Real-life intrinsic capacity screening data from the ICOPE-Care program

Abstract

The Integrated Care for Older People (ICOPE) program is a healthcare pathway that uses a screening test for intrinsic capacity (IC) as its entry point. However, real-life data informing on how IC domains cluster and change over time, as well as their clinical utility, are lacking. Using primary healthcare screening data from more than 20,000 French adults 60 years of age or older, this study identified four clusters of IC impairment: ‘Low impairment’ (most prevalent), ‘Cognition+Locomotion+Hearing+Vision’, ‘All IC impaired’ and ‘Psychology+Vitality+Vision’. Compared to individuals with ‘Low impairment’, those in the other clusters had higher likelihood of having frailty and limitations in both activities of daily living (ADL) and instrumental activities of daily living (IADL), with the strongest associations being observed for ‘All IC impaired’. This study found that ICOPE screening might be a useful tool for patient risk stratification in clinical practice, with a higher number of IC domains impaired at screening indicating a higher probability of functional decline. The Integrated Care for Older People (ICOPE) program was developed to promote a function-centered and individualized approach to healthy aging, but it is not yet widely implemented. In this study, de Souto Barreto et al. used early-stage ICOPE data collected in primary healthcare from more than 20,000 older adults to characterize patterns of intrinsic capacity impairment and associated odds of frailty and disability.