Hi. I'm Louisa Remedios and I'll be taking the first of two sessions that will act as an introduction to the Body of Ageing. And we'll talk about what it means to age well. We're hoping to give you some ideas from the physical perspective, concentrating on the body and its systems to help you answer that more complex question. Are we prepared to live longer. So, to start with we've got a question for your consideration. What does ageing well mean to you? This would be a good time to pause the recording and think about your concepts of ageing. You might jot down a few words or describe, or as somebody you think is ageing well. Put that down. Don't worry about having the right definition, it's your definition and that's what makes this really important. Okay. All right. So has your definition been about avoiding disease and disability and not being sick? Or was it more about activity and engageing with community, more about being involved with what you want to do? Is it being, is it more about the physical or more about mental and social health? Have you got concepts such as independence in there, about people being able to do the domestic chores to keep them safe and out of care? Is it about sustainable relationships for you, have you added that concept? What about having a voice within community, being about to get together with others and really being heard? Is it about incredible feats, athletic feats such as running a triathlon. Or about contributing to communities. Some of those or all of those ideas. There's a lot written in this area. There are a lot of expertise in this area. Many different definitions. And it depends on your own background and discipline. For example definition by a geneticist and a physiotherapist or a psychologist would be very different. And if we asked an older person, and older people what their definitions would be, again, it would be very different, and it's really worth listening and hearing. We should be doing much more of this, asking people what their idea of successful and, or good ageing, healthy ageing is for them. I'll just go back and leave you there. So what would some experts say about defining ageing well? They use language such as ageing positively, healthy ageing, sometimes resilient ageing, active ageing. Here are three fairly classic concepts that I've drawn from the literature, I'd like you to look at them. Think about some of the similarities, and maybe the differences, the themes, that you can see in this. This is a good time to just pause this recording. Okay, so one of the ideas that loops out at me when I see this is when, if you come from a biological or medical background the focus on ageing tends to be about living longer and having fewer diseases, fewer problems. And that's really quite well established. And this other idea comes more from the psychosocial literature, is about choices as an individual. Is about contributing to community. About being an active member of your community and society. And about quality of life, about joy. What's happening more and more is that there's these combinations of these ideas being put together. And this World Health Organisation definition is a really good one in fact. That talks about both the physical, you know the optimisation of physical, social, and mental well being as well as participation and being part of community. They see healthy ageing as a lifelong project, and something that, you know, they’re constantly working on and can influence all the way through our life. One thing I do want to emphasise, is that in fact if we go back one what you will notice is that this physical dimension of this as well as psychological and social. ageing well isn't just about the body anymore, it's much broader. Looks at community and social engagement is out much more at significant level. [COUGH] Sorry. If we look at those again, two factors that are really strong here are the idea that activity is important in all these definitions and the ability to participate is really important in these definitions. And they come through in all of these ideas. And they really picked up very strongly in the ICF model. This notion that there's health, good health is multidimensional and healthy ageing is multidimensional as well as this ability to be active and to participate. And if you look at this model here, this is a framework you might be familiar with was developed by the World Health Organisation. It was ratified in 2001 after a lot of discussion and it was designed so that we have a common language to talk about health. It also emphasises that it's multidimensional. You can see, and it's interactive. You can see those arrows going every which way. And that tells you that each of these factors, domains, influences the others and influences our health experience. To look at them more closely body functions and structures we're talking about physiological and psychological functions. You know, our thinking our reasoning our communication functions our visual functions and hearing functions musculoskeletal functions as well, and the structures of the anatomy that sustains these functions. Now the idea here is that there are a number of definitions around ageing are about a decline in our body functions and systems and it's tended to concentrate on that. The ICF looks at this other dimension and they talk about activities. I'll just give you a bit of a view a reminder of body structures and functions. And activities, really thinking about activities of daily living. So tasks that we do typically independently. Such as dressing, walking, driving, bathing. You know, all the typical tasks we do during the day. And participation is seen as more social engagement. Activity and participation in a lot of the literature are treated together. But really, you can look at the activities as the basis for participation for example, walking is an activity, the participation aspect is the bushwalking, the shopping, the dancing that goes with it. The other elements to look at are the environmental factors. So, it's important to think of this as the physical, the social, and the political. It's not just the physical environment, the lights, the pavements, the buildings, access ramps, that sort of thing, that makes life easier. But it's also the social attitudes. Should we be, as older people, as the attitudes that would be sitting in rocking chairs, or are we expected to be out there making a difference and contributing to the wellness of society? The political agenda is also important. It's also worth thinking about is the funding and resources that are made available and the policies around ageing. The personal factors are the items that are about us that, you know, can't be changed or are difficult to change. They live within the individual. So it's about our history, our genetics, our gender, our age our coping mechanism. Some of the things, as I said, that could be slightly modified. But, they live within us. And then, the final one is the health condition of any diagnosed condition, such as osteoarthritis or Parkinson's, so. You know a motor neuron disease. What are things that might be happening that will influence our health experience. So it's a really useful model for thinking of, in terms of ageing. Now a good way to learn more about it, is to have a more, to complete a personal one on yourselves. I've just completed a little one, so you can have an example. I've only done some bits and pieces of it. To start with the easiest way to start is on personal factors. So, just some elements that you think are important and are likely to influence your experience. At the bottom, there, this is health related quality of life, and more and more people are looking at that to include that concept around the ICF. Very subjective, it's your own attitude to how your health is and what your health is about. Then we talk about environmental factors. Try to fit things in about the environment, physical, social, and political as well. I've put down, for example, government funding. These sort of things do influence our health. As an academic, for example, there’re cuts to government funding, fewer resources, increased stress for staff, which might impact on our health. If we think of just jot down any disorders, conditions you might have been diagnosed with. In our next MOOC my colleague Deborah Virtue will be talking in giving more details on the systems the changes to systems and functions as we age, so we won't spend a lot of time on that. But think and write on about the typical activities you engage in, in a day. And also about the participation. These factors really, as I said, impact on each other. If you look at, for example, my participation it's very sedentary, which, sort of, would suggest that, you know my physical fitness really is at risk. Okay, so that was a personal view. The ICF is also used very effectively for more population view and what we'd like you to use is to use this as homework. So just, just pop down some ideas. And using general knowledge some information you might, may already have on what might be happening as you age to our body functions and structures. Okay. The word by the way impairment is where there is a problem with functions and structure. And I've got some classic examples there. What you can also do is look at the literature if you want to and get a few more details. I've got an example here of, the literature is really strong on multimorbidities, and a multimorbidity is, is defined as more than two chronic problems. And very, very high as you age. The more you age, the more of these conditions tend to exist. So just fill out a chart like this for yourself. It'll just get you thinking more about ageing. And really get you thinking about whether we're ready to live longer. Two other terms I want to draw your attention to. Activity limitation is when you can't complete an activity of course, and a restriction is when you can't participate as you would like. So these notions of impairments, activity limitations, and participation restrictions, are used a lot in the literature to discuss ageing. So if you go onto our final, oops, it's a little bit more information on the environments that I've added to get you thinking about that very, very important element and not considered enough because this is a factor that can be influenced and influenced effectively. So our final slide. So do you think we can live longer purposefully? What do you think you will be doing at 80 or 90? Will you be singing in a rock band or will you be watching the rock band? Will you be running a triathlon or will you be reading about it in the papers or watching it on telly? We know that our health declines with age. We know our body systems are, are, I'll rephrase that, sorry. We know our body functions and systems decline with age, but we also know, looking at the ICF model, that our experience of health can be modified. We can influence it through other domains and other elements. And it's something we actually have some control of and something we can work on. So, have a fabulous time. That's the final slide. Goodbye, and age well. Bye.