A little before 8am, Monday to Friday, 78-year-old Robert Hsu, once a Taiwanese marine and latterly an ice cream salesman in the US, is picked up from his home and taken by bus to the North Miami Beach Wellness Center in Florida.

There he has breakfast, takes part in carefully structured exercise classes, eats a healthy lunch, completes puzzles and plays bingo with other members of the Silver Sneakers health club. And he feels a whole lot better for it.