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Operationalisation of intrinsic capacity in older people and its association with subsequent disability, hospital admission and mortality: results from ELSA

Campbell, Charlotte L; Cadar, Dorina; McMunn, Anne; Zaninotto, Paola; (2023) Operationalisation of intrinsic capacity in older people and its association with subsequent disability, hospital admission and mortality: results from ELSA. The Journals of Gerontology: Series A , Article glac250. 10.1093/gerona/glac250. (In press). Green open access

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Abstract

BACKGROUND: Intrinsic capacity (IC) is a new concept in the healthy ageing field and has many operationalised definitions. In this study, we operationalised IC using item response theory in the English Longitudinal Study of Ageing (ELSA) and tested the predictive value of the scale using subsequent functional ability, mortality, and hospital admission. METHODS: IC was measured at baseline (2004, Wave 2) using 14 dichotomous indicators: word recall, orientation in time, balance, chair rises, walking speed, upper mobility, lower mobility, eyesight, hearing, grip strength, BMI, waist circumference, depressive symptoms, life satisfaction. A two-parameter item response theory model was used to generate a scale of IC at baseline. Logistic regression was used for the prediction of subsequent difficulties, measured by difficulties with ≥1 activities of daily living (ADLs) and ≥1 instrumental activities of daily living (IADLs) at 4 and 8 years after baseline. Competing risk and cox regressions were employed to test prediction of hospital admission and mortality, respectively, over a 14-year follow-up. RESULTS: Intrinsic capacity scores were generated for 4,545 individuals aged on average 70.8 years (SD 7.93). Better baseline IC scores were associated with reduced risk of subsequent difficulties with ADLs and IADLs, hospital admission (SHR=0.99, 95%CI 0.98-0.99) and mortality (HR=0.98, 95%CI 0.98-0.99), when adjusted for sociodemographic and health-related covariates. CONCLUSIONS: These results suggest the utility of this IC score as a measure of risk for future adverse outcomes in older people, potentially above that indicated by other sociodemographic and health-related factors.

Type: Article
Title: Operationalisation of intrinsic capacity in older people and its association with subsequent disability, hospital admission and mortality: results from ELSA
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/gerona/glac250
Publisher version: https://doi.org/10.1093/gerona/glac250
Language: English
Additional information: Copyright © The Author(s) 2022. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Dependence, index, survival
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Education
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute > IOE - Closer
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/10162151
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