A narrative review and expert consensus on barriers, facilitators, and research gaps to healthy and positive ageing - Position of the Multidisciplinary International Positive Ageing Group (MIPAG).

Abstract

Recent developments in healthcare and scientific research have shifted the perception of ageing from a period of decline to recognising its potential for sustained functional ability, well-being, and societal contributions. In light of this perspective, a multidisciplinary panel of experts from five European countries conducted a narrative review of the literature. It convened for a one-day consensus meeting to identify key barriers, facilitators, and research priorities related to healthy ageing. Thus, this paper aims to (1) define the concept of positive ageing, (2) discuss barriers and facilitators to healthy ageing, (3) examine the role of healthcare professionals in maintaining and improving intrinsic capacity, and (4) propose a research agenda to address gaps in healthy ageing. The panel identified 70 barriers and 64 facilitators, structured within the WHO's ICOPE framework, related to intrinsic capacity. Twenty-six interventions across five domains-locomotor, sensory, psychological, cognitive capacities, and vitality- were proposed, aimed at both frail and robust individuals, focusing on social integration, psychological well-being, physiological resilience, deficit management, and disorder prevention. The panel also outlined a research agenda emphasising AI-driven ageing support, improved communication strategies, early frailty detection, and the development of locally adapted guidelines and infrastructure for healthy and positive ageing. This framework emphasizes the importance of early-life interventions and advocates for a preventive, holistic, and multidisciplinary approach to aging. In conclusion, the MIPAG's fosters a proactive mindset and early interventions throughout life to prevent the decline and optimise intrinsic capacity.