Intrinsic Capacity – Moving Beyond Biomarkers for Improved Healthspan
When we think about getting older, many of us focus on avoiding chronic illness. After all, if we lack an age-related diagnosis and our lab tests are in the normal range, we’re aging well, correct?
Maybe.
In 2015, the World Health Organization introduced a new concept to help define parameters for healthy aging and to improve healthspan – known as Intrinsic Capacity (IC). Instead of starting with the diagnosis as the endpoint and examining post-diagnosis health degradation, the IC uses an energy reserves-focused framework that measures a core baseline across five domains: locomotor, cognition, mental health, sensory, and vitality
Five Domains of Intrinsic Capacity (IC) by the WHO
Locomotor
Extends beyond walking on a flat surface. It includes the ability to walk up and down stairs, balance, agility, and stand up from a chair without using your hands.
Cognitive
Examines mental acuity and the pillars of a sharp mind – informational processing, memory, attention and focus, and judgment.
Psychological
Focuses on mood and emotional resilience. It incorporates the direct impact that mental and emotional health has on physical health.
Sensory
Includes vision and hearing. When these senses decline, individuals tend to withdraw from social situations, which can have significant effects on their mental health and contribute to memory issues.
Vitality
Reflects the state of the body’s metabolic function linked to nutritional intake. It is also connected to the overall feeling of well-being, in contrast to exhaustion or overwhelm.
Please refer to the overview table below to learn more about the domains of Intrinsic Capacity and how they affect your daily life.
Cellular Energy Reserve and the Bioenergetic Threshold
The primary driver behind Intrinsic Capacity is the Cellular Energy Reserve, or a cell’s ability to generate energy beyond its innate survival needs. This surplus is fueled by adenosine triphosphate (ATP) generated by the mitochondria, which act both as energy producers and sentinels of the cells.
ATP fuels every single action your body performs – from breathing to standing up from a seated position to remembering where you left your keys.
As we age, our mitochondria slow down and lose their capacity to rapidly generate the energy required for recovery from stressors.
When the mitochondria lack the Bioenergetic Threshold, or the bare minimum level of energy required to provide a cell with the energy required to perform its biological processes or survive, integrity fails. This depletion triggers a cascade that extends from mitochondria to cells, tissues, organs, organ systems, and beyond.
Eventually, this downward spiral in bioenergetics compromises the body’s overall vitality and systems, making repair and recovery difficult. It is at this point that disease can take hold, and the body’s intrinsic capacity begins to plummet.
Addressing the Effects of Aging through Healthspan Optimization
Imagine that the body has an internal health bank account.
The larger the account, the better the recovery from internal and external stressors that deplete energy reserves or savings. Unlike linear chronological aging, which is always moving forward, intrinsic capacity is dynamic.
You can enhance your IC by making regular beneficial deposits, including resistance training, social activities to avoid isolation, and whole-food-based nutrition, as demonstrated in the image below
Recommendations from the WHO include annual hearing and vision screenings to identify declines in these senses, as they may be difficult to detect without expert monitoring.
These simple yet effective lifestyle considerations are essential for protecting independence and improving healthspan potential.
Read / Watch Next
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- A brief read on why healthspan is more important than longevity.
References
- López-Otín, C., Blasco, M. A., Partridge, L., Serrano, M., & Kroemer, G. (2013). The hallmarks of aging. Cell, 153(6), 1194–1217. https://doi.org/10.1016/j.cell.2013.05.039
- Picard, M., & Shirihai, O. S. (2022). Mitochondrial signal transduction. Cell Metabolism, 34(11), 1620–1653. https://doi.org/10.1016/j.cmet.2022.10.008
- Wang, L., Zhou, X. & Lu, T. Role of mitochondria in physiological activities, diseases, and therapy. Mol Biomed 6, 42 (2025). https://doi.org/10.1186/s43556-025-00284-5
- World Health Organization. (2024). Integrated care for older people (ICOPE): Guidance for person-centred assessment and pathways in primary care (2nd ed.). https://www.segg.es/media/descargas/ICOPE-handbook-2nd-final.pdf