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Research Article| Volume 150, P1-6, August 2021

Screening for intrinsic capacity impairments as markers of increased risk of frailty and disability in the context of integrated care for older people: Secondary analysis of MAPT

  • Emmanuel González-Bautista
    Correspondence
    Corresponding author at: Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), 37 Allée Jules Guesde, 31000 Toulouse, France.
    Affiliations
    Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France

    UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France
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  • Philipe de Souto Barreto
    Affiliations
    Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France

    UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France
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  • Sandrine Andrieu
    Affiliations
    Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France

    UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France
    Search for articles by this author
  • Yves Rolland
    Affiliations
    Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France

    UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France
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  • Bruno Vellas
    Affiliations
    Gerontopole of Toulouse, Institute of Aging, Toulouse University Hospital (CHU Toulouse), Toulouse, France

    UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France
    Search for articles by this author
  • for the MAPT/DSA group (members are listed under ‘Contributors’)
Published:June 02, 2021DOI:https://doi.org/10.1016/j.maturitas.2021.05.011
Screening for intrinsic capacity impairments as markers of increased risk of frailty and disability in the context of integrated care for older people: Secondary analysis of MAPT
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Next ArticleHandgrip strength as a predictor of incident hypertension in the middle-aged and older population: The TCLSIH cohort study

      Highlights

      • •
        The more intrinsic capacity impairments an older person has, the higher is the risk of incident frailty and incident disability.
      • •
        Limited mobility, vision impairment and depressive symptoms are predictors of functional decline.
      • •
        The ICOPE Step1 screening tool can detect people at higher risk of functional decline.

      Abstract

      Aim

      This longitudinal secondary analysis of the Multidomain Alzheimer Preventive Trial (MAPT) aimed to test whether the Integrated Care for Older People (ICOPE) Step 1 screening tool is able to identify people at risk of developing frailty and disability in basic (ADL) and instrumental (IADL) activities of daily living among community-dwelling older adults.

      Participants and setting

      Seven hundred and fifty-nine (n = 759) non-demented participants of the MAPT aged 70–89 years were assessed in memory clinics in France between 2008 and 2013.

      Methods

      We measured six intrinsic capacity (IC) impairments, adapted from the ICOPE screening tool. We used Cox models to estimate the adjusted hazard ratios of incident frailty and IADL/ADL disability. Incident frailty was defined by Fried's phenotype, and incident disability was measured according to Lawton and Katz for IADLs and ADLs.

      Results

      Limited mobility (HR= 2.97, 95%CI= 1.85–4.76), depressive symptoms (HR= 2.07, 95%CI= 1.03–4.19), and visual impairment (HR= 1.70, 95%CI 1.01–2.86) were associated with a higher incidence of frailty over 5 years. Each additional IC condition demonstrated a positive association with a higher risk of incident frailty, IADL, ADL disability, with risk increased by 47%, 27%, and 23% over 5 years, respectively.

      Conclusion

      Screening for IC impairments identifies older adults at higher risk of incident frailty and incident IADL/ADL disability. It is relevant to screen for these impairments together because the risk of frailty and disability increases with each additional one.
      ClinicalTrials.gov identifier: NCT00672685

      Keywords

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      Article info

      Publication history

      Published online: June 02, 2021
      Accepted: May 31, 2021
      Received in revised form: April 29, 2021
      Received: September 21, 2020

      Identification

      DOI: https://doi.org/10.1016/j.maturitas.2021.05.011

      Copyright

      © 2021 Elsevier B.V. All rights reserved.

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