Abstract
Objective: This study aimed to assess the status of intrinsic capacity (IC)—a novel function-centered construct proposed by the WHO and examine whether impairment in IC predicts subsequent 1-year activities of daily living (ADL) disability better than a disease-based approach, i. e., multimorbidity status.Methods: This study included data of community-dwelling older adults from the Beijing Longitudinal Study on Aging II aged 65 years or older who were followed up at 1 year. Multivariate logistic regressions were performed to estimate the odds of ADL disability at baseline and 1-year follow-up.Results: A total of 7,298 older participants aged 65 years or older were included in the current study. About 4,742 older adults were followed up at 1 year. At baseline, subjects with a higher impairment in IC domains showed higher odds of ADL disability [adj. odds ratio (OR) = 9.51 for impairment in ≥3 domains, area under the curve (AUC) = 0.751] compared to much lower odds of ADL disability in subjects with a higher number (≥3) of chronic diseases (adj. OR 3.92, AUC = 0.712). At 1-year follow-up, the overall incidence of ADL disability increased with the impairment in IC domains higher than the increase in multimorbidity status. A higher impairment in IC domains showed higher odds of incidence ADL disability for impairment in 2 or ≥3 IC domains (adj. OR 2.32 for impairment in ≥3 domains, adj. OR 1.43 for impairment in two domains, AUC = 0.685). Only subjects who had ≥3 chronic diseases had higher odds of 1-year incident ADL disability (adj. OR 1.73, AUC = 0.681) that was statistically significant.Conclusion: Our results imply that a function-centered construct could have higher predictability of disability compared to the multimorbidity status in community older people. Our results need to be confirmed by studies with longer follow-up.
Highlights
The disability-free life expectancy has not increased at the same pace as the life expectancy in humans [1]
This study participants were from the Beijing Longitudinal Study on Aging II (BLSA II), a representative community-dwelling older population cohort
Subjects who lost to follow-up had similar characteristics as those who were followed at 1 year (Supplementary Material 1)
Summary
The disability-free life expectancy has not increased at the same pace as the life expectancy in humans [1]. There is an increasing notion in geriatrics that the traditional disease-centered approach may be inadequate to meet the healthcare needs of older adults [2, 3]. Strategies that promote “healthy aging” could assist in reducing the burden of disability and dependency in old age. The WHO defines healthy aging as the process of maintaining functional ability that enables well-being in old age [1, 4]. Healthy aging is determined by intrinsic capacity (IC) and the environment (i.e., extrinsic factors) of an individual. In other words, maintaining IC throughout life may serve as a meaningful approach to avoid dependency in old age by achieving optimal functional ability. Detection and prevention of disability or dependency may be needed to maintain autonomy in old age
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