A. Blasimme
Aging Clin Exp Res Epub 2017 Feb 10
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Physical frailty and loss of muscular mass (sarcopenia) are believed to be predictors of age-related conditions, such as disability and loss of autonomy. In this paper, I show that what in political and moral philosophy has come to be known as “the capability approach” may indeed provide much needed conceptual clarification in the area of frailty research. Other than being useful at the theoretical level, the capability approach can definitely help in the implementation of clinical guidelines and public health measures aimed at translating the results that are accumulating from frailty research. I will first briefly review the main philosophical tenets of the capability approach, and then analyze how they relate to current debates about frailty and sarcopenia by introducing the notion of “enablement”. Finally, I will show how my analysis bears on both clinical research in this domain and public policy aimed at tackling some of the age-related issues in an aging society.




Comment: Frailty and sarcopenia, however, are areas in which medicalization may not be the right way to go. Focusing on capabilities and enablements is important also with respect to another set of issues that tend to be overlooked. People in effect may well attach a lot of value to functionings like physical autonomy. However, they may not be equally committed to specific sets of enablements that confer the capability to be physically autonomous. People may have different attitudes towards different kinds of interventions intended to cope with frailty and sarcopenia. This is particularly true of lifestyle-changing interventions. For this reason, some large-scale studies (as for example SPRINT-T) also aim at quantifying how much the proposed behavioral and nutritional interventions depart from the habits of participants, and how much this discrepancy affects compliance with the prescribed physical and nutritional regimes.