Carol Hok Ka Ma, Gerontology Programme, S R Nathan School of Human Development, Singapore University Of Social Sciences, Singapore,
J Frailty Aging. 2024;13(4):514-521. doi: 10.14283/jfa.2024.59.
The World Health Organization (WHO) introduced the Integrated Care for Older People (ICOPE) approach to assist communities in evaluating the intrinsic capacities of older adults and proposing strategies to prevent, mitigate, or reverse declines. This study represents the inaugural attempt to assess intrinsic capacities among older adults in Singapore, aligning with the nation's Healthier Singapore (Healthier SG) initiative aimed at enhancing quality of life.
This study aims to investigate the feasibility of implementing Step 1 screening of the ICOPE framework, which assesses cognition, locomotion, vitality, psychological state, visual and auditory functions, within the Singapore context.
DESIGN, SETTING, AND PARTICIPANTS: Using a mixed-method approach, this cross-sectional study established a baseline understanding of the levels of intrinsic capacity in 367 community-dwelling older adults in Singapore (mean age 71.8 years), elucidated the experiences of administering the ICOPE Step 1 screening tool and the formulation of personalized care plans from the perspective of 25 assessors.
Participants completed ICOPE Step 1 screening, providing basic demographic and health profiles, while assessors engaged in focus group discussions.
Among older participants, 284 exhibited signs of decline in intrinsic capacity. The primary areas of decline were visual impairment (42.0%), hearing loss (33.5%), and cognitive deterioration (31.3%), followed by limited mobility (24.3%), malnutrition (16.1%), and depressive symptoms (16.1%). Assessors found the ICOPE screening tool user-friendly and appreciated its person-centred approach, noting its integration with care plans, which many other tools lacked. They were confident in Singapore's capacity to adopt the ICOPE approach, citing existing practices in assessing intrinsic capacity domains and integrated care models.
Critical steps for successful implementation of the ICOPE framework include follow-up interventions like self-management strategies for declining intrinsic capacity, diagnostic assessments, and routine monitoring. Coordination between healthcare clusters and community care networks is essential for its success.
世界卫生组织（WHO）引入了综合老年人护理（ICOPE）方法，以帮助社区评估老年人的内在能力，并提出预防、减轻或逆转衰退的策略。这项研究是新加坡首次评估老年人内在能力的尝试，与新加坡的“更健康新加坡”（Healthier SG）倡议保持一致，旨在提高生活质量。
本研究旨在调查在新加坡实施 ICOPE 框架第一步筛查的可行性，该框架评估认知、运动、活力、心理状态、视觉和听觉功能。
设计、地点和参与者：使用混合方法，本横断面研究在新加坡确定了 367 名居住在社区的老年人（平均年龄 71.8 岁）的内在能力水平基线，阐明了 25 名评估者从评估者的角度管理 ICOPE 第一步筛查工具和制定个性化护理计划的经验。
参与者完成 ICOPE 第一步筛查，提供基本的人口统计学和健康概况，而评估者则参与焦点小组讨论。
在老年参与者中，有 284 人表现出内在能力下降的迹象。主要的下降领域是视力障碍（42.0%）、听力损失（33.5%）和认知能力下降（31.3%），其次是行动不便（24.3%）、营养不良（16.1%）和抑郁症状（16.1%）。评估者发现 ICOPE 筛查工具易于使用，并赞赏其以患者为中心的方法，指出其与护理计划的整合，而许多其他工具缺乏这一点。他们对新加坡采用 ICOPE 方法的能力充满信心，提到了评估内在能力领域和综合护理模式的现有实践。
成功实施 ICOPE 框架的关键步骤包括后续干预措施，如针对内在能力下降的自我管理策略、诊断评估和常规监测。医疗保健集群和社区护理网络之间的协调对于其成功至关重要。
