- •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.
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.
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.
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.
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
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Maturitas
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Integrated Care For Older People (ICOPE): Guidance for Person-Centred Assessment and Pathways in Primary Care.WHO, Geneva2019(accessed November 14, 2019)
- The structure and predictive value of intrinsic capacity in a longitudinal study of ageing.BMJ Open. 2019; 9e026119https://doi.org/10.1136/bmjopen-2018-026119
- Evidence for the domains supporting the construct of intrinsic capacity.Journals Gerontol. - Ser. A Biol. Sci. Med. Sci. 2018; 73: 1653-1660https://doi.org/10.1093/gerona/gly011
- Redesigning care for older people to preserve physical and mental capacity: WHO guidelines on community-level interventions in integrated care.PLOS Med. 2019; 16e1002948https://doi.org/10.1371/journal.pmed.1002948
- In the Quest of a Standard Index of Intrinsic Capacity. A Critical Literature Review.J. Nutr. Health Aging. 2020; https://doi.org/10.1007/s12603-020-1394-4
- [Causes for care dependency in the context of long-term care insurance].Pflege Z. 2014; 67: 558-561
- MAPT study: a multidomain approach for preventing Alzheimer’s disease: design and baseline data.J. Prev. Alzheimer’s Dis. 2014; 1 (accessed February 5, 2020): 13-22
- Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial.Lancet Neurol. 2017; 16: 377-389https://doi.org/10.1016/S1474-4422(17)30040-6
- The hearing handicap inventory for the elderly: a new tool.Ear Hear. 1982; 3: 128-134https://doi.org/10.1097/00003446-198205000-00006
- Does This Patient Have Hearing Impairment?.JAMA. 2008; 295: 416-428
- Geriatric Depression Scale (GDS).Clin. Gerontol. 1986; 5: 165-173https://doi.org/10.1300/J018v05n01_09
- Frailty in older adults evidence for a phenotype.J. Gerontol. A. Biol. Sci. Med. Sci. 2001; 56A (accessed June 11, 2014): M146-M156
- Assessment of Older People: self-Maintaining and Instrumental Activities of Daily Living1.Gerontologist. 1969; 9: 179-186https://doi.org/10.1093/geront/9.3_Part_1.179
- Progress in development of the index of ADL.Gerontologist. 1970; 10: 20-30https://doi.org/10.1093/geront/10.1_Part_1.20
- Evaluating the yield of medical tests.JAMA. 1982; 247: 2543-2546
- The hazards of hazard ratios.Epidemiology. 2010; 21: 13-15https://doi.org/10.1097/EDE.0b013e3181c1ea43
- Index for rating diagnostic tests.Cancer. 1950; 3: 32-35https://doi.org/10.1002/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3
- Geriatric impairments and disability: the cardiovascular health study.J. Am. Geriatr. Soc. 2010; 58: 1686-1692https://doi.org/10.1111/j.1532-5415.2010.03022.x
- Nonlinear multisystem physiological dysregulation associated with frailty in older women: implications for etiology and treatment.J. Gerontol. A. Biol. Sci. Med. Sci. 2009; 64: 1049-1057https://doi.org/10.1093/gerona/glp076
- Process of physical Disability among older adults–contribution of frailty in the super-aged society.Nagoya J. Med. Sci. 2012; 74: 31-37
- Predicting ADL disability in community-dwelling elderly people using physical frailty indicators: a systematic review.BMC Geriatr. 2011; 11: 33https://doi.org/10.1186/1471-2318-11-33
- Gait Speed Predicts Incident Disability: a Pooled Analysis.J. Gerontol. A. Biol. Sci. Med. Sci. 2016; 71: 63-71https://doi.org/10.1093/gerona/glv126
- Assessment of Function and Disability in Longitudinal Studies.J. Am. Geriatr. Soc. 2010; 58: S308-S312https://doi.org/10.1111/j.1532-5415.2010.02914.x
- Disability in older Adults 1: prevalence, causes, and consequences.Behav. Med. 1999; 24: 147-156https://doi.org/10.1080/08964289.1999.11879271
- Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: a systematic review of longitudinal studies.PLoS ONE. 2017; 12e0178383https://doi.org/10.1371/journal.pone.0178383
- Frailty screening comes of age.J. Nutr. Health Aging. 2014; 18: 453-454https://doi.org/10.1007/s12603-014-0457-9
- Visual Impairment and Frailty: examining an Understudied Relationship.Journals Gerontol. Ser. A. 2020; 75: 596-602https://doi.org/10.1093/gerona/glz182
- Factorial and discriminant validity of the Center for Epidemiological Studies Depression (CES-D) scale.J. Clin. Psychol. 1986; 42: 28-33https://doi.org/10.1002/1097-4679(198601)42:1<28::aid-jclp2270420104>3.0.co;2-t
- Nutritional determinants of frailty in older adults: a systematic review.BMC Geriatr. 2017; 17https://doi.org/10.1186/s12877-017-0496-2
- Aging gut microbiota at the cross-road between nutrition, physical frailty, and sarcopenia: is there a gut–muscle axis?.Nutrients. 2017; 9https://doi.org/10.3390/nu9121303
- Frequency of Conditions Associated with Declines in Intrinsic Capacity According to a Screening Tool in the Context of Integrated Care for Older People.J. Frailty Aging. 2020; 2020: 1-9https://doi.org/10.14283/JFA.2020.42
- Association of age-related hearing loss with cognitive function, cognitive impairment, and dementia a systematic review and meta-analysis.JAMA Otolaryngol. - Head Neck Surg. 2018; 144: 115-126https://doi.org/10.1001/jamaoto.2017.2513
- Vision Impairment and Subjective Cognitive Decline–Related Functional Limitations — United States, 2015–2017.MMWR. Morb. Mortal. Wkly. Rep. 2019; 68: 453-457https://doi.org/10.15585/mmwr.mm6820a2
- Association of 3-Year Multidomain Intervention and Omega-3 Supplementation with Frailty Incidence.J. Am. Geriatr. Soc. 2019; 67: 1700-1706https://doi.org/10.1111/jgs.15994
Published online: June 02, 2021
Accepted: May 31, 2021
Received in revised form: April 29, 2021
Received: September 21, 2020
© 2021 Elsevier B.V. All rights reserved.