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

Maturitas. 2021 Aug;150:1-6. doi: 10.1016/j.maturitas.2021.05.011. Epub 2021 Jun 4.

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: Disability; Frailty; Functional performance; ICOPE; Integrated Care of Older People; Intrinsic capacity; Screening.

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / physiopathology*
  • Delivery of Health Care, Integrated / statistics & numerical data*
  • Disabled Persons / statistics & numerical data*
  • Female
  • Frail Elderly / statistics & numerical data
  • Frailty / diagnosis*
  • Frailty / epidemiology*
  • France / epidemiology
  • Humans
  • Independent Living
  • Longitudinal Studies
  • Male
  • Mass Screening / methods*
  • Randomized Controlled Trials as Topic
  • Research Design

Associated data

  • ClinicalTrials.gov/NCT00672685