J Chew, J Lee, H H C Hernandez, Y L Munro, C L Lim, W S Lim
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引用次数: 0
Abstract
Background: Intrinsic capacity (IC) is a composite indicator of physical and mental capacities that are critical for healthy aging. IC comprises five domains, with "vitality" gaining most attention due to its potential impact on functional and physiological reserves with increasing age. The World Health Organization 2022 framework redefined vitality as an underlying physiological determinant of IC. However, the concept and measurement of vitality and its empirical validation are not well defined.
Objectives: This scoping review aims to: (1) map the conceptual frameworks underpinning vitality within the IC domain and (2) identify existing measures used to assess vitality.
Methods: A systematic search of MEDLINE, PubMed, Embase, Web of Science, and WHO databases (2003-2023) using Arksey and O'Malley's framework and PRISMA-ScR guidelines. Studies involving adults ≥50 years old that addressed vitality in IC were included. We extracted data on conceptual frameworks, measurement tools, and construct validity.
Results: Eighty-one studies met the inclusion criteria. Initial frameworks of vitality focused on nutritional indicators, while recent concepts include neuromuscular function, metabolism, and immune-stress responses. However, operationalization of these concepts remains inconsistent, with most studies relying on anthropometry, appetite, weight loss, and handgrip strength, while immune and stress response-related biomarkers were rarely assessed. Only 10.5 % of studies evaluated construct validity of vitality, and limited studies validated the potential roles of vitality underpinning the other expressed capacities.
Conclusions: Currently, vitality within IC varies in definitions and measurement approaches, with a predominant focus on nutrition and muscle strength. Empirical validation of vitality's role as a foundational IC domain remains limited. Expanding the scope of vitality to include metabolic and immune markers, and deeper examination of the interactions between vitality with other IC domains may enhance understanding and improve assessment frameworks for healthy aging.
背景：内在能力（IC）是生理和心理能力的综合指标，对健康老龄化至关重要。IC包括五个领域，其中“活力”最受关注，因为它随着年龄的增长对功能和生理储备有潜在的影响。世界卫生组织2022框架将活力重新定义为IC的潜在生理决定因素。然而，活力的概念和测量及其实证验证并没有很好地定义。目标：该范围审查旨在：(1)绘制IC领域内支撑活力的概念框架，(2)确定用于评估活力的现有措施。方法：采用Arksey和O'Malley框架和PRISMA-ScR指南系统检索MEDLINE、PubMed、Embase、Web of Science和WHO数据库（2003-2023）。纳入了涉及≥50岁成人的研究，这些研究涉及IC的活力。我们提取了概念框架、测量工具和结构效度方面的数据。结果：81项研究符合纳入标准。最初的活力框架侧重于营养指标，而最近的概念包括神经肌肉功能，代谢和免疫应激反应。然而，这些概念的操作化仍然不一致，大多数研究依赖于人体测量、食欲、体重减轻和握力，而免疫和应激反应相关的生物标志物很少被评估。只有10.5%的研究评估了活力的结构效度，有限的研究证实了活力支撑其他表达能力的潜在作用。结论：目前，IC内的活力在定义和测量方法上有所不同，主要集中在营养和肌肉力量上。活力作为基础集成电路领域的作用的实证验证仍然有限。将活力的范围扩大到包括代谢和免疫标记物，并更深入地研究活力与其他IC域之间的相互作用，可能会增强对健康老龄化的理解并改进评估框架。
期刊介绍：
The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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