Identification of decreased intrinsic capacity: Performance of diagnostic measures of the ICOPE Screening tool in community dwelling older people in the VIMCI study.

Autor: Rojano I Luque X; Fundació Salut i Envelliment UAB (FSIE-UAB), Barcelona, Spain.; Sant Pau Institute for Biomedical Research (IIB Sant Pau), Barcelona, Spain., Blancafort-Alias S; Fundació Salut i Envelliment UAB (FSIE-UAB), Barcelona, Spain. sergi.blancafort@uab.cat.; Sant Pau Institute for Biomedical Research (IIB Sant Pau), Barcelona, Spain. sergi.blancafort@uab.cat., Prat Casanovas S; ABS Ripoll-Sant Joan de les Abadesses, Institut Català de la Salut (ICS), Ripoll, Spain., Forné S; Fundació Sant Hospital, La Seu d'Urgell, Lleida, Spain., Martín Vergara N; EAP Horts de Miró, Institut Català de la Salut (ICS), Reus, Spain., Fabregat Povill P; Hospital de la Santa Creu, Tortosa, Spain., Vila Royo M; Badalona Serveis Assistencials (BSA), Badalona, Spain., Serrano R; EDP Salut Sant Joan, Reus, Spain., Sanchez-Rodriguez D; Department, Brugmann University Hospital, Université Libre de Bruxelles, Brussels, Belgium.; Health Organization Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.; Geriatrics Department, Rehabilitation Research Group, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain., Vílchez Saldaña M; ABS CamprodonInstitut Català de la Salut (ICS), Camprodon, Spain., Martínez I; Fundació Sant Hospital, La Seu d'Urgell, Lleida, Spain., Domínguez López M; Hospital de la Santa Creu, Tortosa, Spain., Riba Porquet F; Hospital de la Santa Creu, Tortosa, Spain., Intxaurrondo González A; Fundació Salut i Envelliment UAB (FSIE-UAB), Barcelona, Spain.; Sant Pau Institute for Biomedical Research (IIB Sant Pau), Barcelona, Spain., Salvà Casanovas A; Fundació Salut i Envelliment UAB (FSIE-UAB), Barcelona, Spain.; Sant Pau Institute for Biomedical Research (IIB Sant Pau), Barcelona, Spain.
Jazyk: angličtina
Zdroj: BMC geriatrics [BMC Geriatr] 2023 Feb 21; Vol. 23 (1), pp. 106. Date of Electronic Publication: 2023 Feb 21.
DOI: 10.1186/s12877-023-03799-0
Abstrakt: Background: The World Health Organization (WHO) has developed the Integrated Care for Older People (ICOPE) strategy to face the challenges of ageing societies. This strategy is focused on person centered care and the assessment intrinsic capacity (IC). Early identification of five domains of IC (cognition, locomotion, vitality, sensory (hearing and vision), and psychological) has been shown to be related with adverse outcomes and can guide actions towards primary prevention and healthy ageing. IC assessment proposed by the WHO ICOPE guidelines is composed by two steps: First, Screening for decreased IC by the ICOPE Screening tool; second, by the reference standard methods. The aim was to assess the performance of diagnostic measures (sensibility, specificity, diagnostic accuracy, and agreement of the ICOPE Screening tool) compared to the reference standard methods in European community-dwelling older adults.
Methods: Cross-sectional analysis of the baseline of the ongoing VIMCI (Validity of an Instrument to Measure Intrinsic Capacity) cohort study, which was carried out in Primary Care centers and outpatient clinics from 5 rural and urban territories in Catalonia (Spain). Participants were 207community dwelling persons ≥ 70-year-old with Barthel ≥ 90, without dementia or advanced chronic conditions who provided their consent to participate. The 5 IC domains were assessed by the ICOPE Screening tool and the reference methods (SPPB, gait speed, MNA, Snellen chart, audiometry, MMSE, GDS5) during patients' visit. Agreement was assessed with the Gwet AC1 index.
Results: ICOPE Screening tool sensitivity was higher for cognition (0.889) and ranged between 0.438 and 0.569 for most domains. Specificity ranged from 0.682 to 0.96, diagnostic accuracy from 0.627 to 0.879, Youden index from 0.12 to 0.619, and Gwet AC1 from 0.275 to 0.842.
Conclusion: The ICOPE screening tool showed fair performance of diagnostic measures; it was helpful to identify those participants with satisfactory IC and showed a modest ability to identify decreased IC in older people with high degree of autonomy. Since low sensitivities were found, a process of external validation would be recommended to reach better discrimination. Further studies about the ICOPE Screening tool and its performance of diagnostic measures in different populations are urgently required.
(© 2023. The Author(s).)
Databáze: MEDLINE
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