Intrinsic Capacity Trajectories: The Underlying Social and Economic Determinants

Excerpt

Against the background of an ageing population globally, healthy ageing, which is the process of developing and maintaining functional ability to enable well-being in older life, is a key priority of the World Health Organization (WHO) (1). This contributes to shift the focus from a traditional disease-centered to a person- and function-centered approach on healthcare, prioritizing that older people retain capabilities to be and to do what they value. Intrinsic capacity (IC) is central to functional ability, representing the composite of all physical and mental capacities an individual can draw upon, while interacting with the environment and social factors to define a person’s functional ability (2). IC is built during the life course and can be modulated by social or economic circumstances through epigenetics and allostatic load, among other mechanisms. Monitoring trajectories of IC in older adults has been suggested by the WHO clinical consortium to inform prevention and to avoid or delay negative health outcomes (3). Longitudinal studies can show how IC changes over time and whether repeatedly measuring IC would allow to predict health outcomes. Besides, declining IC may present before frailty becomes clinically manifest, increasing risk for poor outcomes. …