Healthy ageing, appetite, frailty and sarcopenia: a brief overview

Abstract

In many societies the population is getting older, such that in some western countries it is expected that those over 80 years of age will make up 30% of the population (1-2). In the modern era, due to improved health and better medical support/treatment, many people may spend as many years retired as they did working. Unfortunately, as one ages, the burden of disease increases (2.9 million people in England have >1 long-term condition), longevity is compromised by disability; therefore the drive must be to add life to years rather than just years to life. When people live long, the media often asks “what is the success associated with longevity or successful (healthy) ageing?” Is it a success to live a long life, or is successful ageing the key? Healthy ageing, is defined as a state, where the effect of frailty, sarcopenia, disease and disability have been minimised. Farpour et al (3) discuss the effect that aging has on Iranian people, and Liang et al discuss the findings of a systematic review looking at traditional Chinese’ medicine and subhealth (4), which could be aligned to prefrailty. \n \nIn 2015 the WHO defined Health as “a state of complex physical, mental and social well-being and not merely absence of disease” (5). Healthy ageing was also defined as “the process of developing and maintaining the functional ability that enables well-being in older age”. Rowe and Khan (1987) commented that to age successfully one must avoid disease, remain engaged with life and maintain a high level of physical and cognitive function (6). Healthy ageing is, therefore, a complex interplay between physical, cognitive and social factors, and perhaps is dependent on how we individually respond to the internal and external forces at play (table 1). \n \nThe definition of what is normal and what is abnormal is fraught with difficulty; what is acceptable and what is not? There is a risk that where normative parameters (for younger adults) are exceeded there will be a medicalisation of “older age”! \n \nWhat ultimately matters is the preservation of functional ability, which the majority (75%) of very old people are able to do and live relatively independent lives (6). This paper will discuss the interdependency between healthy ageing, appetite, frailty and sarcopenia and their impact on functional ability.