Muscle strength, memory, mobility, vision, hearing, psychological well-being, and energy level could in the future become important indicators on a par with blood pressure and cholesterol. This is the prospect opened by the concept of intrinsic capacity, a parameter that is drawing growing interest in research on healthy aging and longevity.
Defined by the World Health Organization (WHO), intrinsic capacity represents the overall set of physical and mental resources a person possesses. As explained to the New York Times by John Beard, professor of Active Aging at the Mailman School of Public Health of Columbia University, who clarified the two words: “Intrinsic refers to everything that belongs to the person from within, and capacity indicates how well the organism can function.” The aim is to move beyond assessments based solely on the presence or absence of disease and instead consider the individual’s ability to maintain autonomy and functionality over time.
The Five Domains of Intrinsic Capacity
The assessment of intrinsic capacity is based on five fundamental areas:
- Cognition, encompassing memory, attention, and other mental functions;
- Locomotion, involving muscle strength, balance, mobility, and walking speed;
- Sensory Functions, with particular emphasis on vision and hearing;
- Psychological Well-being, related to mood and the presence of depressive symptoms;
- Vitality, reflecting energy levels and the body’s ability to cope with physical stress.
Some of these parameters are already used in geriatric practice, but currently there is no single test universally recognized to measure intrinsic capacity in its entirety.
A Tool for Early Detection of Functional Decline
According to researchers, the value of this approach lies mainly in the ability to monitor these parameters over time. Even in the absence of obvious diseases, small changes in strength, walking speed, memory, or sensory abilities could serve as early signals of future functional decline.
The timely identification of these variations would allow interventions on modifiable factors such as physical activity, nutrition, sleep quality, social isolation, sensory deficits, or inadequately controlled illnesses, with the goal of preserving independence and quality of life for as long as possible.
Ongoing Trials
Interest in intrinsic capacity is already yielding concrete applications. In France, a program actively monitors older adults through periodic questionnaires addressing the main domains of intrinsic capacity. If deterioration is detected, participants are referred for specialist assessment to explore any critical issues and plan targeted interventions.
Meanwhile, in the United States, some researchers are assessing whether this parameter could become a useful indicator for measuring the effectiveness of interventions and drugs aimed at slowing down the processes of biological aging.
Beyond Disease, Toward Person-Centered Medicine
Intrinsic capacity fits into an increasingly integrated view of health, where not only the presence of a disease matters, but also the maintenance of functions that enable an individual to live autonomously and with satisfaction.
While still under study and validation, this concept could contribute to shifting medicine’s focus from merely treating disease to preserving physical and mental resources across the lifespan, becoming one of the new benchmarks in promoting healthy longevity.
Studies
Beard J, Officer A, de Carvalho I et al. The World report on ageing and health: a policy framework for healthy ageing. The Lancet, 2015; 387, 2145-2154
Chen M, Hanewald K, Si Y, Gu Y, Beard JR. Intrinsic Capacity Across 15 Countries in the Survey of Health, Aging, and Retirement in Europe. JAMA Netw Open. 2025;8(5):e259792. doi:10.1001/jamanetworkopen.2025.9792
Sánchez-Sánchez J, Lu W, Gallardo-Gómez D et al. Association of intrinsic capacity with functional decline and mortality in older adults: a systematic review and meta-analysis of longitudinal studies. The Lancet Healthy Longevity, 5, e480-e492
Tavassoli N, Piau A, Berbon C, et al. Framework Implementation of the INSPIRE ICOPE-CARE Program in Collaboration with the World Health Organization (WHO) in the Occitania Region. J Frailty Aging. 2021;10(2):103-109. doi:10.14283/jfa.2020.26
Fuentealba M, Rouch L, Guyonnet S, et al. A blood-based epigenetic clock for intrinsic capacity predicts mortality and is associated with clinical, immunological and lifestyle factors. Nat Aging. 2025;5(7):1207-1216. doi:10.1038/s43587-025-00883-5
Gm RS, Al S, Ey J, et al. Implementing ICOPE in New Mexico: A process-oriented approach to promoting healthy aging in older adults. JAR Life. 2025;15:100034. Published 2025 Dec 31. doi:10.1016/j.jarlif.2025.100034
https://arpa-h.gov/sites/default/files/2026-05/Consensus%20Statement%20to%20the%20FDA.pdf
Rabheru K, Byles J, Kalache A How “old age” was withdrawn as a diagnosis from ICD-11 The Lancet Healthy Longevity, 2022; 3, e457-e459
