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Journal article
Development, validity, and utility of a model-based intrinsic capacity composite score in community-dwelling older persons
Journals of Gerontology. Series A: Biological Sciences & Medical Sciences, Vol.80(12), pp.1-9
2025
PMID: 41021461
Abstract
BACKGROUND
To address the lack of a composite intrinsic capacity (IC) score based on the World Health Organization (WHO) Integrated Care for Older People (ICOPE) Screening tool, we propose a model-based approach to computing the composite score by developing and validating a model that uses the ICOPE screening items to predict the presence of impaired IC in community-dwelling older adults.
METHODS
In this cross-sectional study, a sample of 1,235 participants (mean[SD], 68[7]years) completed a multi-domain geriatric and fitness assessment, from which we (i) operationalized the ICOPE Steps 1-2 screening/assessment and (ii) derived a 5-point count-based Step 1 composite IC score and an 8-point Step 2 composite IC score. Proportional-odds regression analysis, leveraging on ICOPE screening items, was used to predict, for a given person, the probability that the Step 2 score was ≤6points (impaired IC) and the corresponding mean score (model-based composite IC score).
RESULTS
The model c-statistic for impaired IC was 0.81 (95%CI, 0.79 to 0.86) and calibration was excellent. The model-based IC scores showed stronger discriminative validity than did the count-based scores for the prefrailty/frailty, sarcopenia, and restricted life-space-mobility outcomes (AUC differences, 0.05-0.12; P-values < 0.001). At a decision threshold of 20%, the model-based approach yielded greater net benefit (0.016), and it allowed a greater proportion of participants to potentially delay Step 2 assessment (n = 633 vs 317) without compromising positive and negative predictive values.
CONCLUSIONS
If externally validated, composite IC scores derived from the proposed model-based approach have the potential to facilitate more granular risk stratification and IC monitoring.
Details
- Title
- Development, validity, and utility of a model-based intrinsic capacity composite score in community-dwelling older persons
- Authors
- Yong-Hao Pua (Corresponding Author) - Duke-NUS Medical SchoolLaura Tay - Sengkang General HospitalRoss Allan Clark - University of the Sunshine Coast, Queensland, School of Health - Sports & Exercise ScienceJulian Thumboo - Duke-NUS Medical SchoolEe-Ling Tay - Sengkang General HospitalShi-Min Mah - Sengkang General HospitalWang Min Xian - SingHealthLim Jin Jin - SingHealthGary Kwok Kum Hoe - SingHealthYee-Sien Ng - Sengkang General Hospital
- Publication details
- Journals of Gerontology. Series A: Biological Sciences & Medical Sciences, Vol.80(12), pp.1-9
- Publisher
- Oxford University Press
- Date published
- 2025
- DOI
- 10.1093/gerona/glaf210
- ISSN
- 1758-535X; 1079-5006
- PMID
- 41021461
- Grant note
- This study is funded by National Medical Research Council Centre Grants (CGAug16C027 and CGAug16M011) and the National Innovation Challenge on Active and Confident Ageing Grant (MOH/NIC/HAIG04/2017).
- Organisation Unit
- Healthy Ageing Research Cluster; School of Health - Sports & Exercise Science
- Language
- English
- Record Identifier
- 991166402802621
- Output Type
- Journal article
Metrics
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