The Glossary has been prepared based on principles from many sources, including the creation of the Oxford English Dictionary.
The importance of language in reaching agreement It is very important to agree the meanings of the terms we use, terms such as ageing or growing older. Often disagreements and misunderstandings occur because the people trying to reach agreement are using the same term but with different meanings. This is one reason for producing the Live Longer Better glossary, but there is another.
The importance of language in changing culture To change culture, we have to change language. It is now generally agreed that the culture of an organisation is the most important determinant of success. It is also accepted that a key factor distinguishing leadership from management is that leadership is responsible for shaping the culture whilst management works within that culture.
“When we examine culture and leadership closely, we see that they are two sides of the same coin; neither can really be understood by itself. If one wishes to distinguish leadership from management or administration, one can argue that leadership creates and changes cultures, while management and administration act within a culture.” Source: Schein, E.H. (2004) Organizational Culture and Leadership. John Wiley & Sons Inc. (pp.10-11).
To change culture, the leadership needs to do many things. One of them is to create the right language, for example introducing the word enablement and stopping using the word care. But language can play an even more revolutionary role. It can even create a new reality.
The importance of language in creating reality
The traditional view of language was that it described reality. This is undoubtedly true for physical objects such as “a table” or “chair” however a number of philosophers, anthropologists and sociologists have written how language does not simply describe social reality, it creates it. So, the adoption of a new set of terms creates a new reality.
The clearest description of the relationship between language and reality comes from anthropologists, notably Benjamin Lee Whorf and Edward Sapir, whose Whorf Sapir hypothesis of linguistic relativity is the best articulation of this concept, in the statement that “the fact of the matter is that the ‘real world’ is to a large extent unconsciously built up on the language habits of the group”. Through the use and evolution of language comes social change and social reality. Sociologists have further developed the work of anthropologists. The most accessible sociological text is The Social Construction of Reality by Berger and Luckman. The phenomenon of language creating reality is also very clearly described in thispodcast by Michael Rosenand Lucy Pollock (author of a number of books including the Book about Getting Older).
Words have meanings but the meanings create and change reality as well as expressing it. They change the circuits in the brain, a process sometimes called rewiring. To bring about a paradigm shift, leadership needs to tell people that new circuits are needed and can be created due to the neuroplasticity of the brain.
In changing culture and creating a new reality in which people are positive about the potential for living longer better we need to recognise the important part that language plays in expressing and sustaining the negative, ageist attitudes, that prevail as shown by this extract from the Centre for Ageing Better resources;
Doddery but dear?: Examining age-related stereotype Our report summarising what existing research tells us about the role and impact of language and stereotypes in framing old age and ageing in the UK. Download report
An old age problem? How society shapes and reinforces negative attitudes to ageing Our report looking at the language used by government, the media and social media, advertising and ageing-focused charities in relation to the topics of age, ageing and demographic change. Download report
Age-positive images: our free to use image library We've launched a free library showing ‘positive and realistic’ images of older people in a bid to challenge negative and stereotypical views of later life. The images show a more realistic depiction of ageing and old age – to provide alternatives to the commonly used pictures of ‘wrinkly hands’ or walking sticks. The library, which contains over 400 images and will be regularly updated, offers organisations a wide selection of images that avoid stereotypes associated with older people. View Image library
We need to create a new positive culture and a new reality, moving from one in which population ageing is seen as a tidal wave of need, to a reality in which it is accepted that many of the problems assumed to be caused by the ageing process can be delayed, prevented or reversed, not only by effective NHS clinical care but also by what older people can do for themselves and for other people of all generations. That is the reality of Living Longer Better.
Terms About The Process of Living Longer Better
Term
Meaning
Ageing
Ageing has two characteristics: a decrease in maximum level of performance (for example maximal pulse rate) and a decrease in resilience (namely the ability to respond to a challenge such as a stumble, a change in temperature or a period of inactivity).
Fitness: physical, cognitive and emotional
The proactive development of capacity to perform well and handle a challenge. Live Longer Better considers four dimensions of physical fitness: skill, stamina, strength and suppleness.
Disease
https://www.livelongerbetter.uk/glossary.htmlAn abnormal process such as Alzheimer's disease or Parkinson's disease or a condition defined as being a disease because the person is in a subgroup of the population identified by the level of a variable which expert opinion designates as requiring intervention (for example sarcopenia, pre-diabetes and high blood pressure). The Lancet has proposed that the term multi-morbidity should no longer be used and we should refer instead to MLTC - Multiple Long Term Conditions
Social factors: Ageism
When age is used to categorise and divide people in ways that lead to harm, disadvantage and injustice and eroding solidarity across generations.
(Source: WHO, 2026 Global Report on Ageism)
Social factors: Deprivation
The damaging lack of material benefits considered to be basic necessities in a society. OED The dimensions of deprivation used to classify households are indicators based on four selected characteristics: Education, Employment, Health, Housing.The Office for National Statistics classifies households as having no dimensions of deprivation or as having 1 or 2 or 3 or 4 dimensions
(Source: Office for National Statistics)
Reablement
Reablement services help people to retain or regain their skills and confidence so they can learn to manage again after a period of illness. The reablement approach supports people to do things for themselves. It is a 'doing with' model in contrast to traditional home care, which tends to be a 'doing for' model.
(Source: Social Care Institute for Excellence)
Proactive Care
Proactive case is personalised and coordinated multi-professional support and interventions for people living with complex needs.
(Source: Department of Health and Social Care)
Deconditioning
A complex process of physiological change induced by inactivity that can affect multiple body systems and may result in a decline in physical, psychological and functional abilities. Commonly seen in hospitals and also prevalent in care homes in in those living in their own homes. At present, deconditioning syndrome is probably the most under-recognised, under-reported, under-treated challenge in many hospitals.
(Source: British Geriatric Society)
Reconditioning
Recondition the Nation is a campaign designed to encourage health and care teams to work together to be creative in identifying and implementing ways to reduce deconditioning.
(Source: NHS website)
Disability
A better model of disability, in short, is one that synthesises what is true in the medical and social models without making the mistake each makes in reducing the whole, complex, notion of disability to one of its aspects. This more useful model of disability might be called the biopsychosocial model.
(Source: World Health Organisation - The ICF, the International Classification of Functioning, Disability and Health)
Exposome
How external exposures (spanning social, psychological, behavioural and geo-physical factors) and their interaction with internal factors (such as genetics, epigenetic and physiology), encapsulated by the term 'exposome', affect health trajectories and overall resilience including chronic disease, geriatric syndromes and disability as people age.
Health is a state of complete physical, mental and social wellbeing and not merely the absence of infirmity or disease.
(Source: World Health Organisation 1948)
Wellbeing
https://www.livelongerbetter.uk/glossary.htmlWe assess personal wellbeing using four measures (often referred to as the ONS4). The ONS4 measures ask people to evaluate three aspects of their own wellbeing:
How satisfied they are with their lives overall
Whether they feel they have meaning and purpose in their lives
Their emotions during a particular period (both positive and negative)
These questions capture three types of wellbeing: evaluative, eudenomic and affective experience. (Source: Office for National Statistics)
Frailty and Intrinsic capacity
The presence of three or more out of five indicators: weakness (reduced grip strength), slowness (gait speed), weight loss, low physical activity and exhaustion. People with one or two indicators are classified as pre-frail. The NHS now has the eFI, the Electronic Frailty Index, built into GP information systems. There is now a move away from negative terms to positive terms and for this reason the WHO no longer uses the terms disability and handicap focusing instead on a person's intrinsic capacity
The WHO’s ‘World Report on Ageing and Health’ [15] defines healthy ageing as ‘the process of developing and main- taining the functional ability that enables well-being in older age.’ This definition was later incorporated into the WHO’s ‘Global Strategy on Ageing and Health’ [54], forming the foundation of a conceptual framework built around three interrelated components: IC, environment (i.e. all the factors in the extrinsic world that form the context of an individual’s life) and functional ability (i.e. the health-related attributes that enable people to be and to do what they have reason to value).
Intrinsic capacity derives conceptually from the ‘Interna- tional Classification of Functioning, Disability and Health (ICF)’ [55]. ICF provides a comprehensive framework for describing functioning and disability, adopting a bio-psycho- social model. IC focuses specifically on the individual’s body structure, functioning and activity capacity components, amalgamated as intrinsic physical and mental capacities Cesari et al Age and Ageing 2026; 55: afag138 https://doi.org/10.1093/ageing/afag138
Dementia
Dementia and mild cognitive impairment are characterised by a decline from a previously attained cognitive level but in dementia, in contrast with mild cognitive impairment, the decline affects activities of daily living or social functioning. In mild complex impairment, although the patient can still engage in complex activities (e.g. paying bills or taking medication) greater effort or new strategies might be required. Dementia is usually preceded by mild cognitive impairment and the boundary between the two is grey; many people present to dementia services with mild cognitive impairment. There are many different types of dementia and Alzheimer's disease is the most common. Vascular dementia is the next most common, followed by dementia with Lewy bodies. Mixed dementia with features of more than one cause is also common. Frontotemporal degeneration and dementias associated with brain injury, infections and alcohol abuse are less common. In this Commission, when we use the word dementia we are referring to all the different types of dementia.
(Source: The Lancet Commission on Dementia Prevention, Intervention and Care)
Personalised and Precision Medicine
Originally personalised medicine meant taking into account an individual's needs, preferences and values as well as best current evidence in decision making, with precision medicine also taking into account the individual's genome. The two terms are now used interchangeably.
Social Care
(1) The general duty of a local authority ... is to promote that individual's wellbeing. (2) "Wellbeing" .... means that individual's wellbeing so far as relating to any of the following:
Control by the individual over day-to-day life (including over social care and support, or other support provided to the individual and the way in which it is provided)
Participation in work, education, training or recreation
The individual's contribution to society.
(Source: Social Care Act 2014)
Determinants of Health
The determinants of health include:
the social and economic environment,
the physical environment, and
the person’s individual characteristics and behaviours.
The context of people’s lives determine their health, and so blaming individuals for having poor health or crediting them for good health is inappropriate. WHO 2024
Note: If no source is cited the term has been developed by the Optimal Ageing Programme, part of the Oxford Longevity Project