WHO's report for the decade of healthy ageing 2021–30 sets the stage for globally comparable data on healthy ageing
Authors: Jean-Pierre Michel, Matilde Leonardi, Mike Martin, Matthew Prina
Journal: The Lancet Healthy Longevity (2021)

The new WHO's baseline report for the decade of healthy ageing 2021–30 sets the stage for a change in approach to monitoring the health of older people.1WHOWHO launches baseline report for decade of healthy ageing.https://www.who.int/news/item/17-12-2020-who-launches-baseline-report-for-decade-of-healthy-ageingDate: 2020Date accessed: January 28, 2020Google Scholar On the basis of WHO's 2015 world report on ageing and health,2WHO1st world report on ageing and health.http://www.who.int/ageing/events/world-report-2015-launch/en/Date: 2015Date accessed: January 28, 2020Google Scholar "healthy ageing" is defined as the "ongoing process of developing and maintaining the functional ability that enables wellbeing in older age".2WHO1st world report on ageing and health.http://www.who.int/ageing/events/world-report-2015-launch/en/Date: 2015Date accessed: January 28, 2020Google Scholar This definition distinguishes the three components of healthy ageing: intrinsic capacity, functional ability, and environments.3WHOWHO global strategy and action plan on ageing and health (2016–2020).http://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_17-en.pdfDate: 2016Date accessed: January 28, 2020Google Scholar, 4Beard JR Officer A de Carvalho IA et al.The world report on ageing and health: a policy framework for healthy ageing.Lancet. 2016; 387: 2145-2154Summary Full Text Full Text PDF PubMed Scopus (664) Google Scholar An individual's intrinsic capacity is comprehensively considered by addressing all their physical and mental capacities.5Michel J-P Graf C Ecarnot F Individual healthy aging indices, measurements and scores.Aging Clin Exp Res. 2019; 31: 1719-1725Crossref PubMed Scopus (6) Google Scholar, 6Michel J-P Identification of the best societal measurement of healthy aging.Ann Geriatr Med Res. 2019; 23: 45-49Crossref PubMed Scopus (1) Google Scholar Measurements of environments should at least include access to medications, personal support, assistive devices, and physical barriers that might either facilitate or hinder functional ability. Functional ability is determined by intrinsic capacity and the environment in which an individual lives and interacts. To measure progress toward healthy ageing worldwide, WHO has done a systematic analysis with international stakeholders to identify indicators for each of the three components, collating datasets including 151 718 community-dwelling adults aged 60 years or older who had comparable information on aspects of intrinsic capacity and functional ability. The intent of this baseline report was to gather information on all three healthy ageing components, each including five domains. However, because coverage was restricted to a limited number of items, the report provides data on functional ability, based on comparable data on some basic needs (ability to dress, take medications, and manage money) and two distinct measures of intrinsic capacity (hand grip strength and delayed word recall), for 42 countries with recent nationally representative surveys. These data reveal information on the heterogeneity of the ageing process in these 42 countries, highlighting inequalities by gender and education. This analysis estimates that, currently, at least 142 million people aged 60 years or older are unable to meet the evaluated basic needs. By proving the feasibility of comparing functional ability across countries, the report has shown the urgency of obtaining more comprehensive data on all aspects of intrinsic capacity and functional ability globally while also gathering the most important and comparable environmental information that can be linked to each person. Therefore, WHO, with its baseline report, clearly sets the stage for the acquisition and provision of such data to monitor global progress towards healthy ageing and provides the methods for measuring healthy ageing in a population, beyond disease inventories and analyses of activities and instrumental activities of daily living. Because functional ability is context dependent, monitoring could include rigorous measurements of each of the three components of healthy ageing at the individual and population level. This approach allows the aggregation of individual measurements at the population level. The WHO baseline report documents what data currently exist and what is measured in each dataset in a comparable manner. Importantly, shifting the focus of monitoring on functional ability favours a biopsychosocial person-centred approach that does not classify the health of a population on the basis of the presence or absence of a disease, but on the basis of a level of functioning that is "being and doing what persons have reason to value in the context in which they live".1WHOWHO launches baseline report for decade of healthy ageing.https://www.who.int/news/item/17-12-2020-who-launches-baseline-report-for-decade-of-healthy-ageingDate: 2020Date accessed: January 28, 2020Google Scholar Practically, individuals can have chronic conditions, but if they live within an enabling environment, then they can be able to do what they value. Such healthy ageing that enables wellbeing in older age is the outcome of interest and needs to be measured and monitored individually, nationally, and internationally.7Sanchez-Niubo A Forero CG Wu Y-T et al.Development of a common scale for measuring healthy ageing across the world: results from the ATHLOS consortium.Int J Epidemiol. 2020; (published online Dec 4.)https://doi.org/10.1093/ije/dyaa236Crossref PubMed Scopus (3) Google Scholar The WHO baseline report for the decade of healthy ageing is a milestone in the ageing domain for multiple reasons. First, it clearly defines the biopsychosocial components of healthy ageing (intrinsic capacity, functional ability, and environments). The report also identifies comparable elements of intrinsic capacity and functional ability in older people from 42 different countries and provides multiple feasibility studies on all other aspects of the three components. Second, data analyses show that the characteristics and qualities of the ageing process are extremely heterogeneous and diverse within and between countries. The declines in functioning by age group are not just a consequence of chronological age, changes in physical and mental capacities, or socioeconomic status, they are also context dependent. Third, the baseline report provides the tools to all governments, non-governmental organisations, civil societies, and individuals to address the monitoring of all components of healthy ageing and establish implementation steps to act on these data. Fourth, global healthy ageing measurement milestones are set in 2023, 2026, 2029, and 2030 to update on progress and show that it is possible for governments to act at the policy, system, and service level to enable each person to drive change and age healthier within a more age-friendly environment. This online publication has been corrected. The corrected version first appeared at thelancet.com on March 31, 2021 This online publication has been corrected. The corrected version first appeared at thelancet.com on March 31, 2021 MR reports grants from WHO, during the conduct of the study. All other authors declare no competing interests. Correction to Lancet Healthy Longev 2021; 2: e121–22Michel J-P, Leonardi M, Martin M, Prina M, et al. WHO's report for the decade of healthy ageing 2021–30 sets the stage for globally comparable data on healthy ageing. Lancet Healthy Longev 2021; 2: e121–22—In this Comment, the spelling of author Matilde Leonardi's name was incorrect. Additionally, the fourth to sixth sentences of the first paragraph should read "An individual's intrinsic capacity is comprehensively considered by addressing all their physical and mental capacities.5,6 Measurements of environments should at least include access to medications, personal support, assistive devices, and physical barriers that might either facilitate or hinder functional ability. Full-Text PDF Open Access