Skip to main content
Log in

Frequency of Conditions Associated with Declines in Intrinsic Capacity According to a Screening Tool in the Context of Integrated Care for Older People

  • Original Research
  • Published:
The Journal of Frailty & Aging Aims and scope Submit manuscript

Abstract

Background

The screening tool of the Integrated Care for Older People (ICOPE Step 1), designed to detect declines in the domains of intrinsic capacity, has been incipiently investigated in older adult populations.

Objectives

To retrospectively estimate the frequency of priority conditions associated with declines in intrinsic capacity according to an adaptation of the screening tool ICOPE Step 1 among participants of the Multidomain Alzheimer Preventive Trial (MAPT).

Design

A cross-sectional retrospective analysis from the baseline assessment of the MAPT.

Setting

The data was gathered during a preventive consultation for cardiovascular risk factors in memory clinics in France.

Participants

Seven hundred fifty-nine older adults aged 70–89 years with memory complaints, allocated to the multidomain groups of the MAPT study.

Measurements

Five domains of intrinsic capacity (cognition, locomotion, nutrition, sensorial, and psychological) were assessed using a screening tool similar to the ICOPE Step 1 (MAPT Step 1). The frequency of six conditions associated with declines in intrinsic capacity (cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss, and depressive symptoms) was obtained for older adults with memory complaints participating in the MAPT study.

Results

Overall, 89.3% of the participants had one or more conditions associated with declines in intrinsic capacity. The overall frequency of each condition was: 52.2% for cognitive decline, 20.2% for limited mobility, 6.6% for malnutrition, 18.1% for visual impairment, 56.2% for hearing loss, and 39% for depressive symptoms.

Conclusion

After being screened with an adaptation of the ICOPE step 1 (MAPT step 1) tool, 9/10 older adults had one or more conditions associated with declines in intrinsic capacity. The relative frequency differs across conditions and could probably be lower in a population without memory complaints. The frequency of screened conditions associated with declines in IC highlights how relevant it is to develop function-centered care modalities to promote healthy aging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

CCHA:

Clinical Consortium for Healthy Ageing

COPD:

Chronic obstructive pulmonary disease

FA:

Functional ability

IC:

Intrinsic capacity

ICOPE:

Integrated Care for Older People

MAPT:

Multidomain Alzheimer Preventive Trial

NCD:

Non-communicable disease

OA:

Older adults

WHO:

World Health Organization

References

  1. World Health Organization. Integrated care for older people (ICOPE): Guidance for person-centred assessment and pathways in primary care. [Internet]. Geneva: WHO; 2019 [cited 2019 Nov 14]. 87 p. Available from: https://apps.who.int/iris/bitstream/handle/1066S/326843/WHO-FWC-ALC-19.1-eng.pdf?sequence=17

  2. Thiyagarajan JA, Araujo de Carvalho I, Peña-Rosas JP, Chadha S, Mariotti SP, Dua T, et al. Redesigning care for older people to preserve physical and mental capacity: WHO guidelines on community-level interventions in integrated care. PLOS Med [Internet]. 2019 Oct 18 [cited 2020 Jan 8];16(10):e1002948. Available from: http://dx.plos.org/10.1371/journal.pmed.1002948

    Article  Google Scholar 

  3. World Health Organisation. WHO Clinical Consortium on Healthy Ageing. Report of consortium meeting 1–2 December 2016 in Geneva, Switzerland. 2017;(December).

  4. World Health Organization. World Report on Ageing and Health. Geneva: WHO Press; 2015.

    Google Scholar 

  5. Cesari M, De Carvalho IA, Thiyagarajan JA, Cooper C, Martin FC, Reginster JY, et al. Evidence for the domains supporting the construct of intrinsic capacity. Vol. 73, Journals of Gerontology - Series A Biological Sciences and Medical Sciences. Oxford University Press; 2018. p. 1653–60.

  6. Vellas B, Carrie I, Gillette-Guyonnet S, Touchon J, Dantoine T, Dartigues JF, et al. MAPT study: A multidomain approach for preventing Alzheimer’s disease: design and baseline data. J Prev Alzheimer’s Dis [Internet]. 2014 Jun [cited 2020 Feb 5];1(1):13–22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26594639

    CAS  Google Scholar 

  7. Andrieu S, Guyonnet S, Coley N, Cantet C, Bonnefoy M, Bordes S, et al. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol. 2017 May 1;16(5):377–89.

    Article  CAS  Google Scholar 

  8. Ventry IM, Weinstein BE. The hearing handicap inventory for the elderly: A new tool. Ear Hear. 1982;3(3):128–34.

    Article  CAS  Google Scholar 

  9. Bagai A. Does This Patient Have Hearing Impairment? JAMA. 2008;295(4):416–28.

    Article  Google Scholar 

  10. Yesavage JA, Sheikh JI. Geriatric Depression Scale (GDS). Clin Gerontol [Internet]. 1986 Nov 18;5(1–2): 165–73. Available from: https://doi.org/10.1300/J018v05n01_09

    Article  Google Scholar 

  11. Sindhusake D, Mitchell P, Smith W, Golding M, Newall P, Hartley D, et al. Validation of self-reported hearing loss. The blue mountainshearing study. Int J Epidemiol. 2001;30(6):1371–8.

    Article  CAS  Google Scholar 

  12. Association AS-L-H. Guidelines for Audiologic Screening. www.asha.org/policy [Internet]. 1997 [cited 2020 Feb 7];1-64. Available from: http://www.asha.org/policy/GL1997-00199/

  13. 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 [Internet]. 2019 Nov 2 [cited 2019 Nov 7];9(11):e026119. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31678933

    Article  Google Scholar 

  14. Gutiérrez-Robledo LM, García-Chaíes RE, Pérez-Zepeda MU. Allostatic Load as a Biological Substrate to Intrinsic Capacity: A Secondary Analysis of CRELES. J Nutr Health Aging [Internet]. 2019 [cited 2019 Nov 5];23(9):788–95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31641727

    Article  Google Scholar 

  15. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.

    Article  CAS  Google Scholar 

  16. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, et al. A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. Journals Gerontol. 1994;49(2).

    Google Scholar 

  17. Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, et al. The mini nutritional assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999 Feb;15(2):116–22.

    Article  CAS  Google Scholar 

  18. World Health Organization. World report on vision. Vol. 214, World report on vision. Geneva: WHO Press; 2019. 180–235 p.

    Google Scholar 

  19. Ávila-Funes JA, Helmer C, Amieva H, Barberger-Gateau P, Le Goff M, Ritchie K, et al. Frailty among community-dwelling elderly people in france: The three-city study. Journals Gerontol - Ser A Biol Sci Med Sci. 2008;63(10):1089–96.

    Article  Google Scholar 

  20. Rosenberg A, Mangialasche F, Ngandu T, Solomon A, Kivipelto M. Multidomain Interventions to Prevent Cognitive Impairment, Alzheimer’s Disease, and Dementia: From FINGER to World-Wide FINGERS. J Prev Alzheimer’s Dis [Internet]. 2020 [cited 2020 Mar 23];7(1):29–36. Available from: http://www.ncbi.nlm.nih.gov/pubmed/32010923

    CAS  Google Scholar 

  21. Cherian L, Wang Y, Fakuda K, Leurgans S, Aggarwal N, Morris M. Mediterranean-Dash Intervention for Neurodegenerative Delay (MIND) Diet Slows Cognitive Decline After Stroke. J Prev Alzheimer’s Dis [Internet]. 2019 [cited 2020 Mar 23];6(4):267–73. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31686099

    CAS  Google Scholar 

  22. Udeh-Momoh C, Price G, Ropacki MT, Ketter N, Andrews T, Arrighi HM, et al. Prospective Evaluation of Cognitive Health and Related Factors in Elderly at Risk for Developing Alzheimer’s Dementia: A Longitudinal Cohort Study. J Prev Alzheimer’s Dis [Internet]. 2019 [cited 2020 Mar 23];6(4):256–66. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31686098

    CAS  Google Scholar 

  23. Hardy R, Cooper R, Shah I, Harridge S, Guralnik J, Kuh D. Is chair rise performance a useful measure of leg power? Aging Clin Exp Res. 2010;22(5–6):412–8.

    Article  Google Scholar 

  24. BOHANNON RW. Reference Values for the Five-Repetition Sit-To-Stand Test: a Descriptive Meta-Analysis of Data From Elders. Percept Mot Skills. 2006;103(5):215.

    Article  Google Scholar 

  25. Cederholm T, Jensen GL, Correia MITD, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. J Cachexia Sarcopenia Muscle [Internet]. 2019 Feb 1 [cited 2020 Feb 27];10(1):207–17. Available from: https://ominelibrary.wuey.com/doi/abs/10.1002/jcsm.12383

    Article  CAS  Google Scholar 

  26. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An Inventory for Measuring Depression. Arch Gen Psychiatry. 1961;4(6):561–71.

    Article  CAS  Google Scholar 

  27. Radioff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1(3):385–401.

    Article  Google Scholar 

  28. Suthutvoravut U, Tanaka T, Takahashi K, Akishita M, Iijima K. Living with Family yet Eating Alone is Associated with Frailty in Community-Dwelling Older Adults: The Kashiwa Study. J frailty aging [Internet]. 2019 [cited 2020 Mar 23];8(4):198–204. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31637406

    CAS  Google Scholar 

  29. Montagnier D, Barberger-Gateau P, Jacqmin-Gadda H, Dartigues JF, Rainfray M, Pérès K, et al. Evolution of prevalence of depressive symptoms and antidepressant use between 1988 and 1999 in a large sample of older French people: Results from the personnes agées quid study. J Am Geriatr Soc [Internet]. 2006 Dec [cited 2020 Feb 13];54(12):1839–45. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17198488

    Article  Google Scholar 

  30. Kiiti Borges M, Oiring de Castro Cezar N, Silva Santos Siqueira A, Yassuda M, Cesari M, Aprahamian I. The Relationship between Physical Frailty and Mild Cognitive Impairment in the Elderly: A Systematic Review. J frailty aging [Internet]. 2019 [cited 2020 Mar 23];8(4):192–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31637405

    Google Scholar 

  31. Kwan RYC, Leung AYM, Yee A, Lau LT, Xu XY, Dai DLK. Cognitive Frailty and Its Association with Nutrition and Depression in Community-Dwelling Older People. J Nutr Health Aging [Internet]. 2019 Dec 1 [cited 2020 Mar 23];23(10):943–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31781723

    Article  CAS  Google Scholar 

  32. McGrath R, Erlandson KM, Vincent BM, Hackney KJ, Herrmann SD, Clark BC. Decreased Handgrip Strength is Associated With Impairments in Each Autonomous Living Task for Aging Adults in the United States. J frailty aging. 2019;8(3):141–5.

    CAS  PubMed  Google Scholar 

  33. Zhu RR, Shi J, Yang M, Guan HJ. Prevalences and causes of vision impairment in elderly Chinese: A socioeconomic perspective of a comparative report nested in Jiangsu Eye Study. Int J Ophthalmol. 2016 Jul 18;9(7):1051–6.

    PubMed  PubMed Central  Google Scholar 

  34. Murthy GVS, Vashist P, John N, Pokharel G, Ellwein LB. Prevalence and causes of visual impairment and blindness in older adults in an area of India with a high cataract surgical rate. Ophthalmic Epidemiol. 2010 Aug;17(4):185–95.

    Article  CAS  Google Scholar 

  35. Bourne RRA, Jonas JB, Bron AM, Cicinelli MV, Das A, Flaxman SR, et al. Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe in 2015: Magnitude, temporal trends and projections. Br J Ophthalmol. 2018 May 1;102(5):575–85.

    Article  Google Scholar 

  36. Tomioka K, Ikeda H, Hanaie K, Morikawa M, Iwamoto J, Okamoto N, et al. The Hearing Handicap Inventory for Elderly-Screening (HHIE-S) versus a single question: reliability, validity, and relations with quality of life measures in the elderly community, Japan. Qual Life Res [Internet]. 2013 Jun [cited 2020 Feb 12];22(5):1151–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22833152

    Article  Google Scholar 

  37. United Nations Department of Economic and Social Affairs. Population Division. Ageing Profiles [Internet]. Ageing Profiles. 2019 [cited 2020 Feb 13]. Available from: https://population.un.org/ProfilesOfAgeing2019/index.html

Download references

Acknowledgements: NA

Funding

Funding: The present work was performed in the context of the Inspire Program, a research platform supported by grants from the Region Occitanie/Pyrénées-Méditerranée (Reference number: 1901175) and the European Regional Development Fund (ERDF) (Project number: MP0022856). The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of data; in the preparation of the manuscript; or in the review or approval of the manuscript.

Funding section: The present work was performed in the context of the Inspire Program, a research platform supported by grants from the Region Occitanie/Pyrénées-Méditerranée (Reference number: 1901175) and the European Regional Development Fund (ERDF) (Project number: MP0022856). The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of data; in the preparation of the manuscript; or in the review or approval of the manuscript. “This study received funds from Alzheimer Prevention in Occitania and Catalonia (APOC Chair of Excellence - Inspire Program). The MAPT study was supported by grants from the Gérontopôle of Toulouse, the French Ministry of Health (PHRC 2008, 2009), Pierre Fabre Research Institute (manufacturer of the omega-3 supplement), ExonHit Therapeutics SA, and Avid Radiopharmaceuticals Inc. The promotion of this study was supported by the University Hospital Center of Toulouse. The data sharing activity was supported by the Association Monegasque pour la Recherche sur la maladie d’Alzheimer (AMPA) and the INSERM-University of Toulouse III UMR 1027 Unit».

Author information

Authors and Affiliations

Authors

Consortia

Contributions

Authors contributions: PB, BV and EG conceived the study. EG, statistics and manuscript writing. KV, PB, LM, BV and SA provided inputs and reviewed the manuscript. BV and SA are PIs in MAPT.

Corresponding author

Correspondence to Emmanuel González-Bautista.

Ethics declarations

Ethical standard: This study did not include any experiments involving humans or other animals.

Additional information

MAPT/DSA group: Principal investigator: Bruno Vellas (Toulouse); Coordination: Sophie Guyonnet; Project leader: Isabelle Carrié; CRA: Lauréane Brigitte; Investigators: Catherine Faisant, Françoise Lala, Julien Delrieu, Hélène Villars; Psychologists: Emeline Combrouze, Carole Badufle, Audrey Zueras; Methodology, statistical analysis and data management: Sandrine Andrieu, Christelle Cantet, Christophe Morin; Multidomain group: Gabor Abellan Van Kan, Charlotte Dupuy, Yves Rolland (physical and nutritional components), Céline Caillaud, Pierre-Jean Ousset (cognitive component), Françoise Lala (preventive consultation) (Toulouse). The cognitive component was designed in collaboration with Sherry Willis from the University of Seattle, and Sylvie Belleville, Brigitte Gilbert and Francine Fontaine from the University of Montreal. Co-Investigators in associated centres: Jean-François Dartigues, Isabelle Marcet, Fleur Delva, Alexandra Foubert, Sandrine Cerda (Bordeaux); Marie-Noëlle-Cuffi, Corinne Costes (Castres); Olivier Rouaud, Patrick Manckoundia, Valérie Quipourt, Sophie Marilier, Evelyne Franon (Dijon); Lawrence Bories, Marie-Laure Pader, Marie-France Basset, Bruno Lapoujade, Valérie Faure, Michael Li Yung Tong, Christine Malick-Loiseau, Evelyne Cazaban-Campistron (Foix); Françoise Desclaux, Colette Blatge (Lavaur); Thierry Dantoine, Cécile Laubarie-Mouret, Isabelle Saulnier, Jean-Pierre Clément, Marie-Agnès Picat, Laurence Bernard-Bourzeix, Stéphanie Willebois, Iléana Désormais, Noëlle Cardinaud (Limoges); Marc Bonnefoy, Pierre Livet, Pascale Rebaudet, Claire Gédéon, Catherine Burdet, Flavien Terracol (Lyon), Alain Pesce, Stéphanie Roth, Sylvie Chaillou, Sandrine Louchart (Monaco); Kristelle Sudres, Nicolas Lebrun, Nadège Barro-Belaygues (Montauban); Jacques Touchon, Karim Bennys, Audrey Gabelle, Aurélia Romano, Lynda Touati, Cécilia Marelli, Cécile Pays (Montpellier); Philippe Robert, Franck Le Duff, Claire Gervais, Sébastien Gonfrier (Nice); Yannick Gasnier and Serge Bordes, Danièle Begorre, Christian Carpuat, Khaled Khales, Jean-François Lefebvre, Samira Misbah El Idrissi, Pierre Skolil, Jean-Pierre Salles (Tarbes). MRI group: Carole Dufouil (Bordeaux), Stéphane Lehéricy, Marie Chupin, Jean-François Mangin, Ali Bouhayia (Paris); Michèle Allard (Bordeaux); Frédéric Ricolfi (Dijon); Dominique Dubois (Foix); Marie Paule Bonceour Martel (Limoges); François Cotton (Lyon); Alain Bonafé (Montpellier); Stéphane Chanalet (Nice); Françoise Hugon (Tarbes); Fabrice Bonneville, Christophe Cognard, François Chollet (Toulouse). PET scans group: Pierre Payoux, Thierry Voisin, Julien Delrieu, Sophie Peiffer, Anne Hitzel, (Toulouse); Michèle Allard (Bordeaux); Michel Zanca (Montpellier); Jacques Monteil (Limoges); Jacques Darcourt (Nice). Medico-economics group: Laurent Molinier, Hélène Derumeaux, Nadège Costa (Toulouse). Biological sample collection: Bertrand Perret, Claire Vinel, Sylvie Caspar-Bauguil (Toulouse). Safety management: Pascale Olivier-Abbal. DSA Group: Sandrine Andrieu, Christelle Cantet, Nicola Coley.

Conflict of interest: The authors declare no competing interest relevant to this article.

The members are listed at the end of the manuscript.

Supporting Information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

González-Bautista, E., De Souto Barreto, P., Virecoulon Giudici, K. et al. Frequency of Conditions Associated with Declines in Intrinsic Capacity According to a Screening Tool in the Context of Integrated Care for Older People. J Frailty Aging 10, 94–102 (2021). https://doi.org/10.14283/jfa.2020.42

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.14283/jfa.2020.42

Key words

Navigation