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

Meng, Lin-Chieh; Hsiao, Fei‐Yuan; Huang, Sheng‐Teng; Lu, Wan‐Hsuan; Peng, Li‐Ning; Chen, L.-K.

doi:10.1007/s12603-022-1847-z

Cited by 30 publications

(11 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results are congruent with previous studies which applied the latent class model to IC [ 21 , 22 ]. For example, Yu et al.…”

Section: Discussionsupporting

confidence: 93%

“…Multidomain interventions could be designed and planned to target the most common patterns. So far, studies have reported clusters of IC domain impairments only cross-sectionally and circumscribed to one country [ 21 , 22 ]. Examination of data from the global north and the global south could expand our knowledge of the natural history of IC impairments in older adults.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Exploring the natural history of intrinsic capacity impairments: longitudinal patterns in the 10/66 study

et al. 2023

View full text Add to dashboard Cite

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.

show abstract

“…Our results are congruent with previous studies which applied the latent class model to IC [ 21 , 22 ]. For example, Yu et al.…”

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Exploring the natural history of intrinsic capacity impairments: longitudinal patterns in the 10/66 study

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Studies that used the Step 1 screen as designed reported lower prevalence rates of cognitive loss (e.g. 20.3% in Taiwan, 37 24.3% in Hong Kong 38 and 31% in Spain 39 ) compared with studies that estimated cognitive loss based on the Step 1 screen derived from MMSE (e.g. 52.2% in France 40 ).…”

Section: Discussionmentioning

confidence: 98%

Intrinsic capacity assessment using World Health Organization Integrated Care for Older People Step 1, and the association with frailty in community dwelling older adults

Zhou,

Ng,

Tay

et al. 2024

Geriatrics Gerontology Int

View full text Add to dashboard Cite

AimThis 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.MethodsThis 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.ResultsThis 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).ConclusionsIC 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; ••: ••–••.

show abstract

“…Although these domains may signify distinct aetiologies either individually or compositely, their clustering also uncovers common pathophysiological pathways underlying the decline of IC in the ageing process. A recent cross-sectional study employing latent class analysis identified diverse patterns of IC impairments, characterized by distinct clinical features and negative outcomes within subtypes [7]. The study additionally revealed a strong correlation between impairments in locomotion and cognitive domains, supporting the existence of a physio-cognitive decline syndrome (PCDS) phenotype within the ageing process, wherein older adults without disability and dementia experience concurrent impairments in physical and cognitive function [8].…”

mentioning

confidence: 85%

Multi-Trajectories of Intrinsic Capacity Decline and Their Impact on Age-Related Outcomes: A 20-Year National Longitudinal Cohort Study

2023

Aging dis

View full text Add to dashboard Cite

The existence of intrinsic capacity (IC) subtypes and their distinct impacts on age-related outcomes remain unexplored. This study sought to investigate IC impairment trajectories across domains and their associations with the risk of age-related outcomes, including falls, functional limitations, reduced quality of life (QoL) and mortality at 4-and 8-year follow-ups. The study sample comprised 1,782 older adults residing in the community from the Taiwan Longitudinal Study on Ageing (TLSA). Utilizing group-based multitrajectory modeling, distinct subtypes of IC decline trajectories across various domains were identified. Cox proportional hazard models and multivariable logistic regression analyses were employed to assess the associations between the identified subtypes and age-related outcomes. We identified four subtypes of IC decline: robust with mild decline (n=902), hearing loss with cognitive decline (n=197), physio-cognitive decline (PCD) with depression (n=373), and severe IC decline (n=310). Over the 4-year study period, compared to the robust with mild decline group, hearing loss with cognitive decline group exhibited a significantly higher risk of diminished QoL (OR=2.53 [1.66-3.86], p<0.01), whereas those in the PCD with depression group experienced an elevated risk of falls (OR=1.62 [1.18-2.23], p<0.01), as well as functional limitation (OR=2.61 [1.81-3.75], p<.01). Individuals in the severe IC decline group faced a substantially increased risk of all outcomes of interest. Distinct subtypes of IC decline across different domains have varying impacts on age-related outcomes, highlighting the need for a personalized approach to promote healthy ageing at the population level, while further investigation into specific pathophysiological mechanisms is warranted as well.

show abstract

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

Cited by 30 publications

References 48 publications

Exploring the natural history of intrinsic capacity impairments: longitudinal patterns in the 10/66 study

Exploring the natural history of intrinsic capacity impairments: longitudinal patterns in the 10/66 study

Intrinsic capacity assessment using World Health Organization Integrated Care for Older People Step 1, and the association with frailty in community dwelling older adults

Multi-Trajectories of Intrinsic Capacity Decline and Their Impact on Age-Related Outcomes: A 20-Year National Longitudinal Cohort Study

Contact Info

Product

Resources

About