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Trajectories of Intrinsic Capacity: Determinants and Associations with Disability

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Intrinsic capacity (IC) declines progressively with age, thereby increasing the risk of disability. However, it is less known whether IC trajectories are associated with disability. This study aims to identify the different patterns of IC trajectories in older people, and examine their determinants and associations with Instrumental Activities of Daily Living (IADL).

Design

Cohort study.

Setting

Community centres in different regions in Hong Kong.

Participants and Measurements

Longitudinal data from community-dwelling older people aged 60 years or above (n = 1371) collected between 2016 and 2021 was analysed. Their mean age was 74.5 years, and 78.7% of them were female. Repeated measurements of a set of 14 self-reported items were used to generate IC scores at four time points using a bi-factor model. Latent class growth analysis was performed to identify classes with distinct IC trajectories. The association between class membership and IADL disability was then examined using logistic regression.

Results

Three distinct IC trajectories were identified. The 1st class included those with the highest level of baseline IC and the least declining trajectory, whereas the 3rd class was composed by those with the lowest level of baseline IC and the most declining trajectory. Older age, female gender, lower perceived financial adequacy, living in public or subsidized housing, and chronic diseases were associated with the 3rd class. After adjusting for demographic factors, socioeconomic status, and the number of chronic diseases, the 1st class was more likely to preserve IADL when compared against the 2nd class, with OR being 3.179 (95% CI: 2.152–4.793), whereas for the 3rd class, the OR was 0.253 (95% CI: 0.178–0.359).

Conclusion

Monitoring IC trajectories is of relevance to clinical practice, as it helps shift the focus from treating acute episodes of illness to preserving the functional ability of older people.

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Acknowledgements

We would like to express our gratitude to The Hong Kong Jockey Club Charities Trust for funding the study under The Jockey Club Community eHealth Care Project. We would also like to thank our project partners, namely Stanley Ho Big Data Decision Analytics Research Centre of The Chinese University of Hong Kong (CUHK), The Jockey Club School of Public Health and Primary Care, CUHK, Senior Citizen Home Safety Association, and non-governmental organizations. In addition, we are grateful to the project participants for their contribution to the study.

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Authors and Affiliations

  1. Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China

    R. Yu & J. Woo

  2. Jockey Club Institute of Ageing, The Chinese University of Hong Kong, New Territories, Hong Kong, China

    R. Yu, D. Lai, G. Leung & J. Woo

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  1. R. Yu
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  2. D. Lai
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Correspondence to R. Yu.

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Ethical standards: The study was approved by the Survey and Behavioural Research Ethics Committee of The Chinese University of Hong Kong.

Conflicts of Interest: None declared.

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Yu, R., Lai, D., Leung, G. et al. Trajectories of Intrinsic Capacity: Determinants and Associations with Disability. J Nutr Health Aging 27, 174–181 (2023). https://doi.org/10.1007/s12603-023-1881-5

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