Guo Zhiting, Chen Yuling, Koirala Binu, Li Jiaying, Jia Yingying, Dennison Himmelfarb Cheryl R, Jin Jingfen
The Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU), No.88 Jiefang Road, Shangcheng District, Hangzhou, 310009, Zhejiang Province, China.
Faculty of Nursing, Zhejiang University school of medicine, No.866 Yuhangtang Road, Xihu District, Hangzhou, Zhejiang Province, China.
BMC Geriatr. 2025 Apr 23;25(1):269. doi: 10.1186/s12877-025-05910-z.
Intrinsic capacity (IC), a composite of physical and mental capacities, is a marker of healthy aging. However, the association between changes in IC and trajectories in older adults and the onset of cardiovascular diseases (CVD) remains unclear.
To identify IC trajectories over time and assess the associations between IC trajectories and the incidence of CVD among older adults.
The prospective cohort study used data from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2020. To determine IC trajectory during 2011-2015, we included adults aged 60 years or older without CVD at baseline, who completed the follow-up visits in 2013 and 2015. We assessed IC through five domains (locomotion, sensory, vitality, cognition, and psychology) using the WHO framework. We determined the onset of CVD by self-reported diagnoses of heart disease or stroke. We performed a group-based trajectory model to identify IC trajectory, and cox proportional hazard models to estimate the adjusted hazard ratio (HR) for CVD incident across different IC trajectory groups, adjusting for sociodemographic factors, lifestyle health behaviors, and cardiovascular metabolic factors.
The study included 3 336 adults without CVD at baseline, with the mean age of 66.64 (SD:5.53) years, and 49.4% were male. The baseline mean IC score was 5.40 (SD:1.70). We identified three IC trajectory: (1) moderate IC with subsequent increase (61.3%), (2) low IC with slow decline (27.61%), and (3) high IC with subsequent decline (11.09%). During the average follow-up of 6.78 years, we identified 1,351 cases of incident CVD. After adjusting for covariates, adults who in the low IC with slow decline group were 1.68 (95% CI: 1.38-2.04) times more likely to develop CVD, compared to adults in the high IC with subsequent decline group.
IC trajectory among Chinese older adults is heterogeneous. Low IC with slow declining is associated with an increased risk of CVD incidence.
内在能力（IC）是身体和心理能力的综合体现，是健康老龄化的一个标志。然而，老年人内在能力的变化与轨迹以及心血管疾病（CVD）发病之间的关联仍不明确。
确定随时间变化的内在能力轨迹，并评估老年人内在能力轨迹与心血管疾病发病率之间的关联。
这项前瞻性队列研究使用了中国健康与养老追踪调查（CHARLS）2011年至2020年的数据。为了确定2011 - 2015年期间的内在能力轨迹，我们纳入了基线时年龄在60岁及以上且无心血管疾病的成年人，他们在2013年和2015年完成了随访。我们使用世界卫生组织的框架，通过五个领域（运动、感官、活力、认知和心理）评估内在能力。我们通过自我报告的心脏病或中风诊断来确定心血管疾病的发病情况。我们进行了基于群体的轨迹模型以识别内在能力轨迹，并使用Cox比例风险模型来估计不同内在能力轨迹组中心血管疾病发病的调整后风险比（HR），同时对社会人口学因素、生活方式健康行为和心血管代谢因素进行了调整。
该研究纳入了3336名基线时无心血管疾病的成年人，平均年龄为66.64（标准差：5.53）岁，男性占49.4%。基线时内在能力平均得分为5.40（标准差：1.70）。我们识别出三种内在能力轨迹：（1）中等内在能力且随后上升（61.3%），（2）低内在能力且缓慢下降（27.61%），以及（3）高内在能力且随后下降（11.09%）。在平均6.78年的随访期间，我们识别出1351例心血管疾病发病病例。在对协变量进行调整后，与高内在能力且随后下降组的成年人相比，低内在能力且缓慢下降组的成年人患心血管疾病的可能性高1.68（95%置信区间：1.38 - 2.04）倍。
中国老年人的内在能力轨迹具有异质性。低内在能力且缓慢下降与心血管疾病发病风险增加相关。
