We all want 'healthy aging,' but what is it, really? New report looks for answers

"Healthy aging" sounds like a priority we all can share, but for geriatrics healthcare professionals—the doctors, nurses, pharmacists, physicians assistants, social workers, and many others dedicated to the care we need as we age—that term represents something specific, and something worth defining. Led by Paul Mulhausen, MD, MHS, FACP, AGSF, colleagues from the American Geriatrics Society (AGS) set about doing just that as part of an expert panel convened to look critically at what "healthy aging" really means. Their definition—published in a white paper today in the Journal of the American Geriatrics Society —explores the intersection between our personal care goals and innovations in science, education, and public policy as the place where healthy aging may be understood best.

"Longer life is a priority for individuals and society because it provides opportunities for personal fulfillment and contributions to our communities. But as we learn more about concrete ways to increase longevity," Dr. Mulhausen observed, "we need to work on ways to improve the quality of that time as well."

As the AGS expert panel reports, older adults often live with an array of health concerns, which means that "healthy aging" for a contemporary audience must embrace a broader, person-centered notion of health as something more than the absence of disease or infirmity. Healthy aging involves pivoting to age's influence on our physical, mental, and social needs and expectations, ultimately embracing a "lifespan approach" to care that helps each aging person live the healthiest life possible. This new focal point necessitates replacing our current cultural emphasis on staying young "with age-friendly concepts of engagement, participation, contribution, interconnectedness, activity, and optimal function," as the AGS white paper explains.

Healthy aging also extends beyond clinical services, embracing a complex and interconnected ecosystem that both impacts and is impacted by how we grow older. In this respect, AGS experts highlight several priority areas where communities, health systems, and clinicians can work together to integrate services that foster engagement and independence for us all as we age. These include:

• Greater advocacy supporting policy solutions for older people. Healthy aging requires a coordinated response not only to care but also to community priorities that can promote health, safety, and independence in age-friendly environments. For the AGS expert panel, this means collaborating as advocates across society and professions to align our health systems with the needs of older people while also promoting healthy aging when we are younger. "We can and should position healthy aging as an untapped resource with the capacity to provide inventive solutions as we live longer, healthier lives," the AGS expert report concludes.
• Better public and professional education to make healthy aging an actionable priority. Care that can promote healthy aging rests on ensuring future generations of health professionals and older adults understand and embrace best practices focused on keeping us healthy and independent. This can become even more of a reality today by working early and often to combat ageism (discrimination against older people due to negative and inaccurate stereotypes about age), particularly when it comes to older adults' self-perceptions. "We need to educate individuals and the public to have appropriate expectations about aging...[and w]e must train our health professions students in ways that promote respect, compassion, and dignity," AGS experts observed.
• A deeper commitment to the geriatrics expertise we need as we age. Embracing biology, psychology, and socio-cultural considerations to optimize functional status—the medical term for ensuring we can make the most of our ability to remain mobile, active, and engaged even as our physical condition changes—must remain a top "healthy-aging" priority. "We should work to replace the current cultural emphasis on staying young...with age-friendly concepts of engagement, participation, contribution, interconnectedness, activity, and optimal function," the AGS report notes.
• Renewed attention to social and scientific research that can build our understanding of what healthy aging really means. According to AGS experts, research on aging at the cellular, individual, and community levels represents one of our best opportunities for advancing healthy aging. "We also need better evidence to inform our understanding of the biomedical and psychosocial determinants of healthy aging. We must bridge the gap between promising basic research and its clinical application," the AGS experts conclude.

As for why geriatrics health professionals are uniquely qualified to stake a claim on defining healthy aging and putting it into practice, Susan Friedman, MD, MPH, a member of the panel responsible for the AGS white paper, observes that many principles at the heart of the AGS's definition have been part of geriatrics from the start.

"Geriatrics is a collaborative profession built by clinicians, educators, health system experts, older adults, and caregivers," Dr. Friedman said. "We understand complexity. We are experts in culturally competent, person-centered care. We are skilled in assessing preferences and values, and translating them into prevention, intervention, and advance care planning. Regardless of how society chooses to define 'healthy aging,' these are the practices that make it something we can see—and ideally experience, especially through geriatrics-led insights."