Geriatric Unit - Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, 5° andar, sala C 5006, Bloco C, Porto Alegre, RS CEP 90035-903, Brazil; Post Graduation Program in Medical Sciences: Endocrinology, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2° andar, Porto Alegre, RS CEP 90035-000, Brazil; Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalier-Universitaire de Toulouse, 37 Allés Jules Guesdes, Toulouse, CP 31000, France.
Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo (USP), Av. Dr. Enéas de Carvalho Aguiar, 155, 8° andar, Bloco 8A, Setor Azul, São Paulo, SP CEP 05003-900, Brazil.
Maturitas. 2023 Nov;177:107818. doi: 10.1016/j.maturitas.2023.107818. Epub 2023 Jul 28.
The World Health Organization has developed the Integrated Care for Older People (ICOPE) program, a public health strategy to maintain older adults' functional abilities and promote healthier aging. The approach comprises a 5-step pathway. Step 1 is the screening for impairment in functions, and Step 2 is an in-depth evaluation to confirm the presence and severity of functional impairment. These initial two steps are crucial to determine the subsequent plan of care (Step 3) and follow-up (Step 4). The fifth step encompasses actions to support families and caregivers and to engage communities. This review gathers data from the literature on the prevalence of positive screenings regarding intrinsic capacity detected by the program's first-step screening tool, and on currently available results regarding the instrument's sensitivity and specificity.
Electronic searches were conducted in the PubMed, Cochrane, Embase, and SciElo databases, the medRxiv platform, and recent human aging scientific events, looking for research analyzing the ICOPE screening instrument. Studies reporting data on the prevalence of positive screenings for loss of intrinsic capacity using the proposed screening tool and/or findings on the instrument's sensitivity and specificity were included. A total of 7 publications with participants aged 50 years or more were selected. The prevalence of at least one impairment in intrinsic capacity detected by the instrument varied among the studies from 17.1 % to 94.3 %. Sensitivity ranged from 26.4 % to 100 % and specificity from 22 % to 96 %, depending on the setting and the assessed domain.
Currently available data are heterogeneous, and different results were found among the studies due to diverse settings and methodologies. The evidence on the ICOPE screening tool's performance in different populations is still scarce and reinforces the need for further research worldwide.
世界卫生组织制定了综合老年人护理（ICOPE）计划，这是一项维护老年人功能能力和促进健康老龄化的公共卫生策略。该方法包括 5 个步骤的途径。第 1 步是筛查功能障碍，第 2 步是进行深入评估以确认功能障碍的存在和严重程度。这前两步对于确定后续护理计划（第 3 步）和随访（第 4 步）至关重要。第 5 步包括支持家庭和护理人员以及参与社区的行动。本综述从文献中收集了关于该计划第 1 步筛查工具检测到的内在能力的阳性筛查的流行率的数据，以及关于该工具的敏感性和特异性的现有结果。
在 PubMed、Cochrane、Embase 和 SciELO 数据库、medRxiv 平台以及最近的人类衰老科学活动中进行了电子检索，以寻找分析 ICOPE 筛查工具的研究。选择了 7 篇报告了使用所提出的筛查工具对内在能力丧失进行阳性筛查的流行率数据和关于该工具的敏感性和特异性的研究。共选择了 7 项研究，研究对象年龄均在 50 岁及以上。该工具检测到的内在能力至少有一项受损的发生率在研究中从 17.1%到 94.3%不等。灵敏度范围从 26.4%到 100%，特异性从 22%到 96%，具体取决于研究的设置和评估的领域。
目前可用的数据存在异质性，由于不同的设置和方法学，研究之间存在不同的结果。关于 ICOPE 筛查工具在不同人群中的性能的证据仍然很少，这加强了在全球范围内进行进一步研究的必要性。
