Intrinsic Capacity predicts adverse outcomes using Integrated Care for Older People screening tool in a senior community in Beijing
The World Health Organization (WHO) introduced the concept of intrinsic capacity in order to create a multidimensional model to maintain individual's functional ability. Intrinsic capacity is the composite of all the physical and mental capacities that an individual can draw on at any point in time, and represents the amount of resources one can tap into during his life(WHO, 2015). By interacting with the surrounding environment, intrinsic capacity determines functional ability largely. Considering and organizing the retrieved evidence, five domains are proposed to define the intrinsic capacity: cognition, locomotion, vitality, sensory, and psychosocial, each of which is composed of subdomains(Cesari et al., 2018). In 2017, the WHO published Integrated Care for Older People (ICOPE): Guidelines on community-level interventions to manage declines in intrinsic capacity, and highlighted the importance of focusing on intrinsic capacity to establish effective interventions(WHO, 2017). In 2019, Guidance for person-centered assessment and pathways in primary care were released and recommended ICOPE screening tool to measure intrinsic capacity as the doorway to a more in-depth assessment of the social and health-related needs, and guided timely interventions accordingly(WHO, 2019). Previous research had demonstrated that each separate domain was known to be a predictor of adverse outcomes in older adults(Cesari et al., 2018). However, it is necessary to acknowledge that the five domains should not be considered as standalone silos. Each component closely interacts with the other domains as part of a dynamically interacted environment. Thus, the analysis undertaken with the integrated intrinsic capacity rather than for each domain separately brooks no delay.
To our knowledge, intrinsic capacity presents the reserves of the individual. Whereas, frailty is a state of increased vulnerability to poor resolution of homeostasis after stressors, presents the deficits accumulated with aging, and increases the risk of adverse health outcomes (e.g. falls, hospitalization, disability and death)(Fried et al., 2001; Vermeiren et al., 2016). Thus, frailty and intrinsic capacity might represent the two faces of the same coin. To date, which model can better predict adverse health outcomes is still in its infancy.
Therefore, the main objective of the current work was to analyze the predictive value of intrinsic capacity measured by ICOPE screening tool on the incidence of functional decline and falls in a superior quality senior community and compare its value with frailty.