Chew J, Lee J, Hernandez H H C, Munro Y L, Lim C L, Lim W S
Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore; Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore.
Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore; Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore.
J Frailty Aging. 2025 Aug;14(4):100058. doi: 10.1016/j.tjfa.2025.100058. Epub 2025 Jun 13.
Intrinsic capacity (IC) is a composite indicator of physical and mental capacities that are critical for healthy aging. IC comprises five domains, with "vitality" gaining most attention due to its potential impact on functional and physiological reserves with increasing age. The World Health Organization 2022 framework redefined vitality as an underlying physiological determinant of IC. However, the concept and measurement of vitality and its empirical validation are not well defined.
This scoping review aims to: (1) map the conceptual frameworks underpinning vitality within the IC domain and (2) identify existing measures used to assess vitality.
A systematic search of MEDLINE, PubMed, Embase, Web of Science, and WHO databases (2003-2023) using Arksey and O'Malley's framework and PRISMA-ScR guidelines. Studies involving adults ≥50 years old that addressed vitality in IC were included. We extracted data on conceptual frameworks, measurement tools, and construct validity.
Eighty-one studies met the inclusion criteria. Initial frameworks of vitality focused on nutritional indicators, while recent concepts include neuromuscular function, metabolism, and immune-stress responses. However, operationalization of these concepts remains inconsistent, with most studies relying on anthropometry, appetite, weight loss, and handgrip strength, while immune and stress response-related biomarkers were rarely assessed. Only 10.5 % of studies evaluated construct validity of vitality, and limited studies validated the potential roles of vitality underpinning the other expressed capacities.
Currently, vitality within IC varies in definitions and measurement approaches, with a predominant focus on nutrition and muscle strength. Empirical validation of vitality's role as a foundational IC domain remains limited. Expanding the scope of vitality to include metabolic and immune markers, and deeper examination of the interactions between vitality with other IC domains may enhance understanding and improve assessment frameworks for healthy aging.
内在能力（IC）是对健康老龄化至关重要的身体和心理能力的综合指标。IC包括五个领域，其中“活力”因其对随着年龄增长的功能和生理储备的潜在影响而备受关注。世界卫生组织2022年框架将活力重新定义为IC的潜在生理决定因素。然而，活力的概念、测量及其实证验证尚未明确界定。
本范围综述旨在：（1）梳理IC领域内支撑活力的概念框架；（2）识别用于评估活力的现有测量方法。
使用阿克斯和奥马利的框架以及PRISMA-ScR指南，对MEDLINE、PubMed、Embase、科学网和世卫组织数据库（2003年至2023年）进行系统检索。纳入涉及≥50岁成年人且探讨IC中活力的研究。我们提取了关于概念框架、测量工具和结构效度的数据。
81项研究符合纳入标准。活力的初始框架侧重于营养指标，而最近的概念包括神经肌肉功能、新陈代谢和免疫应激反应。然而，这些概念的操作化仍不一致，大多数研究依赖人体测量、食欲、体重减轻和握力，而与免疫和应激反应相关的生物标志物很少被评估。只有10.5%的研究评估了活力的结构效度，且有限的研究验证了活力作为其他所表达能力基础的潜在作用。
目前，IC中的活力在定义和测量方法上各不相同，主要侧重于营养和肌肉力量。活力作为IC基础领域的作用的实证验证仍然有限。将活力的范围扩大到包括代谢和免疫标志物，并深入研究活力与其他IC领域之间的相互作用，可能会增进理解并改善健康老龄化的评估框架。
