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WHO Approach to Healthy Aging

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Geriatric Medicine

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Abstract

Health systems need a comprehensive and drastic revision of their approaches to promote better care for the aging populations to tackle and solve the stigmas applied to older persons. Healthy aging defines the process of developing and maintaining the functional ability that allows well-being in older age. It is based on three cardinal factors for the person: functional ability (i.e., “health-related attributes that enable people to be and to do what they have reason to value”), intrinsic capacity (i.e., the composite of all the physical and mental capacities of an individual), and environment. The maintenance of functional ability represents the common goal of the public health framework. At the same time, the intrinsic capacity model entails an essential shift from a negative to a positive perception of health, quitting obsolete traditional paradigms (i.e., diseases, impairments, disabilities) to the assessment of the individual’s positive attributes (i.e., functions, reserves).

In this chapter, a novel approach that the World Health Organization has recently described for promoting healthy aging in our societies is presented. The framework promotes a substantial modification of the health and social care systems that should be redesigned having the individual at the center of a multidisciplinary and multidimensional action.

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References

  1. Constitution of the World Health Organization. Published online 1948. https://www.who.int/governance/eb/who_constitution_en.pdf. Accessed 21 May 2019.

  2. WHO | Active ageing: a policy framework. WHO. Published 2002. http://www.who.int/ageing/publications/active_ageing/en/. Accessed 18 July 2020.

  3. World Report on Ageing and Health. World Health Organization; 2015.

    Google Scholar 

  4. Beard J, Officer A, de Carvalho I, et al. The World report on ageing and health: a policy framework for healthy ageing. Lancet. 2015;387(10033):2145–54. https://doi.org/10.1016/S0140-6736(15)00516-4.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Rowe J, Kahn R. Successful aging. Gerontologist. 1997;37(4):433–40.

    Article  CAS  PubMed  Google Scholar 

  6. Baltes PB. On the incomplete architecture of human ontogeny: selection, optimization, and compensation as foundation of developmental theory. In: Staudinger UM, Lindenberger U, editors. Understanding human development. Springer US; 2003. p. 17–43. https://doi.org/10.1007/978-1-4615-0357-6_2.

    Chapter  Google Scholar 

  7. Kahana B, Kahana E. Conceptual and empirical advances in understanding aging well through proactive adaptation. In: Adulthood and aging: research on continuities and discontinuities. Springer International Publishing; 1996. p. 18–40..

    Google Scholar 

  8. Cesari M, Araujo de Carvalho I, Amuthavalli Thiyagarajan J, et al. Evidence for the domains supporting the construct of intrinsic capacity. J Gerontol A Biol Sci Med Sci. 2018;73(12):1653–60. https://doi.org/10.1093/gerona/gly011.

    Article  PubMed  Google Scholar 

  9. The international classification of functioning, disability and health. World Health Organization; 2001.

    Google Scholar 

  10. Dato S, Montesanto A, Lagani V, Jeune B, Christensen K, Passarino G. Frailty phenotypes in the elderly based on cluster analysis: a longitudinal study of two Danish cohorts. Evidence for a genetic influence on frailty. Age. 2012;34(3):571–82. https://doi.org/10.1007/s11357-011-9257-x.

    Article  PubMed  Google Scholar 

  11. Brooks-Wilson AR. Genetics of healthy aging and longevity. Hum Genet. 2013;132(12):1323–38. https://doi.org/10.1007/s00439-013-1342-z.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Cesari M, Vellas B, Gambassi G. The stress of aging. Exp Gerontol. 2013;48(4):451–6. https://doi.org/10.1016/j.exger.2012.10.004.

    Article  PubMed  Google Scholar 

  13. Stuck A, Siu A, Wieland G, Adams J, Rubenstein L. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet. 1993;342(8878):1032–6.

    Article  CAS  PubMed  Google Scholar 

  14. Stuck A, Minder C, Peter-Wüest I, et al. A randomized trial of in-home visits for disability prevention in community-dwelling older people at low and high risk for nursing home admission. Arch Intern Med. 2000;160(7):977–86.

    Article  CAS  PubMed  Google Scholar 

  15. Keating N, Eales J, Phillips JE. Age-friendly rural communities: conceptualizing ‘best-fit’. Can J Aging. 2013;32(4):319–32. https://doi.org/10.1017/S0714980813000408.

    Article  PubMed  Google Scholar 

  16. Devons C. Comprehensive geriatric assessment: making the most of the aging years. Curr Opin Clin Nutr Metab Care. 2002;5(1):19–24. https://doi.org/10.1097/00075197-200201000-00004.

    Article  PubMed  Google Scholar 

  17. Stuck A, Walthert J, Nikolaus T, Büla C, Hohmann C, Beck J. Risk factors for functional status decline in community-living elderly people: a systematic literature review. Soc Sci Med. 1999;48(4):445–69. https://doi.org/10.1016/S0277-9536(98)00370-0.

    Article  CAS  PubMed  Google Scholar 

  18. Cigolle C, Langa K, Kabeto M, Tian Z, Blaum C. Geriatric conditions and disability: the Health and Retirement Study. Ann Intern Med. 2007;147(3):156–64. https://doi.org/10.7326/0003-4819-147-3-200708070-00004.

    Article  PubMed  Google Scholar 

  19. Chaudhry S, McAvay G, Ning Y, Allore H, Newman A, Gill T. Geriatric impairments and disability: the cardiovascular health study. J Am Geriatr Soc. 2010;58(9):1686–92. https://doi.org/10.1111/j.1532-5415.2010.03022.x.

    Article  PubMed  PubMed Central  Google Scholar 

  20. van der Vorst A, Zijlstra G, Witte N, et al. Limitations in activities of daily living in community-dwelling people aged 75 and over: a systematic literature review of risk and protective factors. PLoS One. 2016;11(10):e0165127.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Beard JR, Jotheeswaran AT, Cesari M, Araujo de Carvalho I. The structure and predictive value of intrinsic capacity in a longitudinal study of ageing. BMJ Open. 2019;9(11):e026119. https://doi.org/10.1136/bmjopen-2018-026119.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Belloni G, Cesari M. Frailty and intrinsic capacity: two distinct but related constructs. Front Med (Lausanne). 2019;6:133. https://doi.org/10.3389/fmed.2019.00133.

    Article  PubMed  Google Scholar 

  23. Cesari M, Prince M, Thiyagarajan J, et al. Frailty: an emerging public health priority. J Am Med Dir Assoc. 2016;17(3):188–92. https://doi.org/10.1016/j.jamda.2015.12.016.

    Article  PubMed  Google Scholar 

  24. Mitnitski A, Mogilner A, Rockwood K. Accumulation of deficits as a proxy measure of aging. Sci World J. 2001;1:323–36.

    Article  CAS  Google Scholar 

  25. Rockwood K, Mitnitski A. How might deficit accumulation give rise to frailty? J Frailty Aging. 2012;1(1):8–12.

    CAS  PubMed  Google Scholar 

  26. Fried L, Tangen C, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56. https://doi.org/10.1093/gerona/56.3.M146.

    Article  CAS  PubMed  Google Scholar 

  27. Cesari M, Marzetti E, Thiem U, et al. The geriatric management of frailty as paradigm of “The end of the disease era”. Eur J Intern Med. 2016;31:11–4. https://doi.org/10.1016/j.ejim.2016.03.005.

    Article  PubMed  Google Scholar 

  28. Conti A, Conti A. Frailty and resilience from physics to medicine. Med Hypotheses. 2010;74(6):1090. https://doi.org/10.1016/j.mehy.2010.01.030.

    Article  PubMed  Google Scholar 

  29. Kuh D. Life course epidemiology. J Epidemiol Community Health. 2003;57(10):778–83. https://doi.org/10.1136/jech.57.10.778.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Hardy S, Concato J, Gill T. Resilience of community-dwelling older persons. J Am Geriatr Soc. 2004;52:257–62. https://doi.org/10.1111/j.1532-5415.2004.52065.x.

    Article  PubMed  Google Scholar 

  31. Luthar SS, Cicchetti D, Becker B. The construct of resilience: a critical evaluation and guidelines for future work. Child Dev. 2000;71(3):543–62. https://doi.org/10.1111/1467-8624.00164.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Muth C, Blom J, Smith S, et al. Evidence supporting the best clinical management of patients with multimorbidity and polypharmacy: a systematic guideline review and expert consensus. J Intern Med. Published online October. 2018;24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=30357955

  33. Cesari M, Pérez-Zepeda M, Marzetti E. Frailty and multimorbidity: different ways of thinking about geriatrics. J Am Med Dir Assoc. 2017;18(4):361–4. https://doi.org/10.1016/j.jamda.2016.12.086.

    Article  PubMed  Google Scholar 

  34. Angeloni S. Integrated disability management: an interdisciplinary and holistic approach. SAGE Open. 2013;4:1–15.

    Google Scholar 

  35. Cesari M, Vanacore N, Agostoni C. The two extremes meet: pediatricians, geriatricians and the life-course approach. Pediatr Res. Published online June. 2019;25 https://doi.org/10.1038/s41390-019-0479-4.

  36. Hoogendijk E, Rijnhart J, Kowal P, et al. Socioeconomic inequalities in frailty among older adults in six low- and middle-income countries: results from the WHO Study on global AGEing and adult health (SAGE). Maturitas. 2018;115:56–63.

    Article  PubMed  Google Scholar 

  37. Ory M, Kinney Hoffman M, Hawkins M, Sanner B, Mockenhaupt R. Challenging aging stereotypes: strategies for creating a more active society. Am J Prev Med. 2003;25(3 Suppl 2):164–71. https://doi.org/10.1016/S0749-3797(03)00181-8.

    Article  PubMed  Google Scholar 

  38. Cherubini A, Corsonello A, Lattanzio F. Underprescription of beneficial medicines in older people: causes, consequences and prevention. Drugs Aging. 2012;29(6):463–75.

    Article  CAS  PubMed  Google Scholar 

  39. Integrated Care for Older People (ICOPE): guidance for person-centred assessment and pathways in primary care. World Health Organization; 2019.

    Google Scholar 

  40. Izquierdo M. Multicomponent physical exercise program: Vivifrail. Nutr Hosp. 2019;36(Spec No2):50–6. https://doi.org/10.20960/nh.02680.

    Article  PubMed  Google Scholar 

  41. Camicelli A, Keeffe J, Martin K, Carbone J, Balding C, Taylor H. Vision screening for older people: the barriers and the solutions. Australas J Ageing. 2003;22(4):179–85. https://doi.org/10.1111/j.1741-6612.2003.tb00494.x.

    Article  Google Scholar 

  42. Araujo de Carvalho I, Epping-Jordan J, Pot A, et al. Organizing integrated health-care services to meet older people’s needs. Bull World Health Organ. 2017;95(11):756–63. https://doi.org/10.2471/BLT.16.187617.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Beard J, Bloom D. Towards a comprehensive public health response to population ageing. Lancet. 2015;385(9968):658–61.

    Article  PubMed  Google Scholar 

  44. Cook J. The socio-economic contribution of older people in the UK. Work Older People. 2011;15(4):141–6. https://doi.org/10.1108/13663661111191257.

    Article  Google Scholar 

  45. WHO | Knowledge translation framework for ageing and health. WHO. http://www.who.int/ageing/publications/knowledge_translation/en/. Accessed 18 July, 2020.

  46. Snyder A, Colvin B, Gammack J. Pedometer use increases daily steps and functional status in older adults. J Am Med Dir Assoc. 2011;12(8):590–4.

    Article  PubMed  Google Scholar 

  47. Sim I. Mobile devices and health. N Engl J Med. 2019;381(10):956–68. https://doi.org/10.1056/NEJMra1806949.

    Article  PubMed  Google Scholar 

  48. Althoff T, Sosič R, Hicks J, King A, Delp S, Leskovec J. Large-scale physical activity data reveal worldwide activity inequality. Nature. 2017;547(7663):336–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Wang J, Zhang L, Liu T, Pan W, Hu B, Zhu T. Acoustic differences between healthy and depressed people: a cross-situation study. BMC Psychiatry. 2019;19(1):300. https://doi.org/10.1186/s12888-019-2300-7.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Themistocleous C, Eckerström M, Kokkinakis D. Voice quality and speech fluency distinguish individuals with Mild Cognitive Impairment from Healthy Controls. PLoS One. 2020;15(7):e0236009. https://doi.org/10.1371/journal.pone.0236009.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Brady CJ, Eghrari AO, Labrique AB. Smartphone-based visual acuity measurement for screening and clinical assessment. JAMA. 2015;314(24):2682–3. https://doi.org/10.1001/jama.2015.15855.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. De Sousa KC, Swanepoel DW, Moore DR, Smits C. A smartphone national hearing test: performance and characteristics of users. Am J Audiol. 2018;27(3S):448–54. https://doi.org/10.1044/2018_AJA-IMIA3-18-0016.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Granado-Font E, Flores-Mateo G, Sorlí-Aguilar M, et al. Effectiveness of a smartphone application and wearable device for weight loss in overweight or obese primary care patients: protocol for a randomised controlled trial. BMC Public Health. 2015;15:531. https://doi.org/10.1186/s12889-015-1845-8.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Nighswonger NJ, Claude R, Martin J. On using voice analysis in marketing research. J Market Res. 1981;18(3):350–5. https://doi.org/10.1177/002224378101800308.

    Article  Google Scholar 

  55. MIMOSYS: Vocal analysis app for mental health – Apps on Google Play. https://play.google.com/store/apps/details?id=com.medical_pst.mimosys_release2&hl=en. Accessed 18 July, 2020.

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Author information

Authors and Affiliations

  1. ASP IMMeS Pio Albergo Trivulzio, Milan, Italy

    Tiziano Nestola

  2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Matteo Cesari

Authors
  1. Tiziano Nestola
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  2. Matteo Cesari
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Corresponding author

Correspondence to Matteo Cesari .

Editor information

Editors and Affiliations

  1. Rockport Healthcare Services, Woodland Hills, CA, USA

    Michael Wasserman

  2. Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA

    Debra Bakerjian

  3. Department of Clinical Pharmacy, University of Colorado, Aurora, CO, USA

    Sunny Linnebur

  4. Division of Geriatrics, SUNY Upstate Medical University, Syracuse, NY, USA

    Sharon Brangman

  5. Alliant GMCF, Atlanta, GA, USA

    Adrienne Mims

  6. Division of Geriatric Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Jerry C. Johnson

Section Editor information

  1. California Association of Long Term Care Medicine, Newbury Park, California, USA

    Michael R. Wasserman M.D., CMD

  2. Department of Geriatrics, SUNY Upstate Medical University, Syracuse, New York, USA

    Sharon Brangman MD

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Nestola, T., Cesari, M. (2023). WHO Approach to Healthy Aging. In: Wasserman, M., Bakerjian, D., Linnebur, S., Brangman, S., Mims, A., Johnson, J.C. (eds) Geriatric Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-01782-8_105-1

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  • DOI: https://doi.org/10.1007/978-3-030-01782-8_105-1

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  • Print ISBN: 978-3-030-01782-8

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