Subgrouping Community-Dwelling Older Adults by Intrinsic Capacity Decline-A Cluster Analysis Based on the WHO ICOPE Framework in Rural Taiwan.

BackgroundThe World Health Organization (WHO) published the Integrated Care for Older People (ICOPE) framework to guide assessing and promoting intrinsic capacity of older adults. This study, adopting the WHO ICOPE framework, assessed the intrinsic capacity impairment and investigated the relationship among intrinsic capacity, social engagement, and self-care capacity on performing activities of daily living. It also assessed the sensitivity of the initial brief screening and the detailed full assessment.MethodsThis is a cross-sectional study conducted in 11 community centers in Hong Kong. Intrinsic capacity was assessed in two steps identical to WHO ICOPE handbook: using WHO ICOPE brief screening tool (step 1) and detailed full assessment (step 2) to assess the intrinsic capacity domains of locomotion, cognition, vitality, psychological well-being, and sensory capacity (hearing and vision). Structural equational modeling analysis was used to examine the relationship among intrinsic capacity, social engagement, and self-care capacity, and the mediating role of intrinsic capacity in the relationships.ResultsA total of 304 older adults with a mean age 76.73 (SD = 7.25) years participated in WHO ICOPE Step 1 brief screening, and 221 participants (72.7%) showed intrinsic capacity impairment. After completing Step 2 full assessment, 202 participants (66.4%) had one or more impaired intrinsic capacity domains. The overall sensitivity and specificity of the screening tool were 95% and 57.6% respectively, whereas the sensitivity of each domain ranged from 74.7% to 100%. The percentage of impairment in locomotion (117, 39.8%), cognition (75, 25.5%), psychological well-being (34, 11.6%), vision (75, 24.7%), hearing capacity (82, 27.9%), and vitality (8, 2.7%). People in younger old age (β = -0.29, p < 0.001), with more education (β = 0.26, p < 0.001), and absence of hypertension (β = -0.11, p < 0.05) were more likely to have better intrinsic capacity. Intrinsic capacity was positively associated with self-care capacity in performing activities of daily living (β = 0.21, p < 0.001) and social engagement (β = 0.31, p < 0.001).ConclusionsThe ICOPE screening tool is a sensitive instrument to detect intrinsic capacity impairment among community-dwelling older adults and it does not demand substantial workforce; its use is worthy to be supported. The intrinsic capacity impairment in community-dwelling older adults are prevalent, in particular, in locomotor and cognitive capacity. Actions should be taken to slow or prevent the impairment, support self-care and social engagement in old age.

Complex relationships among various domains of intrinsic capacity and their associated factors in community-dwelling older adults: A network analysis.

Intrinsic Capacity Impairment Patterns and their Associations with Unfavorable Medication Utilization: A Nationwide Population-Based Study of 37,993 Community-Dwelling Older Adults.

Development of the Brief Geriatric Assessment for the General Practitioner.

Background Intrinsic capacity (IC) is conceptualized by World Health Organization (WHO) with a focus on healthy aging. Identifying impairment could help in making a person-centred plan for the care of older adults. Objectives Establish the prevalence of IC among community-dwelling older adults age >60, the prevalence of impairment in each domain, and identify factors associated with an impairment in IC. Methods This cross-sectional observational study in the community setting included 1000 older adults aged 60 years and above in two-year study period. The 6 domains of IC including cognition, locomotor capacity, psychological, vitality, hearing, and vision were derived from the comprehensive geriatric assessment. The IC composite score was calculated based on these domains, and a higher IC score indicated greater IC. Results During the study period, 1000 older adults, with the median age of 66.5 (IQR-63-73) were included, and 629 (62.9%) were women. Only in 157 (15.7%) community-dwelling older adults, all 6 domains were intact. Impairment in one, two, and three domains was seen in 442 (42.2%), 305 (30.5%), and 91 (9.1%), respectively. The most prevalent impaired domain was locomotor (593, 59.3%), followed by vision (441, 44.1%), hearing (193, 19.3%), cognition (106, 10.6%), mood (38, 3.8%), and vitality (37, 3.7%). The factors associated with lower IC included increasing age (β-coefficient −0.01, 95% CI: −0.02 to −0.01, p value = 0.002), impaired activities of daily living (β-coefficient −0.13, 95% CI: −0.49 to −0.18, p value <0.001), and chronic neurologic illness (β-coefficient −0.10, 95% CI: −0.77 to −0.18, p value = 0.001). Conclusions In conclusion, we found that impairment in IC was frequent in community-dwelling older adults, and it is associated with age, presence of chronic neurologic illness, and declining functionality. The adoption of IC should be seen as an opportunity to disseminate geriatric care in our healthcare systems which lack the necessary attention to the needs of older persons.

BackgroundAs intrinsic capacity (IC) declines, older adults are at a significantly increased risk of frailty, care dependency, and death. Currently, the research on IC among older adults in China was still insufficient. We aimed to identify the status quo and influencing factors among community-dwelling older adults in China and explore the relationship between IC, external environment, and social network.MethodsA convenience sampling method was used to collect 312 older people from May 2023 to February 2024 in five communities in Chengdu, Sichuan Province. Data were collected using the general information questionnaire, Integrated Care of the Elderly (ICOPE) screening tool, World Health Organization Quality of live scale (WHOQOL-100), and Social Network Scale (LSNS-6).ResultsThe IC score among Chinese community-dwelling older adults was 3.39 ± 1.60, and the prevalence of IC decline was 86.9%. Marital status, age, number of chronic diseases, social network, and external environment were influencing factors of IC, which explained 35.7% of the total variance. External environment and social network were positively correlated with IC.ConclusionsChinese community-dwelling older adults had low IC scores and a high prevalence of IC decline. The government should focus on IC for older adults, especially those who are older, not married or widowed, and suffering from multiple chronic diseases. In addition, the richer the external resources available to older adults, the more social support they received, and the better the IC. These findings could provide a theoretical basis for managing and improving IC in older adults.

IntroductionThe World Health Organisation recently defined the construct of intrinsic capacity (IC), a function-based marker of older adult’s health encompassing all mental and physical capacities of the individual. Multicomponent physical exercise (MCE) is a potential intervention capable to maintain/increase IC at older age; however, evidence is scarce on the effects of MCE on IC in cognitively impaired pre-frail/frail older adults.MethodsSecondary analyses of a randomised clinical trial. One hundred and eighty-eight older outpatients (age = 84.06 ± 4.77, 70.2% women) presenting with pre-frailty/frailty (according to Fried Criteria) and mild cognitive impairment (MCI)/mild dementia were recruited in the Geriatric clinics of three tertiary hospitals in Spain. Subjects were randomised to participate in the 12-week home-based individualised Vivifrail MCE or usual care. An IC index was created based on the z-score of the locomotion (Short Physical Performance Battery), cognitive (Montreal Cognitive Assessment), psychology (15-item Geriatric Depression Scale Yesavage) and vitality (handgrip strength) domains.ResultsAfter the 3-month intervention, linear mixed models showed significant between-group differences in the evolution of the IC composite score (β=0.48; 95% confidence interval [CI] = 0.24, 0.74; P < 0.001), IC Locomotion (β = 0.42; 95% CI = 0.10, 0.74; P < 0.001), IC Cognition (β = 0.45; 95% CI = 0.03, 0.87; P < 0.05) and IC Vitality domains (β = 0.50; 95% CI = 0.25, 0.74 at 3-month) favouring the MCE group.ConclusionsThe 12-week Vivifrail multicomponent exercise program is an effective strategy to enhance IC, especially in terms of locomotion, cognition and vitality IC domains in community-dwelling older adults with pre-frailty/frailty and MCI/mild dementia, compared to usual care.

Objective:This study aimed to examine the intrinsic capacity in Chinese older adults and its determinants (sociodemographic, lifestyle-related, environmental, and health-related factors) based on the WHO Integrated Care for Older People (ICOPE) framework.Methods:A cross-sectional community-based study was conducted among 485 community-dwelling older adults recruited from 4 community health service centers in Xinxiang City, Henan Province between August 2024 and February 2025. Intrinsic capacity was assessed across 5 domains: locomotion, cognition, vitality, psychology, and sensory capacity (hearing and vision). Structural equation model (SEM) was used to examine relationships among intrinsic capacity, sociodemographic factors, lifestyle, family support, social participation, healthcare access, and health conditions.Results:More than a half of subjects were female (61.2%), married (84.7%), having less than high school education (52%), with a mean age of 73.7 years (SD = 5.5). About 55.9% showed intrinsic capacity impairment, with most impairment of cognition (49.9%), followed by vision (44.9%), hearing (23.7%), locomotion (22.5%), vitality (18.1%), and psychological capacity (13%). The SEM demonstrated good fit and explained 83% of the variance in intrinsic capacity. Significant determinants, ranked by effect size, included dietary habits (β = .544), age (β = −.303), pain (β = −.240), handgrip strength (β = .205), social participation (β = .181), access to healthcare services (β = .138), hospitalization (β = −.10), and physical exercise (β = .089). All paths in the model were statistically significant ( p ′ 0.05).Conclusions:The SEM analysis demonstrated that dietary habits, handgrip strength, social participation, access to healthcare services, and physical exercise were positively associated with intrinsic capacity, while age, pain, and hospitalization showed negative associations. These findings suggest that primary care approaches focusing on multi-domain interventions, particularly health promotion, self-care, and early screening, may be promising areas for future public health initiatives. Community-based programs integrating these modifiable factors should be prioritized to promote intrinsic capacity and functional independence among Chinese community-dwelling older adults.

Intrinsic capacity (IC) is a clinically meaningful and potentially modifiable outcome that predicts dependence, hospital admission, and mortality in older adults. Research on the relationships among polypharmacy, potentially inappropriate medications (PIMs), and IC in older adults remains scarce. We therefore examined the associations of polypharmacy and PIM use with IC decline in community-dwelling older adults. In this cross-sectional study, we analyzed data from the World Health Organization (WHO) Integrated Care for Older People (ICOPE) screening and corresponding medical records collected during annual senior health examinations in Taiwan. Participants were adults aged ≥ 65 years who completed the WHO ICOPE screening. IC was scored across six domains-locomotion; sensory function (vision and hearing); vitality; psychological well-being; and cognition-yielding a total score from 0 to 6. An IC score ≤ 4 denoted decline. Polypharmacy was defined as the concurrent use of ≥ 5 medications, and PIMs were identified according to the 2019 Beers Criteria. Among 394 participants (mean age 72.0 ± 6.7 years; 51.8% female), the average daily medication count was 6.4 ± 7.1. More than 50% of participants received ≥ 1 PIM, and 36.8% met criteria for polypharmacy. The mean IC score was 4.5 ± 1.1, and 43.9% of participants exhibited IC decline. After adjustment for age, gender, and number of comorbidities, PIM use was associated with a 2.06-fold increase and polypharmacy with a 2.46-fold increase in the risk of IC decline, respectively. Polypharmacy and PIM use are highly prevalent among community-dwelling older adults and are significantly associated with an increased risk of IC decline. These findings underscore the need for medication review and deprescribing strategies to preserve intrinsic capacity in this population.

Intrinsic capacity (IC) is a concept related to functionality that reflects healthy aging. ATPase inhibitory factor 1 (IF1) is a multifaceted protein that regulates mitochondrial oxidative phosphorylation (OXPHOS), and may be involved in IC. The objective of this study is to investigate the association between plasma levels of IF1 and IC changes in community-dwelling older adults. Community-dwelling older adults from the Multidomain Alzheimer Preventive Trial (MAPT Study) were enrolled in this study. A composite IC score was calculated based on 4 IC domains: locomotion, psychological dimension, cognition, and vitality (with data available annually over 4 years of follow-up). Secondary analyses were conducted on the sensory domain (with data available only for 1 year of follow-up). Mixed-model linear regression adjusted for confounders was conducted. A total of 1 090 participants with usable IF1 values were included in the study (75.3 ± 4.4 years; 64% females). Compared to the lowest quartile, both the low- and high-intermediate IF1 quartiles were found to be cross-sectionally associated with greater composite IC scores across 4 domains (βlow-intermediate, 1.33; 95% confidence interval [CI] 0.06-2.60 and βhigh-intermediate, 1.78; 95% CI 0.49-3.06). In the secondary analyses, the highest quartile was found to be associated with a slower decline in composite IC scores across 5 domains over 1 year (βhigh 1.60; 95% CI 0.06-3.15). The low- and high-intermediate IF1 quartiles were also found to be cross-sectionally associated with greater locomotion (βlow-intermediate, 2.72; 95% CI 0.36-5.08) and vitality scores (βhigh-intermediate, 1.59; 95% CI 0.06-3.12), respectively. This study is the first to demonstrate that levels of circulating IF1, a mitochondrial-related biomarker, are associated with IC composite scores in both cross-sectional and prospective analyses among community-dwelling older adults. However, further research is needed to confirm these findings and elucidate the potential underlying mechanisms that may explain these associations.

Intrinsic capacity transitions as predictors of frailty transitions in community-dwelling older adults: Findings from the Korean Frailty and Aging Cohort Study

Rest–activity behavior clusters within individuals to form patterns are of significant importance to their intrinsic capacity (IC), yet they have rarely been studied. A total of 1253 community-dwelling older adults were recruited between July and December 2021 based on the baseline survey database of the Fujian Prospective Cohort Study on Aging. Latent profile analysis was used to identify profiles of participants based on rest–activity behaviors, whereas logistic regression analysis was carried out to investigate the relationship between profiles and IC. We identified three latent profiles including: (1) Profile 1—labeled “Gorillas”: High physical activity (PA), moderate sedentary behaviors (SB), screen time (ST) and sleep (n = 154, 12%), (2) Profile 2—labeled as “Zebras”: Moderate PA, low SB, ST and high sleep (n = 779, 62%), and (3) Profile 3—labeled as“Koalas”: High SB, ST, low PA and sleep (n = 320, 26%). Logistic regression revealed a negative correlation between low IC and the “Gorillas” profile (β = − 0.945, P < 0.001) as well as the “Zebras” profile (β = − 0.693, P < 0.001) among community-dwelling older adults, with the “Koalas” profile showing the weakest IC compared to the other profiles. The demographic traits i.e., female, older age, living alone, and low educational level also correlated with low IC. Identifying trends of rest–activity behaviors may help in drawing focus on older adults at risk of decreasing IC, and develop personalized improvement plans for IC.

BackgroundIntrinsic capacity (IC) is defined as the combined physical and mental capacities of older adults and is closely related with their functional abilities. This study examined how specific types and patterns of leisure activities (LA) associate with distinct domains and overall levels of intrinsic capacity (IC) in community-dwelling older adults from Beijing, China.MethodsThis study included 916 participants (aged 70.19 ± 6.23 years) from four communities in Beijing. The five IC-related domains, namely, locomotion, cognition, psychological, vitality, and sensory domains were assessed using the tools recommended by WHO. Leisure activities, including physical leisure activities (PLA) and intellectual leisure activities (ILA), were analyzed using a 8-question self-administered questionnaire. Multivariate logistic regression analyses were performed to determine the association of IC with LA and types of LA after adjustment of confounding variables, including demographic characteristics and health status parameters.ResultsAmong the 916 study subjects, 605 (65.8%) showed impairment in at least one dimension of IC. The total score of LA was 6 (4,7). Furthermore, LA (OR = 1.150, 95% CI = 1.041–1.271) and ILA (OR = 1.202, 95% CI = 1.046–1.382) were associated with IC after adjusting for the covariates. In the subgroup analyses, LA (OR = 1.242, 95% CI = 1.069–1.442) and ILA (OR = 1.427, 95% CI = 1.145–1.780) were associated with IC in the males, but the correlation was not observed in the females. Among the different age subgroups, individuals in the 70–79 year age group showed association between LA and IC. All the types of LA, except pet-keeping and volunteerism, showed correlation with one or more dimensions of IC.ConclusionsLA and LA types are independently associated with IC in community-dwelling older adults. Therefore, participation in diverse leisure activities is necessary for maintaining and improving IC in the older adults.

Intrinsic capacity in community-dwelling older adults and cancer survivors: a comparative study.

The World Health Organization (WHO) defines Intrinsic Capacity (IC) as the integration of an individual's physiological and psychological capacities. Encompassing five dimensions- locomotion, cognitive, vitality, psychological, and sensory function-it plays a central role in the assessment of healthy ageing. This study aimed to evaluate the association between IC and hip fractures among community-dwelling older adults in China. This population-based longitudinal study analyzed data from 3102 community-dwelling residents aged ≥ 60 years in the China Health and Retirement Longitudinal Study (CHARLS), with baseline assessments conducted in 2011 and a 4-year follow-up through 2015. IC was assessed across five domains: cognitive, psychology, vitality, locomotion, and sensory function. The outcome measure was self-reported hip fracture, while demographic characteristics and other covariates were analyzed as potential confounders. Multivariable logistic regression models were employed to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CI). The relationship between IC and hip fracture was further evaluated using restricted cubic splines and subgroup analyses. A total of 3,102 older adults (57.16% male) with a median age of 65.00 years were included. Over the 4-year follow-up, 96 participants (3.09%) experienced hip fractures. Regarding IC, the total IC score for the entire cohort was 1.56 ± 1.07(range 0-5, a total score of ≥ 2 is defined as IC impairment). The hip fracture group exhibited significantly higher IC scores compared to the non-fracture group (2.14 ± 1.06 vs.1.14 ± 1.06, p < 0.001). Baseline IC impairment (observed in 48.42% of participants) was associated with a 2.34-fold higher incidence of hip fracture compared to those without impairment (4.39% vs.1.88%). Analysis revealed that each 1-point increase in IC score among individuals aged ≥ 60 years was associated with a 55% elevated risk of hip fracture (adjusted OR = 1.55, 95% CI 1.25-1.94, p < 0.001). When stratified by IC status, the effect was more pronounced with IC-impaired. Compared to without impaired group, individuals with IC impairment had 87% higher risk of fracture (adjusted OR = 1.87, 95% CI 1.72-2.98, p = 0.009). Additionally, a linear relationship was demonstrated between IC and hip fracture risk. Among community-dwelling older adults, the composite IC score demonstrated a significant independent association with an elevated risk of hip fracture. Regular monitoring of individual IC scores may serve as an early warning indicator to initiate preventive interventions.