Functional health index of intrinsic capacity: multi-domain operationalisation and validation in the Singapore Longitudinal Ageing Study (SLAS2).

CY, Cheong; P, Yap; MSZ, Nyunt; G, Qi; X, Gwee; KB, Yap; TP, Ng; Wee, Shiou Liang

doi:10.1093/ageing/afac011

0 FHI_IC_afac011.pdf (514.29 kB)

Functional health index of intrinsic capacity: multi-domain operationalisation and validation in the Singapore Longitudinal Ageing Study (SLAS2).

journal contribution

posted on 2023-09-19, 09:02 authored by Cheong CY, Yap P, Nyunt MSZ, Qi G, Gwee X, Yap KB, Ng TP, Shiou Liang WeeShiou Liang Wee

Background: adhocapproachesareusedtocreatecompositeindexesofintrinsiccapacity(IC)basedonfivedomainsrecommendedbytheWorldHealthOrganizationforhealthyageing.Weexaminedhowcombinationsofdomain-specificmeasuresdeterminemeasurementperformancesofcompositeICindexes. inthispopulation-basedprospectivecohortstudy,community-dwellingolderpersons(N=2,906)aged55yearsandabovewererecruited.Weused12domain-specificmeasures:cognition(Mini-MentalStateExamination,MMSE),psychological(GeriatricDepressionScale,GDS),locomotion(TimedUp-andGo[TUG],GV,KneeExtensionStrength,PerformanceOrientatedMobilityAssessment),sensory(logarithmoftheMinimumAngleofResolution[LogMAR]visionandWhisperTesthearing)andvitality(forcedexpiratoryvolumein1secondpulmonaryfunction,ElderlyNutritionalIndicatorsforGeriatricMalnutritionAssessment[ENIGMA],NutritionalScreeningInitiative)toderive144composite2-to5-domainfunctionalhealthindexes(FHI),andevaluatedtheirabilitiestopredict9-yearmortalityandtheirassociationswithhealthdeterminants. with5-domainFHI,TUG,logMARandMMSEshowedthelargestfactorloadings(0.65–0.75).Allsingle-domainFHIweresignificantlyassociatedwithmortalityrisks.Areaunderthereceiveroperatingcharacteristiccurve(AUC)valuesofmortalitypredictionincreasedwiththenumberofdomains(frommean0.615forsingle-domainFHItomean0.705for5-domainFHI),butthedifferencebetween3-domainversus4-domainFHI(P=0.082)orversus5-domainFHI(P=0.109)wasnotstatisticallysignificant.HighestAUCs(P<0.001)ofbestperformingFHIweresingle-domainTUG:0.735;2-domainTUG+ENIGMA:0.743;3-domainTUG+LogMAR+ENIGMA:0.762;4-domainTUG+MMSE+LogMAR+ENIGMA:0.757;5-domainTUG+MMSE+GDS+LogMAR+ENIGMA:0.751.FHIshowedexcellentconstructvaliditybasedoncorrelationswithknownhealthdeterminants. amongSingaporeanolderadults,cognition,sensoryandlocomotionarepredominantICdomains.Amulti-domainICindexperformsbetterwithmoredomainmeasures,butaminimalist3-domainindexperformsjustasrobustlyasa4-or5-domainindex.Methods: Results: Conclusions: