This Lancet Healthy Longevity commentary examines whether improvements in intrinsic capacity — the composite of vitality, locomotion, cognition, psychological, and sensory function that underpins WHO's healthy ageing model — are shared equally across socioeconomic strata and successive birth cohorts. The analysis indicates that population-level gains in late-life function coexist with persistent socioeconomic gradients, meaning later-born generations do not benefit uniformly. Functional ability in older age is framed as the product of intrinsic capacity interacting with environment, placing structural conditions alongside individual physiology as determinants of healthspan.
Key Points
- Intrinsic capacity spans vitality, locomotion, cognition, psychology, and sensory function
- Socioeconomic gradients in late-life capacity persist across successive birth cohorts
- Functional ability reflects intrinsic capacity interacting with environmental conditions
Longevity Analysis
Intrinsic capacity offers a measurable composite of function that integrates movement, cognition, mood, sensory input, and underlying energy reserve — a more informative target than disease counts for anyone tracking trajectory rather than diagnosis. The socioeconomic gradient identifies interference that operates upstream of any individual protocol: chronic environmental and material stressors that load the stress response, constrain movement and recovery, and erode reserve decades before symptoms appear. Measuring these five domains serially, rather than waiting for functional loss to declare itself, converts healthy ageing from a population statistic into something a clinician and patient can act on.
Original published by The Lancet Healthy Longevity, by Natasja M van Schoor, Laura A Schaap.