Member Organization of the Planetary Health Alliance.

VLMA is not a medical service provider and does not issue medical licenses or IBLM certification.