Mobility disability & Healthy aging Mobility disorders / - PowerPoint PPT Presentation

Promoting “healthy ageing” among people who already have “mobility disabilities” I don’t have any conflict of interest in relation with the topic of my today lecture

Mobility disability & Healthy aging • Mobility disorders / disabilities o Definitions o Age-related mobility disorders • Healthy aging o History of the concepts o Current WHO definition • Take home messages o How promoting healthy ageing in mobility disabled

Mobility disability & Healthy aging • Mobility disorders / disabilities o Definitions o Age-related mobility disorders • Healthy aging o History of the concepts o Current WHO definition • Take home messages o How promoting healthy ageing in mobility disabled

Mobility d Mobility disor isorder ders / s / disa disability bility Self-reports of a lot of difficulties or inability to - walk a quarter of a mile without sitting and within time limit of 15 minutes - walk up 10 stairs VESTERGAARD S et al J Am Geriatr Soc 2009;57:260-5 GILL TM et al J Am Geriatr Soc JAGS 2006; 54: 248 – 54 FRIED L et al J Am Geratr Soc 1997; 45: 92-100 “PERFORMANCE BASED MOBILITY DISABILITY” = inability to increase your walking speed > 0.4m/s  severely disabled and would require a mobility aid (walker, mobility scooter, wheelchair or crutches ) to walk in the community

Mobility d Mobility disor isorder ders / s / disa disability bility ETIOLOGY  - congenital - illness - physical injury & trauma - ageing/frailty process/age-related disability  The functional abilities and limitations resulting from the impairment will vary from individual to individual https://ung.edu/student-disability-services/_uploads/files/disabilities/Mobililty-Disorders.pdf

Mobility disability & Healthy aging • Mobility disorders / disabilities o Definitions o Age-related mobility disorders • Healthy ageing o History of the concepts o Current WHO definition • Take home messages o How promoting healthy ageing in mobility disabled

«Healthy ageing» vs. «Successful ageing» Number of scientific papers published on: «HEALTHY» AGEING «SUCCESSFUL» AGEING 2016 > 500 2016 > 3’000 2017 (September 19) > 380 2017 (September 19) > 2’400 Ego integrity vs despair Active ageing Successful ageing & Index of ADL (1950) (1963) (2002) diseases (2009) Cognitive and emotional Activity theory Ageing successfully Civic engagement aspects of successful ageing (1961) (1972) (2004) (2010) Disengagement theory Successful ageing Gerotranscendence Healthy & active ageing (1961) (1987; 1998) (2005) (2011) Successful ageing Selective optimization Healthy ageing Resilient Ageing (1961) (2006) (2014) with compensation (1990) Successful ageing Productive ageing Cultural aspects of WHO Healthy ageing (1963) (1990) (2015) “ good ageing ” (2007) MICHEL JP et al JAMDA 2017; 18: 460-4

«Healthy ageing» vs. «Successful ageing» Number of scientific papers published on: «HEALTHY» AGEING «SUCCESSFUL» AGEING 2016 > 500 2016 > 3’000 2017 (September 19) > 380 2017 (September 19) > 2’400 1902 - 2015 Katz cluster: Havighurst cluster: 609 publications 1’146 publications + 1,682 citation links + 3’946 citation links Perspectives of Perspectives of measurements older persons themselves KUSUMASTUTI S et al Maturitas 2016; 93: 4-12

Bibliometric Networks visualizing KUSUMASTUTI S et al Maturitas 2016; 93: 4-12 the 100 most cited publications on “Healthy / Successful Ageing ” Havighurst cluster Katz cluster Use of the CitNetExplorer software within the Web of Science Core Collection Database

Bibliometric Networks visualizing KUSUMASTUTI S et al Maturitas 2016; 93: 4-12 the 100 most cited publications on “Healthy / Successful Ageing ” Havighurst cluster Across the lifespan, the Havighurst cluster Katz cluster highlights the importance WHO 2015 of the continuous, adaptive Healthy Ageing processes, adults undergo to modify their goals in the face of losses Measurement that are often gradual of the ageing process by researchers Self report quality of the Katz cluster views ageing process ageing primarily from the perspective of measurements determined by researchers : older persons’ functioning Use of the CitNetExplorer software within the Web of Science Core Collection Database

World Health Organization 1st global report on Ageing & Health «Healthy ageing is more than just the absence of disease” Margaret CHAN, WHO General Director 2016

Importance of the new WHO definition of “HEALTHY AGEING” “Process of developing and maintaining the FUNCTIONAL ABILITY that enables wellbeing in older age” WHO, World report on Healthy Ageing, WHO Geneva, 30 September 2016

Intrinsic capacity & Functional ability FUNCTIONAL ABILITY = made up of intrinsic capacity of the individual, ENVIRONMENTAL characteristics and interactions between them Environment Individual Health determinants FUNCTIONAL ABILITY INTRINSIC CAPACITY Intrinsic capacity  Environment INDIVIDUAL = composite of all the physical and mental capacities WHO, World report on Healthy Ageing, WHO Geneva, 30 September 2015

Trajectories ajectories of of intrinsic intrinsic ca capacity pacity and and functio functional nal ability bility Education & life long learning Supporting the building & Psychosocial adaptation maintenance of intrinsic capacity Supportive environment +++ Access to affordable health care Social system Enabling Functional people at need ability to do the things that “are important High and stable Declining Significant to them” capacity capacity loss of capacity WHO, World report on Healthy Ageing, WHO Geneva, 30 September 2015

Trajectories ajectories of of intrinsic intrinsic ca capacity pacity and and functio functional nal ability bility Education & life long learning Supporting the building & Psychosocial adaptation maintenance of intrinsic capacity Supportive environment +++ Access to affordable health care Social system Functional Living in ability FUNCTIONAL INDEPENDENCE within our own surroundings High and stable Declining Significant until the end of life capacity capacity loss of capacity WHO, World report on Healthy Ageing, WHO Geneva, 30 September 2015

AGE FRIENDLY COMMUNITY Global Age-friendly Cities: A Guide – WHO Geneva 2007

Political entreprising mind Public health prospects Academic defender Administrative wish Geriatric/Rehab leaders Financial & social supports Training of MDs Training of the HCWs Senior-friendly hospital commitments Change of care paradigm AGE-FRIENDLY HEALTH CARE

Life long achievement Secure/stress less Conti tinuing educati tion Post-graduate teaching Pre-graduate teaching Senior Confidence in friendly Family contact care hospitals Dignified death Advance care Informal care at home directives Formal care at home Aged Hospital / Patient Institution of Care Hospital stay HOSPITAL READMISSIONS Hospital discharge to HOME

Mobility disability & Healthy aging • Mobility disorders / disabilities o Definitions o Age-related mobility disorders • Healthy aging o History of the concepts o Current WHO definition • Take home messages o How promoting healthy ageing in mobility disabled

“Healthy ageing” domains tested in 10 recent studies  in case of mobility disorders    in case of mobility disorders MICHEL JP et al JAMDA 2017; 18: 460-4

Different “Healthy ageing” domains tested in 10 recent studies  in case of mobility disorders  PERSONAL LIFE  SOCIAL LIFE ENVIRONMENT  MICHEL JP et al JAMDA 2017; 18: 460-4

Different “Healthy ageing” domains tested in 10 recent studies  in case of mobility disorders Across the lifespan, the Havighurst cluster highlights the importance of the continuous, adaptive processes, that adults undergo to modify their goals in the face of losses that are often gradual  PERSONAL LIFE  SOCIAL LIFE ENVIRONMENT  MICHEL JP et al JAMDA 2017; 18: 460-4

Mobility disorders «Healthy Ageing»

Mobility disorders Which definition Wellbeing of & «Healthy Ageing» society integration are you using ?

I do thank you for your kind attention