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Li N, Wang N, Lin S, Yuan Y, Huang F, Zhu P. A latent profile analysis of rest-activity behavior patterns among community-dwelling older adults and its relationship with intrinsic capacity. Sci Rep 2024; 14:18786. [PMID: 39138254 PMCID: PMC11322643 DOI: 10.1038/s41598-024-69114-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 07/31/2024] [Indexed: 08/15/2024] Open
Abstract
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.
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Affiliation(s)
- Na Li
- The Shengli Clinical Medical College of Fujian Medical University, Fuzhou, People's Republic of China
- Department of Nursing, Fujian Provincial Hospital, Fuzhou, People's Republic of China
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Nan Wang
- The School of Nursing, Fujian Medical University, Fuzhou, People's Republic of China
| | - Siyang Lin
- The Shengli Clinical Medical College of Fujian Medical University, Fuzhou, People's Republic of China
| | - Yin Yuan
- The Shengli Clinical Medical College of Fujian Medical University, Fuzhou, People's Republic of China
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, People's Republic of China
| | - Feng Huang
- The Shengli Clinical Medical College of Fujian Medical University, Fuzhou, People's Republic of China.
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, People's Republic of China.
- Fujian Provincial Center of Geriatrics, Fuzhou, People's Republic of China.
- Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, People's Republic of China.
| | - Pengli Zhu
- The Shengli Clinical Medical College of Fujian Medical University, Fuzhou, People's Republic of China.
- Fujian Provincial Institute of Clinical Geriatrics, Fuzhou, People's Republic of China.
- Fujian Provincial Center of Geriatrics, Fuzhou, People's Republic of China.
- Fujian Provincial Key Laboratory of Geriatrics, Fuzhou, People's Republic of China.
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de Souto Barreto P, Gonzalez-Bautista E, Bischoff-Ferrari HA, Pelegrim de Oliveira V, Gorga Bandeira de Mello R, Andrieu S, Berbon C, Tavassoli N, Beard JR, Rolland Y, Soto Martín ME, Vellas B. Real-life intrinsic capacity screening data from the ICOPE-Care program. NATURE AGING 2024:10.1038/s43587-024-00684-2. [PMID: 39122839 DOI: 10.1038/s43587-024-00684-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 07/15/2024] [Indexed: 08/12/2024]
Abstract
The Integrated Care for Older People (ICOPE) program is a healthcare pathway that uses a screening test for intrinsic capacity (IC) as its entry point. However, real-life data informing on how IC domains cluster and change over time, as well as their clinical utility, are lacking. Using primary healthcare screening data from more than 20,000 French adults 60 years of age or older, this study identified four clusters of IC impairment: 'Low impairment' (most prevalent), 'Cognition+Locomotion+Hearing+Vision', 'All IC impaired' and 'Psychology+Vitality+Vision'. Compared to individuals with 'Low impairment', those in the other clusters had higher likelihood of having frailty and limitations in both activities of daily living (ADL) and instrumental activities of daily living (IADL), with the strongest associations being observed for 'All IC impaired'. This study found that ICOPE screening might be a useful tool for patient risk stratification in clinical practice, with a higher number of IC domains impaired at screening indicating a higher probability of functional decline.
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Affiliation(s)
- Philipe de Souto Barreto
- IHU HealthAge, Toulouse, France.
- CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France.
- Institute on Aging of the Toulouse University Hospital (CHU Toulouse), Toulouse, France.
| | - Emmanuel Gonzalez-Bautista
- IHU HealthAge, Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
- Institute on Aging of the Toulouse University Hospital (CHU Toulouse), Toulouse, France
| | - Heike A Bischoff-Ferrari
- IHU HealthAge, Toulouse, France
- Department of Geriatrics and Aging Research, University of Zurich, Zurich, Switzerland
| | - Vitor Pelegrim de Oliveira
- Institute on Aging of the Toulouse University Hospital (CHU Toulouse), Toulouse, France
- Geriatric Unit - Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Sandrine Andrieu
- IHU HealthAge, Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
| | | | | | - John R Beard
- International Longevity Center - USA, Columbia University, New York, NY, USA
| | - Yves Rolland
- IHU HealthAge, Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
- Institute on Aging of the Toulouse University Hospital (CHU Toulouse), Toulouse, France
| | - Maria Eugenia Soto Martín
- IHU HealthAge, Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
- Institute on Aging of the Toulouse University Hospital (CHU Toulouse), Toulouse, France
| | - Bruno Vellas
- IHU HealthAge, Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, INSERM, UPS, Toulouse, France
- Institute on Aging of the Toulouse University Hospital (CHU Toulouse), Toulouse, France
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Cao X, Yi X, Chen H, Tian Y, Li S, Zhou J. Prevalence of intrinsic capacity decline among community-dwelling older adults: a systematic review and meta-analysis. Aging Clin Exp Res 2024; 36:157. [PMID: 39088112 PMCID: PMC11294388 DOI: 10.1007/s40520-024-02816-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND The concept of intrinsic capacity (IC) was introduced to define healthy aging and active aging based on functional capacity, yet there is limited understanding of the risk of IC decline at a population level. AIMS To consolidate existing evidence for rates of IC decline and risk factors among community-dwelling adults 60 years or older. METHODS According to the PRISMA guidelines, the literature search was independently conducted by two researchers in 8 databases from inception to January 2024 without language restrictions using combinations of free words and subject words. Qualities of included studies were assessed using Joanna Briggs Institute's (JBI's) critical appraisal checklist for prevalence studies. To pool the data, a random-effect meta-analysis was performed, followed by subgroup analysis and sensitivity analysis. All analyses were performed by Stata14.0. RESULTS From 1594 records, 15 studies were extracted with 33,070 participants for meta-analysis. The pooled prevalence of IC decline in community settings was 67.8% (95% CI: 57.0-78.5%; P < 0.001). The prevalence of IC decline in China (66.0%; 95% CI: 53.2-78.9%) was found to be slightly lower than in other countries/regions (73.0%; 95% CI: 59.8-86.3%); however, this difference was not statistically significant. Other subgroup analyses revealed no statistically significant differences in prevalence. Age, hypertension, diabetes, gender, education level, living status, smoking, regular exercise, marital status, and osteoarthritis are associated with IC decline. CONCLUSION More than two-thirds of older adults in the community are affected by IC decline, and age, hypertension, diabetes, female sex, low education level, living alone, smoking, irregular exercise, unmarried, and osteoarthritis are all risk factors for IC decline.
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Affiliation(s)
- Xia Cao
- Health Management Center, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Changsha, 410013, China
| | - Xuanzi Yi
- Department of General Practice, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Changsha, 410013, China
| | - Hui Chen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410008, China
| | - Yusheng Tian
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410008, China
| | - Sihong Li
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410008, China
| | - Jiansong Zhou
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410008, China
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Beyene MB, Visvanathan R, Ahmed M, Benyamin B, Beard JR, Amare AT. Development and validation of an intrinsic capacity score in the UK Biobank study. Maturitas 2024; 185:107976. [PMID: 38537388 DOI: 10.1016/j.maturitas.2024.107976] [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: 11/27/2023] [Revised: 02/06/2024] [Accepted: 03/14/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND In 2015, the World Health Organization introduced the concept of intrinsic capacity (IC) to define the individual-level characteristics that enable an older person to be and do the things they value. This study developed an intrinsic capacity score for UK Biobank study participants and validated its use as a tool for health outcome prediction, understanding healthy aging trajectories, and genetic research. METHODS Our analysis included data from 45,208 UK biobank participants who had a complete record of the ten variables included in the analysis. Factor adequacy was tested using Kaiser-Meyer-Olkin, Barthelt's, and the determinant of matrix tests, and the number of factors was determined by the parallel analysis method. Exploratory and confirmatory factor analyses were employed to determine the structure and dimensionality of indicators. Finally, the intrinsic capacity score was generated, and its construct and predictive validities as well as reliability were assessed. RESULTS The factor analysis identified a multidimensional construct comprising one general factor (intrinsic capacity) and five specific factors (locomotor, vitality, cognitive, psychological, and sensory). The bifactor structure showed a better fit (comparative fit index = 0.995, Tucker Lewis index = 0.976, root mean square error of approximation = 0.025, root mean square residual = 0.009) than the conventional five-factor structure. The intrinsic capacity score generated using the bifactor confirmatory factor analysis has good construct validity, as demonstrated by an inverse association with age (lower intrinsic capacity in older age; (β) =-0.035 (95%CI: -0.036, -0.034)), frailty (lower intrinsic capacity score in prefrail participants, β = -0.104 (95%CI: (-0.114, -0.094)) and frail participants, β = -0.227 (95%CI: -0.267, -0.186) than robust participants), and comorbidity (a lower intrinsic capacity score associated with increased Charlson's comorbidity index, β =-0.019 (95%CI: -0.022, -0.015)). The intrinsic capacity score also predicted comorbidity (a one-unit increase in baseline intrinsic capacity score led to a lower Charlson's comorbidity index, β = 0.147 (95%CI: -0.173, -0.121)) and mortality (a one-unit increase in baseline intrinsic capacity score led to 25 % lower risk of death, odds ratio = 0.75(95%CI: 0.663, 0.848)). CONCLUSION The bifactor structure showed a better fit in all goodness of fit tests. The intrinsic capacity construct has strong structural, construct, and predictive validities and is a promising tool for monitoring aging trajectories.
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Affiliation(s)
- Melkamu Bedimo Beyene
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia; Adelaide Geriatrics Training and Research with Aged Care Centre (GTRAC), Faculty of Health and Medical Sciences, University of Adelaide, Woodville, SA, 5011, Australia
| | - Renuka Visvanathan
- Adelaide Geriatrics Training and Research with Aged Care Centre (GTRAC), Faculty of Health and Medical Sciences, University of Adelaide, Woodville, SA, 5011, Australia; Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia
| | - Muktar Ahmed
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Beben Benyamin
- Australian Centre for Precision Health, Allied Health and Human Performance, University of South Australia, Adelaide 5000, Australia; South Australian Health and Medical Research Institute, Adelaide 5000, Australia
| | - John R Beard
- International Longevity Centre USA, Columbia University Mailman School of Public Health, NY, USA
| | - Azmeraw T Amare
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia; Adelaide Geriatrics Training and Research with Aged Care Centre (GTRAC), Faculty of Health and Medical Sciences, University of Adelaide, Woodville, SA, 5011, Australia.
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Giudici KV, de Souto Barreto P, Guyonnet S, Beard JR, Takeda C, Cantet C, Andrieu S, Vellas B. Predictive Capacity of the Integrated Care for Older People Screening Tool for Intrinsic Capacity Impairments: Results From the INSPIRE-T Cohort. J Gerontol A Biol Sci Med Sci 2024; 79:glae112. [PMID: 38676323 DOI: 10.1093/gerona/glae112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The Integrated Care for Older People (ICOPE) approach was developed by the World Health Organization (WHO) aiming to shift the traditional focus of care based on diseases to a function- and person-centered approach, focused on maintaining and monitoring intrinsic capacity (IC). This study aimed to investigate the ability of the ICOPE screening tool to identify older people with clinically meaningful impairments in IC domains. METHODS This cross-sectional analysis included 603 older adults, participants (mean age 74.7 [SD = 8.8] years, women 59.0%) of the INSPIRE Translational (INSPIRE-T) cohort. Responses at screening were compared to results of the subsequent in-depth assessment (ie, Mini-Mental State Examination, Mini Nutritional Assessment, Short Physical Performance Battery, Patient Health Questionnaire-9, and clinical investigation of vision problems) to determine its predictive capacity for impairments at the IC domains (ie, cognition, psychological, sensory (vision), vitality, and locomotion). RESULTS The ICOPE screening items provided very high sensitivity for identifying abnormality in vision (97.2%) and varied from 42.0% to 69.6% for the other domains. High specificity (>70%) was observed for all the IC domains, except for vision (2.7%). CONCLUSIONS The ICOPE screening tool can be a useful instrument enabling the identification of older people with impairments in IC domains, but studies with different populations are needed. It should be considered as a low-cost and simple screening tool in clinical care.
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Affiliation(s)
- Kelly Virecoulon Giudici
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France
| | - Philipe de Souto Barreto
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France
- CERPOP UMR1295, University of Toulouse III, Inserm, UPS, Toulouse, France
| | - Sophie Guyonnet
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France
- CERPOP UMR1295, University of Toulouse III, Inserm, UPS, Toulouse, France
| | - John R Beard
- International Longevity Center USA, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Catherine Takeda
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France
| | - Christelle Cantet
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France
- CERPOP UMR1295, University of Toulouse III, Inserm, UPS, Toulouse, France
| | - Sandrine Andrieu
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France
- Department of Epidemiology and Public Health, Toulouse University Hospital (CHU Toulouse), Toulouse, France
| | - Bruno Vellas
- Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France
- CERPOP UMR1295, University of Toulouse III, Inserm, UPS, Toulouse, France
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Tan F, Wei X, Zhang J, Zhao Y, Tong X, Michel JP, Shao R, Gong E. The assessment and detection rate of intrinsic capacity deficits among older adults: a systematic review and meta-analysis. BMC Geriatr 2024; 24:485. [PMID: 38831281 PMCID: PMC11149255 DOI: 10.1186/s12877-024-05088-w] [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: 03/24/2024] [Accepted: 05/17/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Assessing and monitoring intrinsic capacity (IC) is an effective strategy to promote healthy ageing by intervening early in high-risk populations. This review systematically analyzed the global detection rates of IC deficits and explored variations across diverse populations and data collection methods. METHODS This study was preregistered with PROSPERO, CRD42023477315. In this systematic review and meta-analysis, we systematically searched ten databases from January 2015 to October 2023, for peer-reviewed, observational studies or baseline survey of trials that assessed IC deficits among older adults aged 50 and above globally following the condition, context and population approach. The main outcome was intrinsic capacity deficits which could be assessed by any tools. Meta-analyses were performed by a random-effect model to pool the detection rates across studies and subgroup analyses were conducted by populations and data collection methods. RESULTS Fifty-six studies conducted in 13 countries were included in the review and 44 studies with detection rates of IC were included in the meta-analysis. The pooled detection rate of IC deficits was 72.0% (65.2%-78.8%) and deficits were most detected in sensory (49.3%), followed by locomotion (40.0%), cognition (33.1%), psychology (21.9%), and vitality (20.1%). Variations in detection rates of IC deficits were observed across studies, with higher rates observed in low- and middle-income countries (74.0%) and hyper-aged societies (85.0%). Study population and measurement tools also explained the high heterogeneity across studies. CONCLUSION IC deficits are common among older adults, while heterogeneity exists across populations and by measurement. Early monitoring with standardized tools and early intervention on specific subdomains of IC deficits are greatly needed for effective strategies to promote healthy ageing.
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Affiliation(s)
- Fangqin Tan
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31, Beijige 3 Aly, Dongcheng District, Beijing, China
| | - Xiaoxia Wei
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31, Beijige 3 Aly, Dongcheng District, Beijing, China
| | - Ji Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31, Beijige 3 Aly, Dongcheng District, Beijing, China
| | - Yihao Zhao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31, Beijige 3 Aly, Dongcheng District, Beijing, China
| | - Xunliang Tong
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Centre of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jean-Pierre Michel
- University of Geneva, Geneva, Switzerland
- French Academy of Medicine, Paris, France
| | - Ruitai Shao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31, Beijige 3 Aly, Dongcheng District, Beijing, China.
- State Key Laboratory of Respiratory Health and Multimorbidity, Chinese Academy of Medical Sciences & Peking Union Medical College, 31, Beijige 3 Aly, Dongcheng District, Beijing, China.
| | - Enying Gong
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 31, Beijige 3 Aly, Dongcheng District, Beijing, China.
- State Key Laboratory of Respiratory Health and Multimorbidity, Chinese Academy of Medical Sciences & Peking Union Medical College, 31, Beijige 3 Aly, Dongcheng District, Beijing, China.
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Hsueh YT, Lin YK, Cheng SC. The effect of progressive exercise prescription for group exercise guidance for Taiwan seniors and Integrated Care for old People: Post-event movement observation. Prev Med Rep 2024; 42:102728. [PMID: 38655501 PMCID: PMC11033191 DOI: 10.1016/j.pmedr.2024.102728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024] Open
Abstract
Purpose This study is aimed at the seniors of the "2022 Taiwan Senior Citizens Fitness Club Subsidy Plan" with a sample. Method The doctor will diagnose and confirm whether the physical condition suits participation. Then, the professional sports instructor will design and arrange a progressive fitness enhancement group course suitable for the Senior person's physical fitness, conducted four times a week, every 2 h, for three months of group course training. Afterward, four group course instructors analyzed the motor ability of the three periods through a video, divided into 21 evaluation indicators. The data collection will be from January to May 2023. In addition, the Integrated Care for Old People (ICOPE) was used to assess the situation. Result The results showed that all indexes were significantly better than those in week one at week 6. All indexes at week 12 were significantly better than those in week one and week 6 (p < .001), and the benefit of all indicators was the largest (Cohen's d: 2.79-5.11), the reliability of the scores of each index ICC (0.73-0.94). Conclusion Progressive and multifaceted guidance on how to safely and effectively enhance the physical activity of senior citizens may be the most suitable method. Through progressive energy enhancement, the participants' physical activity and cognitive function can be improved, especially the overall rhythm of the music, which can be combined with high and low impact, dynamic and static balance control, agility, flexibility, and extensibility to achieve the benefits of health promotion.
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Affiliation(s)
- Ying-Ting Hsueh
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Yen-Kuang Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Shih-Chung Cheng
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
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Su HC, Liu CH, Chen HY, Wu YL, Griffiths MD, Li CY, Hou WH, Lin CY, Yang YC. Assessing intrinsic capacity in Taiwan: Initial psychometric properties of the Integrated Care for Older People Screening Tool for Taiwanese (ICOPES-TW). BMC Geriatr 2024; 24:477. [PMID: 38822234 PMCID: PMC11141031 DOI: 10.1186/s12877-024-05071-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/13/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND The World Health Organization (WHO) proposed the concept of intrinsic capacity (comprising composite physical and mental capacity) which aligns with their concepts of healthy aging and functional ability. Consequently, the WHO promotes the Integrated Care for Older People (ICOPE) framework as guidance for geriatric care. Consequently, each government should have a screening tool corresponding to ICOPE framework to promote geriatric care. The present study examined the initial psychometric properties of the Taiwan version of ICOPE (i.e., ICOPES-TW). METHODS Older people (n = 1235; mean age = 72.63 years; 634 females [51.3%]) were approached by well-trained interviewers for participation. A number of measures were administered including the ICOPES-TW, WHOQOL-AGE (assessing quality of life [QoL]), Clinical Frailty Scale (assessing frailty), Barthel Index (assessing basic activity of daily living [BADL]), and Lawton Instrumental Activities of Daily Living Scale (assessing instrumental activity of daily living [IADL]). RESULTS The ICOPES-TW had a two-factor structure (body functionality [eigenvalue = 1.932] and life adaptation [eigenvalue = 1.170]) as indicated by the results of exploratory factor analysis. Internal consistency of the ICOPES-TW was low (Cronbach's α = 0.55 [entire ICOPES-TW], 0.45 (body functionality factor), and 0.52 (life adaptation factor). ICOPES-TW scores were significantly (i) positively correlated with age (r = 0.321), IADL (r = 0.313), and frailty (r = 0.601), and (ii) negatively correlated with QoL (r=-0.447), and BADL (r=-0.447), with all p-values < 0.001. CONCLUSION The ICOPES-TW could be a useful screening tool for healthcare providers to quickly evaluate intrinsic capacity for Taiwanese older people given that it has moderate to strong associations with age, BADL, IADL, QoL, and frailty.
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Affiliation(s)
- Hui-Chen Su
- Department of Neurology, National Cheng-Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chieh-Hsiu Liu
- Department of Family Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Hung-Yu Chen
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan, 701401, Taiwan
| | - Yi-Lin Wu
- Department of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Wen-Hsuan Hou
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Department of Physcial Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan, 701401, Taiwan.
- Faculty of Health and Life Sciences, INTI International University, Nilai, Malaysia.
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Yi-Ching Yang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan, 701401, Taiwan.
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Ohta R, Yakabe T, Adachi H, Sano C. Linking Agricultural Activity Frequency to Loneliness in Rural Hospital Patients: A Cross-Sectional Study. Cureus 2024; 16:e59909. [PMID: 38854219 PMCID: PMC11161130 DOI: 10.7759/cureus.59909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction Agriculture is deeply woven into the fabric of rural life, influencing the economy, and the social and health dynamics of rural communities. While it offers physical and mental health benefits through regular physical activity and interaction with nature, the solitary nature of farming activities may also lead to social isolation. This study explores the complex relationship between the frequency of agricultural engagement and feelings of loneliness among rural inhabitants with chronic diseases, addressing a gap in the literature concerning the impact of agricultural practices on social well-being. Method A cross-sectional analysis was conducted among patients over 40 who frequented the general medicine department in Unnan City, a rural area of Japan. The study utilized the Japanese version of the University of California, Los Angeles (UCLA) Loneliness Scale to assess loneliness and collected data on agricultural activity frequency through questionnaires. Multivariate logistic regression analyses examined the association between agricultural activities and loneliness, controlling for demographic and health-related variables. Results Among 647 participants, higher frequencies of agricultural activities were significantly associated with increased loneliness, especially for individuals engaging in agriculture four to five times weekly or daily. Engaging in agricultural activities four to five times weekly and daily significantly increased the likelihood of higher loneliness levels, with odds ratios (OR) of 1.80 (p = 0.039) and 2.47 (p < 0.01), respectively, when compared to engagement less than once a week. Age emerged as an influential factor, with individuals aged 75 and older showing increased odds of experiencing higher loneliness (OR 1.56, p = 0.025). Conclusion The study underscores the dual nature of agricultural engagement in rural communities, highlighting its role in both supporting physical health and contributing to social isolation. These findings advocate for developing targeted interventions that mitigate loneliness among rural populations, suggesting the need for a balanced approach that encompasses social and healthcare strategies to enhance the overall well-being of individuals engaged in agriculture.
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Affiliation(s)
| | | | | | - Chiaki Sano
- Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN
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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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Zhou K, Ng YS, Tay EL, Mah SM, Tay L. Intrinsic capacity assessment using World Health Organization Integrated Care for Older People Step 1, and the association with frailty in community dwelling older adults. Geriatr Gerontol Int 2024; 24:457-463. [PMID: 38597589 DOI: 10.1111/ggi.14869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 02/27/2024] [Accepted: 03/27/2024] [Indexed: 04/11/2024]
Abstract
AIM This study aimed to investigate the association between intrinsic capacity (IC) and frailty in community-dwelling older adults. Specifically, we examined the utility of the World Health Organization's Integrated Care for Older People Step 1 screen for identifying frail older persons in the community. METHODS This is a cross-sectional analysis of a community frailty screening initiative. IC loss was ascertained using the World Health Organization's Integrated Care for Older People Step 1 questions. The Clinical Frailty Scale was used to categorize participants as robust (Clinical Frailty Scale S1-3) or frail (Clinical Frailty Scale ≥4). Logistic regression was used to analyze the association of individual and cumulative IC losses with frailty, adjusting for confounders. Additionally, the diagnostic performance of using cumulative IC losses to identify frailty was assessed. RESULTS This study included 1164 participants (28.2% frail). Loss in locomotion (adjusted odds ratio [AOR] 1.47, 95% CI 1.07-2.02), vitality (AOR 1.58, 95% CI 1.04-2.39), sensory (AOR 1.99, 95% CI 1.51-2.64) and psychological capacities (AOR 1.92, 95% CI 1.45-2.56) were significantly associated with frailty. Loss in more than three IC domains was associated with frailty. Using loss in at least three ICs identifies frailty, with sensitivity of 38.6%, specificity of 83.5% and positive predictive value of 47.4%. Using loss in at least four ICs improved specificity to 96.9%, and is associated with the highest positive predictive value of 57.6% and highest positive likelihood ratio of 3.55 for frailty among all cut-off values. The area under the receiver operating characteristic curve was 0.64 (95% CI 0.61-0.68). CONCLUSIONS IC loss as identified through World Health Organization's Integrated Care for Older People Step 1 is associated with frailty community-dwelling older adults. Geriatr Gerontol Int 2024; 24: 457-463.
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Affiliation(s)
- Ke Zhou
- Department of Geriatric Medicine, Sengkang General Hospital, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Yee Sien Ng
- Department of Rehabilitation Medicine, Singapore General Hospital, Singapore
- Geriatric Education and Research Institute, Singapore
| | - Ee Ling Tay
- Department of Physiotherapy, Sengkang General Hospital, Singapore
| | - Shi Min Mah
- Department of Physiotherapy, Sengkang General Hospital, Singapore
| | - Laura Tay
- Department of Geriatric Medicine, Sengkang General Hospital, Singapore
- Geriatric Education and Research Institute, Singapore
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da Costa Teixeira LA, Soares LA, Lima LP, Avelar NCP, de Moura JA, Leopoldino AAO, Figueiredo PHS, Parentoni AN, Mendonça VA, Lacerda ACR. Cognitive function is associated with performance in time up and go test and with leptin blood levels in community-dwelling older women. Sci Rep 2024; 14:9841. [PMID: 38684691 PMCID: PMC11058236 DOI: 10.1038/s41598-024-60274-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 04/21/2024] [Indexed: 05/02/2024] Open
Abstract
Considering the challenge that cognitive dysfunction and dementia represent to health is imperative to prioritize early diagnosis strategies and explore the pathophysiological mechanisms. There is no consensus on specific markers and physical tests that indicate cognitive decline in older. The objective of this study was to evaluate a panel of inflammatory biomarkers and physical function and investigate their association with cognitive function in community-dwelling older women. Seventy-one participants were included in this study. Cognitive function was assessed by Mini Mental State Examination, muscle strength using dynamometer, body composition using Dual X-ray absorptiometry, respiratory muscle strength using manuvacuometer, and physical function using the Short Physical Performance Battery and Time Up and Go (TUG) tests. Blood samples were collected to analyze a panel of inflammatory biomarkers. The cognitive function was associated with TUG (β = - 0.48; 95%IC = - 0.54 to - 0.21; p < 0.001), inspiratory muscle strength (β = 0.30; 95%IC = 0.005-0.03; p = 0.009), and leptin concentrations (β = 0.32; 95% IC = 0.001-0.006; 0.007). Time spent on TUG test and leptin levels accounted for 27% of variability in cognitive function independent of age. Poorer physical function with leptin plasma levels is associated with decreased cognitive function in older women. These findings contribute to comprehension of pathophysiology underlying cognitive decline and informing the development of new approaches to prevent, diagnose, monitoring and treat cognitive decline in aging.
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Affiliation(s)
- Leonardo Augusto da Costa Teixeira
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Luana Aparecida Soares
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Liliana Pereira Lima
- Programa de Pós-Graduação em Ciências Fisiológicas (PPGCF), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | | | - Julia Araújo de Moura
- Programa de Pós-Graduação em Educação Física (PPGEF-UnB), Universidade de Brasília, Brasília, DF, Brazil
| | | | - Pedro Henrique Scheidt Figueiredo
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Adriana Netto Parentoni
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Vanessa Amaral Mendonça
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Programa de Pós-Graduação em Ciências da Saúde (PPGCS), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil.
- Programa de Pós-Graduação em Reabilitação e Desempenho Funcional (PPGReab), Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil.
- Departamento de Fisioterapia, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG, Brazil.
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Chang YH, Lin CY, Chou YT, Chen HY, Su HC, Wu YL, Yang YC, Hou WH. A simple scoring algorithm based on intrinsic capacity for functional ability in community-dwelling older adults in Taiwan. BMC Geriatr 2024; 24:370. [PMID: 38664604 PMCID: PMC11044441 DOI: 10.1186/s12877-024-04969-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 04/12/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Intrinsic capacity (IC) is a comprehensive indicator of the overall well-being of older adults, and assessing of IC can help identify early stage of disability and tailor intervention to individual needs. However, there is a lack of effective and simple IC assessment tools. This study aimed to establish predictive scoring algorithms of IC to identify older adults at high risk of impaired functional ability. METHODS We conducted a cross-sectional study in Southern Taiwan, measuring IC using 7 subitems: cognition, locomotion, vitality, vision, hearing, psychological well-being, and medication usage were measured. Functional ability outcomes included frailty, basic activities of daily living, and instrumental activities of daily living (IADL). The capability of 7 domains of IC in predicting functional ability was assessed by multivariable logistic regression. The prediction of capability of scoring algorithms was indicated by receiver operating characteristic (AUC) curves and measures of sensitivity and specificity. RESULTS A total of 1,152 older adults were recruited and analyzed. Locomotion emerged as a significant predictor of IADL disability and worsening frailty. The IC-based weighted scoring algorism for predicting IADL demonstrated satisfactory capability (AUC: 0.80), as did the algorithm for predicting worsening frailty (AUC: 0.90). The optimal cutoff points for predicting IADL disability and frailty worse were estimated respectively at 13 and 16, with sensitivity/specificity values of 0.74/0.75 for the IADL prediction algorithm and 0.92/0.77 for the frailty prediction algorithm. CONCLUSION Our 7-domain IC screening tool proves to be sensitive and practical for early identification of functional disability and frailty among community-dwelling older adults in Taiwan.
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Affiliation(s)
- Ya-Hui Chang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Tsung Chou
- Department of Health Management Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Yu Chen
- Department of Health Management Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Chen Su
- Department of Neurology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Lin Wu
- Department of Nursing, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ching Yang
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Hsuan Hou
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan.
- Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.
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Augusto da Costa Teixeira L, Rocha-Vieira E, Aparecida Soares L, Mota de Oliveira F, Aparecida Oliveira Leopoldino A, Netto Parentoni A, Amaral Mendonça V, Cristina Rodrigues Lacerda A. The strong inverse association between plasma concentrations of soluble tumor necrosis factor receptors type 1 with adiponectin/leptin ratio in older women. Cytokine 2024; 176:156512. [PMID: 38281360 DOI: 10.1016/j.cyto.2024.156512] [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: 10/30/2023] [Revised: 12/27/2023] [Accepted: 01/16/2024] [Indexed: 01/30/2024]
Abstract
Complex inflammatory crosstalk between muscular and adipose organs during ageing is controlled by adipokines and myokines. The Adiponectin/Leptin ratio (A/L ratio) has proven to be a promising biomarker for identifying insulin sensitivity, cardiovascular risk and adipose tissue inflammation. Although the A/L ratio has been related to inflammatory conditions, its ability to associate with or indicate the behavior of other inflammatory mediators remains unknown. The present study aimed to verify the association between the A/L ratio and a panel of inflammatory biomarkers in community-dwelling older women. The plasmatic concentrations of adiponectin, leptin, resistin, brain-derived neurotrophic factor (BDNF), interferon-gamma (IFN-γ), interleukins 2, 4, 5, 6, 8 and 10, tumour necrosis factor (TNF) and its soluble receptors (sTNF-r) 1 and 2 were evaluated in 71 community-dwelling older women with 75 (±7) years. The A/L ratio was negative and inverse correlated with BNDF (r = -0.29; p = 0.01), IL-8 (r = -0.37; p = 0.001) and sTNFr- 1 (r = -0.98; p < 0.001) levels. A strong and inverse association, with proportional effect, between A/L ratio and sTNFr-1 concentrations was found (Adjusted R2 = 0.22; β = -0.48; p > 0.001). It suggests that the presence of sTNFr-1 causes an inflammatory effect that affect cross-talk between muscle and adipose tissue, contributing to pro-inflammatory imbalance, which may have molecular and functional consequences. In addition, we provide insights into diagnostic biomarkers for inflammation, especially related to muscle wasting and intrinsic capacity in older people.
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Affiliation(s)
- Leonardo Augusto da Costa Teixeira
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil
| | - Etel Rocha-Vieira
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Faculdade de Medicina do campus JK da UFVJM, Brazil
| | - Luana Aparecida Soares
- Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Programa de pós-graduação em Reabilitação e Desempenho Funcional da UFVJM, Brazil
| | | | | | | | - Vanessa Amaral Mendonça
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Faculdade de Medicina do campus JK da UFVJM, Brazil; Programa de pós-graduação em Reabilitação e Desempenho Funcional da UFVJM, Brazil; Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Cristina Rodrigues Lacerda
- Programa de pós-graduação em ciências da saúde da UFVJM, Brazil; Centro Integrado de Pesquisa e pós-graduação em saúde (CIPq-saúde) da UFVJM, Brazil; Faculdade de Medicina do campus JK da UFVJM, Brazil; Programa de pós-graduação em Reabilitação e Desempenho Funcional da UFVJM, Brazil; Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.
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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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de Oliveira VP, Ferriolli E, Lourenço RA, González-Bautista E, de Souto Barreto P, de Mello RGB. The sensitivity and specificity of the WHO's ICOPE screening tool, and the prevalence of loss of intrinsic capacity in older adults: A scoping review. Maturitas 2023; 177:107818. [PMID: 37542782 DOI: 10.1016/j.maturitas.2023.107818] [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: 02/14/2023] [Revised: 05/26/2023] [Accepted: 07/27/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND The World Health Organization has developed the Integrated Care for Older People (ICOPE) program, a public health strategy to maintain older adults' functional abilities and promote healthier aging. The approach comprises a 5-step pathway. Step 1 is the screening for impairment in functions, and Step 2 is an in-depth evaluation to confirm the presence and severity of functional impairment. These initial two steps are crucial to determine the subsequent plan of care (Step 3) and follow-up (Step 4). The fifth step encompasses actions to support families and caregivers and to engage communities. This review gathers data from the literature on the prevalence of positive screenings regarding intrinsic capacity detected by the program's first-step screening tool, and on currently available results regarding the instrument's sensitivity and specificity. METHODS AND FINDINGS Electronic searches were conducted in the PubMed, Cochrane, Embase, and SciElo databases, the medRxiv platform, and recent human aging scientific events, looking for research analyzing the ICOPE screening instrument. Studies reporting data on the prevalence of positive screenings for loss of intrinsic capacity using the proposed screening tool and/or findings on the instrument's sensitivity and specificity were included. A total of 7 publications with participants aged 50 years or more were selected. The prevalence of at least one impairment in intrinsic capacity detected by the instrument varied among the studies from 17.1 % to 94.3 %. Sensitivity ranged from 26.4 % to 100 % and specificity from 22 % to 96 %, depending on the setting and the assessed domain. CONCLUSION Currently available data are heterogeneous, and different results were found among the studies due to diverse settings and methodologies. The evidence on the ICOPE screening tool's performance in different populations is still scarce and reinforces the need for further research worldwide.
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Affiliation(s)
- Vitor Pelegrim de Oliveira
- Geriatric Unit - Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, 5° andar, sala C 5006, Bloco C, Porto Alegre, RS CEP 90035-903, Brazil; Post Graduation Program in Medical Sciences: Endocrinology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2° andar, Porto Alegre, RS CEP 90035-000, Brazil; Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalier-Universitaire de Toulouse, 37 Allés Jules Guesdes, Toulouse, CP 31000, France.
| | - Eduardo Ferriolli
- Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo (USP), Av. Dr. Enéas de Carvalho Aguiar, 155, 8° andar, Bloco 8A, Setor Azul, São Paulo, SP CEP 05003-900, Brazil.
| | - Roberto Alves Lourenço
- Faculty of Health Sciences, Internal Medicine Department, Human Aging Research Laboratory, Universidade do Estado do Rio de Janeiro, Av. Mal. Rondon, 381, Rio de Janeiro, RJ CEP 20950-003, Brazil.
| | - Emmanuel González-Bautista
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalier-Universitaire de Toulouse, 37 Allés Jules Guesdes, Toulouse, CP 31000, France
| | - Philipe de Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalier-Universitaire de Toulouse, 37 Allés Jules Guesdes, Toulouse, CP 31000, France
| | - Renato Gorga Bandeira de Mello
- Geriatric Unit - Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, 5° andar, sala C 5006, Bloco C, Porto Alegre, RS CEP 90035-903, Brazil; Post Graduation Program in Medical Sciences: Endocrinology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2° andar, Porto Alegre, RS CEP 90035-000, Brazil.
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Liu Y, Du Q, Jiang Y. Detection rate of decreased intrinsic capacity of older adults: a systematic review and meta-analysis. Aging Clin Exp Res 2023; 35:2009-2017. [PMID: 37543528 DOI: 10.1007/s40520-023-02515-7] [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: 03/19/2023] [Accepted: 07/20/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVES To systematically assess the prevalence of decreased intrinsic capacity in older adults, stratified by relevant factors such as country, sex, sample source, and region. METHODS We conducted a comprehensive search of PubMed, Web of Science, EMBASE, The Cochrane Library, PsychINFO, CINAHL, China Knowledge Resource Integrated Database, Wanfang Database, Weipu Database, and Chinese Biomedical Database to collect studies published on the decline of intrinsic capacity in older adults before February 24, 2023. The results of the study were analyzed using the Stata 15.0 software package, using a random-effects model to estimate the pooled detection rate of decreased intrinsic capacity in older adults. The Joanna Briggs Institute Critical Appraisal Tool was used to assess the quality of all included studies. RESULTS A total of 16 studies (67,881 older adults in 4 countries) were included. The results showed that the pooled detection rate of decreased intrinsic capacity in older adults was 76.1% (95% CI: 68.0%-84.2%). The 16 studies had obvious heterogeneity, and further subgroup analysis showed that the detection rate of decreased intrinsic capacity in older adults was higher in developed countries, females, and hospitals. Thirteen studies found that the pooled detection rate was 73.7% (95%: CI 64.5%-82.8%) for decreased intrinsic capacity in Chinese older adults, with higher rates in mainland China and Hong Kong than in Taiwan. CONCLUSIONS Our study suggests that intrinsic capacity declines more rapidly in older adults. Understanding the degree of decline in the intrinsic capacity of older adults will help to provide an important basis for the formulation and development of care policies for older adults. TRIAL REGISTRATION NUMBER PROSPERO (CRD42023402680).
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Affiliation(s)
- Yaxin Liu
- School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Road, Wenjiang District, Sichuan Province, 611137, Chengdu City, China
| | - Qiufeng Du
- School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Road, Wenjiang District, Sichuan Province, 611137, Chengdu City, China
| | - Yunlan Jiang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Road, Wenjiang District, Sichuan Province, 611137, Chengdu City, China.
- Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-Qiao Road, Chengdu City, 610072, Sichuan Province, China.
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Lu F, Li J, Liu X, Liu S, Sun X, Wang X. Diagnostic performance analysis of the Integrated Care for Older People (ICOPE) screening tool for identifying decline in intrinsic capacity. BMC Geriatr 2023; 23:509. [PMID: 37612657 PMCID: PMC10463906 DOI: 10.1186/s12877-023-04180-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/18/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Intrinsic capacity (IC) is a comprehensive indicator of an individual's positive attributes. The World Health Organization (WHO) recommends a two-step approach to assess IC decline among older people. The first step involves the used of the integrated care for older people (ICOPE) screening tool to identify potential issues, and the second step involves using detailed assessments for confirmation. This study aimed to assess the diagnostic performance of the ICOPE screening tool as a simple preliminary screening to identify IC decline among community-dwelling older people, which has been rarely reported in China. METHODS This cross-sectional study included 228 community-dwelling older individuals aged ≥ 75 (mean age, 84.0 ± 4.4 years; 131 [57.5%] females) who completed the IC evaluation according to the WHO IC assessment pathway. The diagnostic performance of the ICOPE screening tool was calculated using a 2 × 2 table and a receiver operating characteristic curve. RESULTS The proportion of possible IC decline identified by the ICOPE screening tool was 79.4%, whereas the actual IC decline assessed by the detailed assessment was 73.2%, mainly in locomotion. The ICOPE screening tool showed sensitivity and specificity of 94.6% and 62.3%, respectively, with an overall diagnostic accuracy of 86.0%. The diagnostic effectiveness of the ICOPE screening tool was 0.91 (95% confidence interval: 0.87-0.95, p = 0.020). Except for the sensory dimension, the sensitivity of the ICOPE screening tool for diagnosing impairments in each dimension of the IC was the highest in the cognition domain (100%) and the lowest in the vitality domain (51.3%), whereas the specificity was the highest in vitality (94.7%) and the lowest in cognition (55.6%). CONCLUSIONS The ICOPE screening tool exhibits high sensitivity and can be used as an IC screening tool in community-dwelling older people. However, further improvements are needed in the vitality dimension of the ICOPE screening tool to enhance its sensitivity in identifying individuals at risk of malnutrition.
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Affiliation(s)
- Fei Lu
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, China
| | - Jiaojiao Li
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, China
| | - Xiaohong Liu
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, China.
| | - Shuo Liu
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, China
| | - Xiaohong Sun
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, China
| | - Xueying Wang
- Yanyuan Rehabilitation Hospital, No.2, Jingrong Street, Nanshao Town, Changping District, Beijing, China
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Gonzalez-Bautista E, Llibre-Guerra JJ, Sosa AL, Acosta I, Andrieu S, Acosta D, Llibre-Rodríguez JDJ, Prina M. Exploring the natural history of intrinsic capacity impairments: longitudinal patterns in the 10/66 study. Age Ageing 2023; 52:afad137. [PMID: 37517058 PMCID: PMC10387229 DOI: 10.1093/ageing/afad137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND intrinsic capacity (IC) is a construct encompassing people's physical and mental abilities. There is an implicit link amongst IC domains: cognition, locomotion, nutrition, sensory and psychological. However, little is known about the integration of the domains. OBJECTIVES to investigate patterns in the presentation and evolution of IC domain impairments in low-and-middle-income countries and if such patterns were associated with adverse outcomes. METHODS secondary analyses of the first two waves of the 10/66 study (population-based surveys conducted in eight urban and four rural catchment areas in Cuba, Dominican Republic, Puerto Rico, Venezuela, Peru, Mexico and China). We applied latent transition analysis on IC to find latent statuses (latent clusters) of IC domain impairments. We evaluated the longitudinal association of the latent statuses with the risk of frailty, disability and mortality, and tested concurrent and predictive validity. RESULTS amongst 14,923 participants included, the four latent statuses were: high IC (43%), low deterioration with impaired locomotion (17%), high deterioration without cognitive impairment (22%), and high deterioration with cognitive impairment (18%). A total of 61% of the participants worsened over time, 35% were stable, and 3% improved to a healthier status.Participants with deteriorated IC had a significantly higher risk of frailty, disability and dementia than people with high IC. There was strong concurrent and predictive validity. (Mortality Hazard Ratio = 4.60, 95%CI 4.16; 5.09; Harrel's C = 0.73 (95%CI 0.72;0.74)). CONCLUSIONS half of the study population had high IC at baseline, and most participants followed a worsening trend. Four qualitatively different IC statuses or statuses were characterised by low and high levels of deterioration associated with their risk of disability and frailty. Locomotion and cognition impairments showed other trends than psychological and nutrition domains across the latent statuses.
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Affiliation(s)
- Emmanuel Gonzalez-Bautista
- Maintain Aging Research Team, CERPOP, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
- Institute on Aging, Toulouse University Hospital (CHU), Gerontopole, Toulouse, France
- Department of Health Service & Population Research, King’s College London, Institute of Psychiatry, Psychology &Neuroscience, London, UK
| | | | - Ana L Sosa
- National Institute of Neurology and Neurosurgery of Mexico, National Autonomous University of Mexico, Mexico City, Mexico
| | - Isaac Acosta
- Internal Medicine Department, Geriatric Section, Universidad Nacional Pedro Henriquez Ureña, Santo Domingo, Dominican Republic
| | - Sandrine Andrieu
- Maintain Aging Research Team, CERPOP, Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Daisy Acosta
- Internal Medicine Department, Geriatric Section, Universidad Nacional Pedro Henriquez Ureña, Santo Domingo, Dominican Republic
| | | | - Matthew Prina
- Department of Health Service & Population Research, King’s College London, Institute of Psychiatry, Psychology &Neuroscience, London, UK
- Faculty of Medical Sciences, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
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20
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Gaussens L, González-Bautista E, Bonnefoy M, Briand M, Tavassoli N, De Souto Barreto P, Rolland Y. Associations between Vitality/Nutrition and the Other Domains of Intrinsic Capacity Based on Data from the INSPIRE ICOPE-Care Program. Nutrients 2023; 15:nu15071567. [PMID: 37049408 PMCID: PMC10096560 DOI: 10.3390/nu15071567] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND The vitality domain of intrinsic capacity (IC) represents the synthesis of biological interactions and metabolism. As part of the Integrated Care for Older People (ICOPE) program developed by the World Health Organization (WHO), vitality focuses on the nutritional status of older adults. The objective of this work was to describe the vitality domain of IC in community-dwelling older people and to examine the associations of the vitality components (appetite loss and weight loss) with the other IC domains assessed within the framework of ICOPE. METHODS Cross-sectional data were obtained between January 2020 and February 2022 through the INSPIRE-ICOPE-Care program, a real-life ICOPE implementation initiative developed in the Occitania region of France. Participants were men and women aged 60 and older, looking for primary care services within the French healthcare system. RESULTS Appetite loss was reported by 14.0% (2013) of the participants, and weight loss by 12.4% (1788). A total of 863 participants (6.01%) declaring weight loss also suffered from appetite loss. In total, 2910 participants (20.27%) screened positive for the domain of vitality. Appetite loss was significantly associated with positive screenings for the domains of cognition (OR = 2.14 [1.84;2.48]), vision (OR = 1.51 [1.28;1.79]), hearing (OR = 1.18 [1.01;1.37]), psychology (OR = 3.95 [3.46;4.52]), and locomotion 'OR = 2.19 [1.91;2.51]). We found significant associations of weight loss with the IC domains of cognition (OR = 1.65 [1.42;1.93]), psychology (OR = 1.80 [1.56;2.07]), locomotion (OR = 1.64 [1.41;1.91]), vision (OR = 1.24 [1.04;1.47]), and hearing (OR = 1.32 [1.12;1.55]). People reporting simultaneous appetite and weight loss showed higher odds of screening positive for psychological (OR = 5.33 [4.53;6.27]) and locomotion impairments (OR = 3.38 [2.88;3.98]). CONCLUSIONS Appetite and weight loss are common among older people and are related to other potential IC impairments, especially psychological and locomotion. Further studies are needed to explore the longitudinal associations of vitality with the incidence of clinically meaningful declines in the other IC domains.
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Affiliation(s)
- Luc Gaussens
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 31300 Toulouse, France
| | - Emmanuel González-Bautista
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 31300 Toulouse, France
| | - Marc Bonnefoy
- Service de Médecine Gériatrique, CHU Lyon, Groupement Hospitalier Sud, 69495 Pierre-Bénite, France
| | - Marguerite Briand
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 31300 Toulouse, France
| | - Neda Tavassoli
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 31300 Toulouse, France
| | - Philipe De Souto Barreto
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 31300 Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPS, 31062 Toulouse, France
| | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, 31300 Toulouse, France
- CERPOP UMR 1295, University of Toulouse III, Inserm, UPS, 31062 Toulouse, France
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21
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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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22
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Rojano i Luque X, Blancafort-Alias S, Prat Casanovas S, Forné S, Martín Vergara N, Fabregat Povill P, Vila Royo M, Serrano R, Sanchez-Rodriguez D, Vílchez Saldaña M, Martínez I, Domínguez López M, Riba Porquet F, Intxaurrondo González A, Salvà Casanovas A. Identification of decreased intrinsic capacity: Performance of diagnostic measures of the ICOPE Screening tool in community dwelling older people in the VIMCI study. BMC Geriatr 2023; 23:106. [PMID: 36809987 PMCID: PMC9945724 DOI: 10.1186/s12877-023-03799-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/03/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND The World Health Organization (WHO) has developed the Integrated Care for Older People (ICOPE) strategy to face the challenges of ageing societies. This strategy is focused on person centered care and the assessment intrinsic capacity (IC). Early identification of five domains of IC (cognition, locomotion, vitality, sensory (hearing and vision), and psychological) has been shown to be related with adverse outcomes and can guide actions towards primary prevention and healthy ageing. IC assessment proposed by the WHO ICOPE guidelines is composed by two steps: First, Screening for decreased IC by the ICOPE Screening tool; second, by the reference standard methods. The aim was to assess the performance of diagnostic measures (sensibility, specificity, diagnostic accuracy, and agreement of the ICOPE Screening tool) compared to the reference standard methods in European community-dwelling older adults. METHODS Cross-sectional analysis of the baseline of the ongoing VIMCI (Validity of an Instrument to Measure Intrinsic Capacity) cohort study, which was carried out in Primary Care centers and outpatient clinics from 5 rural and urban territories in Catalonia (Spain). Participants were 207community dwelling persons ≥ 70-year-old with Barthel ≥ 90, without dementia or advanced chronic conditions who provided their consent to participate. The 5 IC domains were assessed by the ICOPE Screening tool and the reference methods (SPPB, gait speed, MNA, Snellen chart, audiometry, MMSE, GDS5) during patients' visit. Agreement was assessed with the Gwet AC1 index. RESULTS ICOPE Screening tool sensitivity was higher for cognition (0.889) and ranged between 0.438 and 0.569 for most domains. Specificity ranged from 0.682 to 0.96, diagnostic accuracy from 0.627 to 0.879, Youden index from 0.12 to 0.619, and Gwet AC1 from 0.275 to 0.842. CONCLUSION The ICOPE screening tool showed fair performance of diagnostic measures; it was helpful to identify those participants with satisfactory IC and showed a modest ability to identify decreased IC in older people with high degree of autonomy. Since low sensitivities were found, a process of external validation would be recommended to reach better discrimination. Further studies about the ICOPE Screening tool and its performance of diagnostic measures in different populations are urgently required.
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Affiliation(s)
- Xavier Rojano i Luque
- grid.477257.40000 0004 4904 4581Fundació Salut i Envelliment UAB (FSIE-UAB), Barcelona, Spain ,grid.413396.a0000 0004 1768 8905Sant Pau Institute for Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Sergi Blancafort-Alias
- Fundació Salut i Envelliment UAB (FSIE-UAB), Barcelona, Spain. .,Sant Pau Institute for Biomedical Research (IIB Sant Pau), Barcelona, Spain.
| | - Susanna Prat Casanovas
- grid.22061.370000 0000 9127 6969ABS Ripoll-Sant Joan de les Abadesses, Institut Català de la Salut (ICS), Ripoll, Spain
| | - Susanna Forné
- Fundació Sant Hospital, La Seu d’Urgell, Lleida, Spain
| | - Nuria Martín Vergara
- grid.22061.370000 0000 9127 6969EAP Horts de Miró, Institut Català de la Salut (ICS), Reus, Spain
| | | | - Maria Vila Royo
- grid.432291.f0000 0004 1755 8959Badalona Serveis Assistencials (BSA), Badalona, Spain
| | | | - Dolores Sanchez-Rodriguez
- grid.411371.10000 0004 0469 8354Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium ,grid.4861.b0000 0001 0805 7253 Health Organization Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium ,grid.20522.370000 0004 1767 9005Geriatrics Department, Rehabilitation Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | | | - Iris Martínez
- Fundació Sant Hospital, La Seu d’Urgell, Lleida, Spain
| | | | | | - Aimar Intxaurrondo González
- grid.477257.40000 0004 4904 4581Fundació Salut i Envelliment UAB (FSIE-UAB), Barcelona, Spain ,grid.413396.a0000 0004 1768 8905Sant Pau Institute for Biomedical Research (IIB Sant Pau), Barcelona, Spain
| | - Antoni Salvà Casanovas
- grid.477257.40000 0004 4904 4581Fundació Salut i Envelliment UAB (FSIE-UAB), Barcelona, Spain ,grid.413396.a0000 0004 1768 8905Sant Pau Institute for Biomedical Research (IIB Sant Pau), Barcelona, Spain
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Lu F, Liu S, Liu X, Li J, Jiang S, Sun X, Huang X, Wang X. Comparison of the predictive value of intrinsic capacity and comorbidity on adverse health outcome in community-dwelling older adults. Geriatr Nurs 2023; 50:222-226. [PMID: 36805953 DOI: 10.1016/j.gerinurse.2023.02.001] [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: 11/11/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVES To compare the predictive value of intrinsic capacity (IC) and comorbidity on all-cause mortality and falls. METHODS This prospective cohort study included 220 older adults (84.0±4.4 years) followed for 3 years in a community in Beijing. The methodology recommended by the World Health Organization was used to assess IC, and comorbidity was assessed by the Cumulative Illness Rating Scale for Geriatrics. RESULTS The areas under the characteristic curve of IC and comorbidity were 0.78 vs. 0.67 (p=0.033), respectively, in predicting all-cause mortality, and 0.69 vs. 0.61 in predicting falls (p=0.032). The vitality domain impairment (odds ratio [OR]=3.28, p=0.013), and cognition domain impairment (OR=3.97, p=0.004) were significantly associated with all-cause mortality. Locomotion domain impairment (OR=2.35, p=0.010) was associated with higher fall risk. CONCLUSION IC might be a better predictor than comorbidity in community-dwelling older adults, in which the vitality, locomotion and cognition domains should be given more attention.
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Affiliation(s)
- Fei Lu
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dong Cheng District, Beijing, 100730, China
| | - Shuo Liu
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dong Cheng District, Beijing, 100730, China
| | - Xiaohong Liu
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dong Cheng District, Beijing, 100730, China.
| | - Jiaojiao Li
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dong Cheng District, Beijing, 100730, China
| | - Shan Jiang
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dong Cheng District, Beijing, 100730, China
| | - Xiaohong Sun
- Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dong Cheng District, Beijing, 100730, China.
| | - Xia Huang
- The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College, 301 Dashi Road, Nanan District, Chongqing, 400060, China
| | - Xueying Wang
- Yanyuan Rehabilitation Hospital, No. 2, Jingrong street, Nanshao Town, Changping District, Beijing, 102200, China
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Tang WH, Yu TH, Lee HL, Lee YJ. Interactive effects of intrinsic capacity and obesity on the KDIGO chronic kidney disease risk classification in older patients with type 2 diabetes mellitus. Diabetol Metab Syndr 2023; 15:1. [PMID: 36588165 PMCID: PMC9806894 DOI: 10.1186/s13098-022-00975-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Intrinsic capacity (IC) is a novel concept focusing on normal and healthy aging. The effect of IC on the risk of chronic kidney disease (CKD) according to KDIGO category in older type 2 diabetes mellitus (T2DM) patients has rarely been studied. We investigated whether a decline in IC is associated with the risk of CKD according to KDIGO 2012 categories. METHODS This is a cross-sectional study. The exposure variables (IC score and body mass index) and outcome variable (KDIGO categories of the risk of CKD) were collected at the same timepoint. A total of 2482 older subjects with T2DM managed through a disease care program were enrolled. The five domains of IC, namely locomotion, cognition, vitality, sensory, and psychological capacity were assessed. Based on these domains, the IC composite score was calculated. CKD risk was classified according to the KDIGO 2012 CKD definition. Univariate and multivariate analyses were used to assess the association between IC score and KDIGO categories of risk of CKD. RESULTS The KDIGO CKD risk category increased in parallel with IC score (p for trend < 0.0001). In multivariate analysis, compared to those with an IC score 0, the odds ratio of having a KDIGO moderately increased to very high risk category of CKD was 1.76 (1.31-2.37) times higher for those with an IC score of 2-5. Furthermore, an increased IC score was associated with a higher prevalence of moderate and severe obesity. Moreover, there was a synergistic interaction between IC score and obesity on the KDIGO moderately increased to very high risk category of CKD (synergy index = 1.683; 95% CI 0.630-3.628), and the proportion of the KDIGO moderately increased to very high risk category of CKD caused by this interaction was 25.6% (attributable proportion of interaction = 0.256). CONCLUSIONS Our findings indicate that IC score may be closely related to the KDIGO moderately increased to very high risk category of CKD. In addition, there may be a synergistic interaction between IC score and obesity, and this synergistic interaction may increase the KDIGO CKD risk stage.
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Affiliation(s)
- Wei-Hua Tang
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Yuli Branch, Hualien, 98142 Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112304 Taiwan
| | - Teng-Hung Yu
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, 82445 Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan
| | - Hui-Lan Lee
- Health Promotion Administration, Ministry of Health and Welfare, Taipei, 10320 Taiwan
| | - Yau-Jiunn Lee
- Lee’s Endocrinologic Clinic, No. 130 Min-Tzu Rd, Pingtung, 90000 Taiwan
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Zhang S, Peng LN, Otsuka R, Liang CK, Nishita Y, Arai H, Chen LK. Comparative Analysis of Intrinsic Capacity Impairments, Determinants, and Clinical Consequences in Older Community-Dwellers in Japan and Taiwan: Longitudinal Studies Showing Shared Traits and Distinct Presentations. J Nutr Health Aging 2023; 27:1038-1046. [PMID: 37997726 DOI: 10.1007/s12603-023-2020-z] [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: 08/13/2023] [Accepted: 10/19/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES Despite the recognized impact of intrinsic capacity (IC) impairment on healthy aging, international comparisons in different sociocultural contexts are scarce. This study aimed to compare IC impairment among community-dwelling older adults in Japan and Taiwan to explore the context of healthy aging in different countries. DESIGN Comparative observational study. SETTING National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA) in Japan and Longitudinal Aging Study of Taipei (LAST) in Taiwan. PARTICIPANTS 794 individuals (age range, 60.0-86.5 years) from NILS-LSA and 1,358 (60.0-96.7 years) from LAST. MEASUREMENTS IC impairment was evaluated across the domains of locomotion, cognition, vitality, sensory capacity, and psychological well-being. Participants were categorized as having impaired IC or healthy. We investigated associations between IC impairment, falls, and all-cause mortality. RESULTS IC impairment was present in 54.9% and 37.3% of participants in the NILS-LSA and LAST cohorts, respectively. Male NILS-LSA participants with impaired IC (odds ratio [OR]:1.50, 95% confidence interval [CI]:1.03-2.20), with hearing loss (OR:1.98, 95% CI:1.00-3.90) were more likely to fall. In LAST, impaired locomotion (OR:2.14, 95% CI:1.46-3.14) increased the risk of falls. Men with impaired IC (hazard ratio [HR]; 2.14, 95% CI:1.10-4.15) and visual impairment (HR:2.21, 95% CI:1.15-4.25) and women with impaired psychological well-being (HR:4.94, 95% CI:1.28-18.97) in the NILS-LSA cohort had greater risk for all-cause mortality; however, this was not shown for LAST participants. CONCLUSION The prevalence and distribution of IC impairment and associated biomarkers differed significantly between participants in Japan and Taiwan. However, the associations with adverse outcomes remained similar, emphasizing the need for tailored interventions for healthy aging.
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Affiliation(s)
- S Zhang
- Liang-Kung Chen, MD, PhD, Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec 2, Shih-Pai Road, Taipei, Taiwan 11217, , Tel: +886-2-28757830, Fax: +886-2-28757711
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Leung AYM, Zhao IY, Lin S, Lau TK. Exploring the Presence of Humanoid Social Robots at Home and Capturing Human-Robot Interactions with Older Adults: Experiences from Four Case Studies. Healthcare (Basel) 2022; 11:healthcare11010039. [PMID: 36611499 PMCID: PMC9818881 DOI: 10.3390/healthcare11010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Social robots have the potential to bring benefits to aged care. However, it is uncertain whether placing these robots in older people's home is acceptable and whether human-robot interactions would occur or not. METHODS Four case studies were conducted to understand the experiences of older adults and family caregivers when humanoid social robot Ka Ka was placed in homes for two weeks. RESULTS Four older adults and three family caregivers were involved. Older adults interacted with the social robot Ka Ka every day during the study period. 'Talking to Ka Ka', 'listening to music', 'using the calendar reminder', and 'listening to the weather report' were the most commonly used features. Qualitative data reported the strengths of Ka Ka, such as providing emotional support to older adults living alone, diversifying their daily activities, and enhancing family relationships. The voice from Ka Ka (female, soft, and pleasing to the ear) was considered as 'bringing a pleasant feeling' to older adults. CONCLUSIONS In order to support aging-in-place and fill the gaps of the intensified shortage of health and social manpower, it is of prime importance to develop reliable and age-friendly AI-based robotic services that meet the needs and preferences of older adults and caregivers.
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Affiliation(s)
- Angela Y. M. Leung
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Research Institute of Smart Aging (RISA), The Hong Kong Polytechnic University, Hong Kong 999077, China
- Correspondence: ; Tel.: +852-2766-5587
| | - Ivy Y. Zhao
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Research Institute of Smart Aging (RISA), The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Shuanglan Lin
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Terence K. Lau
- WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Research Institute of Smart Aging (RISA), The Hong Kong Polytechnic University, Hong Kong 999077, China
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Wu W, Sun L, Li H, Zhang J, Shen J, Li J, Zhou Q. Approaching person-centered clinical practice: A cluster analysis of older inpatients utilizing the measurements of intrinsic capacity. Front Public Health 2022; 10:1045421. [PMID: 36438281 PMCID: PMC9692078 DOI: 10.3389/fpubh.2022.1045421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Maintaining the intrinsic capacity (IC) of older inpatients is a novel view in providing person-centered treatments in clinical practice. Uncertainty remains regarding the primary nature of IC among older hospitalized patients. Objectives We aimed to understand the status of IC among older inpatients by a cluster analysis based on IC measurements. Methods This is a cross-sectional study conducted in the geriatric department of Beijing Hospital in China. Older inpatients who were older than 60 years and who underwent comprehensive geriatric assessments were included. The inpatients were classified into subgroups based on 13 measurements of IC according to unsupervised methods (K-means cluster analysis and t-SNE). Subgroup differences were investigated for domains of IC, age, sex, frailty, activities of daily living, and falls. Results A total of 909 inpatients with a mean age of 76.6 years were included. Almost 98% of the inpatients showed IC impairment. Locomotion impairment was the most prevalent problem (91.1%), followed by sensory impairment (61.4%), psychological impairment (57.3%), cognition decline (30.7%), and vitality problem (29.2%). A total of five clusters were obtained by classification: Cluster 1 (56.6% of the participants) showed high IC with fair impairment of locomotion and vision; clusters 2 and 3 (37.8 % of the participants) had additional impairment of sleep in the psychological domain; clusters 4 and 5 (5.6% of the participants) represented a severe loss of all the IC domains; and clusters 1-5 showed a gradual decline in the IC score and were significantly associated with increased age, frailty, decreased activities of daily living, and falls. Significant correlations among the domains were observed; the locomotion domain showed the strongest links to the others in network analysis. Conclusions Great declines in IC and disparities between IC domains were found in older inpatients. IC-based primary assessment and classification enabled us to identify the variation of functional abilities among the older inpatients, which is pivotal for designing integrated treatment or care models in clinical practice.
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Affiliation(s)
- Wenbin Wu
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China,*Correspondence: Wenbin Wu
| | - Liang Sun
- The Key Laboratory of Geriatrics, National Center of Gerontology of National Health Commission, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hong Li
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jie Zhang
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Ji Shen
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Li
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Qi Zhou
- The Key Laboratory of Geriatrics, National Center of Gerontology of National Health Commission, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
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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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