What Defines an Age-Friendly Health System?; Comment on “Developing a Conceptual Framework for an Age-Friendly Health System: A Scoping Review”

Articles in Press

Document Type : Commentary

Author

Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA, USA

Abstract

To address some of the changing needs of the increasing number of older adults, theories and conceptual frameworks designed to make environments and healthcare settings more welcoming to, and supportive of, older adults, have been proposed. Most recently, significant attention has been given to the concept of an “age-friendly health system.” While the concept of age-friendly environments is not new, how such environments are operationalized varies, few data are available on outcomes, and there remains debate about the essential nature of key components of an age-friendly environment. This commentary discusses the conceptual framework proposed by Karami and colleagues published in the 2023 edition of the International Journal of Health Policy and Management. Questions are raised about the meaning of age-friendly and how it can be integrated into a life-span perspective of health.

Keywords

References

  1. Karami B, Ostad-Taghizadeh A, Rashidian A, Tajvar M. Developing a conceptual framework for an age-friendly health system: a scoping review. Int J Health Policy Manag. 2023;12:7342. doi:34172/ijhpm.2023.7342
  2. Lawton MP, Nahemow L. Ecology and the aging process. In: Eisdorfer C, Lawton MP, eds. The Psychology of Adult Development and Aging. American Psychological Association; 1973.
  3. Wahl HW, Weisman GD. Environmental gerontology at the beginning of the new millennium: reflections on its historical, empirical, and theoretical development. Gerontologist. 2003;43:616-627. doi:1093/geront/43.5.616
  4. Grudniewicz A, Gray CS, Boeckxstaens P, De Maeseneer J, Mold J. Operationalizing the chronic care model with goal-oriented care. Patient. 2023;16(6):569-578. doi:1007/s40271-023-00645-8
  5. Ferrucci L, Orini S. Comprehensive geriatric assessment: an updated perspective. In: Pilotto A, Martin FC, eds. Comprehensive Geriatric Assessment. Springer International Publishing; 2018:1–10. Practical Issues in Geriatrics.
  6. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness. JAMA. 2002;288(14):1775-1779. doi:1001/jama.288.14.1775
  7. Volpato S, Guralnik JM. The different domains of the comprehensive geriatric assessment. In: Pilotto A, Martin FC, eds. Comprehensive Geriatric Assessment. Springer International Publishing; 2018:11-25.
  8. Sum G, Nicholas SO, Nai ZL, Ding YY, Tan WS. Health outcomes and implementation barriers and facilitators of comprehensive geriatric assessment in community settings: a systematic integrative review [PROSPERO registration no.: CRD42021229953]. BMC Geriatr. 2022;22(1):379. doi:1186/s12877-022-03024-4
  9. Mahmoud A, Goodwin VA, Morley N, et al. How can we improve Comprehensive Geriatric Assessment for older people living with frailty in primary care and community settings? A qualitative study. BMJ Open. 2024;14(3):e081304. doi:1136/bmjopen-2023-081304
  10. Fulmer T, Mate KS, Berman A. The age-friendly health system imperative. J Am Geriatr Soc. 2018;66(1):22-24. doi:1111/jgs.15076
  11. The American College of Surgeons. CMS Age FriendlyHospital Measure. Accessed May 25, https://www.facs.org/quality-programs/accreditation-and-verification/geriatric-surgery-verification/cms-age-friendly-hospital-measure/.
  12. Tzeng HM, Franks HE, Passy E. Facilitators and barriers to implementing the 4Ms framework of age-friendly health systems: a scoping review. Nurs Rep. 2024;14(2):913-930. doi:3390/nursrep14020070
  13. Zisberg A, Rayan-Gharra N, Danial-Saad A, Rogozinski A, Fraiman PS, Segel-Karpas D. Age-friendly healthcare: an evolutionary concept analysis. J Clin Nurs. Dec 2024;33(12):4635-4650. doi:1111/jocn.17457
  14. Fan B, Wang M, Chen M, Luo H, Wang X, Yang Y. Age-friendly hospitals: a concept analysis. BMC Geriatr. 2025;25(1):726. doi:1186/s12877-025-06400-y
  15. Chao TS, Huang H. The East Asian age-friendly cities promotion – Taiwan’s experience and the need for an oriental paradigm. Global Health Promotion. 2016;23(1 suppl):85-89. doi:1177/1757975916641612
  16. Coyle CE, Gleason SR, Mutchler JE. Spillover benefits and achieving sustainability of age-friendly communities. Gerontologist. 2022;62(1):29-35. doi:1093/geront/gnab060
  17. Korte M, Graupner J, Thompson K, Gleason LJ. Age Friendly care: what do community aging services professionals need to know? Gerontol Geriatr Educ. 2024;45(2):156-165. doi:1080/02701960.2022.2151443
  18. Wallhagen MI. Perceived control theory: a recontextualized perspective. J Clin Geropsychol. 1998;4(2):119-140.
  19. World Health Organization (WHO). Framework to implement a life course approach in practice. July 3, 2025. https://www.who.int/publications/i/item/9789240112575.
International Journal of Health Policy and Management

Articles in Press, Corrected Proof
Available Online from 29 November 2025

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History

  • Received Date: 17 August 2025
  • Revised Date: 03 November 2025
  • Accepted Date: 17 November 2025
  • First Published Date: 29 November 2025
  • Published Date: 29 November 2025

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