JMIR Publications

ABSTRACT

Background:

Intrinsic capacity is an important indicator of healthy aging and comprises six core domains: locomotion, vitality, vision, hearing, cognition, and psychology. Impairments in these domains are common among older adults and may be interconnected, potentially affecting overall functional capacity. However, the interrelationships among these domains and their relative importance remain insufficiently understood in hospitalized older adults. Clarifying these relationships may help identify key domains for targeted interventions and inform strategies to maintain or improve overall intrinsic capacity.

Objective:

Based on the World Health Organization (WHO) Integrated Care for Older People (ICOPE) intrinsic capacity assessment framework, this study aimed to investigate the correlations among the six core dimensions of intrinsic capacity in hospitalized older adults, construct an interdimensional network model, identify key domains, and provide a scientific basis for targeted functional maintenance interventions in clinical practice.

Methods:

Using convenience sampling, 2,236 older inpatients from the geriatric departments of seven hospitals were recruited between March and December 2025. The Chinese version of the WHO ICOPE screening tool was used to assess the six dimensions. Pearson correlation and multiple linear regression analyses were performed. A partial correlation network was constructed using the qgraph package in R 4.3.2. Strength, closeness, and betweenness centrality were calculated, and network stability was assessed using the case-dropping bootstrap method implemented in the bootnet package.

Results:

The mean intrinsic capacity score was 3.68 ± 1.69, and only 7.90% of participants had intact function across all six domains. Hearing (65.00%) and locomotion (63.50%) impairments were the most prevalent, whereas psychological impairment was the least prevalent (11.50%). All pairwise correlations among the six domains were significantly positive (all P < 0.001). The strongest correlation was between locomotion and cognition (r = 0.624), followed by that between vision and hearing (r = 0.587). Network analysis showed that vitality and psychology had the shortest path lengths. Based on stable centrality indicators, psychology, locomotion, and vitality were identified as core hub domains, whereas hearing exhibited the lowest centrality. Strength (CS = 0.672) and betweenness centrality (CS = 0.517) demonstrated good stability, whereas closeness centrality (CS = 0.050) showed poor stability.

Conclusions:

Intrinsic capacity was generally poor among hospitalized older adults, with high prevalences of locomotion and hearing impairment. The six domains were significantly interconnected, with psychology, locomotion, and vitality acting as core hubs and hearing occupying a relatively isolated position. These findings suggest that intrinsic capacity is an interconnected system rather than a collection of independent functions. Prioritizing interventions targeting core hub domains may help optimize overall intrinsic capacity in hospitalized older adults. Clinical Trial: Not applicable.