Lifespan is the calendar years from birth to death. Healthspan is the years in which a person can stay in their own home, walk, and sustain work and relationships. People are living longer; years spent with disease and disability can also lengthen. The two measures are not the same.
In 1980, Fries defined faster delay of the onset of disease and disability relative to age at death as compression of morbidity: the period spent with disease is pushed towards the end of life. The reverse is also seen: life lengthens, and years spent in dependency also lengthen. The longevity programme tracks not the count of years but where function stops.
What do A–F show?
The same screen places the person on a single stage. When multiple findings are present, the heaviest threshold applies.
- A — Protection: no decline in five domains
- B — Early finding: mild decline in a single domain or a prefrail picture
- C — Multidomain decline: mild or moderate findings in more than one domain
- D — Marked capacity loss: marked decline in at least one domain
- E — Frailty: Fried score of three or higher
- F — Help with daily function: support is needed for activities of daily living (ADL)
Follow-up is done with the same form every three to twelve months. At C and above, which systems the decline relates to are read together. Metabolism, immunity, muscle, nerve, kidney, lung, and vessel are on the same list; vessel is not priority.
Detail: ageing stages. Individual screen: assessment. Five domains: ICOPE and intrinsic capacity. Frame: healthy longevity.