Intrinsic capacity and its dimensions in relation to functional ability in older adults: A systematic review and meta-analysis

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics Pub Date : 2025-04-18 DOI:10.1016/j.archger.2025.105860

Yilin Cheng, Weiyao Li, Shuqin Xiao, Yuxin Chen, Xiaoyan Qi

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引用次数: 0

Abstract

Objectives

This study aims to explore the association between declines in intrinsic capacity and its individual domains with functional impairment in older adults and to compare the predictive ability of overall intrinsic capacity and its specific domains for functional disability.

Methods

We systematically searched PubMed, Embase, Cochrane Library, Web of Science, SinoMed, CNKI, Wanfang, and VIP databases from inception to December 26, 2024. Meta-analysis was conducted using RevMan 5.4. Study quality was assessed with the Newcastle-Ottawa Scale, and evidence quality was evaluated using GRADE guidelines. The study protocol was registered in PROSPERO (CRD42025634431).

Results

This meta-analysis included 15 longitudinal studies with 53,648 participants. Declines in locomotion, cognition, psychological well-being, and vitality were significantly associated with increased Activities of Daily Living (ADL) disability risk. Vision impairment also elevated ADL disability risk but hearing loss did not. Overall intrinsic capacity decline was linked to higher ADL disability risk (OR = 1.22, 95 % CI [1.16, 1.28]), with locomotion demonstrating stronger predictive power than overall intrinsic capacity. For instrumental activities of daily living (IADL) disability, declines in locomotion, cognition, psychological well-being, and vitality were significant risk factors. Sensory functions showed no significant association. Overall intrinsic capacity decline was strongly associated with IADL disability risk (OR = 1.41, 95 % CI [1.29, 1.54]), with no individual dimension showing significantly greater predictive power than overall intrinsic capacity. The GRADE evidence quality was rated as moderate.

Conclusions

This study confirms the role of overall intrinsic capacity and its individual domains in predicting functional impairment in older adults. It also compares the predictive value of overall intrinsic capacity with that of its specific domains, identifying locomotion decline as a key driver of functional impairment. Future research should further explore the longitudinal interactions among multiple intrinsic capacity domains using standardized intrinsic capacity assessment methods to refine the theoretical framework of healthy aging.

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老年人内在能力及其维度与功能能力的关系：系统回顾和荟萃分析

目的探讨老年人内在能力下降及其个别领域与功能障碍之间的关系，并比较整体内在能力及其特定领域对功能障碍的预测能力。方法系统检索PubMed、Embase、Cochrane Library、Web of Science、SinoMed、CNKI、万方、VIP等数据库，检索时间自成立至2024年12月26日。采用RevMan 5.4进行meta分析。使用纽卡斯尔-渥太华量表评估研究质量，使用GRADE指南评估证据质量。该研究方案已在PROSPERO注册（CRD42025634431）。结果本荟萃分析包括15项纵向研究，53,648名参与者。运动、认知、心理健康和活力的下降与日常生活活动（ADL）残疾风险的增加显著相关。视力障碍也会增加ADL残疾的风险，但听力损失不会。整体内在能力下降与较高的ADL残疾风险相关（OR = 1.22, 95% CI[1.16, 1.28]），运动表现出比整体内在能力更强的预测能力。对于日常生活工具活动（IADL）残疾，运动、认知、心理健康和活力的下降是重要的危险因素。感觉功能无显著相关性。整体内在能力下降与IADL残疾风险密切相关（OR = 1.41, 95% CI[1.29, 1.54]），没有个体维度显示出比整体内在能力更强的预测能力。GRADE证据质量评定为中等。结论本研究证实了整体内在能力及其个体域在预测老年人功能障碍中的作用。它还比较了整体内在能力的预测值与其特定领域的预测值，确定运动能力下降是功能障碍的关键驱动因素。未来的研究应采用标准化的内在能力评估方法，进一步探索多个内在能力域之间的纵向相互作用，完善健康老龄化的理论框架。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of gerontology and geriatrics 医学-老年医学

CiteScore

7.30

自引率

5.00%

发文量

198

审稿时长

16 days

期刊介绍： Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published. Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.