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Zhou Y, Wang G, Li J, Liu P, Pan Y, Li Y, Ma L. Trajectory of intrinsic capacity among community-dwelling older adults in China: The China health and retirement longitudinal study. Arch Gerontol Geriatr 2024; 124:105452. [PMID: 38728820 DOI: 10.1016/j.archger.2024.105452] [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: 02/20/2024] [Revised: 04/07/2024] [Accepted: 04/19/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUNDS Intrinsic capacity (IC), the sum of individual mental and physical capabilities, as well as living environment and behavior, jointly determine the functional ability of older adults, shifting the focus from disease to function. At the population level, IC in older adults is associated with adverse health outcomes, such as disability, falls, and death. At the individual level, IC changes dynamically. However, studies on the longitudinal IC trajectory and the factors influencing IC deterioration are limited. We aimed to analyze the IC trajectory and explore the risk factors for IC deterioration in Chinese older adults. METHODS Data were obtained from the baseline (2011-2012) and 4-year follow-up (2015) CHARLS surveys, including 1906 people aged 60 years and older. IC comprises six dimensions: locomotion, vitality, hearing, vision, cognition, and psychology. IC trajectory was categorized into three groups: improved, maintained, and deteriorated. Logistic regression analysis was used to analyze factors influencing the trajectory of IC deterioration. RESULTS After 4 years, 32.1 % had deteriorated, 38.5 % remained stable, and 29.4 % had improved. Age, low level of education, widowed were independently associated with IC deterioration. CONCLUSIONS Dynamic IC monitoring supports the development of individualized intervention policies to delay or prevent IC deterioration.
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Affiliation(s)
- Yaru Zhou
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, PR China
| | - Guanzhen Wang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, PR China
| | - Jiatong Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, PR China
| | - Pan Liu
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, PR China
| | - Yiming Pan
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, PR China
| | - Yun Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, PR China
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, PR China.
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Zhao Y, Jiang Y, Tang P, Wang X, Guo Y, Tang L. Adverse health effects of declined intrinsic capacity in middle-aged and older adults: a systematic review and meta-analysis. Age Ageing 2024; 53:afae162. [PMID: 39058916 DOI: 10.1093/ageing/afae162] [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: 02/03/2024] [Revised: 04/25/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Intrinsic capacity refers to a broad range of health traits, including the physiological and psychological changes brought on by aging. Previous research has shown that intrinsic capacity, as an independent emerging construct, is a highly effective predictor of several health outcomes. OBJECTIVE We aimed to summarise the predictive effect of intrinsic capacity at baseline on health outcomes among middle-aged and older adults. DESIGN A systematic review and meta-analysis. PARTICIPANTS Middle-aged and older adults. METHODS We systematically searched up to 3 April 2024 in 10 electronic databases. Studies investigating the predictive effect of baseline composite intrinsic capacity and health outcomes were included. Publications that had reported hazard ratios (HRs) or odd ratios (ORs) and 95% confidence intervals (CIs) as effect size were considered. RESULTS A total of 23 publications were included. The sample size ranged from 100 to 17 031. The results of the meta-analysis showed statistically significant prediction of adverse health outcomes such as disability (OR = 1.84, 95% CI: 1.68-2.03, I2 = 41%, Pheterogeneity=.10), falls (OR = 1.38, 95% CI: 1.19-1.60, I2 = 45%, Pheterogeneity=.11), hospitalisation (OR = 2.25, 95% CI: 1.17-4.3, I2 = 68%, Pheterogeneity=.08), mortality (OR = 1.72, 95% CI: 1.54-1.91, I2 = 32%, Pheterogeneity=.12) and frailty (OR = 1.57, 95% CI: 1.45-1.70, I2 = 2%, Pheterogeneity=.31) by the baseline composite intrinsic capacity. CONCLUSIONS Declined intrinsic capacity has potential predictive value for adverse health outcomes, further high-quality study is needed to validate these findings and strengthen their cumulative impact. Attention to health outcomes should also focus on both breadth and category precision.
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Affiliation(s)
- Yuan Zhao
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Yueying Jiang
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Panpan Tang
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Xueqing Wang
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Yunyu Guo
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Leiwen Tang
- Department of Nursing, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
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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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Dashner J, Espín-Tello SM, Chen SW, Hollingsworth H, Bollinger R, Morgan KA, Stark S. Influence of falls, fall-related injuries, and fear of falling on social participation in people aging with long-term physical disability: a cross-sectional study. Disabil Rehabil 2023:1-9. [PMID: 38108275 DOI: 10.1080/09638288.2023.2293990] [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: 04/12/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE This study examined prevalence and relationships among falls, injuries, fear of falling, and social participation in people aging with long-term physical disability (PAwLTPD). MATERIALS AND METHODS A convenience sample of 474 PAwLTPD recruited from community agencies and social media as baseline of a longitudinal cohort study. Inclusion criteria: 45-65 years, self-reported physical disability for ≥5 years, and English-speaking. Self-report surveys of physical/mental health, falls in the past year, fear of falling, and Patient-Reported Outcomes Measurement Information System (PROMIS) ability and satisfaction with participation in social roles and activities measures were collected. RESULTS Mean age 56.8 years; participants were mostly female (66.7%) and White (61.4%). Nearly 65% reported a fall; 56.6% of falls resulted in injury. Falls and fall-related injuries were associated with worse physical/mental health and presence of >5 health conditions. Seventy-five percent of participants reported fear of falling. Lower ability and satisfaction with participation were found in participants who fell and worried about falls. CONCLUSIONS PAwLTPD are at increased risk of falls, fall-related injuries, and fear of falling, which affects their ability to engage in social activities. Future research is needed to understand circumstances associated with falls and to develop effective interventions to address falls in PAwLTPD.
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Affiliation(s)
- Jessica Dashner
- Program in Occupational Therapy, WA University School of Medicine in St. Louis, St. Louis, USA
| | - Sandra M Espín-Tello
- Instituto de Investigación Sanitaria Aragón, Universidad de Zaragoza, Zaragoza, Spain
| | - Szu-Wei Chen
- Program in Occupational Therapy, WA University School of Medicine in St. Louis, St. Louis, USA
| | - Holly Hollingsworth
- Program in Occupational Therapy, WA University School of Medicine in St. Louis, St. Louis, USA
| | - Rebecca Bollinger
- Program in Occupational Therapy, WA University School of Medicine in St. Louis, St. Louis, USA
| | - Kerri A Morgan
- Program in Occupational Therapy, WA University School of Medicine in St. Louis, St. Louis, USA
| | - Susan Stark
- Program in Occupational Therapy, WA University School of Medicine in St. Louis, St. Louis, USA
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Shen S, Xie Y, Zeng X, Chen L, Guan H, Yang Y, Wu X, Chen X. Associations of intrinsic capacity, fall risk and frailty in old inpatients. Front Public Health 2023; 11:1177812. [PMID: 37886051 PMCID: PMC10598390 DOI: 10.3389/fpubh.2023.1177812] [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: 03/02/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction This study explored the associations of intrinsic capacity (IC), fall risk, and frailty in geriatric inpatients. Methods A total of 703 hospitalized patients aged 75 years or older were recruited for this retrospective observational study from Zhejiang Hospital using a comprehensive geriatric assessment. The IC composite score was constructed from the scores of the Chinese version of the Mini-Mental State Examination, Short Physical Performance Battery, Short Form Mini Nutritional Assessment, 15-item Geriatric Depression Scale, and self-reported hearing and vision impairment. Adverse outcomes were recorded as the fall risk and frailty using the Morse Fall Scale and the Clinical Frailty Scale. Spearman's correlation coefficient analyses and multivariate logistic regression models were used to explore the associations between IC, high fall risk, and frailty. Results Declined IC composite scores were associated with increased risks of falls [odds ratio (OR) = 0.64, 95% confidence interval (CI): 0.57-0.72] and frailty (OR = 0.45, 95%CI: 0.37-0.54) among older hospitalized patients after adjusting for the related potential confounders. In addition, decreased cognitive, vitality, locomotion, and psychological scores were associated with increased adverse health conditions, with ORs ranging from 0.26 to 0.70. Vision impairment was observed to increase the risk of frailty (OR = 0.42, 95%CI: 0.23-0.76) after adjusting for the related potential confounders. Discussion This study indicated that declined IC was associated with fall risk and frailty in older inpatients. Further prospective studies are needed to explore the longitudinal associations between baseline IC and subsequent risk of falls and frailty.
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Affiliation(s)
- Shanshan Shen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Yanhong Xie
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Xingkun Zeng
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Lingyan Chen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Huilan Guan
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Yinghong Yang
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Xiushao Wu
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
| | - Xujiao Chen
- Department of Geriatrics, Zhejiang Hospital, Hangzhou, China
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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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