Azmeraw T. Amare, Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia, Tel: +61 8 83137438, E-Mail:
J Frailty Aging. 2024;13(3):193-202. doi: 10.14283/jfa.2024.30.
In 2015, the World Health Organization (WHO) introduced the concept of intrinsic capacity (IC) to define healthy aging based on functional capacity. In this scoping review, we summarized available evidence on the development and validation of IC index scores, the association of IC with health-related factors, and its biological basis. The review specifically focused on identifying current research gaps, proposed strategies to leverage biobank datasets, and opportunities to study the genetic mechanisms and gene-environment interactions underlying IC.
The literature search was conducted across six databases, including PubMed, CINAHL, Web of Science, Scopus, AgeLine, and PsycINFO, using keywords related to IC.
This review included 84 articles, and most of them (n=38) adopted the 5-domains approach to operationalize IC, utilizing correlated five factors or bifactor structures. Intrinsic capacity has consistently shown significant associations with socio-demographic and health-related outcomes, including age, sex, wealth index, nutrition, exercise, smoking, alcohol use, ADL, IADL, frailty, multimorbidity, and mortality. While studies on the biological basis of the composite IC are limited, with only one study finding a significant association with the ApoE gene variants, studies on specific IC domains - locomotor, vitality, cognitive, psychological, and sensory suggest a heritability of 20-85% of IC and several genetic variants associated with these subdomains have been identified. However, evidence on how genetic and environmental factors influence IC is still lacking, with no available study to date.
Our review found that there was inconsistency in the use of standardized IC measurement tools and indicators, but the IC indices had shown good construct and predictive validity. Research into the genetic and gene-to-environment interactions underlying IC is still lacking, which calls for the use of resources from large biobank datasets in the future.
2015 年，世界卫生组织（WHO）提出了内在能力（IC）的概念，根据功能能力来定义健康老龄化。在本次范围综述中，我们总结了现有关于 IC 指数得分的开发和验证、IC 与健康相关因素的关联以及其生物学基础的证据。本综述特别关注确定当前研究差距、提出利用生物库数据集的策略，以及研究 IC 背后的遗传机制和基因-环境相互作用的机会。
文献检索在六个数据库中进行，包括 PubMed、CINAHL、Web of Science、Scopus、AgeLine 和 PsycINFO，使用与 IC 相关的关键词。
本综述包括 84 篇文章，其中大多数（n=38）采用 5 域方法来操作化 IC，利用相关的五个因素或双因素结构。内在能力一直与社会人口学和健康相关的结果（包括年龄、性别、财富指数、营养、运动、吸烟、饮酒、ADL、IADL、虚弱、多种疾病和死亡率）有显著关联。虽然关于综合 IC 生物学基础的研究有限，只有一项研究发现与 ApoE 基因变异有显著关联，但关于特定 IC 领域（运动、活力、认知、心理和感官）的研究表明，IC 的遗传率为 20-85%，并已确定了几个与这些子领域相关的遗传变异。然而，关于遗传和环境因素如何影响 IC 的证据仍然缺乏，迄今为止尚无可用的研究。
我们的综述发现，标准化 IC 测量工具和指标的使用存在不一致性，但 IC 指数显示出良好的结构和预测有效性。关于 IC 背后的遗传和基因-环境相互作用的研究仍然缺乏，这呼吁未来利用大型生物库数据集的资源。
