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Kim J, Lee Y, Kim M, Won CW, Kim MK, Shim JS. Dietary patterns and intrinsic capacity in older adults: a 6-year prospective cohort study. J Nutr Health Aging 2024; 28:100314. [PMID: 38986175 DOI: 10.1016/j.jnha.2024.100314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVES Only a few studies have investigated dietary patterns and intrinsic capacity (IC). This study examined the prospective associations between dietary patterns, IC, and IC sub-domains over 6 years in community-dwelling Korean older adults. DESIGN A prospective cohort study. SETTING AND PARTICIPANTS Data were obtained from participants aged 70-84 years in the Korean Frailty and Aging Cohort Study (2016-2022). The study population included 665 enrollees at baseline who completed IC and dietary data. METHODS Dietary data were obtained from baseline surveys of the nutritional sub-cohort using two nonconsecutive 24-hour dietary recalls, and dietary patterns were derived using cluster analysis. IC was constructed by measuring cognitive, locomotor, vitality, sensory, and psychological domains. A generalized estimating equation was used to analyze the longitudinal associations between dietary patterns, IC, and IC sub-domain scores. RESULTS In total, 665 enrollees were included in the analysis. After adjusting for confounders, in older men, the dietary pattern of cluster 1 (variety of healthy foods and alcohols) compared to that of cluster 2 (rice and kimchi) was positively associated with changes in the IC score (ß = 0.41, 95% confidence interval [CI] = 0.04-0.78). In older women, the dietary pattern of cluster 1 (variety of healthy foods) was positively associated with changes in the IC score (ß = 0.30, 95% CI = 0.02-0.58), IC score group (ß = 0.11, 95% CI = 0.02-0.20), and psychological domain (ß = 0.25, 95% CI = 0.11-0.38) compared to that of cluster 3 (rice, vegetables, and kimchi). CONCLUSIONS Dietary patterns (variety of healthy foods) were positively associated with changes in IC scores and their sub-domains in older adults.
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Affiliation(s)
- Jinhee Kim
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, 164 World cup-ro, Youngtong-gu, Suwon 16499, Republic of Korea; Institute on Aging, Ajou University Medical Center, 164 World cup-ro, Youngtong-gu, Suwon 16499, Republic of Korea
| | - Yunhwan Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, 164 World cup-ro, Youngtong-gu, Suwon 16499, Republic of Korea; Institute on Aging, Ajou University Medical Center, 164 World cup-ro, Youngtong-gu, Suwon 16499, Republic of Korea.
| | - Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, 23 Kyung Hee Dae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea.
| | - Chang Won Won
- Department of Family Medicine, Kyung Hee University Medical Center, 23 Kyung Hee Dae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Mi Kyung Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea
| | - Jee-Seon Shim
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
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Wei X, Chen Y, Qin J, Yang Y, Yang T, Yan F, Zhang Z, Han L, Ma Y. Factors associated with the intrinsic capacity in older adults: A scoping review. J Clin Nurs 2024; 33:1739-1750. [PMID: 38345142 DOI: 10.1111/jocn.17017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/07/2024] [Accepted: 01/10/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION In 2015, the term 'intrinsic capacity' (IC) was proposed by the World Health Organisation to promote healthy aging. However, the factors associated with IC are still discrepant and uncertain. AIM We aim to synthesise the factors connected with IC. METHODS This scoping review followed the five-stage framework of Arksey and O'Malley and was reported using PRISMA-ScR guidelines. RESULTS In all, 29 articles were included. IC of older adults is associated with demographic characteristics, socioeconomic factors, disease conditions, behavioural factors, and biomarkers. Age, sex, marital status, occupation status, education, income/wealth, chronic diseases, hypertension, diabetes, disability, smoking status, alcohol consumption, and physical activity were emerged as important factors related to the IC of older adults. CONCLUSIONS This review shows that IC is related to multiple factors. Understanding these factors can provide the healthcare personnel with the theoretical basis for intervening and managing IC in older adults. RELEVANCE TO CLINICAL PRACTICE The influencing factors identified in the review help to guide older adults to maintain their own intrinsic capacity, thereby promoting their health and well-being. The modifiable factors also provide evidence for healthcare personnel to develop targeted intervention strategies to delay IC decline. NO PATIENT OR PUBLIC CONTRIBUTION As this is a scoping review, no patient or public contributions are required.
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Affiliation(s)
- Xiaoqin Wei
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Yajing Chen
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Jiangxia Qin
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Yiyi Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Tingting Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Fanghong Yan
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
| | - Ziyao Zhang
- Lanzhou University of Arts and Science, Lanzhou, Gansu Province, China
| | - Lin Han
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
- Nursing Department, Gansu Provincial Hospital, Lanzhou, Gansu Province, China
| | - Yuxia Ma
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou, Gansu Province, China
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van Soest AP, Beers S, van de Rest O, de Groot LC. The Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) Diet for the Aging Brain: A Systematic Review. Adv Nutr 2024; 15:100184. [PMID: 38311314 PMCID: PMC10942868 DOI: 10.1016/j.advnut.2024.100184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/10/2024] Open
Abstract
The Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet seems a promising approach to preserve brain function during aging. Previous systematic reviews have demonstrated benefits of the MIND diet for cognition and dementia, though an update is needed. Additionally, other outcomes relevant to brain aging have not been summarized. Therefore, this systematic review aims to give an up-to-date and complete overview on human studies that examined the MIND diet in relation to brain aging outcomes in adults aged ≥40 y. Ovid Medline, Web of Science core collection, and Scopus were searched up to July 25, 2023. Study quality was assessed using the Newcastle-Ottawa Scale and the Cochrane Risk-of-Bias tool. We included 40 articles, of which 32 were unique cohorts. Higher MIND diet adherence was protective of dementia in 7 of 10 cohorts. Additionally, positive associations were demonstrated in 3 of 4 cohorts for global cognition and 4 of 6 cohorts for episodic memory. The protective effects of the MIND diet on cognitive decline are less apparent, with only 2 of 7 longitudinal cohorts demonstrating positive associations for global decline and 1 of 6 for episodic memory decline. For other brain outcomes (domain-specific cognition, cognitive impairments, Parkinson's disease, brain volume, and pathology), results were mixed or only few studies had been performed. Many of the cohorts demonstrating protective associations were of North American origin, raising the question if the most favorable diet for healthy brain aging is population-dependent. In conclusion, this systematic review provides observational evidence for protective associations between the MIND diet and global cognition and dementia risk, but evidence for other brain outcomes remains mixed and/or limited. The MIND diet may be the preferred diet for healthy brain aging in North American populations, though evidence for other populations seems less conclusive. This review was registered at PROSPERO as CRD42022254625.
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Affiliation(s)
- Annick Pm van Soest
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands.
| | - Sonja Beers
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Ondine van de Rest
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Lisette Cpgm de Groot
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
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Huang ZT, Lai ETC, Luo Y, Woo J. Social determinants of intrinsic capacity: A systematic review of observational studies. Ageing Res Rev 2024; 95:102239. [PMID: 38382677 DOI: 10.1016/j.arr.2024.102239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/07/2024] [Accepted: 02/17/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND The World Health Organization defined healthy ageing as the maintenance of functional ability with ageing. Intrinsic capacity is a measurement of healthy ageing, and can be shaped by social determinants. However, an overall understanding of how multiple social determinants contribute to intrinsic capacity remains unclear. We aim to summarize observational studies investigating the relationships between social determinants and intrinsic capacity among community-dwelling adults. METHODS A systematic search was conducted through Medline, Embase, PsycInfo, Web of Science, and CINAHL until August 14, 2023. RESULTS After reviewing 813 articles, we included 21 studies from nine countries in Asia, Europe, and America. Seventeen studies used a cross-sectional design and the others were longitudinal studies. Social determinants related to intrinsic capacity can be classified into five domains, containing socioeconomic status (16, 76.2% of studies), lifestyles (14, 66.7%), psychosocial factors (9, 42.9%), material circumstances (4, 19.0%), and healthcare systems (1, 4.8%). Strong evidence supported that better intrinsic capacity was associated with higher education, higher wealth, more physical activities, no smoking, more social engagement, and being married or partnered. The relationships of intrinsic capacity with dietary patterns and alcohol drinking were contradictory across studies. Research on the associations of working status, housing environments, and healthcare accessibility with intrinsic capacity was insufficient to draw conclusions. CONCLUSION These findings highlight roles of socioeconomic status, lifestyles, and psychosocial factors in improving intrinsic capacity thus promoting healthy ageing. Future research is needed to investigate causal relationships between social determinants and intrinsic capacity, especially material circumstances and healthcare systems.
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Affiliation(s)
- Zi-Ting Huang
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Eric T C Lai
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
| | - Yan Luo
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Jean Woo
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China; Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China
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Yeung SSY, Kwan M, Woo J. Composition of healthy diets for older persons. Curr Opin Clin Nutr Metab Care 2024; 27:17-23. [PMID: 37522819 DOI: 10.1097/mco.0000000000000972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
PURPOSE OF REVIEW This study aims to review recent evidence (2022-2023) on the role of diet in promoting healthy aging in older adults. RECENT FINDINGS Current evidence of diet and healthy aging is limited to epidemiological studies. A healthy diet is beneficial for individual domains of intrinsic capacity, that is, cognition, locomotion, vitality, psychological, and/or sensory functions, with sex-specific differences reported. Only a few studies used the multidimensional concept of intrinsic capacity as an outcome. This review supports that a healthy diet for older adults consists of plenty of plant-based foods, adequate protein-rich foods, and healthy fats. Next to quantity, improving the quality and variety within food groups play a role in optimizing health. Data on the associations between adherence to national food-based dietary guidelines and intrinsic capacity are scarce. SUMMARY A healthy diet, centered on plant-based foods, adequate protein-rich foods and healthy fats, potentially promotes healthy aging. Future studies may evaluate the association between adherence to healthy dietary patterns (particularly national food-based dietary guidelines) and the multidimensional concept of intrinsic capacity, with consideration of sex-specific differences. Clinical trials are warranted to inform the causal effects of diet and outcomes related to intrinsic capacity.
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Affiliation(s)
- Suey S Y Yeung
- Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | - Jean Woo
- Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China
- Institute of Health Equity
- Department of Medicine and Therapeutics
- Centre for Nutritional Studies, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Liao X, Shen J, Li M. Effects of multi-domain intervention on intrinsic capacity in older adults: A systematic review of randomized controlled trials (RCTs). Exp Gerontol 2023; 174:112112. [PMID: 36736466 DOI: 10.1016/j.exger.2023.112112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
Intrinsic capacity is central to the maintenance of function in older adults, and maintaining optimal intrinsic capacity is of great importance to promote healthy aging. The purpose of this systematic review and meta-analysis was to analyze the impact of multi-domain interventions on intrinsic capacity in older adults, intervention components, and potential interactions between components. A total of 6740 published articles were screened until August 2022, and the review included 25 randomized controlled trials that analyzed populations, interventions, control groups, and outcomes. The meta-analysis showed improvements in the primary outcome indicators in the intervention group compared to the control group. These included increased scores on the Mini-Mental State Examination as an indicator of cognitive function, decreased scores on the Geriatric Depression Scale (GDS-15) as an indicator of psychological ability and increased scores on the Short Physical Performance Battery (SPPB) as an indicator of physical performance, with only the SPPB indicator analyzed showing greater heterogeneity. Significant improvements were also seen in the secondary indicators Time-to-Walk Test (TUG), gait speed, Chair Stand Test (CST), grip strength values and BMI. There was insufficient data for the Mini Nutritional Assessment (MNA) as an indicator of vitality to conduct a meta-analysis. Studies were of moderate to high quality. The results of this review indicate that multi-domain interventions can maintain the level of intrinsic capacity in older adults and are equally effective in older adults with declining self-care abilities.
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Affiliation(s)
- Xiaoyan Liao
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Yuzhong district, #1 Youyi road, Chongqing 400014, China
| | - Jun Shen
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Yuzhong district, #1 Youyi road, Chongqing 400014, China.
| | - Miao Li
- Nursing Department, The First Affiliated Hospital of Chongqing Medical University, Yuzhong district, #1 Youyi road, Chongqing 400014, China
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Liang Y, Shang S, Gao Y, Zhai J, Cheng X, Yang C, Zhang R. Measurements of Intrinsic Capacity in Older Adults: A Scoping Review and Quality Assessment. J Am Med Dir Assoc 2023; 24:267-276.e2. [PMID: 36332688 DOI: 10.1016/j.jamda.2022.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/21/2022] [Accepted: 09/24/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES This review summarizes the measurements of intrinsic capacity in 5 domains across different studies and evaluates the quality of research papers. DESIGN Scoping review of papers written in English and Chinese published in peer-reviewed journals. SETTING AND PARTICIPANTS The intrinsic capacity of older adults was assessed using the multidomain structure (Cognition, Locomotion, Psychological, Sensory and Vitality) proposed by the World Health Organization. METHODS We searched PubMed, MEDLINE, and Web of Science for papers in English, and CNKI, CBM for papers written in Chinese published until September 13, 2022. Both cross-sectional and cohort studies of multidomain measurements of intrinsic capacity were included. Three independent reviewers appraised the quality of studies, and Cohen's kappa was calculated to determine interrater reliability. Data were listed by author, year, setting, country, age range and number of participants, measurement and calculation of intrinsic capacity, and data acquisition method. RESULTS We included 53 studies. Twenty-one studies were of high quality, 31 studies were of moderate quality, and 1 study was of low quality. Measurements of intrinsic capacity and derivation of the summative index score were heterogeneous. Intrinsic capacity was usually assessed in 4 or 5 domains. Sensory was the most frequently overlooked domain or subdivided into vision and hearing in some studies. Indicators of vitality were the most heterogeneous. We also found consistency in heterogeneous measurements. The most common measurements of cognition, locomotion, and psychological capacity were the Mini-Mental State Examination, Short Physical Performance Battery, and Geriatric Depression Scale respectively. Self-reported questionnaires were commonly adopted in sensory domain. The Mini-Nutritional Assessment and grip strength were the most measured indicators of vitality. CONCLUSIONS AND IMPLICATIONS The focus on capacity and disease should be balanced to better promote healthy aging in older adults. Heterogeneity of intrinsic capacity measurements underscores the need for consensus about standardized measurements and calculation procedures.
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Affiliation(s)
- Yetian Liang
- The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China
| | | | - Yaxuan Gao
- The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China; Hebei Puai Aged Care Ltd. Co., Shijiazhuang, Hebei Province, PR China
| | - Jiahui Zhai
- The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China
| | - Xiaohan Cheng
- The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China
| | - Chen Yang
- The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China
| | - Ruili Zhang
- The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, PR China.
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Muneera K, Muhammad T, Althaf S. Socio-demographic and lifestyle factors associated with intrinsic capacity among older adults: evidence from India. BMC Geriatr 2022; 22:851. [PMID: 36368936 PMCID: PMC9652958 DOI: 10.1186/s12877-022-03558-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 10/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Since the traditional models missed the possibility of formulating personalised programs centred on a person's priorities and values, it was a pressing priority to shift from traditional disease-centred to a function-based approach of healthy ageing, which is defined as 'the process of developing and maintaining the functional ability that enables well-being in older age'. The present study aimed to assess the prevalence of high intrinsic capacity (IC) of older adults and to examine the socio-demographic and lifestyle factors associated with IC among older adults in India. METHODS The study utilises the individual-level data from the first wave of the Longitudinal Aging Study in India (LASI) conducted during 2017-18. The total sample size for the present study was 24,136 older adults (11,871 males and 12,265 females) aged 60 years and above. Descriptive statistics, along with bivariate analysis, was employed to present the preliminary results. Additionally, multivariable linear and logistic regression analyses were conducted to find out the association of socio-demographic and lifestyle factors with IC and its components. RESULTS The mean IC score was found to be 7.37 (SD = 1.6) in this study. A proportion of 24.56% of older adults was observed to be in the higher IC category. Increasing age was negatively associated with high IC for older men and women. Older people who smoke tobacco (β = -0.23; CI: -0.32--0.13) and chew tobacco (β = -0.11; CI: -0.18--0.03) were less likely to experience high IC compared to their respective counterparts. Older adults who reported episodic alcohol drinking were less likely to have high IC (β = -0.20; CI:-0.32--0.07). The engagement in moderate physical activity (β = 0.12; CI:0.01-0.23), vigorous physical activity (β = 0.12; CI:0.05-0.20) and yoga-related activity (β = 0.18; CI:0.09-0.26) were significantly positively associated with high IC. Among the five domains of IC, education was significantly associated with higher capacity in each domain, and increasing age was found to be a significant predictor of lower capacity in each IC domain except locomotion. Older men and women engaged in vigorous physical activity had 35 and 19% significantly higher odds of high capacity in sensory (aOR = 1.35; CI: 1.12-1.62) and psychological (aOR = 1.19; CI: 1.06-1.34) domains, respectively. CONCLUSIONS The study revealed that lifestyle behaviours including tobacco use, episodic alcohol drinking and physical activity are strongly associated with IC among older adults in India. The findings suggest that healthy lifestyle behaviours should be encouraged among older adults as an effort to improve their IC, which is the key determinant of functional ability and quality of life in later years of life.
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Affiliation(s)
- K. Muneera
- National Institute of Technology, Calicut, 673601 Kerala India
| | - T. Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - S Althaf
- National Institute of Technology, Calicut, 673601 Kerala India
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Lin S, Wang F, Zheng J, Yuan Y, Huang F, Zhu P. Intrinsic Capacity Declines with Elevated Homocysteine in Community-Dwelling Chinese Older Adults. Clin Interv Aging 2022; 17:1057-1068. [PMID: 35832608 PMCID: PMC9272847 DOI: 10.2147/cia.s370930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/26/2022] [Indexed: 12/16/2022] Open
Abstract
Purpose Intrinsic capacity (IC) reflects the overall health status of older adults and has great public health significance. But few studies described the related biomarkers for IC. The aim of this study was to investigate the association between homocysteine (Hcy) and IC in older adults. Participants and Methods This cross-sectional study included 1927 community-dwelling Chinese older adults aged 60–98 years from May 2020 to December 2020. Data were collected through interviews, physical examinations, and laboratory tests. IC involved five domains of cognition, locomotion, sensory, vitality, and psychology evaluated by the Mini-cog scale, 4-m walk test, self-reported visual and hearing conditions, MNA-SF scale, and GDS-4 scale, respectively. The score of each domain dichotomized as 0 (normal) and 1 (impaired) was added together to an IC total score. Low IC was defined as a score of 3–5, and high IC as 0–2. Hcy was measured by a two-reagent enzymatic assay. A restricted cubic spline regression model was used to explore the non-linear relationship between Hcy and low IC. Results Hcy was higher in the low IC group than in the high IC group. Restricted cubic spline analysis revealed a J-shaped nonlinear association between Hcy and low IC. The risk of IC decline was slowly decreased until 8.53 µmol/L of Hcy (OR=0.753, 95% CI=0.520–1.091, P=0.132), and increased with elevations of per 5 µmol/L Hcy afterwards (OR=1.176, 95% CI=1.059–1.327, P=0.005). Among the five domains of IC, Hcy had ORs of 1.116 (1.009–1.247) for cognition impairment, 1.167 (1.055–1.305) for vitality, and 1.160 (1.034–1.303) for psychology per 5 µmol/L increase in Hcy above the change point. Additional sensitivity analysis also demonstrated the nonlinear association between Hcy and low IC. Conclusion Hcy had a J-shaped association with low IC. Higher Hcy (Hcy ≥8.53µmol/L) might provide clinical implications for early identifying the risk of low IC.
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Affiliation(s)
- Siyang Lin
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China
| | - Fang Wang
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China.,Fujian Health College, Fuzhou, Fujian, People's Republic of China.,Nursing School of Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Jiaxin Zheng
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China
| | - Yin Yuan
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China.,Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, People's Republic of China.,Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, People's Republic of China
| | - Feng Huang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China.,Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, People's Republic of China.,Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, People's Republic of China
| | - Pengli Zhu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China.,Fujian Provincial Center for Geriatrics, Fuzhou, Fujian, People's Republic of China.,Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, Fujian, People's Republic of China
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López-Ortiz S, Lista S, Peñín-Grandes S, Pinto-Fraga J, Valenzuela PL, Nisticò R, Emanuele E, Lucia A, Santos-Lozano A. Defining and assessing intrinsic capacity in older people: A systematic review and a proposed scoring system. Ageing Res Rev 2022; 79:101640. [PMID: 35569785 DOI: 10.1016/j.arr.2022.101640] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/30/2022] [Accepted: 05/07/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION The World Health Organization has introduced the term 'intrinsic capacity' (IC) as a marker of healthy ageing. However, controversy exists on the definition and assessment of IC. We aimed to review the definitions and methods used for the assessment of IC in older adults. In addition, we proposed a new IC scoring method. METHODS A systematic search was performed in PubMed, Web of Science, Cochrane Library, Scopus and SPORTDiscus (up to February 10th, 2022) for studies assesing IC in older adults (>60 years). RESULTS Thirty-three studies were included. There is overall consensus on the definition of IC as well as on its different dimensions, that is: locomotion, vitality, sensory, cognition and psychological. However, the methods for assessing each of these five dimensions differ substantially across studies and there is no consensus on the best method to compute an eventual global compound score to evaluate IC taking into account all its different dimensions. CONCLUSIONS The IC represents a highly relevant clinical concept that has been unfortunately underutilized. We propose a standardization for the assessment of each dimension of IC, with a global 0 (worst) to 10 (highest) score.
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