Frailty, Successful Aging, Resilience, and Intrinsic Capacity: a Cross-disciplinary Discourse of the Aging Process

Abstract

The relationship between successful aging, frailty, intrinsic capacity, and resilience is explored, in terms of underlying physiology, indicators, and utility. Frailty may be regarded as the reverse of successful aging conceptually, but more appropriate for clinical management and health promotion programs. Intrinsic capacity may be used as indicator of healthy aging, and the concept of resilience more relevant in research efforts to understand the heterogeneous age-related changes. In prevention of geriatric syndromes and diseases, as well as in the formulation of health policies, the use of a negative undesirable state (such as frailty) may elicit more response than the alternative approach of maintaining intrinsic capacity. For example, smoking cessation strategies heavily use negative images, as opposed to “maintaining good lung function.” Similarly, in hospital management, frailty assessment has rapidly become incorporated into management in various specialties such as cardiology, renal medicine, and oncology, in addition to Geriatric Medicine and primary care. Successful aging, frailty, resilience, and intrinsic capacity share many common features; the use of these terms represents different approaches towards describing age-related changes at all levels: from cellular, physiological systems, to whole persons and community.