<i>Ars Longa</i> : Michelangelo Buonarroti's Longevity (1475–1564) Analyzed by His Musculature

The year 2025 marks the 550th anniversary of the birth of Michelangelo Buonarroti (1475–1564), one of the longest-lived artists of the Italian Renaissance [1]. Hence, this year offers a timely opportunity to re-examine a work of art that may offer valuable insights into his longevity. Michelangelo had a long and highly productive life as a sculptor, painter, architect, anatomist, and, to a lesser degree, a poet. His talent was recognized early on, and at the age of 15, he was taken into the Medici household by Lorenzo the Magnificent, ruler of Florence and famous patron of the arts. After 4 years there, he moved to Rome and eventually created works for 7 popes at various times during his lifetime. Moreover, he was considered a genius by many of his contemporaries, including the celebrated Renaissance artist and historian Giorgio Vasari [1, 2]. Research suggests the average life expectancy of Renaissance artists was approximately 63.6 ± 0.9 years for painters and 67.4 ± 1.1 years for sculptors [3]. Michelangelo, however, was a notable exception, as he remained active until the age of 89. The reasons behind his remarkable longevity remain unclear, largely due to the paucity of studies on the topic. The analysis offered here provides a unique interpretation of a representation of the artist, which may help shed light on some of the key factors that contributed to his extended lifespan. This type of analysis has gained significant recognition in various fields of medical science, particularly for enhancing students' observational skills, clinical reasoning, empathy, and ethical awareness [4]. This is especially true because in this study model it is possible to achieve, at least in part, an intersection of medical sciences with the arts and humanities. Accordingly, many medical schools have adopted this model to strengthen the humanistic dimension of medical education. The method—commonly referred to as iconodiagnosis—involves a retrospective medical diagnosis based on a work of art, allowing for inferences about the health of the individual portrayed. Moreover, it also represents a multidisciplinary and transcultural exercise, which improves and expands the knowledge of the History of Medicine, Art History, and History in general. This approach is especially valuable in cases where no written or biological records are available regarding the subject's health. Therefore, the physical features portrayed in a work of art play a crucial role in supporting iconodiagnostic evaluations [4]. Michelangelo depicted in old age as a blind pilgrim led by a dog (reverse) [diameter: 5.9 cm; gross weight: 52.42 g]. Courtesy National Gallery of Art, Washington; Samuel H. Kress Collection. Previous studies have shown a positive correlation between calf circumference and muscle mass, with smaller calf measurements being linked to sarcopenia and even increased mortality risk. Sarcopenia, a condition common in older adults, involves the progressive loss of muscle mass and function, significantly affecting overall health and quality of life. Thus, sarcopenia constitutes a key factor of physical disability that prevents older adults from leading independent lives [6]. Therefore, Michelangelo's prominently muscular calf suggests that, despite his advanced age, he exhibited no signs of sarcopenia. Another important factor is that Michelangelo was primarily a sculptor, engaging in the physically demanding task of carving large stone blocks using hammers and chisels [1]. This type of labor results in a caloric expenditure comparable to that of longshoremen handling heavy loads. In this context, previous studies have shown that both longshoremen and sculptors involved in moving substantial weights tend to have greater longevity than control populations, suggesting that work-related physical activity may contribute to a longer lifespan [3]. Moderate exercise decreases several of the immune processes thought to be important in atherogenesis. Reductions in both the inflammatory cytokine cascade and circulating levels of C-reactive protein, a marker of overall systemic inflammation, have been related to physical exercise. Additionally, in humans, exercise improves the antibody response upon immunization for influenza and decreases susceptibility to upper respiratory tract infections. Moderate exercise has been shown to ameliorate the age-related decline in T-cell function and innate immunity. These observations suggest that prior to the advent of antibiotics, exercise may have been one of the few interventions protecting individuals from infectious disease mortality [3]. Therefore, the physical exertion involved in Michelangelo's lifelong work as a sculptor, handling large stone blocks, may have provided a protective effect on his cardiovascular and immune systems. Supporting this notion, Giorgio Vasari noted that Michelangelo was remarkably resilient, rarely fell ill, and was capable of enduring significant physical fatigue [1]. The literature also indicates that, beyond remaining physically active and fully engaged in stone carving well into old age, Michelangelo followed a moderate diet and limited his wine consumption [2]. It is therefore plausible that Michelangelo's diet reflected the Mediterranean dietary pattern, which had been prevalent in Italy since antiquity [7]. His many years living and working with the papal court in Rome [1, 2] likely afforded him access to a variety of foods associated with this diet. Recent evidence suggests that the Mediterranean diet has protective effects against a range of chronic diseases, including cardiovascular and neurodegenerative disorders, type 2 diabetes, certain cancers, and increased overall survival [7]. Thus, these eating habits may have further contributed to his overall health and, by extension, his longevity. Although Michelangelo often reflected in his poetry on the physical discomforts of aging, he remained creatively and intellectually active. For example, in a madrigal from around 1550, he laments the aging of his body—nothing more than “bones and strings inside my leather bag”—and his face, which “has a shape enough to terrify” [8]. However, his collaborations with younger artists, such as Daniele da Volterra, and his connection with emerging religious movements, such as the Spirituali, revitalized his spirituality, poetry, and artistic themes, inspiring new iconographic explorations [8]. Such intergenerational and spiritual renewal may have played a role in his enduring vitality and longevity. Michelangelo showed no signs of cognitive decline and remained intellectually active, composing poetry until his final days. His poetic achievements reflect his enduring mental vitality and longevity [1, 2, 5, 8]. This sustained acuity may have been reinforced by his good physical condition and absence of sarcopenia in old age. If people knew how hard I worked to get my mastery, it wouldn't seem so wonderful at all. Therefore, we can infer that Michelangelo's longevity may be associated, at least in part, with the good physical/muscular conditioning he acquired as a sculptor, especially in old age. Another key aspect of this analysis is that, beyond the clinical observation of Michelangelo's physical condition in old age, it also illuminates theoretical dimensions of his life that are essential to understanding how environmental factors may have influenced his longevity. These theoretical considerations complement the clinical data, allowing for a more comprehensive assessment of Michelangelo's overall health. In this context, it becomes evident that the artist maintained several lifelong habits potentially beneficial to his longevity, including adherence to a Mediterranean-style diet, intergenerational engagement in artistic and spiritual circles, and sustained physical and intellectual activity. Given this, it should be noted that this description could serve as a basis for other studies seeking to better understand some of the factors that contributed to longevity in antiquity, especially in periods where medical records are unavailable. Accordingly, this type of approach represents a cultural exercise that can help medical students develop clinical reasoning, ethics, and empathy, which are fundamental to the practice of geriatric and humanistic medicine. The entire manuscript was written and organized by Deivis de Campos. The author of this description is grateful for the support (image acquisition) of the National Gallery of Art, Washington, D.C., United States. This work did not receive any grant from funding agencies in the public, commercial, or not-for-profit sectors. The author declares no conflicts of interest.