Sánchez-Sánchez Juan Luis, Rolland Yves, Cesari Matteo, de Souto Barreto Philipe
Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.
Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France; CERPOP UMR1295, Université de Toulouse, Inserm, UPS, Toulouse, France.
J Am Med Dir Assoc. 2022 May;23(5):872-876.e4. doi: 10.1016/j.jamda.2021.08.035. Epub 2021 Sep 25.
The predictive ability of the novel intrinsic capacity (IC) construct has been scarcely investigated in the nursing home setting. The objective of this study was to investigate the associations of IC and its individual domains with mortality, hospitalization, pneumonia onset, and functional status decline in a population of nursing home residents (NHRs).
We undertook an analysis using data from the INCUR study, a prospective observational study. Data were collected at baseline, at 6 and 12 months by trained staff.
A total of 371 NHRs (mean age 85.91 ± 7.34) dwelling in Southern France.
A baseline IC composite score was constructed from scores in the Short Physical Performance Battery, Abbreviated Mental Test, 10-item Geriatric Depression Scale, The Short Form of the Mini-Nutritional Assessment, and self-reported hearing and vision impairments. Adverse outcomes were registered by medical records checking. Functional status evolution was evaluated through changes in the Katz Index. Cox regression was used for associations between IC and its domains and adverse outcomes. Linear mixed models were used in the case of functional status evolution.
Our analysis revealed associations between a composite score of IC and death [hazard ratio 0.33; 95% confidence interval (CI) 0.15-0.73] and functional status evolution (β = 0.14; 95% CI 0.018-0.29) in our population. Although greater values in IC vitality/nutrition domain were associated with survival (HR 0.84; 95% CI 0.70-0.99), IC cognitive domain was associated with decreased odds of hospitalization (HR 0.91; 95% CI 0.84-0.99) and lower declines in functional status (β = 0.04; 95% CI 0.01-0.07), whereas the IC locomotion domain was inversely associated with pneumonia incidence (HR 0.84; 95% CI 0.72-0.98).
Our results contribute to preliminary evidence linking greater IC levels and lower risk of late-life adverse outcomes.
新型内在能力（IC）结构的预测能力在养老院环境中鲜有研究。本研究的目的是调查IC及其各个领域与养老院居民（NHRs）群体的死亡率、住院率、肺炎发病以及功能状态下降之间的关联。
我们使用了INCUR研究的数据进行分析，这是一项前瞻性观察性研究。数据由经过培训的工作人员在基线、6个月和12个月时收集。
共有371名居住在法国南部的NHRs（平均年龄85.91±7.34）。
根据简短体能测试、简易精神状态检查、10项老年抑郁量表、简易营养评估简表以及自我报告的听力和视力障碍得分构建基线IC综合评分。通过检查医疗记录来记录不良结局。通过Katz指数的变化评估功能状态演变。使用Cox回归分析IC及其领域与不良结局之间的关联。在功能状态演变的情况下使用线性混合模型。
我们的分析揭示了IC综合评分与我们研究人群中的死亡[风险比0.33；95%置信区间（CI）0.15 - 0.73]以及功能状态演变（β = 0.14；95% CI 0.018 - 0.29）之间的关联。尽管IC活力/营养领域的较高值与生存相关（HR 0.84；95% CI 0.70 - 0.99），但IC认知领域与住院几率降低相关（HR 0.91；95% CI 0.84 - 0.99）以及功能状态下降幅度较小相关（β = 0.04；95% CI 0.01 - 0.07），而IC运动领域与肺炎发病率呈负相关（HR 0.84；95% CI 0.72 - 0.98）。
我们的结果为将较高的IC水平与较低的晚年不良结局风险联系起来提供了初步证据。
