Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, China.
Yanyuan Rehabilitation Hospital, No.2, Jingrong Street, Nanshao Town, Changping District, Beijing, China.
BMC Geriatr. 2023 Aug 23;23(1):509. doi: 10.1186/s12877-023-04180-x.
Intrinsic capacity (IC) is a comprehensive indicator of an individual's positive attributes. The World Health Organization (WHO) recommends a two-step approach to assess IC decline among older people. The first step involves the used of the integrated care for older people (ICOPE) screening tool to identify potential issues, and the second step involves using detailed assessments for confirmation. This study aimed to assess the diagnostic performance of the ICOPE screening tool as a simple preliminary screening to identify IC decline among community-dwelling older people, which has been rarely reported in China.
This cross-sectional study included 228 community-dwelling older individuals aged ≥ 75 (mean age, 84.0 ± 4.4 years; 131 [57.5%] females) who completed the IC evaluation according to the WHO IC assessment pathway. The diagnostic performance of the ICOPE screening tool was calculated using a 2 × 2 table and a receiver operating characteristic curve.
The proportion of possible IC decline identified by the ICOPE screening tool was 79.4%, whereas the actual IC decline assessed by the detailed assessment was 73.2%, mainly in locomotion. The ICOPE screening tool showed sensitivity and specificity of 94.6% and 62.3%, respectively, with an overall diagnostic accuracy of 86.0%. The diagnostic effectiveness of the ICOPE screening tool was 0.91 (95% confidence interval: 0.87-0.95, p = 0.020). Except for the sensory dimension, the sensitivity of the ICOPE screening tool for diagnosing impairments in each dimension of the IC was the highest in the cognition domain (100%) and the lowest in the vitality domain (51.3%), whereas the specificity was the highest in vitality (94.7%) and the lowest in cognition (55.6%).
The ICOPE screening tool exhibits high sensitivity and can be used as an IC screening tool in community-dwelling older people. However, further improvements are needed in the vitality dimension of the ICOPE screening tool to enhance its sensitivity in identifying individuals at risk of malnutrition.
内在能力（IC）是个体积极属性的综合指标。世界卫生组织（WHO）建议采用两步法评估老年人的 IC 下降情况。第一步是使用老年人综合护理（ICOPE）筛查工具来识别潜在问题，第二步是使用详细评估进行确认。本研究旨在评估 ICOPE 筛查工具作为一种简单的初步筛查工具，用于识别中国社区居住的老年人的 IC 下降情况，这在以前的研究中很少报道。
本横断面研究纳入了 228 名年龄≥75 岁（平均年龄 84.0±4.4 岁；131 名[57.5%]女性）的社区居住老年人，他们根据 WHO IC 评估途径完成了 IC 评估。使用 2×2 表和受试者工作特征曲线计算 ICOPE 筛查工具的诊断性能。
ICOPE 筛查工具识别的可能 IC 下降比例为 79.4%，而详细评估评估的实际 IC 下降比例为 73.2%，主要发生在运动方面。ICOPE 筛查工具的敏感性和特异性分别为 94.6%和 62.3%，总诊断准确性为 86.0%。ICOPE 筛查工具的诊断效果为 0.91（95%置信区间：0.87-0.95，p=0.020）。除了感觉维度外，ICOPE 筛查工具在认知领域诊断 IC 各维度损伤的敏感性最高（100%），在活力领域最低（51.3%），而特异性在活力方面最高（94.7%），在认知方面最低（55.6%）。
ICOPE 筛查工具具有较高的敏感性，可以作为社区居住老年人的 IC 筛查工具。然而，ICOPE 筛查工具在活力维度上需要进一步改进，以提高其识别营养不良风险个体的敏感性。
