It’s never too early for geriatrics: the tempoforme® experience
Having just returned from my PROGRAMMING COST Action 21122 Short-Term Scientific Mission at the tempoforme® unit, I remain fascinated by another way of looking at frailty and geriatric prevention. The program tempoforme® – bien vieillir en Hauts-de-France – is an innovative model of care developed under the leadership and scientific supervision of Prof. Eric Boulanger and hosted in a modern, well-equipped structure affiliated with the Geriatric Department of the University Hospital of Lille.
Contrary to other geriatric departments, the persons benefiting from the services of this unit are much younger (starting from 45 years old!) and free of dependency for the moment. One might think “45 yo?!!! Isn’t it a bit too early to start visiting a geriatric department?!”, but the answer is that it is never too early for starting planning for our later life, the trajectory of our ageing having already got into track since early life.
Prof. Boulanger’s team — a group of kind, motivated, and highly skilled nurses and physicians — offers, during a 3 hours’ visit, a comprehensive assessment aimed at identifying early signs of frailty and developing personalised intervention plans to prevent functional decline and late-life disability.
Equipped with a wide range of instruments and validated tools for detecting early signs of organ and system ageing, and combining technical expertise with the right dose of empathy, the team assesses mobility, cognition, vision and hearing, body composition, cardio-respiratory and bone health, blood biomarkers, as well as lifestyle factors such as physical activity, nutrition, sleep, stress, and social engagement. Anthropometric measurements, questionnaires, clinical interviews, instrumental assessments, blood tests and physical examination all contribute to building a detailed picture of the individual’s health status and projected ageing trajectory.
The visit continues with an in-depth exchange with the physician, who explains the findings using powerful visual representations of the test results and illustrations of life trajectories with and without (pre)frailty, highlighting the importance of a proactive approach to preventing late-life disability. The team synthesises the results, and the physician co-constructs — together with the individual — a personalised prevention plan focused on priority areas. Finally, the motivational interview conducted by a skilled nurse has remarkable transformative potential in terms of patient empowerment, therapeutic alliance, and behavioural change.
Most individuals leave tempoforme® with at least one factor of frailty or prefrailty identified — something that might otherwise have remained undetected for years before causing more serious problems. Sometimes, they may also leave with a certain frustration regarding the failure of the “standard” medical approach to identify such issues earlier. Most importantly, however, they leave with a personalised prevention plan, a strong sense of satisfaction regarding the attention devoted to their case, and often with a genuine “epiphany” about what has been the problem so far and what they need to change moving forward. The motivational interview becomes a powerful tool for mobilising internal resources and translating intention into action.
tempoforme® is undoubtedly an innovative approach. Complementary to the WHO ICOPE model, it offers specialised and in-depth comprehensive assessment for individuals at risk of frailty, starting really early — long before things become irreversible. Yet it remains an isolated example of preventive medicine, still an exception within the predominantly reactive model of healthcare.
Shouldn’t we begin projecting ourselves into the future if we continue on the same path? And isn’t it time to embrace the recommended interventions and behavioural changes needed to prepare for a healthier and more robust older age? Since the time of Hippocrates, we have known that prevention is better than cure.
Undoubtedly, the extraordinary progress of medicine has dramatically improved outcomes in the treatment of acute and chronic conditions. But, at least in the field of age-related diseases and geriatric syndromes, there is often a frustrating feeling that our effectiveness eventually reaches its limits. Perhaps shifting the starting point of geriatric prevention decades earlier could be the key to modify a person’s declining trajectory towards frailty and dependency and change outcomes in long-term.
Of course, this also raises important questions regarding the active role of the individual — the person who is not yet a patient — as well as the boldness required from policymakers to invest in models whose benefits may only become visible decades later. Still, I am convinced that if enough middle-aged adults could benefit today from services such as tempoforme®, then 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. As one member of the team beautifully told the individuals undergoing assessment: “We would like you to stay active and keep riding your bike until your last day.”
From the perspective of PROGRAMMING, preventive geriatrics and proactive interventions decades before older age may represent a particularly challenging field in terms of implementation and investment by health policymakers, especially in countries where the culture of geriatric medicine, healthy ageing, and early prevention has not yet been fully integrated into healthcare systems and professional training. Yet there are reasons for optimism. While teaching frailty management at the Postgraduate Course of the University of Athens — in a country without a strong geriatric tradition — and presenting the tempoforme® model, I was struck by the strong interest shown by students and healthcare professionals already active in clinical practice, who deeply appreciated this preventive approach to ageing.
Major transformations — whether at a micro, meso, or macro level — require faith, courage, and perseverance. For me, the time spent at tempoforme® was a deeply inspiring experience and so would most probably be for other PROGRAMMING members aspiring to promote geriatric medicine in all its potential.
Prof Boulanger, would be willing to welcome those of you who would like to pay a visit to the tempoforme® premises at the University Hospital of Lille, as an activity associated to the 22nd EuGMS congress to taken place in Lille on the 16th-18th of September 2026.
For more information about tempoforme® check out https://tempoforme.fr/
