For W.H.O Healthy Aging is not a life without diseases (disease can happen at any age) but “Healthy Ageing is the process of developing and maintaining the functional ability that enables wellbeing in older age.”   However, our health care systems are not organized to maintain people’s Intrinsic Capacities (I.C); over their lifetimes, but to identify and treat acute episodes of illness (1).

Changing the emphasis of health care systems from focusing on acute and diseases conditions to promoting integrated care that will result in Healthy Ageing is urgently needed. W.H.O defines intrinsic capacity as the combination of the individual’s physical and mental – including psychosocial – capacities, and functional. The W.H.O program identify 5 Intrinsic capacities (fig 1): Mobility, Cognition, Vitality, -Psycho-social, neuro-sensorial: Vision, Earing.

Because healthy ageing depends on an individual’s intrinsic capacity (IC), on the environment, and the interactions between them, a focus on IC has the potential to design interventions for improving the health of individuals. Inability to undertake various ADLs without the assistance of others can happen as a result of a significant loss of intrinsic capacity. Taking a life course approach, the WHO model of Healthy Ageing points out that this period of significant loss of capacity in old age is most often preceded by some early decline.

We can   maintain  functions with aging by 3 different steps: a.Increase intrinsic capacity  reserves in early aging (45-70 yrs); b. Preserve cognitive functions in late aging (70 yrs +); c. Restore cognitive functions when needed

With such program the W.H.O aims to decrease by 15 millions the number of dependent older adults by 2025 fig 2

Références

  1. WHO Clinical Consortium on Healthy Ageing 2017 – report of consortium meeting 21 and 22 November 2017 in Geneva, Switzerland. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO.
  2. Cesari M1,2,3,4,Araujo de Carvalho I5, Amuthavalli Thiyagarajan J5, Cooper C6, Martin FC7, Reginster JY8, Vellas B1,2, Beard JR5. Evidence for The Domains Supporting The Construct of Intrinsic Capacity. J Gerontol A Biol Sci Med Sci. 2018 Feb 2. doi: 10.1093/gerona/gly011. [Epub ahead of print]