Intrinsic capacity - count what a person can do, not what they have got
20th October 2026
John Beard, who directed the WHO work from which intrinsic capacity emerged and now directs the International Longevity Centre USA at Columbia University, argues that healthy ageing should be measured by function rather than by counting diagnoses. Intrinsic capacity sums what sits on the person’s side - thinking, moving, psychological resilience, the senses and vitality - and France now runs a national programme using it as the entry point to care, with humble checks such as a chair-rise test, memory questions and a whispered hearing test. In England and China, newer generations score better mainly because they start from a higher peak, not because they decline more slowly: 68 is the new 62 on Beard’s conservative reading.
Key takeaways:
- The framework sorts need, not just health: people with high and stable capacity, declining capacity, or significant losses each need different help, and care can begin at drift rather than at crisis
- There is no agreed standard for measuring it yet: Beard warns that poor measures grabbed to justify biomarkers could destroy the field’s credibility, and that simply adding sub-scores can make a little hearing loss look equal to a major loss of cognition
- Drug developers are interested in capacity as a faster trial endpoint - GLP-1s, SGLT-2 inhibitors and the shingles vaccine are named - but nobody has run such a study yet, and Beard’s own advice stays basic: move, eat well, manage stress, do not smoke or overdo drinking
Hype check: Proven - the WHO origin of the framework, its use as the entry point in a French national programme, and the higher-peak pattern in English and Chinese cohort data. Promising - intrinsic capacity as a midlife-trackable endpoint that could shorten longevity trials. Marketing - any clinic, wearable or biomarker already claiming to measure intrinsic capacity to a standard; Beard himself says no agreed standard exists yet.