Intrinsic Capacity vs. Multimorbidity: A Function-Centered Construct Predicts Disability Better Than a Disease-Based Approach in a Community-Dwelling Older Population Cohort
机构：[1]Department of Geriatrics, Neurology and Neurobiology, National Clinical Research Center for Geriatric Disease, Xuanwu Hospital of Capital Medical University, Beijing, China,神经科系统内科系统神经内科老年医学科首都医科大学宣武医院[2]Department of Respiration, Xuanwu Hospital of Capital Medical University, Beijing, China,首都医科大学宣武医院[3]Key Laboratory for Neurodegenerative Disease of the Ministry of Education, Beijing Key Laboratory for Parkinson’s Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China,[4]Clinical Center for Parkinson’s Disease, Capital Medical University, Beijing, China,[5]Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
Objective: This study aimed to assess the status of intrinsic capacity (IC)-a novel function-centered construct proposed by the WHO and examine whether impairment in IC predicts subsequent 1-year activities of daily living (ADL) disability better than a disease-based approach, i. e., multimorbidity status.</p> Methods: This study included data of community-dwelling older adults from the Beijing Longitudinal Study on Aging II aged 65 years or older who were followed up at 1 year. Multivariate logistic regressions were performed to estimate the odds of ADL disability at baseline and 1-year follow-up.</p> Results: A total of 7,298 older participants aged 65 years or older were included in the current study. About 4,742 older adults were followed up at 1 year. At baseline, subjects with a higher impairment in IC domains showed higher odds of ADL disability [adj. odds ratio (OR) = 9.51 for impairment in >= 3 domains, area under the curve (AUC) = 0.751] compared to much lower odds of ADL disability in subjects with a higher number (>= 3) of chronic diseases (adj. OR 3.92, AUC = 0.712). At 1-year follow-up, the overall incidence of ADL disability increased with the impairment in IC domains higher than the increase in multimorbidity status. A higher impairment in IC domains showed higher odds of incidence ADL disability for impairment in 2 or >= 3 IC domains (adj. OR 2.32 for impairment in >= 3 domains, adj. OR 1.43 for impairment in two domains, AUC = 0.685). Only subjects who had >= 3 chronic diseases had higher odds of 1-year incident ADL disability (adj. OR 1.73, AUC = 0.681) that was statistically significant.</p> Conclusion: Our results imply that a function-centered construct could have higher predictability of disability compared to the multimorbidity status in community older people. Our results need to be confirmed by studies with longer follow-up.</p>
基金：
The National Key R&D Program
of China, No. 2018YFC1312001, 2017YFC0840105, and
2017ZX09304018; and the Key Realm R&D Program of
Guangdong Province 2018B030337001.
第一作者机构：[1]Department of Geriatrics, Neurology and Neurobiology, National Clinical Research Center for Geriatric Disease, Xuanwu Hospital of Capital Medical University, Beijing, China,
共同第一作者：
通讯作者：
通讯机构：[1]Department of Geriatrics, Neurology and Neurobiology, National Clinical Research Center for Geriatric Disease, Xuanwu Hospital of Capital Medical University, Beijing, China,[3]Key Laboratory for Neurodegenerative Disease of the Ministry of Education, Beijing Key Laboratory for Parkinson’s Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders, Beijing, China,[4]Clinical Center for Parkinson’s Disease, Capital Medical University, Beijing, China,[5]Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
推荐引用方式(GB/T 7714)：
Zhao Jing,Chhetri Jagadish K.,Chang Yi,et al.Intrinsic Capacity vs. Multimorbidity: A Function-Centered Construct Predicts Disability Better Than a Disease-Based Approach in a Community-Dwelling Older Population Cohort[J].FRONTIERS IN MEDICINE.2021,8:doi:10.3389/fmed.2021.753295.
APA：
Zhao, Jing,Chhetri, Jagadish K.,Chang, Yi,Zheng, Zheng,Ma, Lina&Chan, Piu.(2021).Intrinsic Capacity vs. Multimorbidity: A Function-Centered Construct Predicts Disability Better Than a Disease-Based Approach in a Community-Dwelling Older Population Cohort.FRONTIERS IN MEDICINE,8,
MLA：
Zhao, Jing,et al."Intrinsic Capacity vs. Multimorbidity: A Function-Centered Construct Predicts Disability Better Than a Disease-Based Approach in a Community-Dwelling Older Population Cohort".FRONTIERS IN MEDICINE 8.(2021)
