ROME (AP) — Pope Francis turned 87 on Sunday, closing out a year that saw big milestones in his efforts to reform the Catholic Church as well as health scares that raise questions about his future as pope.

Francis celebrated his birthday with cake during a festive audience with children Sunday morning, and there were “Happy Birthday” banners in St Peter’s Square during his weekly noon blessing.

One early present came Saturday, when a Vatican tribunal handed down a mix of guilty verdicts and acquittals in a complicated trial that Francis had supported as evidence of his financial reforms. The biggest-name defendant, Cardinal Angelo Becciu, was convicted of embezzlement and sentenced to five-and-a-half years in prison.

“It was quite a year for a pope who’s obviously thinking about legacy and finishing up,” said Christopher Bellitto, professor of history at Kean University in New Jersey.

Only seven popes are known to have been older than Francis at the time of their deaths, according to the online resource Catholic Hierarchy. Francis is fast closing in on one of them, Pope Gregory XII, perhaps best known for having been the most recent pope to resign until Pope Benedict XVI stepped down in 2013.

Gregory was 88-and-a-half when he voluntarily stepped down in 1415 in a bid to end the Western Schism, in which there were three rival claimants to the papacy. Francis has said he, too, would consider resigning if his health made him unable to carry on, but more recently he said the job of pope is for life.

Twice this year, however, Francis’ less-than-robust respiratory health forced him to cancel big events: In spring, a bout of acute bronchitis landed him in the hospital for three days and made him miss the Good Friday procession at the Colosseum.

More recently, a new case of bronchitis forced him to cancel a planned trip to Dubai to participate in the UN climate conference. Francis had part of one lung removed as a young man and seems to be increasingly prone to respiratory problems that make breathing difficult and speaking even more so.

In between those events, he was hospitalised again in June for nine days for surgeons to repair an abdominal hernia and remove scar tissue from previous intestinal surgeries.

The hospitalisations have raised questions about Francis’ ability to continue the globetrotting rigors of the modern-day papacy, which is increasingly dependent on the person of the pope, said David Gibson, director of the Center on Religion and Culture at Fordham University.

“It’s a great improvement from the time when the pope was just a king in his throne surrounded by a royal court,” he said. “But with such expectations can any pope govern into his 80s and even 90s and be effective?”

While Francis’ health scares punctuated his 87th year, perhaps the biggest milestone of all, and one that is likely to shape the remainder of Francis’ pontificate, was Benedict’s December 31 death.