Ruby Yu, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong, China, Tel: (852) 3943 5142, Fax: (852) 2637 9215, E-mail:
J Nutr Health Aging. 2023;27(3):174-181. doi: 10.1007/s12603-023-1881-5.
OBJECTIVES: Intrinsic capacity (IC) declines progressively with age, thereby increasing the risk of disability. However, it is less known whether IC trajectories are associated with disability. This study aims to identify the different patterns of IC trajectories in older people, and examine their determinants and associations with Instrumental Activities of Daily Living (IADL). DESIGN: Cohort study. SETTING: Community centres in different regions in Hong Kong. PARTICIPANTS AND MEASUREMENTS: Longitudinal data from community-dwelling older people aged 60 years or above (n = 1371) collected between 2016 and 2021 was analysed. Their mean age was 74.5 years, and 78.7% of them were female. Repeated measurements of a set of 14 self-reported items were used to generate IC scores at four time points using a bi-factor model. Latent class growth analysis was performed to identify classes with distinct IC trajectories. The association between class membership and IADL disability was then examined using logistic regression. RESULTS: Three distinct IC trajectories were identified. The 1st class included those with the highest level of baseline IC and the least declining trajectory, whereas the 3rd class was composed by those with the lowest level of baseline IC and the most declining trajectory. Older age, female gender, lower perceived financial adequacy, living in public or subsidized housing, and chronic diseases were associated with the 3rd class. After adjusting for demographic factors, socioeconomic status, and the number of chronic diseases, the 1st class was more likely to preserve IADL when compared against the 2nd class, with OR being 3.179 (95% CI: 2.152-4.793), whereas for the 3rd class, the OR was 0.253 (95% CI: 0.178-0.359). CONCLUSION: Monitoring IC trajectories is of relevance to clinical practice, as it helps shift the focus from treating acute episodes of illness to preserving the functional ability of older people.
目的:内在能力(IC)随年龄增长而逐渐下降,从而增加残疾的风险。然而,IC 轨迹是否与残疾有关则知之甚少。本研究旨在确定老年人中不同的 IC 轨迹模式,并探讨其决定因素及其与工具性日常生活活动(IADL)的关系。
设计:队列研究。
地点:香港不同地区的社区中心。
参与者和测量:分析了 2016 年至 2021 年间收集的 1371 名 60 岁或以上社区居住的老年人的纵向数据。他们的平均年龄为 74.5 岁,其中 78.7%为女性。使用双因素模型,通过重复测量一套 14 项自我报告项目,在四个时间点生成 IC 评分。然后使用潜类增长分析来确定具有不同 IC 轨迹的类。最后,使用逻辑回归检验类别的成员身份与 IADL 残疾之间的关系。
结果:确定了三种不同的 IC 轨迹。第 1 类包括基线 IC 水平最高且下降轨迹最小的人群,而第 3 类则由基线 IC 水平最低且下降轨迹最大的人群组成。年龄较大、女性、较低的感知财务充足度、居住在公共或补贴住房中和患有慢性疾病与第 3 类相关。调整人口统计学因素、社会经济地位和慢性疾病数量后,与第 2 类相比,第 1 类更有可能保留 IADL,OR 为 3.179(95%CI:2.152-4.793),而对于第 3 类,OR 为 0.253(95%CI:0.178-0.359)。
结论:监测 IC 轨迹与临床实践相关,因为它有助于将关注焦点从治疗急性疾病发作转移到保护老年人的功能能力上。
J Nutr Health Aging. 2023
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