Melting away

Last week I was in Geneva, for a consultation meeting of the World Health Organisation on healthy ageing. A good occasion to write another blog after my 6 months stay over two years ago at WHO where I wrote a blog every week.

Why I had to go to Geneva again? The WHO published a big world report recently on ageing and health with ample information on this topic. The next step is an action plan on what countries and the WHO itself can do to ensure that people in future live longer in good health. We came together with countries and various organisations to discuss this action plan that has to be approved next year during the World Health Assembly.

In the report, WHO makes a distinction between intrinsic capacity and functional ability. Intrinsic capacity is the same as physical capacity and may remain high till the end of life and then decline suddenly. But this capacity can also decline earlier in your life course (because you get one or more chronic diseases for example). Genes, personal factors and luck partly determine what trajectory life has in stock for you. But of course you also can influence it yourself. Prevention is important during your entire life course and in the end also determines how fit you still are. So don't smoke and don't eat processed meat and your intrinsic capacity will probably decline only later in life.

Then functional ability. This is, simply said, what you can still do given your intrinsic capacity. The environment you live in determines how much extra functioning you can gain. This can be due to help by family members, assisting technology, your house being adapted for old age by the municipality, how age friendly the city is you live in and so on. A health system that is aligned to the needs of older people and a good long term care system that supports people who really need it with nursing, washing, shopping etc. also help to raise this level of functional ability. And not to forget, a culture in which elderly are seen as useful members of society and where they are not subject to abuse also helps them to keep doing the things they want. And that is exactly the definition of healthy ageing. To be able to keep doing the things you value, also in old age.

Readers of this blog of two years ago may remember that at this point I usually introduced a film I saw that week and that I connected to the topic of the blog. Therefore I went again to the art cinema la Scala in the nice neighbourhood Eaux Vives where they screened a film by Luc Jacquet, the Oscar-winning director of international smash hit March of the Penguins. He now made a documentary in Antarctica “Ice and the Sky (La Glace et le Ciel). The film looks at the life of one man: French polar explorer and glaciologist Claude Lorius.

His biggest breakthrough was the fortunate discovery that the chemical composition of snow allowed him to calculate the exact temperature on the day it fell, which means that samples from thousands of years ago could be surveyed to get an idea of the rise and fall of temperatures over extended periods of time. He thus found proof for climatologists’ hypothesis that our planet went through hot and cold periods of about 100,000 years each, which in turn allowed him to prove that the rate of climate change over the last 100 years is not a normal variation in temperature, and must thus be caused by man.

Gorgeously choreographed shots, many of them filmed with the help of drones, show Lorius surveying the melting water of glaciers or the burning forests that are the result of climate change. Entirely wordless, they convey the idea that the beauty-filled natural world indeed seems to be slipping away from the old man who first suggested this would happen and who now worries about what kind of world his grandchildren will be living in.

Now what this story about climate change has to do with healthy ageing as defined by the World Health Organisation? Well, just like the ice sheets in Antarctica, your and Lorius' health and intrinsic capacity will melt away in the years to come. But more serious, the intrinsic capacity of our climate is seriously compromised and we will need to do a lot to prevent further worsening. This means burning less fossil fuels and eating less meat (ah, wasn't that also good for your health as well?).

It also means that we will have to work on our functional ability of living on planet earth. We have to adjust to climate change like to old age, by introducing new ways to cope with natural disasters, and by offering long-term care to those who will have to leave the places where they now live and work (New York, Miami, Bangladesh and Netherlands to name a few of places that will have disappeared in 200 years from now).
And just like with respect for the elderly, paying more respect for nature and our planet will also help us to keep enjoying our lives. Elderly abuse and abuse of our planet should both be avoided and we need a different mind set.

Perhaps contradicting myself now at the end: like age friendly environments, we will also need environmental friendly ageing. That means for example not allowing electric bikes anymore for people under 75 and no absurd heating of rooms to 25c or more. Now that would mean a contribution to not melting away for the rest of us!