Publication:

Intrinsic capacity declines and fall risk among older adults: an integrated care for older people-based assessment at an urban health training centre in Western Maharashtra

Background Intrinsic capacity (IC), defined by the world health organization (WHO) as a composite of all physical and mental capacities of an individual, is central to healthy ageing. The WHO integrated care for older people (ICOPE) step 1 screening tool is a rapid, feasible approach to detect early declines in locomotion, cognition, vitality, sensory function and psychological well-being. Indian evidence from primary care settings, especially urban health training centres (UHTCs), remains limited. To assess the prevalence of IC declines using the WHO ICOPE Step 1 tool among older adults attending an UHTC in Pune, and to determine associated factors.

Methods A cross-sectional study was conducted among 120 older adults (≥60 years) attending the UHTC in Pune. Consecutive sampling was used. Data were collected using a structured questionnaire including socio-demographic factors, chronic diseases, falls, functional ability and the WHO ICOPE Step 1 screening tool.

Results The mean age of participants was 68.9±6.4 years; 54.2% were female. IC decline was present in 72.5% of older adults. Domain-wise declines were: sensory (52.5%), locomotion (48.3%), psychological (35%), cognition (31.7%) and vitality (28.3%). Age ≥70 years (OR 2.1; p=0.04), multimorbidity (OR 2.3; p=0.03) and ≥1 fall in past year (OR 3.0; p=0.01) were significantly associated with IC decline. ADL/IADL dependence was reported in 41.6% of those with declines.

Conclusions IC decline is highly prevalent among older adults attending the UHTC in Pune. The ICOPE step 1 tool is practical and effective for community and primary care screening.