Barely stopping to eat, drink or sleep, her longest "ultra-run" covered more than 100 miles and took three days and three nights to complete. Now this US supergran from Maryland is hoping to double her personal best by running a blistering six-day race in Arizona next month.
Although born athletic, slim and tall, the veteran of more than 70 marathons doubled her weight after getting married and having a child. Frightened for her future health and determined to change her lifestyle for the sake of her daughter, she adopted a more nutritious diet and, slowly, began to increase the amount of exercise she did, first walking, then running. She ran her first marathon in 1988 and hasn't looked back since.
"I never visit a medical tent, I never have blisters and I don't wear socks," she explained. "People always ask me what I am taking, but I'm not taking anything. I just have a really high quality way of eating and 'Chi running' - a technique using the principles of T'ai Chi - is a major part of my endurance."
Over the past 40 years, she believes she has run thousands of miles and the physical results are astounding. Her resting heart rate is equal to that of a fit twentysomething, her body fat just 12% and her blood pressure equally low.
It's an incredible achievement for any human being but one which is almost inconceivable for most people over 60. Pushing your body to its physical limits could, however, be the secret to a long life.
Dr Charles Eugster is a 94-year-old bodybuilder, World Masters Rowing gold medallist, international decathlete and Swiss national fitness champion. He believes increasing his muscle mass has helped him reverse the ageing process, shedding 10 to 20 years off his body composition - the percentages of fat, bone and muscle.
Sport was initially no more than a hobby for the London-born dentist, who gave up athletics when he started university. He moved to Zurich to set up a private dental practice in 1954 and despite taking up rowing again at 63, he was shocked by the rate at which his body was deteriorating.
At the age of 86, Eugster embarked on a vanity project to shape up and reverse the signs of ageing by joining a bodybuilding club, initially training with a former Mr Universe and now working with an expert on fitness for the older generation.
He claims bodybuilding has reversed and slowed down the effects of sarcopenia - loss of muscle strength due to ageing - helping to prevent injuries from falling.
As we age, the body follows a natural pattern of degeneration, explains Kelly Marshall, fitness expert for Nutracheck. The speed and degree of this change, however, can be influenced by the individual. Although our metabolic rate slows and we lose muscle mass, if we continue to effectively stimulate the muscle fibres with strength training and intense periods of exercise, then we can offset these changes.
This is because of the ability of muscle to remember a movement which is consistently repeated, and therefore our bodies have the capability of performing incredible physical achievements even when older.
"As long as someone doesn't have an underlying heart condition, and some congenital defects are undetectable, then essentially older individuals shouldn't fear pushing their bodies as long as they consider total body function and balance," Marshall says.
However exercise doesn't have to be extreme to be beneficial.
According to Marshall, regular exercise helps to prevent and manage more than 20 chronic conditions, including coronary heart disease, stroke, type two diabetes, cancer, obesity, mental health problems and musculoskeletal conditions.
There is, however, a massive need to educate older adults on not only why keeping fit is important but how to exercise.
In 2011, a report by the Chief Medical Officer found that less than half of men (40%) and only 28% of women in England were achieving the recommended activity levels to achieve health benefits.
Because of muscle and joint degeneration, high impact sports such as running may not be appropriate for everyone. The key is finding an exercise which is suitable for that person's needs and limitations.
Eugster's current trainer, Sylvia Gattiker, says there is not enough scientific research into the effects of exercise on people beyond the age of 70. The former Swiss gymnastics and aerobics champion agrees, however, that loss of muscle mass is the key area which needs to be addressed in any fitness regime for older people. The muscles, she explains, have a huge influence on the whole health of your body, including the organs and the brain.
Gattiker explains: "The important thing is that they have to train very intensively but then they have to rest because the central nervous system also gets tired. In older age, this takes a little bit longer."
GP Dr Bram Brons, of HealthExpress.co.uk, says he would advise anyone considering undertaking extreme physical exercise to speak to their doctor. He adds: "If someone who is aged 65 or over has no physical problems then generally they should aim for a mix of aerobic and muscle strengthening exercises. Usually, I would suggest two half hour runs and two half hour brisk walks a week. I would also recommend, in the same week, that they took two half hour sessions aimed at building muscle such as swimming."
For the extremely fit who have experienced the incredible benefits of pushing their minds and bodies to the limit, stopping is not an option.
Holsden-Smith said: "One day, when my time comes, I'm going to feel good enough to go for a run, and something is going to tell me, 'You see that nice tree over there, go take a seat there', and that'll be it.
"So no nursing homes, no tubes, no family members feeling sorry for me. I will have had a wonderful, healthy life and will have worn out everything that would be there to keep me alive. It's like wearing out an old pair of shoes."
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