Department of Geriatric, Zhejiang Hospital, Hangzhou, China,
Department of Geriatric, Zhejiang Hospital, Hangzhou, China.
Gerontology. 2021;67(3):267-275. doi: 10.1159/000512794. Epub 2021 Mar 18.
Intrinsic capacity (IC) is a novel view focusing on healthy aging. The effect of IC on adverse outcomes in older hospitalized Chinese adults is rarely studied.
This study focused on investigating the impact of IC domains on the adverse health outcomes including new activities of daily living (ADL) dependency, new instrumental activities of daily living (IADL) dependency, and mortality over a 1-year follow-up.
In a retrospective observational population-based study, a total of 329 older hospitalized patients from Zhejiang Hospital in China were enrolled and completed 1-year follow-up. The 5 domains of IC including cognition, locomotion, sensory, vitality, and psychological capacity were assessed at admission. The IC composite score was calculated based on these domains, and the higher IC composite score indicated the greater amount of functional capacities reserved. Multivariate logistic regression models were used to explore the association between IC at baseline and 1-year adverse outcomes.
During the 1-year follow-up, 69 patients (22.5%) experienced new ADL dependency, 103 patients (33.6%) suffered from new IADL dependency, and 22 patients (6.7%) died. After adjusting for age, sex, education level, comorbidities, and polypharmacy, low Mini-Mental State Examination (MMSE) scores at admission predicted 1-year new ADL dependency (odds ratio [OR] = 2.31, 95% confidence interval [CI]: 1.12-4.78) and new IADL dependency (OR = 2.15, 95% CI: 1.14-4.04) among older hospitalized patients, but no significance was obtained between IC domains and mortality. Higher IC composite score at admission was associated with decreased risks of 1-year new ADL dependency (OR = 0.53, 95% CI: 0.40-0.70) and new IADL dependency (OR = 0.76, 95% CI: 0.61-0.95), and 1-year mortality (OR = 0.48, 95% CI: 0.31-0.74) after adjustment for the possible confounders.
Loss of ICs at admission predicted adverse health outcomes including new ADL and IADL dependency and mortality 1 year after discharge among older hospitalized patients.
内在能力（IC）是一种关注健康老龄化的新观点。IC 对中国老年住院患者不良结局的影响很少有研究。
本研究旨在探讨 IC 各领域对新日常生活活动（ADL）依赖、新工具性日常生活活动（IADL）依赖和 1 年死亡率等不良健康结局的影响。
在一项回顾性观察性基于人群的研究中，共纳入中国浙江大学附属医院的 329 名老年住院患者，并完成了 1 年的随访。在入院时评估了包括认知、运动、感觉、活力和心理能力在内的 5 个 IC 领域。根据这些领域计算 IC 综合评分，较高的 IC 综合评分表明保留的功能能力越多。使用多变量逻辑回归模型探讨基线时 IC 与 1 年不良结局之间的关系。
在 1 年的随访期间，69 名患者（22.5%）出现新的 ADL 依赖，103 名患者（33.6%）出现新的 IADL 依赖，22 名患者（6.7%）死亡。在校正年龄、性别、教育程度、合并症和多药治疗后，入院时的简易精神状态检查（MMSE）评分较低预测 1 年新 ADL 依赖（优势比[OR] = 2.31，95%置信区间[CI]：1.12-4.78）和新 IADL 依赖（OR = 2.15，95%CI：1.14-4.04），但 IC 各领域与死亡率之间无显著相关性。入院时较高的 IC 综合评分与 1 年新 ADL 依赖（OR = 0.53，95%CI：0.40-0.70）和新 IADL 依赖（OR = 0.76，95%CI：0.61-0.95）以及 1 年死亡率（OR = 0.48，95%CI：0.31-0.74）的风险降低相关，且在调整可能的混杂因素后具有统计学意义。
入院时 IC 的丧失预测了老年住院患者出院后 1 年内新的 ADL 和 IADL 依赖以及死亡率等不良健康结局。
