Key Facts:
- Australia's ageing population is placing increasing strain on a health system that spends over $270 billion annually, with the vast majority directed at treating illness rather than preventing it - government spending on prevention totals just $5.4 billion.
- Many conditions associated with ageing, including cardiovascular disease, type 2 diabetes, osteoporosis and frailty, are predictable and preventable, yet the health system remains largely reactive.
- Falls are the leading cause of injury-related hospitalisations in Australia, accounting for more than 240,000 admissions and costing over $5 billion annually, with a hip fracture carrying a one-in-three mortality rate within 12 months.
- Muscle mass and strength begin declining from our thirties, yet only around one in four Australian adults undertakes strength training at least twice a week - a gap with serious consequences for independence, balance and long-term health.
- Evidence-led, clinically supervised strength training should be treated as a vital sign and prioritised as a scalable, practical solution to delay functional decline, reduce pressure on hospitals and aged care, and improve quality of life for older Australians.
OpEd: Ageing isn't inevitable decline. It's a system failure we can afford to fix but choose not to
By Brett Long, CEO, Kieser Australia
Australia is ageing, and how we respond will determine whether our health system remains sustainable or increasingly overwhelmed.
Today, one in six Australians is aged over 65. Within a generation, that will rise to almost one in four. This shift is often framed as an unavoidable burden on hospitals, aged care and government budgets. But that framing misses a critical truth: many of the conditions we associate with ageing are not inevitable. They are predictable, and, in many cases, preventable.
Australia already spends more than $270 billion a year on health, more than 10 per cent of GDP. Governments fund almost $190 billion of that annual bill. Yet the vast majority of this spending is directed toward treating the consequences of decline rather than preventing it.
Hospitals alone account for around $113.8 billion in annual health expenditure. Aged care adds another $36.4 billion, with the majority spent on residential care once people can no longer live independently.
By contrast, government spending on public health and prevention sits at just $5.4 billion, a small fraction of total health outlays.
This imbalance matters, because the costs we are absorbing are not random. They follow a well-established pattern.
Health conditions such as cardiovascular disease, type 2 diabetes, osteoporosis, falls, frailty and cognitive decline rarely appear suddenly in older age. They develop over time, shaped by a complex interplay of factors, including the gradual decline of muscle mass, strength and functional capacity.
As these physical foundations decline, people become increasingly vulnerable, to illness, to injury, and ultimately to a loss of independence.
Falls provide one of the clearest examples of this system failure.
Falls are now the leading cause of injury-related hospitalisations and deaths in Australia, accounting for more than 240,000 hospital admissions each year and costing the health system over $5 billion annually. For older Australians, a fall often marks the beginning of a significant decline, triggering hospitalisation, accelerated deconditioning and transition into residential care. Approximately 90% of hip fractures are the result of a fall, and mortality rates remain high, with one in three individuals dying within 12 months.
Yet despite the scale of this burden, we continue to intervene late.
Our health system remains largely reactive. We respond once people fall, once bones break, once mobility is lost. Prevention is widely discussed, but rarely implemented in a way that is measurable, supervised and evidence-led.
One of the most striking gaps is strength. Muscle mass and strength begin to decline as early as our thirties, accelerating after the age of 60 and again during key life stages such as perimenopause and menopause. This loss is not cosmetic. It is strongly linked to insulin resistance, cardiovascular risk, bone density loss, impaired balance and increased falls risk.
And yet only around one in four Australian adults undertakes strength training at least twice a week.
This matters because strength is not simply about fitness. It is about function. The ability to get up from a chair, climb stairs, carry groceries, stabilise a stumble or recover from illness. These are the capabilities that keep people independent, and keep them out of hospital beds and aged care facilities.
This gap is not theoretical. We see the consequences of it every day. Across our network of 33 clinics, we're working with over 32,000 Australians, with an average age of 60 years. Many arrive after years of inactivity, chronic pain or repeated injury. Others are referred by GPs, surgeons or health insurers who recognise that without restoring strength, recovery will stall.
What is notable is not just the demand, but the outcomes.
Within our clinically supervised, evidence-led programs, clients demonstrate measurable improvements in muscle strength, functional capacity and activities of daily living. Many complete their initial program and continue training well beyond six or twelve months, embedding strength as an ongoing part of their health.
These improvements translate into reduced pain, improved balance, greater confidence and preserved independence, the factors that directly reduce the risk of falls, fractures and progression into higher levels of care.
This is particularly critical for women in mid-life.
Perimenopause and menopause are a critical, and often overlooked, inflection point. Hormonal changes accelerate muscle and bone loss and increase cardiovascular and metabolic risk. Heart disease remains the leading cause of death for Australian women, yet prevention still lags behind.
Decline is a natural part of ageing, but its trajectory is not fixed, without targeted, strength-based intervention it accelerates, while with it, progression can be meaningfully slowed.
During menopause women are often at an increased risk of osteoporosis, a disease that begins much earlier in life but only presents later. By the time they are diagnosed, significant decline has already occurred. That is why intervention needs to start earlier.
The opportunity here is not theoretical. It is practical.
If we can help people maintain strength, balance and functional capacity for longer, we can delay, sometimes by years, the point at which they fall, fracture, require surgery or enter residential care. Even modest delays, applied across a population, would ease pressure on hospitals, reduce aged care demand and improve quality of life for older Australians.
This is not about asking people to "exercise more" in a generic sense. It is about treating strength as a vital sign, something that is assessed, trained and progressed under professional supervision, just as we manage blood pressure or cholesterol.
As Australia grapples with an ageing population and rising health expenditure, we cannot afford to treat functional decline as inevitable. The data tells us where the burden lies. Evidence-led strength training offers a credible, scalable way to slow the ageing process and reduce avoidable strain on our health system.
Australia is living longer. The challenge now is to ensure we are living stronger and healthier, for longer.
About Brett Long
Brett is the CEO and a Director of Kieser Australia. As a musculoskeletal physiotherapist, he worked in private practice and public hospital emergency and orthopaedic wards before joining Kieser in 2013. Outside of Kieser, he is Chair of Victorian branch of the APA PBA committee, on the Curriculum Advisory Board at Swinburne University, and also a guest lecturer at Melbourne, La Trobe and Swinburne Universities
About us:
About Kieser Australia
Kieser is a national network of physiotherapy-led clinics delivering exercise-based therapy as healthcare .
Kieser's model is defined by three core truths:
Clinical: Programs are designed and delivered by qualified physiotherapists, exercise physiologists and exercise scientists, using medically certified, specialised equipment and evidence-based protocols.
Personal: Every program is tailored to the individual, combining clinical reasoning with personalised strength and rehabilitation pathways to restore function and support long-term independence.
Proven: Outcomes are tracked, measured and reviewed. Kieser delivers measurable improvements in pain, function and quality of life, while helping reduce reliance on surgery, hospital care and long-term medication.
This model supports Australians across all ages and stages, from injury recovery to chronic disease management and healthy ageing.
