Aging, Functioning, and Rehabilitation: Proceedings of a Workshop (2024)
Chapter: Front Matter
Aging, Functioning, and
Rehabilitation
______
Ruth Cooper, Adrienne Formentos,
and Allison Boman, Rapporteurs
Board on Global Health
Board on Health Care Services
Health and Medicine Division
Proceedings of a Workshop
NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by a contract between the National Academy of Sciences and the University Foundation (Stiftung Universität Luzern) on behalf of the NOMIS Foundation and the Velux Stiftung. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-71888-2
International Standard Book Number-10: 0-309-71888-0
Digital Object Identifier: https://doi.org/10.17226/27763
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2024. Aging, functioning, and rehabilitation: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/27763.
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PLANNING COMMITTEE FOR AGING, FUNCTIONING, AND REHABILIATION: A WORKSHOP
WALTER FRONTERA (Chair), Professor, University of Puerto Rico School of Medicine
SOMNATH CHATTERJI, World Health Organization, Emeritus
JULIA PATRICK ENGKASAN, Associate Professor, Universiti Malaya
NICOLE R. KEITH, Executive Associate Dean, Indiana University Bloomington
MATILDE LEONARDI, Director, Fondazione IRCCS Istituto Neurologico “Carlo Besta”
GEROLD STUCKI, Professor, University of Lucerne
Staff
RUTH COOPER, Program Officer
ADRIENNE FORMENTOS, Associate Program Officer
JOSEPH GOODMAN, Senior Program Assistant
KAREN HELSING, Director, Standing Committee of Medical and Vocational Experts for the Social Security Administration’s Disability Programs
TRACY LUSTIG, Director, Forum on Aging, Disability, and Independence
SHARYL NASS, Senior Board Director, Board on Health Care Services
JULIE PAVLIN, Senior Board Director, Board on Global Health
JULIE WILTSHIRE, Senior Finance Business Partner
Consultant
ALLISON BOMAN, Writer
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Reviewers
This proceedings of a workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
CANDACE GOH XIAO HUEY, Hospital Beaufort, Malaysia
MELISSA SELB, Swiss Paraplegic Research, Switzerland
KATARZYNA WAC, University of Geneva, Switzerland
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by DAVID B. REUBEN, University of California, Los Angeles, United States. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies. We also thank staff member Samantha Koretsky for reading and providing helpful comments on this manuscript.
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Acknowledgments
The National Academies of Sciences, Engineering, and Medicine’s Board on Health Care Services wishes to express its sincere gratitude to the planning committee chair, Walter Frontera, for his valuable contributions to the development and orchestration of this workshop. The board also wishes to thank all the members of the planning committee, who collaborated to ensure a workshop replete with informative presentations and moderated rich discussions. The board is grateful for the support of our workshop sponsors, without which we could not have undertaken this project.
The board is deeply appreciative for the generous support and hospitality of the University of Lucerne and thanks Cristina Mesa Vieira and Colette Lenherr for their logistical support of the workshop. The board wishes to thank the supporting scientists from the University of Lucerne and Swiss Paraplegic Research—Nicola Diviani, Marija Glisic, Diana Pacheco, Sara Rubinelli, and Carla Sabariego—for their support with the panel concept notes and in helping to moderate the virtual questions.
Deep appreciation goes to staff at the National Academies of Sciences, Engineering, and Medicine for their support in the workshop process, especially Torrie Brown, Annalee Gonzales, Benjamin Hubbert, Jo’Elie Louis, Amber McLaughlin, Alexandra Molina, Jose Portillo, Leslie Sim, and Taryn Young. We also thank the staff of the National Academy of Medicine for their support of the workshop. Finally, the board thanks the workshop panelists, who generously shared their expertise and their time with workshop participants.
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Contents
WHO’s International Classification of Functioning, Disability and Health
Disability-Adjusted Life Years
Rehabilitation in Health Systems: The Time Is Now
FUNCTIONING AND REHABILITATION FOR HEALTHY LONGEVITY
Operationalizing Functioning for Population Health
Role of Functioning in Healthy Longevity Research
MAKING A COMPELLING INVESTMENT CASE FOR OPTIMIZING FUNCTIONING
Measuring and Enhancing Functioning in Health Systems
Building Evidence for an Investment Case
Reflections on Building the Economic Case for Functioning and Rehabilitation
IMPROVING REHABILITATION IN HEALTH SERVICES DELIVERY AND CARE ACROSS THE LIFE COURSE
Rehabilitation as a Strategy for Promoting Healthy Aging
Prehabilitation, Prevention, and Maintenance for Maximizing Functioning
Rehabilitation as a Health Strategy for All Populations
Reflections on Developing Health Services for Rehabilitation and Functioning
FUNCTIONING AS THE FOUNDATION FOR HEALTHY LONGEVITY RESEARCH
Harmonizing Research Addressing Functioning
Standardized Collection of Functioning Information
Using Functioning Data for 360-Degree Research
Reflections on Developing a Research Agenda for Functioning
ADVOCATING FOR POLICIES THAT SUPPORT HEALTHY LONGEVITY
Advocating for Functioning as the Third Indicator of Health
Raising Awareness: The Policy Advocate Perspective
New Directions for Health and Disability
Reflections on Promoting Advocacy for Functioning and Rehabilitation
Boxes and Figures
BOXES
1Suggestions for Moving the Field Forward
3Characteristics of Functioning and Cost Data Needed to Build an Investment Case
FIGURES
2Highlights for implementing human functioning within health systems
3Disability-adjusted life-years
4Life course opportunities for intervention
6Trajectories of healthy aging: Optimizing functional ability
7Integrated Care for Older People
8Life situations drive people’s health function
9Reimagined whole-life-oriented rehabilitation strategy
11Assistive technology demonstrates a nine-to-one return on investment
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Acronyms and Abbreviations
| CAT | computerized adaptive testing |
| ClinFIT | Clinical Functioning Information Tool |
| DALY | disability-adjusted life year |
| FNAT | Functional Needs Assessment Tool |
| ICD | International Classification of Diseases |
| ICF | International Classification of Functioning, Disability and Health |
| ICOPE | Integrated Care for Older People |
| LMIC | low- or middle-income country |
| NAM | National Academy of Medicine |
| OECD | Organisation for Economic Co-operation and Development |
| PAHO | Pan American Health Organization |
| UN | United Nations |
| WHO | World Health Organization |
