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. 2023 Jul 1;52(7):afad137.
doi: 10.1093/ageing/afad137.

Exploring the natural history of intrinsic capacity impairments: longitudinal patterns in the 10/66 study

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Exploring the natural history of intrinsic capacity impairments: longitudinal patterns in the 10/66 study

Emmanuel Gonzalez-Bautista et al. Age Ageing. .

Abstract

Background: intrinsic capacity (IC) is a construct encompassing people's physical and mental abilities. There is an implicit link amongst IC domains: cognition, locomotion, nutrition, sensory and psychological. However, little is known about the integration of the domains.

Objectives: to investigate patterns in the presentation and evolution of IC domain impairments in low-and-middle-income countries and if such patterns were associated with adverse outcomes.

Methods: secondary analyses of the first two waves of the 10/66 study (population-based surveys conducted in eight urban and four rural catchment areas in Cuba, Dominican Republic, Puerto Rico, Venezuela, Peru, Mexico and China). We applied latent transition analysis on IC to find latent statuses (latent clusters) of IC domain impairments. We evaluated the longitudinal association of the latent statuses with the risk of frailty, disability and mortality, and tested concurrent and predictive validity.

Results: amongst 14,923 participants included, the four latent statuses were: high IC (43%), low deterioration with impaired locomotion (17%), high deterioration without cognitive impairment (22%), and high deterioration with cognitive impairment (18%). A total of 61% of the participants worsened over time, 35% were stable, and 3% improved to a healthier status.Participants with deteriorated IC had a significantly higher risk of frailty, disability and dementia than people with high IC. There was strong concurrent and predictive validity. (Mortality Hazard Ratio = 4.60, 95%CI 4.16; 5.09; Harrel's C = 0.73 (95%CI 0.72;0.74)).

Conclusions: half of the study population had high IC at baseline, and most participants followed a worsening trend. Four qualitatively different IC statuses or statuses were characterised by low and high levels of deterioration associated with their risk of disability and frailty. Locomotion and cognition impairments showed other trends than psychological and nutrition domains across the latent statuses.

Keywords: intrinsic capacity; latent transitions; longitudinal analysis; natural history of functional decline; older people.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Four latent statuses of IC impairments and their domain impairments. The four latent statuses result from the latent transitions modelling and cluster participants with similar probabilities of domain impairments. We have labelled each latent status according to the quantity and type of the IC domains affected, with high deterioration meaning at least three domains affected.
Figure 2
Figure 2
Prevalence and transition probabilities amongst the latent statuses at baseline and follow-up. The blue arrows indicate a transition to a stable or worsening latent status. Curved arrows mark transitions with an accelerated decline in IC. The green arrow signals a transition to a latent status with higher IC.

References

    1. Beard JR, Officer A, De Carvalho IA et al. The world report on ageing and health: a policy framework for healthy ageing. Lancet 2016; 387: 2145–54. - PMC - PubMed
    1. Cesari M, De Carvalho IA, Thiyagarajan JA et al. Evidence for the domains supporting the construct of intrinsic capacity. J Gerontol - Ser A Biol Sci Med Sci 2018; 73: 1653–60. - PubMed
    1. Beard JR, Jotheeswaran AT, Cesari M, Araujo de Carvalho I. The structure and predictive value of intrinsic capacity in a longitudinal study of ageing. BMJ Open 2019; 9: 1–11. 10.1136/bmjopen-2018-026119. - DOI - PMC - PubMed
    1. Beard JR, Si Y, Liu Z, Chenoweth L, Hanewald K. Intrinsic capacity: validation of a new WHO concept for healthy aging in a longitudinal Chinese study. J Gerontol A Biol Sci Med Sci 2022; 77: 94–100. - PubMed
    1. Freeze RD, Raschke RL. An Assessment of Formative and Reflective Constructs in IS Research. Norway: European Conference on Information Systems, 2007.

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