During a checkup recently, an 82-year-old patient asked me what more he could do to stay healthy. It was tempting to tell Mr. Johnson to keep doing what he's been doing -- he is in great shape.

But he wanted advice, so we talked about what helps older people to live longer, and live well.

First, it's important to know that people live longer these days thanks to modern medicine and our increased knowledge and awareness of healthy behaviors. In short, 80 is the new 65.

If you make 80 in good condition, you have a higher chance of making it to 90, or even 100. So how do we do that?

Past decisions matter. Mr. Johnson -- not his real name -- does not smoke, and he avoided tobacco when he was younger. He drinks only a few alcoholic beverages each week, and his moderate diet helped keep his weight in a healthy range and out of danger for diabetes. He also wears a seat belt and avoids driving at night.

Many people who have not yet lived to Mr. Johnson's age don't always understand the significance of our health decisions until we contemplate how to extend a happy life that has already run long.

Genetics do matter, but prevention matters more than ever before.

Everyone, seniors included, should make sure they receive the doctor-recommended vaccinations, including your annual flu shot. It's also important to make sure you get screened regularly for conditions that could matter in the long run.

Colon cancer and blood pressure checks are easy. Ask about depression, another simple screening for a treatable condition. Mammograms, prostate checks, cervical cancer and bone density screening are all important.

Despite their best efforts, many aging folks do develop conditions such as high blood pressure or diabetes. If you do develop a chronic disease, your management of it will have direct bearing on the length and quality of your life.

It could mean new dietary and exercise requirements -- probably changes that you should make anyway -- and medication, which should be used as gently as possible. You might need regular tests, as well, so you and your doctor can keep track of your health.

Even people without health complications can expect some additional maintenance requirements. If you don't use it you will lose it. Regular exercise is important for seniors who hope to maintain limber joints.

Make sure you design your environment. Keep an eye open for tripping hazards in the home, and think about handholds for the shower or stairs. Speaking of stairs, they can be a big challenge as we age, and potentially a reason to consider single-story housing options.

Finally, walking and talking are perishable skills. The healthiest seniors walk around their community, and have a community in which to walk. They keep active and stay connected to family and friends, and keep their brains active.

That's what Mr. Johnson does. He's very engaged with his friends and his son, and remained so even after his wife died a year ago.

He's even thinking about volunteering at a local school, and adopting a dog to keep him walking -- and adding some unconditional love to his life.

Dr. Pepper practices family medicine at the Martinez Health Center. Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at theairdoctor@gmail.com. For more health information, go to www.cchealth.org.