Abstract
Objectives: The World Health Organization (WHO) proposed the Integrated Care for Older People (ICOPE) screening tool to identify older people with priority conditions associated with declines in intrinsic capacity (IC). We aimed to determine the clinical utility of the WHO ICOPE screening tool in a Chinese population.Method: A total of 376 adults aged 68.65 ± 11.41 years participated in the study. IC was assessed with the WHO ICOPE screening tool, covering five domains: cognitive, locomotor, sensory, vision, and psychological capacity. We assessed the activities of daily living (ADL); instrumental activities of daily living (IADL); the Fried frailty phenotype; FRAIL scale; Strength, Assistance With Walking, Rising From chair, Climbing Stairs, and Falls (SARC-F) scale; Mini-mental State Examination (MMSE); Geriatric Depression Scale (GDS); social frailty; and quality of life.Results: There were 260 (69.1%) participants who showed declines in one or more IC dimensions. The percentages of decline in mobility, cognition, vitality, hearing, vision, and psychological capacity were 25.3, 46.8, 16.2, 15.4, 11.7, and 12.0%, respectively. IC decreased with increasing age. After adjusting for age, sex, and multimorbidity, participants with declines in IC were more likely to be older, frail, and disabled. They also had worse physical, mental, and overall health. There was a higher prevalence of declines in IC in participants with frailty. After adjusting for age, IC was positively correlated with walking speed, resilience score, and MMSE score and negatively correlated with frailty, SARC-F score, IADL score, GDS score, and physical and mental fatigue. The IC score was not associated with body composition variables such as fat-free mass, body fat percentage, or visceral fat area. Higher IC was associated with better quality of life. The area under the curve of the receiver operating characteristic (AUC-ROC) for the ICOPE screening tool vs. Fried phenotype, FRAIL, ADL disability, IADL disability, and SARC-F were 0.817, 0.843, 0.954, 0.912, and 0.909, respectively.Conclusion: Our research affirms that the ICOPE screening tool is useful to identify adults with poor physical and mental function in a Chinese sample. This tool may assist in identifying declines in IC in an integrative care model and help slow down function decline and onset of care dependence.
Highlights
The increase in the aging population has emerged as a major global phenomenon
Inclusion criteria consisted of relatively healthy participants without acute illness and aged ≥50 years who were admitted for a physical examination and completed the World Health Organization (WHO) Integrated Care for Older people (ICOPE) screening assessment
Those with physical frailty and social frailty had decreased intrinsic capacity (IC) when compared to the nonfrail participants (Figures 1E,F)
Summary
The increase in the aging population has emerged as a major global phenomenon. Frailty is an important construct that has been used in geriatric medicine over the past 20 years to conceptualize the age-related increase in vulnerability at an individual level [1, 2]. Frailty is defined as a geriatric syndrome characterized by the reduced ability of an individual to maintain physiological homeostasis and increased risks of adverse clinical outcomes [3]. To overcome the weaknesses of the frailty concept and to better disseminate geriatric care to the aging population, the World Health Organization (WHO) recently proposed a novel model for healthy aging oriented around trajectories of functional ability [8]. This model holds great potential to make a significant public health impact, by aiding in healthy aging. While traditional healthcare models focus on the identification and treatment of medical conditions, IC emphasizes on the positive attributes of individuals, i.e., focuses on maintaining an individual’s functional capacities throughout life course rather than treating a particular illness
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