Shin Ji Hye, Sagong Hae, Yoon Ju Young
College of Nursing, Seoul National University, Seoul, Republic of Korea.
College of Nursing, Auburn University, 710 South Donahue Drive Auburn, Auburn, AL, USA.
Arch Gerontol Geriatr. 2025 Apr;131:105772. doi: 10.1016/j.archger.2025.105772. Epub 2025 Jan 27.
Functional ability (FA), a key determinant of healthy aging, is determined by intrinsic capacity (IC), environmental factors, and their interactions. IC is a composite of physical and mental capacities that undergo constant change. Therefore, understanding the factors that influence IC requires a multi-level analysis of individuals to optimize its trajectory.
Individuals aged ≥ 65 were included in the Korean Longitudinal Study of Aging (2012-2020). Impaired IC (IIC) scores were tracked over eight years using latent class growth modeling to classify trajectory patterns. Determinants were identified through multinomial logistic regression. The relationship between IIC trajectory and FA decline was assessed using Kaplan-Meier analysis and the Cox proportional hazards model.
Of the 7486 subjects, 2268 (mean age 72.26 [SD 5.31] years; female 56.4 %) were included after excluding those who were underage, had lost independence, or were missing baseline data. The IIC trajectories were categorized into four classes: low-persistent (Class 1, 48.46 %); low-increasing (Class 2, 17.46 %); high-decreasing (Class 3, 20.37 %); and high-stable (Class 4, 13.71 %). Over a mean follow-up of 7.21 years, 536 individuals experienced a decline in FA. After adjusting for confounders, the hazard ratios (HRs) were 1.95 (95 % CI 1.51-2.50) for class 2, 1.93 (1.50-2.46) for class 3, and 3.41 (2.64-4.39) for class 4 compared to class 1. Additionally, age, gender, marital status, employment, social participation, and living status had overlapping effects on both IC and FA.
Understanding the heterogeneity of IC, combined with multidomain interventions, can enable FA maintenance and promote healthy aging.
功能能力（FA）是健康老龄化的关键决定因素，由内在能力（IC）、环境因素及其相互作用决定。IC是身体和心理能力的综合体现，且会不断变化。因此，了解影响IC的因素需要对个体进行多层次分析，以优化其发展轨迹。
年龄≥65岁的个体纳入韩国老龄化纵向研究（2012 - 2020年）。使用潜在类别增长模型追踪受损IC（IIC）评分八年，以分类轨迹模式。通过多项逻辑回归确定决定因素。使用Kaplan - Meier分析和Cox比例风险模型评估IIC轨迹与FA下降之间的关系。
在7486名受试者中，排除未达年龄、失去独立能力或缺少基线数据的个体后，纳入2268名（平均年龄72.26[标准差5.31]岁；女性占56.4%）。IIC轨迹分为四类：低持续性（第1类，48.46%）；低增长性（第2类，17.46%）；高下降性（第3类，20.37%）；高稳定性（第4类，13.71%）。平均随访7.21年期间，536名个体的FA出现下降。调整混杂因素后，与第1类相比，第2类的风险比（HR）为1.95（95%置信区间1.51 - 2.50），第3类为1.93（1.50 - 2.46），第4类为3.41（2.64 - 4.39）。此外，年龄、性别、婚姻状况、就业、社会参与和生活状况对IC和FA均有重叠影响。
了解IC的异质性并结合多领域干预措施，可维持FA并促进健康老龄化。
