“Aging in good health, a challenge that physiotherapists want to help meet”

Pascale Mathieu is president of the National Council of the Order of Masseurs-Physiotherapists. France Mourey is a physiotherapist and university professor at the University of Bourgogne Franche-Comté.

The aging of the population is a major challenge that our society must face. In France, by 2050, a third of French people will be over 60 years old, according to INSEE. If this figure is well known, one reality is much less so: life expectancy without disability reflects too early pathological aging. Women can expect to live 65.3 years without disability for a total life expectancy of 84.8 years (in 2022), men 63.8 years for a life expectancy of 78.4 years. These disabilities, whether motor, sensory or cognitive, have direct consequences on the quality of life of older people and generate significant health costs. Should we accept this prospect of fifteen to twenty years of life with poor health? Or are we determined to generalize early and effective interventions to prevent these disabilities?

For aging to become an opportunity rather than a problem, it is essential to change our outlook on aging. To understand – and teach – the distinction between normal and pathological aging, to recognize the inter-individual variability of aging (each person develops in a different way), to take into account the specificities of aging in disabled people. But also to fight against ageism, this assumption of incapacity of older people which leads to discrimination, stereotypical objectives and excesses of language towards them.

Encourage activity, identify weaknesses, re-educate disabilities

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Health professionals have a duty to set an example in this area, just as they have a crucial role to play in supporting healthy aging. Physiotherapists are on the front line and are ready to take on the challenge of prevention. Their expertise in mobility, muscle strength and balance is essential to helping older adults maintain their independence.

As players in primary prevention, they encourage regular physical activity, which helps maintain good health, prevents most age-related chronic diseases including neuro-progressive diseases, and contributes to mental health. In secondary prevention, they are able to identify the fragility of aging people, take care of them through appropriate exercises and help prevent falls, which are responsible for more than 100,000 hospitalizations and 10,000 deaths each year in France. As part of tertiary prevention, they improve the situation of people already in a situation of dependence through specific rehabilitation sessions. They must also work closely with other healthcare professionals to provide a comprehensive and coordinated approach to care.

For systematic screening of motor fragility

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We still need to allow physiotherapists to accomplish their mission. Strengthening their initial training on normal and pathological aging, as well as their continuing training in geriatrics, particularly through Continuing Professional Development, seems essential to us. Setting up regular meetings with the population, at key moments in people’s lives, is just as important. The new “My prevention assessment” system for four periods of life, particularly for 60-65 year olds and 70-75 year olds, is going in the right direction but must address all health topics in 30 to 45 minutes.

We believe that a specific screening assessment for motor fragility in aging people, with regular reassessment as provided for in the Icope (Integrated Care for Older People) program, must be carried out by physiotherapists. This assessment must be offered at home, where the vast majority of the population wishes to age. It must be systematic upon entry into nursing homes, where 21% of people over 85 live. Particular vigilance must also be paid to people leaving hospitalization, when returning home. As for rehabilitation in geriatrics, it deserves the creation of a specific act, with precise expectations in terms of dynamic balance and continuation of daily life activities.

Changing our view of aging also means thinking about the quality of life of elderly people, dependent or not, and their contribution to society. Our discipline, which combines prevention and rehabilitation, is resolutely turned towards the future, supporting progress in reconstructive medicine and surgery, and the development of technologies adapted to the daily lives of seniors. Old age, far from being a defeat, is a victory over time! Let’s mobilize to make it a success.