A life-course approach to healthy ageing: maintaining physical capability

Abstract

Research on healthy ageing lacks an agreed conceptual framework and has not adequately taken into account the growing evidence that social and biological factors from early life onwards affect later health. We conceptualise healthy ageing within a life-course framework, separating healthy biological ageing (in terms of optimal physical and cognitive functioning, delaying the onset of chronic diseases, and extending length of life for as long as possible) from changes in psychological and social wellbeing. We summarise the findings of a review of healthy ageing indicators, focusing on objective measures of physical capability, such as tests of grip strength, walking speed, chair rises and standing balance, which aim to capture physical functioning at the individual level, assessing the capacity to undertake the physical tasks of daily living. There is robust evidence that higher scores on these measures are associated with lower rates of mortality, and more limited evidence of lower risk of morbidity, and of age-related patterns of change. Drawing on a research collaboration of UK cohort studies, we summarise what is known about the influences on physical capability in terms of lifetime socioeconomic position, body size and lifestyle, and underlying physiology and genetics; the evidence to date supports a broad set of factors already identified as risk factors for chronic diseases. We identify a need for larger longitudinal studies to investigate age-related change and ethnic diversity in these objective measures, the dynamic relationships between them, and how they relate to other component measures of healthy ageing. Robust evidence across cohort studies, using standardised measures within a clear conceptual framework, will benefit policy and practice to promote healthy ageing.

What can the life course approach contribute to an understanding of longevity risk?

“…I therefore find the framework proposed by Blane et al to be less innovative when seen from the perspective of social--behavioural aging science. I was also surprised that the relationship to the life course approach in the health and epidemiology area, e.g., as suggested by Kuh and colleagues (e.g., Kuh et al, 2014), was not described.…”

“…These two lines of research converged at times, but also searched to define themselves from each other across the decades (e.g., life--span researchers also use the cohort concept to understand historical changes in late--life cognitive functioning; sociologist have a tendency to accuse life--span researchers of under--rating the role of socioeconomic status (SES) across full lives). More recently, health research has significantly added to both life course as well as life--span research and it seems that epidemiology increasingly searches for the inclusion of distal antecedent factors, when it comes to the predictions of a range of endpoints such as diseases and functional limitations (e.g., Ben--Shlomo & Kuh, 2002;Kuh et al, 2014).…”

Grip strength and healthy aging

“…The basic pattern of age-related changes in grip strength across adult life is described as follows: grip strength peaks and maintains in the fourth decade, then starts to decline from the fifth or sixth decades 35) . The age-related decline in grip strength in adults has been reported in a number of previous longitudinal studies 2,20,[36][37][38][39] .…”

Stress und optimales Altern

“…Die Entwicklungen in der biologischen Grundlagenforschung [64,65] machen es zunehmend möglich, diese Ergebnisse in einen klinischen Bezug [66][67][68][69][70] und einen kontextualen, den Lebenslauf integrierenden Rahmen [71,72] zu setzen und mit Fokus auf das Individuum einerseits und die Gesellschaft andererseits geeignete Interventionen zu entwickeln.…”