Previously submitted to: JMIR Aging (no longer under consideration since Jan 23, 2025)
Date Submitted: Dec 26, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Integrated care for older people screening tool for measuring intrinsic capacity: findings from national ICOPE implementation in Taiwan
ABSTRACT
Background:
The World Health Organization (WHO) developed the Integrated Care for Older People (ICOPE) screening tool to identify older adults with priority conditions linked to declines in intrinsic capacity (IC). However, there is a need for cross-cultural validation of the ICOPE screening tool.
Objective:
This study aimed to assess the reliability and validity of the ICOPE screening tool, which evaluates six domains—cognition, locomotion, vitality, vision, hearing, and psychological health—in the context of Taiwan.
Methods:
The study population comprised three groups: 185,287 older adults who participated in the national ICOPE assessments in 2023, 716 older adults involved in a regional ICOPE implementation in southern Taiwan, and 53 community-dwelling older adults who underwent a one-week test-retest reliability assessment during June–July 2024, also in southern Taiwan. The study evaluated the tool's convergent validity, construct validity, predictive validity, internal consistency reliability, and test-retest reliability.
Results:
Factor analysis identified two dimensions: physical function and life adaptation. Convergent validity indicated significant associations between abnormal IC in overall, physical, and life adaptation domains and the following factors: female gender, older age, lower education (elementary school or below), widowhood, higher number of chronic diseases, screenings conducted at medical centers, screenings conducted at outpatient clinics or inpatient facilities, quality of life, and frailty. Discriminant validity showed that IC abnormalities in the overall, physical, and life adaptation domains were similar among older adults born in different seasons. Predictive validity demonstrated that the overall IC abnormality predicted frailty and dependency in the basic activity of daily living (BADL), with areas under the curve (AUC) of 0.914 and 0.944, respectively, while the physical function dimension predicted these outcomes with AUCs of 0.902 and 0.924, respectively. Internal consistency reliability, assessed by the Kuder-Richardson 20 coefficient, ranged from 0.376 to 0.501. The one-week test-retest reliability showed Kappa agreements for cognition (0.168), mobility (0.372), nutrition (0.542), vision (0.295), hearing (0.237), and depression (-0.031). The intra-class correlation coefficient for the one-week test-retest reliability was 0.503.
Conclusions:
The ICOPE screening in Taiwan demonstrates good convergent, construct, and predictive validity but limited reliability. It can serve as a preliminary screening tool for assessing the IC of older adults with the application of repeated measures and alternate forms.
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