How Can We Achieve Healthy Aging?

Population aging affects all countries, and all income groups. To date, epidemiologists and public health professionals have contributed to this discourse by examining the impact of non-communicable diseases, while gerontologists and geriatricians have been engaged in developing the study of frailty, which may represent a better public health indicator of aging well, and may be regarded as a measure of intrinsic capacity in older people, using a more negative descriptor. There has been little cross-talk between the two disciplines, resulting in a situation that does not allow society to meet the needs of older people in a responsive way. The World Health Organization provided an impetus with the publication of the first World Report on Aging and Health in 2015, which emphasizes functional capacity as a main goal rather than mortality [1]. It further proposes that functional capacity may be achieved by a combination of promoting (or retarding the decline) of intrinsic capacity. The latter is a product of personal factors such as socioeconomic status, education, and lifestyle, together with physical and social environmental factors. Thus, our response to population aging should incorporate these principles, at social and health policy levels, as well as further downstream to units that provide direct care. The articles in this special issue contribute to different facets in this discourse.

The World Health Organization is at the same time promoting the Age-Friendly City movement, in which over 300 countries have participated to date [2]. This concept is a major contributor to promoting functional capacity. This area is explored in the papers by Tiraphat S. et al., Portegijs E. et al., Aboderin I. et al., Wong M. et al., Yu R. et al., and Ho H.C. et al. [3,4,5,6,7,8]. The importance of social environment is discussed by Lotvonen S. et al. as well as Wong A. et al. [9,10]. Analysis of factors contributing to frailty in two Chinese populations with different profiles and health and social care systems provide more in-depth insight regarding strategies for the prevention of frailty or for maintaining intrinsic capacity [11]. How technology may be used is explored by Santa-Mancilla et al. [12]. Yamada et al. [13] addresses a more downstream issue relating to interventions for healthy life expectancy. With respect to policy and the organization of health and social care systems, an ideal design to meet current needs is discussed [14]; meanwhile, the Singapore government has already formulated policy to tackle frailty [15]. Finally, an intriguing exploration of blue zones in China provides further stimulus for carrying out research on the role of nutritional and other environmental factors in healthy aging [16].