Hwang An-Chun, Chen Liang-Yu, Tseng Sung-Hua, Huang Chung-Yu, Yen Ko-Han, Chen Liang-Kung, Lin Ming-Hsien, Peng Li-Ning
Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Geriatric Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Geriatric Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan.
J Nutr Health Aging. 2024 Oct;28(10):100359. doi: 10.1016/j.jnha.2024.100359. Epub 2024 Sep 14.
To develop an intrinsic capacity (IC) score and to investigate the association between IC transition with overall and cause-specific mortality, incident disability and healthcare utilization.
Retrospective cohort study SETTING AND PARTICIPANTS: Data from 1852 respondents aged ≥ 65 years who completed the 1999 and 2003 surveys of the Taiwan Longitudinal Study on Aging were analyzed.
Transitions of IC score were categorized into three groups: (1) Improved IC (IC >0), (2) Stable IC (IC = 0), (3) Worsened IC (IC <0). Cox regression and subdistribution hazard models were used to investigate IC transitions and 4-year overall and cause-specific mortality, respectively. Logistic regression were employed to develop weighted IC score (wIC, 0-16) and assess its association with incident disability and healthcare utilization. Similar analysis were repeated using non-weighted IC (nIC, 0-8) to ensure robustness.
Comparing to decreased wIC group, stable or increased wIC participants had significantly lower 4-year all-cause mortality, and death from infection, cardiometabolic/cerebrovascular diseases, organ failure and other causes. (Hazard ratio (HR) ranged from 0.36 to 0.56, 95% CI ranged from 0.15 to 1.00, p ≤ 0.049 in the stable wIC group; HR ranged from 0.41 to 0.51, 95% CI ranged from 0.22 to 0.94, p ≤ 0.034 in the increased wIC group). Moreover, individuals with stable or increased wIC demonstrated lower risk of incident disability and hospitalization. (Odds ratio (OR) = ranged from 0.34 to 0.70, 95% CI ranged from 0.19 to 1.00, p ≤ 0.048). Participants with stable wIC also exhibited reduced risk of emergency department visits (OR = 0.58, 95% CI = 0.41 to 0.82, p = 0.002). These results were generally consistent in the nIC model.
Participants with stable or increased IC experienced significantly lower all-cause and most cause-specific mortality, incident disability, and healthcare utilization, which was independent of baseline IC and comorbidities. The findings remained consistent across weighted and non-weighted IC model.
制定一种内在能力（IC）评分，并研究IC转变与全因死亡率、特定病因死亡率、新发残疾及医疗保健利用之间的关联。
回顾性队列研究
分析了1852名年龄≥65岁的受访者的数据，这些受访者完成了1999年和2003年台湾老年纵向研究的调查。
IC评分的转变分为三组：（1）IC改善（IC>0），（2）IC稳定（IC = 0），（3）IC恶化（IC<0）。分别使用Cox回归和亚分布风险模型研究IC转变与4年全因死亡率及特定病因死亡率。采用逻辑回归制定加权IC评分（wIC，0 - 16），并评估其与新发残疾及医疗保健利用的关联。使用非加权IC（nIC，0 - 8）重复类似分析以确保稳健性。
与wIC降低组相比，wIC稳定或升高的参与者4年全因死亡率以及感染、心脏代谢/脑血管疾病、器官衰竭和其他原因导致的死亡显著降低。（稳定wIC组的风险比（HR）范围为0.36至0.56，95%置信区间（CI）范围为0.15至1.00，p≤0.049；升高wIC组的HR范围为0.41至0.51，95%CI范围为0.22至0.94，p≤0.034）。此外，wIC稳定或升高的个体新发残疾和住院风险较低。（优势比（OR）范围为0.34至0.70，95%CI范围为0.19至1.00，p≤0.048）。wIC稳定的参与者急诊就诊风险也降低（OR = 0.58，95%CI = 0.41至0.82，p = 0.002）。这些结果在nIC模型中总体一致。
IC稳定或升高的参与者全因死亡率和大多数特定病因死亡率、新发残疾及医疗保健利用显著降低，这与基线IC和合并症无关。这些发现在加权和非加权IC模型中均保持一致。
