Alarmed by the sustainability of our health and social security systems, longevity has become a great societal challenge. In line with evolutionary logic we see a continuous increase of average life expectancy and maximal lifespan. Striving for a healthy old age, however, is an infelicitous expression as for human subjects the ageing process cannot be ultimately postponed. Not disregarding the huge variation in health trajectories, in old age we will all suffer from frailty and infirmity. As yet efforts of the biomedical arena are almost exclusively focused on stalling the ageing process and preventing dysfunction. Too little effort is spend on how to inspire and coach the great majority of people who still feel relatively well notwithstanding the presence of multiple age-related disorders. There is a strong rationale to separate the quest to live in good health for longer from actively and effectively negotiating the challenge of functional decline in old age. In particular, we emphasise a focus on adjusting the environment in order to correct the gene–environment mismatch that contributes to ill health. An additional strategy is to empower people to set ambitions and to realise appropriate goals, in spite of infirmity. Striving for vitality presents a striking opportunity to achieve subjective feelings of life satisfaction when ageing.