Defining and assessing intrinsic capacity in older people: A systematic review and a proposed scoring system

López-Ortiz, Susana; Lista, Simone; Peñín-Grandes, Saúl; Pinto-Fraga, José; Nisticò, Robert; Emanuele, Enzo; Lucı́a, Alejandro; Santos‐Lozano, Alejandro

doi:10.1016/j.arr.2022.101640

Cited by 57 publications

(33 citation statements)

References 87 publications

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“…The concept of IC, defined by the WHO to promote healthy aging, greatly contributes to clinical practice; however, it has been largely underutilized to date (8). Primary studies on IC were usually performed in the community, while the level of IC maintained by the older inpatients or outpatients is scarcely known.…”

Section: Introductionmentioning

confidence: 99%

“…Consensus on how to assess the different dimensions of IC has not been reached yet; also, the relationship between the domains of IC is not clear (8,13), which is important because it affects how we understand and use IC in clinical practice. A total of three modes were commonly used to quantify IC: a sum of z-scores of each domain divided by the number of domains or a summed total score (3,13), a single use of each domain (14), and a cluster analysis (6).…”

Section: Introductionmentioning

confidence: 99%

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Approaching person-centered clinical practice: A cluster analysis of older inpatients utilizing the measurements of intrinsic capacity

Sun

et al. 2022

Front. Public Health

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BackgroundMaintaining 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.ObjectivesWe aimed to understand the status of IC among older inpatients by a cluster analysis based on IC measurements.MethodsThis 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.ResultsA 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.ConclusionsGreat 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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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Approaching person-centered clinical practice: A cluster analysis of older inpatients utilizing the measurements of intrinsic capacity

Sun

et al. 2022

Front. Public Health

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“…Therefore, our study should be deemed as hypothesis generating—rather than hypothesis—testing. Consequently, IC operationalisation was constrained by data availability and might have slightly deviated from currently available proposed approaches [ 76 ]. Especially remarkable is the inability to include the sensory domain in the composite IC score, due to the categorical nature of the available data in this domain in the present study.…”

Section: Discussionmentioning

confidence: 99%

Effects of a 12-week Vivifrail exercise program on intrinsic capacity among frail cognitively impaired community-dwelling older adults: secondary analysis of a multicentre randomised clinical trial

et al. 2022

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

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“…There is agreement that intrinsic capacity has multiple dimensions—including locomotion, vitality, sensory, cognition, and psychological domains. However, the methods for assessing each of these five dimensions presently differ across studies ( 51 ).…”

Section: Nutrition Matters Across the Lifespanmentioning

confidence: 99%

Good nutrition across the lifespan is foundational for healthy aging and sustainable development

et al. 2023

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Ensuring healthy lives and promoting wellbeing across the age spectrum are essential to sustainable development. Nutrition is at the heart of the World Health Organization (WHO) Sustainable Development Goals, particularly for Sustainable Development Goal 2/Subgoal 2, which is to End all forms of malnutrition by 2030. This subgoal addresses people of all ages, including targeted groups like young children and older adults. In recent decades, there have been marked advances in the tools and methods used to screen for risk of malnutrition and to conduct nutritional assessments. There have also been innovations in nutritional interventions and outcome measures related to malnutrition. What has been less common is research on how nutritional interventions can impact healthy aging. Our Perspective article thus takes a life-course approach to consider what is needed to address risk of malnutrition and why, and to examine how good nutrition across the lifespan can contribute to healthy aging. We discuss broad-ranging yet interdependent ways to improve nutritional status worldwide—development of nutritional programs and policies, incorporation of the best nutrition-care tools and methods into practice, provision of professional training for quality nutritional care, and monitoring health and economic benefits of such changes. Taken together, our Perspective aims to (i) identify current challenges to meeting these ideals of nutritional care, and to (ii) discover enabling strategies for the improvement of nutrition care across the lifespan. In harmony with the WHO goal of sustainable development, we underscore roles of nutrition to foster healthy human development and healthy aging worldwide.

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Defining and assessing intrinsic capacity in older people: A systematic review and a proposed scoring system

Cited by 57 publications

References 87 publications

Approaching person-centered clinical practice: A cluster analysis of older inpatients utilizing the measurements of intrinsic capacity

Approaching person-centered clinical practice: A cluster analysis of older inpatients utilizing the measurements of intrinsic capacity

Effects of a 12-week Vivifrail exercise program on intrinsic capacity among frail cognitively impaired community-dwelling older adults: secondary analysis of a multicentre randomised clinical trial

Good nutrition across the lifespan is foundational for healthy aging and sustainable development

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