In France, entering an institution does not happen by chance around a birthday. According to the DREES, after age 75, one person in twelve lives in an institution and 86% of residents are dependent, compared to only 13% of people of the same age who remain at home. The median age of entry into an EHPAD is 88 years and 8 months, and more than one in two residents is classified in GIR 1–2, the heaviest level of dependency.
However, several recent studies point to a common key to these trajectories: our way of life between the ages of 50 and 70. The German newspaper Welt summarizes this idea with a shocking formula: “Our lifestyle between the ages of 50 and 70 decides whether we will go to a retirement home.” An Australian study published in 2023 in the journal J Epidemiol Community Health supports this observation, number by number. The challenge is not only to live longer, but to delay the loss of autonomy as long as possible.
50–70 years, a pivotal decade for avoiding the retirement home
Between the ages of 50 and 70, habits become entrenched as the body begins to naturally lose muscle mass and balance. It is also the age of retirement, sometimes widowhood or isolation, which can encourage a sedentary lifestyle. When physical activity decreases, sitting time increases, sleep deteriorates and the pounds set in, every daily gesture becomes a little more costly. Ten or fifteen years later, these micro-renunciations add up to falls, fractures, then needing help to wash or dress.
The study published in J Epidemiol Community Health followed 127,108 people over the age of 60 between 2006 and 2009, over a median follow-up of 11.3 years. In total, 23,094 participants, or approximately 18%, were admitted to institutions. The researchers constructed a lifestyle score based on several factors: tobacco, alcohol, diet, sleep, physical activity, sedentary lifestyle and social ties.
Compared to the most favorable lifestyle group, the least favorable group had a 43% increased risk of institutionalization (HR 1.43), and this risk rose to 2.15 for participants who were only 60 to 64 years old at baseline.
Take action today between 50 and 70 years old
To reduce the risk of EHPAD, the advice is concrete: walk briskly several times a week, add a little muscle strengthening, split the time spent sitting, protect your sleep, curb smoking and alcohol, take care of your diet and your social connections.
In France, an appointment with the treating doctor or a preventive assessment can help identify early weaknesses, for example difficulty getting up from a chair without using your hands or walking for a few minutes without stopping. Every adjustment counts, especially between the ages of 50 and 70, when the trajectory still remains largely adjustable.