The Core Components of Healthy Aging
The World Health Organization's definition of healthy aging focuses on functional ability that enables well-being, rather than simply the absence of disease. It is a holistic, person-centered concept emphasizing adaptability and resilience. The definition is built upon three interacting components: intrinsic capacity, functional ability, and the environment.
Intrinsic Capacity
Intrinsic capacity refers to the combination of a person's physical and mental capabilities. These capabilities are influenced by factors like genetics, lifestyle, and health conditions. Key domains include:
- Locomotion: The ability to move.
- Vitality: Energy, metabolism, and immune function.
- Cognition: Thinking and memory abilities.
- Psychology: Mental health and emotional well-being.
- Senses: Sight and hearing.
Functional Ability
Functional ability is what a person can do and what they value doing, resulting from the interaction between their intrinsic capacity and their environment. This is a dynamic concept, influenced by how well the environment supports or hinders an individual's capabilities. Key domains include:
- Meeting basic needs: Self-care activities.
- Learning, growing, and making decisions: Personal development and autonomy.
- Being mobile: Moving around safely.
- Building and maintaining relationships: Social connections.
- Contributing to society: Engaging in productive activities.
The Environment
The environment encompasses all factors in a person's physical and social world that impact their life. This includes:
- Built environment: Physical surroundings and accessibility.
- People and their relationships: Social support systems.
- Attitudes and values: Societal views on aging, including ageism.
- Health and social policies: Government frameworks impacting health and social care.
Comparison of WHO Healthy Aging with Older Concepts
The WHO's definition of healthy aging is a progression from previous models, offering a more inclusive and person-centered perspective.
| Feature | WHO Healthy Aging (2015) | "Active Aging" (2002) | "Successful Aging" (1980s) |
|---|---|---|---|
| Core Concept | Functional ability | Optimizing opportunities for health, participation, and security | Absence of disease and disability |
| Scope | Holistic, person-centered, and comprehensive | Focused on individual behavior and government policy | Often criticized for being narrow, exclusive, and unrealistic |
| Inclusivity | Accommodates diversity in older age; healthy aging is possible even with chronic conditions | Aimed at encouraging engagement but could exclude those with health challenges | Excludes those with unavoidable degenerative conditions |
| Focus | Interaction between individual capacity and environment | Emphasizes individual choices and policy framework | Primarily biomedical, focusing on objective health metrics |
| Measurement | Standardized indicators for intrinsic capacity, functional ability, and environments | Less standardized, varying measures across different studies | Often limited to biomedical indicators |
Promoting and Measuring Healthy Aging
The WHO and partners are working through the UN Decade of Healthy Ageing (2021–2030) to implement the healthy aging framework. Key priorities include combating ageism, creating age-friendly environments, delivering person-centered care, and strengthening long-term care. Measuring healthy aging goes beyond life expectancy, focusing on indicators for intrinsic capacity, functional ability, and environmental factors to monitor progress and inform interventions.
Conclusion
The WHO's definition of healthy aging, centered on functional ability and well-being, marks a significant shift from older models. By considering the interplay between intrinsic capacity, functional abilities, and the environment, the WHO offers a comprehensive framework for supporting older people. This approach acknowledges the diversity of aging experiences and advocates for systemic changes to create supportive societies. Healthy aging is viewed as a dynamic, lifelong process of adaptation and empowerment.
