Medication hasn't changed in years (Topiramate).
Diet . . . I was tracking that with an app, since my consistent weight loss and a discussion at my last health check. Body fat levels dropped since last year, at 15% in August (optimal is 18% for my age/gender). Muscle mass same as last year, which is not good (doing lots of exercise, so should have increased.
Diet app showed that I'm hitting 50% of intake for protein, 75% carbs on days when I train and cycle commute, about parity on other days. That's including using a protein shake. I've added a lot more nuts. Was low on vitamins, so started taking a multivitamin.
When I was at my peak (felt like my peak, I had a real performance punch), some of my training included gym time, particularly 30 min hard sessions on a cross trainer. I'd set the cross trainer to 'hills' and then try to improve the average watts each week. Don't have that anymore. Really don't feel like I could do a session like that anymore either!
Rest - variable. Probably getting 5-6 hours sleep a night. Generally very tired.