Table 1 Components, domains and concepts of the healthy ageing model for the older population in Ecuador
Healthy Ageing Components | Domains | Healthy group | Less healthy group |
|---|---|---|---|
Intrinsic capacity | Physiological and metabolic health | Absence of the following diagnoses: arterial hypertension, diabetes, cancer, chronic lung disease, cardiovascular disease, cerebrovascular disease, arthritis, rheumatism, osteoporosis and osteoarthritis, others; or the presence any of these diseases, but they are under treatment or they do not limit the functional status of the older person. | With a diagnosis of at least one of the aforementioned diseases, which are not under control, and/or limit the functional status of the older person. |
Geriatric syndromes | Absence of polypharmacy [17], urinary and fecal incontinence [18,19,20] and no falls syndrome [21, 22]. | Presence of any: polypharmacy, urinary and fecal incontinence and falls syndrome. | |
Risk factors | Absence of risk factors for cardiovascular disease such as blood pressure > 150/90, fasting glucose ≥126, obesity (body mass index, [BMI] ≥ 30), no alcohol consumption more than 1 day a week, no current and past tobacco use, physical activity and no hypercholesterolemia according to Adult Treatment Panel III (ATP-III) [23]. | Presence of any risk factors for cardiovascular disease: blood pressure > 150/90, fasting glucose ≥126, obesity (body mass index, [BMI] ≥ 30) or presence of at least one of: alcohol consumption more than 1 day a week, current and past tobacco use, no physical activity and abnormal values of lipoproteins and triglycerides [23]. | |
Physical capacity | Meets 6 to 7 of the following: 1) stands with the feet together keeping eyes open, 2) stands with the heel of one foot in front of the other foot, 3) stands on one foot without leaning or holding onto anything, 4) feels able to get up quickly from the chair five times, 5) gets up quickly from the chair five times, 6) feels able to get up from the chair with the arms on the chest five times, and, 7) gets out of the chair with the arms on the chest five times [4]. Absence of disability according to the Katz activities of daily living (ADL) test [24]. | Meets 5 or less of the above instructions. Presence of disability according to the Katz activities of daily living (ADL) test [24]. | |
Cognitive ability | Absence of dementia and cognitive deficit. Cognitive ability was obtained from the modified Mini-mental assessment. A score ≥ 14 was used as a cut-off point for the absence of cognitive deficit [25]. | Presence of dementia and/or cognitive deficit. A score < 13 in the Mini-mental assessment was used to define cognitive deficit [25]. | |
Psychological well-being | Absence of physical, sexual or psychological abuse collected by directly asking the older person. Absence of depression by using of the Yesavage geriatric depression scale [26,27,28]. | Presence of any of following: -Physical, sexual or psychological abuse. | |
Social and political environment | Social welfare | Absence of negligence, and/or economic violence. A score of ≤9 in the Gijón scale, was defined as a good / acceptable social situation [29]. | Presence of negligence, and/or economic violence. A score of > 10 in the Gijón scale [29]. |
Political environment | An older person beneficiary of social security or receiving a non-contributory pension, and having access to health services, as well as receiving support from different institutions. | An older person who does not have social security, nor receive a non-contributory pension. Does not have access to health services, as well as recipients of support from different institutions. | |
Interaction of the older person with the environment | Participation in the community | An older person participating in recreational activities, and acting as volunteer in an institution or organization in the community at least once a month [5]. | An older person who does not participate in recreational activities, neither acts as volunteer in an institution or organization in the community. |
Recipient or provider of support | An older person receiving or providing support from children, siblings and other family or friends. | An older person who does not receive or provide support from children, siblings and other family or friends |