Integrated care for older people improved intrinsic capacity in elderly patients: a case control study.

OBJECTIVES: Observe the effect of integrated care for older people on intrinsic capacity in elderly patients. METHODS: Sixty elderly patients from department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between June 2021 and December 2021 were selected and divided into control group and intervention group with 30 patients in each group using random sampling method. Two groups implement routine care, and the intervention group implement integrated care by a "hospital-community-family" multidisciplinary team. After 12 weeks of intervention, the differences in frailty, cognition, depression scores, comprehension social support scores, and World Quality of Life Scale scores were compared between the two groups. RESULTS: Before intervention, there was no significant difference in the grip strength, step speed, frailty scores, cognition, depression scores, social support and quality of survival between the control group and the intervention group. After intervention, grip strength and depression scores improved both in the control group and the intervention group, but there was no difference between the two groups. Cognitive scores, comprehension social support and quality of survival scores improved only in the intervention group, while only the cognitive ability showed significant differences between the intervention group and the control group after 12 weeks of intervention (P<0.05). CONCLUSIONS: Integrated care for older people intervention can help to improve the intrinsic capacity of the patients, especially cognitive abilities.

Correlation Between Intrinsic Capacity and Muscle Strength and Quality in Older Patients with Cardiovascular Disease: A Cross-Sectional Study.

Background: Cardiovascular disease (CVD) has become the leading cause of death worldwide. High muscle mass can reduce the incidence and mortality of CVD. In recent years, increasing attention has been given to the relationship between intrinsic capacity (IC) and CVD. This study aims to explore the relationship between the decline of IC, muscle strength, and muscle quality in older patients with CVD, providing a new method and basis for early recognition of IC decline in the older adults. Methods: This cross-sectional study included 475 older individuals from communities in Zhejiang. General data were collected, and a comprehensive geriatric assessment (CGA) was conducted. Participants with CVD were divided into three groups: IC retention, IC impairment, and IC significantly impaired. Bioelectrical impedance analysis (BIA) measurements were completed. Student's t-test or non-parametric tests (Mann-Whitney) were used to analyze the correlation between IC and muscle-related indicators. The best cutoff values were obtained using ROC curve analysis. Results: Compared to non-CVD patients, CVD patients were older, more educated, and had higher rates of polypharmacy and comorbidity. IC decreased more significantly in CVD patients. Age (P=0.001), Fried (P=0.024), and GDS-5 (P=0.002) increased with the severity of IC decline. ADL (P=0.002), MMSE (P=0.000), MNA-SF (P=0.000), SARC-Calf (P=0.026), waist circumference (P=0.037), and muscle quality (P=0.010) decreased with the decline in IC. When IC decreased, the cutoff values for hand grip strength, waist circumference, and muscle quality were 25.45 kg, 72.55 cm, and 3.05, respectively. When IC decreased significantly, the cutoff values were 17.15 kg, 71.55 cm, and 2.28, respectively. Conclusion: The results of this study showed that in patients with CVD, the hand grip strength and muscle quality of patients with IC injury were lower than those of patients with IC retention.

Cohort comparison of vision and hearing in 75- and 80-year-old men and women born 28 years apart.

PURPOSE: We compared the vision and hearing of older men and women born 28 years apart. In addition, we explored factors explaining the possible cohort differences. METHODS: Two independent cohorts of 75- and 80-year-old men and women were assessed as a part of the Evergreen study in 1989-1990 (n = 500) and the Evergreen II study in 2017-2018 (n = 726). Studies were conducted with similar protocols, and differences between cohorts were compared for distance visual acuity and hearing acuity. We also studied whether educational level and health factors (i.e. total cholesterol, blood pressure, BMI, and smoking status) underlie the possible cohort differences. Independent samples t-test, Pearson chi-squared test, and linear regression analyses were used as statistical analyses. RESULTS: Across age and sex groups, the later-born cohort had better visual acuity and a lower prevalence of visual impairment compared to the earlier-born cohort. In hearing, 75-year-old men in the later-born cohort had better hearing acuity, with average hearing level at 32 dB compared to 36 dB in the earlier-born cohort, and 80-year-old men had a lower prevalence of moderate or worse hearing loss (74 % vs. 54 %) than men in the earlier-born cohort. Similar differences were not observed for women. The cohort differences in distance visual acuity and hearing acuity attenuated when adjusting for education level. CONCLUSIONS: Today older adults retain better vision longer than before, but cohort differences in hearing are less obvious. Differences between cohorts may be partly due to advances in education.

Effectiveness of Integrated Care for Older Pepole (ICOPE) in Improving Intrinsic Capacity in Older Adults: A Systematic Review and Meta-Analysis.

OBJECTIVE: Conduct a systematic review of existing studies on intrinsic capacity (IC) and a meta-analysis of studies to assess the overall effectiveness of ICOPE in improving IC in older adults. METHODS: Ten databases were systematically searched from inception to November 8, 2023, and the search was last updated on January 2, 2024. Randomised controlled trials (RCTs) were included. The main outcomes were IC (cognition, psychological, sensory, vitality and locomotion). RESULTS: The results showed ICOPE had a significant effect in improving cognitive function (SMD = 0.36; 95% CI, 0.17 to 0.56, p < 0.001, 12 RCTs, 7926 participants) and depressive symptoms (SMD = -0.70; 95% CI, -0.96 to -0.43, p < 0.001, 26 RCTs, 11,034 participants), but there was no statistically significant difference in improving locomotion (SMD = 0.16; 95% CI, -0.03 to 0.34, p = 0.098, 3 RCTs, 1580 participants). Meta-regression analysis shows that intervention duration should be paid attention to when the source of heterogeneity is discussed on the cognition. CONCLUSION: The results suggest that ICOPE may be a potentially effective approach to help improve the IC in older adults, showing significant potential for improving cognitive function and reducing depressive symptoms in particular. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: ICOPE is expected to provide effective strategies to enhance issues such as IC and may be an innovative way to improve the overall health of older adults. This result provides strong support for geriatric nursing practice and encourages the adoption of ICOPE as a viable nursing approach to promote healthy ageing.

Application of the Medical Research Council guidance for complex interventions in the development of VIeSA, an intervention to support healthy ageing among community-dwelling older adults.

BACKGROUND: The ageing population, coupled with the desire to age-in-place, highlight the need for programs that target health promotion as a means of maintaining functional ability, autonomy, and independence among community-dwelling older adults. This paper describes the development of the VIeSA intervention, which aimed to model a healthy ageing trajectory, including the identification of the necessary tools and methods, that would allow people older people, in partnership with health and social care professionals, to define personal health-related goals and the actions to achieve them. A key element of the intervention development was the creation of a support tool intended to assist this process. METHODS: The UK Medical Research Council (MRC) guidance on developing and evaluating complex interventions was applied in the development of the intervention and of the support tool. A participatory approach was selected, with stakeholders engaged on different occasions to allow the refinement of the intervention and of the support tool. Following the steps and suggested actions in the MRC development phase, the development process was conducted by identifying (1) the evidence base and (2) the theoretical framework and (3) by modelling the process and outcomes of the intervention. RESULTS: Following a literature review on effective interventions for functional ability, draft 1 of the support tool was designed. Focus groups with stakeholders provided feedback on this draft allowing for its refinement in terms of content, language use, and structure (draft 2). A review of the approaches for health promotion delivery led to further additions to the tool (draft 3) and informed the content of the training of health and social care professionals. After their training, professionals provided feedback on the acceptability, appropriateness, and feasibility of different elements of the intervention. Results suggested that no further major refinement to the intervention or support tool was necessary. CONCLUSIONS: The design and development of the VIeSA intervention using the MRC guidance allowed for a clarity of direction, an optimised content in terms of usefulness and accessibility for all concerned stakeholders, and greater opportunities for its implementation and uptake.

Association Between Intrinsic Capacity and Hospital Admission Among Older Adults in the Emergency Department.

This prospective cohort study assessed the impact of intrinsic capacity on hospital admissions among older adults after an Emergency Department (ED) visit. Assessing 1132 patients according to WHO's Integrated Care for Older People guidelines between March 1 and August 30, 2022, we found that 784 (69.26%) were admitted. The admission group demonstrated significantly lower intrinsic capacity scores (mean ± SD, 2.92 ± 1.29) compared to the discharge group (3.44 ± 1.23; p < .001). Multivariable logistic regression showed that higher intrinsic capacity scores were associated with lower odds of admission (adjusted odds ratio [aOR] = 0.81; 95% CI: 0.71-0.92; p < .001). Notably, patients with malnutrition had significantly higher odds of admission (OR = 3.12; 95% CI: 2.16-4.50; p < .001). These findings underscore the importance of integrating the intrinsic capacity assessment with traditional clinical indicators in the emergency care of older adults.

Development and validation of a functional ability index for older adults: a multicohort study.

BACKGROUND: The aim of this study was to develop and validate a functional ability index (FAI) that incorporates aspects of intrinsic capacity and environmental factors of older individuals based on the World Health Organization framework of healthy ageing. METHODS: Data of 7016 participants ≥60 years participating in the baseline survey of China Health and Retirement Longitudinal Study was used for the development and internal validation of the FAI. External validation was performed in a separate cohort of 1295 older individuals aged ≥60 years. Functional independency was considered the primary outcome and additional proxies of healthy ageing were considered as secondary outcomes. Cluster dendrogram was used to identify the distinct hierarchical clusters of all included variables for inclusion in the FAI. Backward elimination logistic regression model was implemented to identify the most significant variables associated with independency to be included in the FAI. RESULTS: The FAI score ranged from 0 to 19 and individuals having FAI ≥ 12 were more likely to be independent and at lower risk of negative outcomes. For each unit increase in the FAI the risk of having independency increased by 30%-58% cross-sectionally in the two cohorts, whilst the 2-year risk of independency increased by 20%. The FAI demonstrated a C-statistic of 0.73 (95% confidence interval, 0.72 and 0.75) for the primary outcome. CONCLUSIONS: The FAI we developed effectively measured the functional ability status of community dwelling older individuals. FAI could serve as a tool for evaluating older individual's functional ability in routine health assessment.

The development of intrinsic capacity measures for longitudinal research: The Longitudinal Aging Study Amsterdam.

BACKGROUND: The World Health Organization has introduced the construct of intrinsic capacity (IC) as an important component of healthy ageing and overall well-being in older adults The present study aimed to develop domain-specific and composite IC scores and to validate these scores by examining their longitudinal relation with functioning. METHODS: We used prospective data on participants aged 57 to over 90 years, with a 10-year follow-up, from the Longitudinal Aging Study Amsterdam, an ongoing cohort study of older Dutch men and women Using a formative, stepwise approach, we identified indicators across the different domains of IC, i.e. vitality, sensory, cognition, psychology, and locomotion, using a combination of unidimensional factor analyses and Partial Least Squares Structural Equation Modelling (PLS-SEM). Next, domain-specific and composite IC scores were generated, and the construct validity (score across age groups) and criterion validity (relationship with change in functional limitations) were assessed. RESULTS: The multiple unidimensional factor analyses and PLS-SEM identified a total of 18 indicators, covering the five domains of IC. The mean composite IC score was 70.9 (SD = 0.9) in men and 69.7 (0.8) in women. The domain-specific and composite IC scores all showed good construct validity, with known-group validation results indicating age-related declines. A higher composite IC score was associated with less functional limitations over time (B = 0.20, 95%CI [0.19, 0.22]). CONCLUSION: The developed domain-specific IC scores and the composite IC score effectively discriminated age-related declines in IC. Additionally, the composite IC score was longitudinally associated with functional limitations. By creating this comprehensive and reliable tool for tracking IC, we aim to provide valuable insights into the dynamics of ageing and support more effective strategies for promoting health and well-being throughout later life. These scores establish a foundation for future research to track longitudinal changes across various IC domains and relate these changes to key age-related outcomes.

Handgrip strength: A simple and effective tool to recognize decreased intrinsic capacity in Chinese older adults.

OBJECTIVES: Intrinsic capacity impairment results in poor outcomes among older adults. Here we tested handgrip strength as a screening tool for IC impairment in community-dwelling older adults in Xinjiang, China. We assessed the diagnostic accuracy and established optimal cut-off points for handgrip strength in the detection of intrinsic capacity impairment. METHODS: In total, 1072 participants were included using a multilevel random sampling method. Intrinsic capacity was constructed according to the definition of the Integrated Care for Older People screening tool proposed by the WHO. RESULTS: Altogether, 73.4 % (787/1072) participants had intrinsic capacity impairment. The prevalence of intrinsic capacity impairment for hearing, vision, mobility, cognition, psychological, and vitality domains was 8.6 %, 4.8 %, 39.6 %, 47.3 %, 12.0 %, and 18.8 %, respectively. The adjusted odds ratios [95 % confidence interval) for handgrip strength was 0.935 [0.914-0.956]. The area under the curve of the receiver operating characteristic curve for handgrip strength of older men, and handgrip strength of older women with intrinsic capacity impairment were 0.7278, and 0.7534, respectively. The handgrip strength cut-off points were 28.47 kg (60-69 years), 25.76 kg (70-79 years), and 24.45 kg (≥80 years) for men, and 20.75 kg (60-69 years), 19.90 kg (70-79 years), and 16.17 kg (≥80 years) for women. CONCLUSIONS: Handgrip strength can be used as a convenient tool for evaluating intrinsic capacity. Weak handgrip strength and low education level were associated with intrinsic capacity impairment in community-dwelling older adults in Xinjiang. Using the cut-off points of handgrip strength for different age groups and genders, older adults with impaired intrinsic capacity can be identified, which may reduce the occurrence of adverse outcomes.

Intrinsic capacity transitions predict overall and cause-specific mortality, incident disability, and healthcare utilization.

OBJECTIVES: To develop an intrinsic capacity (IC) score and to investigate the association between IC transition with overall and cause-specific mortality, incident disability and healthcare utilization. DESIGN: Retrospective cohort study SETTING AND PARTICIPANTS: Data from 1852 respondents aged ≥ 65 years who completed the 1999 and 2003 surveys of the Taiwan Longitudinal Study on Aging were analyzed. MEASUREMENTS: Transitions of IC score were categorized into three groups: (1) Improved IC (IC2003-1999 >0), (2) Stable IC (IC2003-1999 = 0), (3) Worsened IC (IC2003-1999 <0). Cox regression and subdistribution hazard models were used to investigate IC transitions and 4-year overall and cause-specific mortality, respectively. Logistic regression were employed to develop weighted IC score (wIC, 0-16) and assess its association with incident disability and healthcare utilization. Similar analysis were repeated using non-weighted IC (nIC, 0-8) to ensure robustness. RESULTS: Comparing to decreased wIC group, stable or increased wIC participants had significantly lower 4-year all-cause mortality, and death from infection, cardiometabolic/cerebrovascular diseases, organ failure and other causes. (Hazard ratio (HR) ranged from 0.36 to 0.56, 95% CI ranged from 0.15 to 1.00, p ≤ 0.049 in the stable wIC group; HR ranged from 0.41 to 0.51, 95% CI ranged from 0.22 to 0.94, p ≤ 0.034 in the increased wIC group). Moreover, individuals with stable or increased wIC demonstrated lower risk of incident disability and hospitalization. (Odds ratio (OR) = ranged from 0.34 to 0.70, 95% CI ranged from 0.19 to 1.00, p ≤ 0.048). Participants with stable wIC also exhibited reduced risk of emergency department visits (OR = 0.58, 95% CI = 0.41 to 0.82, p = 0.002). These results were generally consistent in the nIC model. CONCLUSION: Participants with stable or increased IC experienced significantly lower all-cause and most cause-specific mortality, incident disability, and healthcare utilization, which was independent of baseline IC and comorbidities. The findings remained consistent across weighted and non-weighted IC model.

The ability of decline in intrinsic capacity to indicate the risk of mortality in older adults: A meta-analysis.

OBJECTIVE: To evaluate the ability of decline in intrinsic capacity to indicate the risk of mortality in older adults. DESIGN: Meta-analysis. METHODS: PubMed, EMBASE, Web of Science, the Cochrane Library, Wanfang Database, CNKI, VIP, and CBM were searched for relevant studies published from inception to October 31, 2023. Stata17.0 software was used to perform the meta-analysis. A random effects model was used to pool the results of the risk of mortality (as hazard ratios, HRs) in older adults and decline in intrinsic capacity. The Newcastle Ottawa Scale was used to evaluate the quality of studies. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was used to determine the confidence in the estimated effect of pooled outcomes. RESULTS: Twelve studies, with a total of 38,531 participants, were included in this meta-analysis. The findings show that older adults with intrinsic capacity decline have a higher risk of mortality (HR = 1.11, 95 % CI 1.08-1.14, I2 = 95.9 %, P<0.001) than older adults with normal intrinsic capacity. The pooled HR estimates for the locomotion, vitality, and cognitive dimensions of intrinsic capacity in the prediction of mortality were 0.89 (HR = 0.89, 95%CI 0.83-0.96, I2 = 41.3 %, P = 0.146), 0.76 (HR = 0.98, 95 % CI 0.59-0.97, I2 = 60.8 %, P = 0.078), and 0.99 (HR = 0.99, 95 % CI 0.98-1.00, I2 = 0.0 %, P = 0.664), respectively. The pooled HR estimates of the psychological dimension to predict mortality were not statistically significant (P > 0.05). GRADE evaluations of outcome indicators were of moderate confidence. CONCLUSIONS: Decline in intrinsic capacity is a significant predictor of mortality. Locomotion, vitality, and cognition dimensions can all predict mortality. Clinical personnel should early assess the intrinsic capacity of older adults, focusing on changes in the dimensions of locomotion and vitality, to identify the risk of mortality, avoid adverse health outcomes, and improve the quality of life of older adults. Review protocol registered in PROSPERO: CRD42023481246.

Intrinsic capacity loss rates and protective factors among individuals aged 80 years and older in Chinese nursing homes: A latent class analysis.

Prior to this cross-sectional study, the intrinsic capacity (IC) loss rates and protective factors in nursing homes for individuals aged 80 and older remained unexplored. Analysing 434 participants, this study found 86.9 % of individuals experienced the loss of at least one IC domain, with detailed losses in locomotion, vision, vitality, hearing, psychological, and cognitive capacities at rates of 83.2 %, 52.8 %, 50.9 %, 46.5 %, 44.9 %, and 44.0 %, respectively. Following latent class analysis (LCA), five distinct IC impairment patterns were noted, with locomotor impairment emerging as a central component across most classes. IC protective factors for persons aged 80 years and older included financial stability, being male or younger within the cohort, junior high school or higher education, being married, no smoking history, manageable comorbidity levels, minimal medication use, good sleep, and not using assistive devices. Based on these five classes, this study provides a potential practical framework alongside recommendations for IC care strategies in the oldest-old, emphasising the importance of locomotor function in maintaining the overall IC.

The association between Internet use and intrinsic capacity among older adults in China: The mediating role of social participation.

OBJECTIVE: This study aims to explore the relationship between Internet use and intrinsic capability among Chinese older adults, and the potential mediating role of social participation. METHODS: We verified the correlation between Internet use and intrinsic capacity using multiple linear regression and verified the mediating role of social participation using the Sobel and Bootstrap tests. RESULTS: The results of multiple linear regression show that there is a significant positive association between Internet use and intrinsic capacity (B = 0.717, p < .001); and social participation plays a mediating role, explaining a total of 20.5% of the association (indirect effect = 0.147, 95% CI: 0.067-0.227). CONCLUSION: Our findings suggest that Internet use significantly improves intrinsic capacity among Chinese older adults, with social participation playing a mediating role. Increasing Internet adoption rates and promoting social participation may help improve intrinsic capacity among older adults.

Intrinsic capacity transitions as predictors of frailty transitions in community-dwelling older adults: Findings from the Korean Frailty and Aging Cohort Study.

BACKGROUND: Frailty is associated with reduced intrinsic capacity (IC). However, studies evaluating longitudinal transitions between IC and frailty are limited. We conducted longitudinal analyses to investigate the association between intrinsic capacity (IC) and frailty transitions among community-dwelling older adults in Korea. METHODS: A total of 2,345 older adults who completed baseline and two-year follow-up surveys were selected from the Korean Frailty and Aging Cohort Study. IC was measured in five domains: locomotion, vitality, cognition, psychology, and sensory function. Frailty was defined using the Fried frailty phenotype. Transitions in IC and frailty were assessed. Logistic regression analysis was used to analyze the association between baseline IC, IC transitions, and frailty transitions. RESULTS: During the two-year follow-up, 17.8 % of participants improved, 20.4 % worsened, and 61.8 % maintained the same frailty status. Low IC (odds ratio [OR]=1.93; 95 % confidence interval [CI]=1.42-2.61) significantly predicted remaining frail or worsening frailty. Worsened IC increased the risk of remaining frail or worsening frailty, whereas improved IC decreased this risk. Among the IC domains, the onset of new locomotion (OR=3.33; 95 % CI=2.39-4.64), vitality (OR=2.12; 95 % CI=1.55-2.91), and psychological (OR=3.61; 95 % CI=2.64-4.92) impairment predicted remaining frail or worsening frailty. CONCLUSIONS: Low and worsened IC were associated with an increased risk of remaining frail or worsening frailty over two years. These findings indicate that changes in IC can predict frailty transitions, thereby emphasizing the importance of enhancing IC in preventing frailty progression.

The effect of the interaction between intrinsic capacity and social support on the trajectories of activities of daily living in older adults.

OBJECTIVES: This study explored the effect of the interaction between intrinsic capacity and social support on the activities of daily living in the older adults. METHODS: A total of 3,124 older adults participated in the study. Data on the assessment of intrinsic capacity as well as activities of daily living (ADL) and social support were collected. The latent growth curve model (LGCM) was used to examine the effect of the interaction between social support and intrinsic capacity on the activities of daily living in the older adults. RESULTS: A total of 3,730 older adults were included at baseline, and 3,124 older adults completed the 4-year follow-up. The ADL score of the older adults showed a significant downward trend with time over 4 years (ß=-0.115, P<0.05). In the elderly population with high intrinsic capacity, the ADL of individuals with low levels of social participation decreased significantly over time (ß=-0.114, P=0.012). In the elderly group with low intrinsic capacity, the ADL of individuals with low levels of social participation (ß=-0.245, P=0.005) and high levels of life care (ß=-0.167, P=0.001) decreased significantly over time. CONCLUSION: This is the first longitudinal study to explore the effects of interactions among intrinsic capacity, social participation and family support on the trajectory of ADL in the older adults from the perspective of the life course. Social participation can effectively improve functional ability of older adults with low intrinsic capacity. Life care is beneficial for maintaining the functional ability of older adults with intact intrinsic capacity, but it accelerates the deterioration of the functional ability of older adults with low intrinsic capacity.

[Prevention of frailty]. / Prävention der Frailty.

BACKGROUND: The presence of frailty in older patients increases the risk for adverse health events and for a loss of independence. Measures for the prevention of this geriatric syndrome should be incorporated into routine healthcare. OBJECTIVE: What types of interventions could be effective in the prevention of frailty and how can preventive strategies be successfully implemented? METHOD: Narrative review article. RESULTS: The concept of frailty is multidimensional and potential starting points for a prevention of frailty can be found within different dimensions (e.g., dimensions of physical activity and nutrition, psychosocial dimension). Epidemiological analyses have identified factors that increase or decrease the risk for becoming frail. Evidence from randomized controlled trials that examined the effectiveness of specific interventions in the prevention of frailty is still limited. Based on the available data, interventions using physical exercise appear to be effective in preventing frailty. In primary care in Germany the frailty status of older patients is not yet routinely recorded, which impedes the identification of patients at risk (patients with pre-frailty) and the implementation of targeted preventive strategies. The Integrated Care for Older People (ICOPE) concept of the World Health Organization offers a potential approach to prevent frailty and to promote healthy ageing within the population. CONCLUSION: The prevention of frailty is possible and reasonable. Comprehensive and targeted preventive strategies are yet to be implemented.

Sleep disturbances and intrinsic capacity trajectories among Chinese older adults: The Rugao Longevity and Ageing Study.

Age related decline of intrinsic capacity (IC) is the core of the functional ability and risk factor of adverse outcomes such as disability, hospitalization, and mortality. However, the relationship between sleep disturbance and IC decline are largely unknown. We conducted a longitudinal study and used data of 1514 community elders from the aging arm of the Rugao Longevity and Ageing Study. We found that poor sleep quality is cross-sectional associated with an increased risk of lower IC. In longitudinal analysis, sleep disturbances were inversely associated with composite IC score changes after adjusting for confounders (PSQI>5 vs. PSQI≤5: mean difference [-0.23], P = 0.0005), suggesting that poor sleep quality was associated with a decline in IC during the follow-up period. In conclusion, sleep disturbances were associated with worse IC changes. The results suggest that improving sleep health may help prevent IC decline and hence decreasing the burden of geriatric nursing practice.

Declined intrinsic capacity predicts long-term mortality in Chinese older adults: Beijing Longitudinal Study of Aging.

BACKGROUND: Intrinsic capacity reflects an individual's functions and capacities across their lifetime. There are few studies on whether the level of intrinsic capacity can predict long-term mortality in Chinese populations. OBJECTIVE: To explore the effects of intrinsic capacity on long-term outcomes in older Chinese adults. METHODS: Data were obtained from the Beijing Longitudinal Study of Aging. Overall, 1699 community-dwelling adults aged ≥60 years were included and followed up for 8 years. Intrinsic capacity was determined according to the World Health Organization definition. The predictive ability for adverse outcomes was assessed using the age- and sex-adjusted Cox proportional hazards model. RESULTS: A decline in intrinsic capacity domains was observed in 729 (42.9 %) participants. Declines in the mobility, cognition, vitality, sensory and psychology domains were observed in 21.8 %, 15.1 %, 11.4 %, 9.10 %, and 14.2 % of the participants, respectively. Low intrinsic capacity was associated with worse physical performance, frailty, social frailty, chronic diseases, fracture, and falls. A greater decline in intrinsic capacity predicted an elevated 8-year mortality rate (decline in overall intrinsic capacity hazard ratio 2.91, 95 % confidence interval 2.44-3.47, P < 0.001; decline in one domain hazard ratio 2.11, 95 % confidence interval 1.71-2.61, P < 0.001; decline in two domains hazard ratio 3.54, 95 % confidence interval 2.81-4.45, P < 0.001; decline in three or more domains hazard ratio 5.30, 95 % confidence interval 4.09-6.87, P < 0.001); adjusted models did not affect prediction performance. Among the five domains of intrinsic capacity, cognition was the strongest predictor of mortality (hazard ratio 3.17, 95 % confidence interval 2.63-3.81, P < 0.001). CONCLUSIONS: Intrinsic capacity is useful in identifying older adults at higher risk of adverse outcomes, presenting significant implications for healthcare policies in China.

A latent profile analysis of rest-activity behavior patterns among community-dwelling older adults and its relationship with intrinsic capacity.

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 (ß = - 0.945, P < 0.001) as well as the "Zebras" profile (ß = - 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.