It’s Never Too Early for Geriatrics: the tempoforme® Experience

Author: Marina Kotsani

Affiliation: PROGRAMMING COST Action chair

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Having just returned from my PROGRAMMING COST Action 21122 Short-Term Scientific Mission at the tempoforme® unit in Lille, I remain fascinated by another way of approaching frailty and geriatric prevention. Developed under the leadership of Prof. Eric Boulanger and affiliated with the Geriatric Department of the University Hospital of Lille, tempoforme® proposes an innovative and proactive vision of healthy ageing.

What makes the model particularly striking is that the people attending the unit are much younger than those usually seen in geriatric settings, sometimes starting from the age of 45. Yet the philosophy behind tempoforme® is precisely that ageing trajectories and frailty develop progressively over decades, long before disability becomes visible.

During a 3-hour visit, a multidisciplinary team of highly skilled nurses and physicians performs a comprehensive assessment aimed at identifying early signs of frailty and developing personalised prevention plans. Mobility, cognition, cardio-respiratory health, body composition, lifestyle habits, nutrition, sleep, stress, and social engagement are all explored through clinical tools, instruments, and laboratory tests. Together with the physician, beneficiaries co-construct realistic prevention goals adapted to their priorities and lifestyle. The motivational interview plays a particularly powerful role in encouraging behavioural change and patient empowerment.

Most individuals leave tempoforme® with previously unrecognised factors of (pre)frailty identified, along with a personalised plan to timely address them. In this sense, tempoforme® represents a remarkable example of preventive geriatrics, complementary to initiatives such as the WHO ICOPE, but with a particularly in-depth and specialised approach.

Shifting the healthcare’s paradigm and the starting point of geriatric prevention decades earlier could be key to modify a person’s declining trajectory towards frailty and dependency. This also requires the active role of the individual as well as some boldness from policymakers to invest in models whose benefits may only become visible decades later.

Still, perhaps if enough middle-aged adults could benefit today from services such as tempoforme®, in a few decades geriatricians would spend far less time managing extreme frailty, healthcare systems would be relieved of a considerable burden of disability, and, most importantly, older people would enjoy healthier, more active, and more fulfilling lives.