Aliberti Márlon J R, Bertola Laiss, Szlejf Claudia, Oliveira Déborah, Piovezan Ronaldo D, Cesari Matteo, de Andrade Fabíola Bof, Lima-Costa Maria Fernanda, Perracini Monica Rodrigues, Ferri Cleusa P, Suemoto Claudia K
Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
Research Institute, Hospital Sirio-Libanes, São Paulo, Brazil.
Lancet Reg Health Am. 2022 May 27;12:100284. doi: 10.1016/j.lana.2022.100284. eCollection 2022 Aug.
While efforts have been made to validate intrinsic capacity (IC) as a multidimensional indicator of healthy aging in high-income countries, we still need evidence from lower-income countries. We examined associations of IC with wide ranges of activities of daily living in a nationally representative sample of Brazilians aged≥50 years.
This cross-sectional analysis included 7175 participants from the Brazilian Longitudinal Study of Aging. IC domains (cognitive, psychological, sensory, locomotor, and vitality) were determined using self-reported and physical performance measures. IC was operationalized through factorial analysis. We investigated associations of IC and its domains with functional ability in basic, instrumental, and advanced activities of daily living (ADL, IADL, and AADL) using logistic regressions adjusted for sociodemographic, clinical, and modifiable risk factors.
The IC bi-factorial model revealed satisfactory goodness-of-fit. Preserved ability in ADL and IADL, respectively, ranged from 69% and 29% to 89% and 74% across IC quartiles. In adjusted analyses, every standard deviation increment in IC composite score was associated with almost twice the odds of preserved ADL (OR=1·72; 95%CI=1·54-1·93), preserved IADL (OR=1·95; 95%CI=1·77-2·16), and high performance in AADL (OR=1·79; 95%CI=1·59-2·00). Similar results were reported using the IC domains as predictors. Although age, race/ethnicity, and education did not modify associations of IC with functional ability, we found sex differences with stronger relationships of IC with preserved ADL or IADL in females.
Our results support IC validity and reliability to measure healthy aging in diverse socioeconomic and cultural settings. Incorporating IC in routine practices can promote holistic and person-centered care approaches in aging societies.
The Brazilian Ministry of Health and Ministry of Science, Technology, Innovation, and Communication.
尽管在高收入国家已努力验证内在能力（IC）作为健康老龄化的多维指标，但我们仍需要低收入国家的证据。我们在一个全国代表性的≥50岁巴西样本中研究了IC与广泛的日常生活活动之间的关联。
这项横断面分析纳入了巴西老龄化纵向研究的7175名参与者。IC领域（认知、心理、感官、运动和活力）通过自我报告和身体表现测量来确定。IC通过因子分析进行操作化。我们使用针对社会人口学、临床和可改变风险因素进行调整的逻辑回归，研究了IC及其领域与基本、工具性和高级日常生活活动（ADL、IADL和AADL）中的功能能力之间的关联。
IC双因子模型显示出令人满意的拟合优度。在IC四分位数中，ADL和IADL的保留能力分别从69%和29%到89%和74%不等。在调整分析中，IC综合评分每增加一个标准差，与ADL保留（OR=1.72；95%CI=1.54-1.93）、IADL保留（OR=1.95；95%CI=1.77-2.16）以及AADL高表现（OR=1.79；95%CI=1.59-2.00）的几率几乎翻倍相关。使用IC领域作为预测因子也报告了类似结果。尽管年龄、种族/民族和教育并未改变IC与功能能力之间的关联，但我们发现存在性别差异，女性中IC与保留的ADL或IADL之间的关系更强。
我们的结果支持IC在不同社会经济和文化背景下测量健康老龄化的有效性和可靠性。将IC纳入常规实践可以促进老龄化社会中整体和以人为主的护理方法。
巴西卫生部以及科学、技术、创新和通信部。
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