Developing an Asian Intrinsic Capacity Index: Factor Analysis and Validation Against Frailty in Community-Dwelling Older Adults

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JM Lim1, T Wu1, MT Pereira2, GRS Lim3, MZ Chen3

1. Lee Kong Chian School of Medicine; Nanyang Technological University; Singapore; 2. Faculty of Dentistry; National University of Singapore; Singapore; 3. Division of Geriatric Medicine; Department of Medicine; National University Hospital; Singapore

Abstract

Introduction

Intrinsic Capacity (IC), a concept proposed by the World Health Organisation (WHO), refers to the combination of an individual's physical and mental abilities. However, IC’s latent structure may vary across populations and measurement approaches, where frameworks derived elsewhere may not generalise well. Based on underlying domains of IC-related measures in an Asian older adult population, we developed an IC index, and evaluated its association with frailty.

Methods

A cross-sectional analysis was conducted using data from community screening events involving adults aged ≥50 years (n=817). Assessments spanned physical capacity (SARC-F, Timed Up and Go [TUG], Short Physical Performance Battery [SPPB], Oral Frailty-5 [OF-5]), psychological status (Geriatric Depression Scale-15 [GDS-15], UCLA Loneliness Scale [UCLA-3], Pittsburgh Sleep Quality Index [PSQI]), nutrition (Simplified Nutritional Appetite Questionnaire [SNAQ]), and cognition (Abbreviated Mental Test [AMT]),

Sampling adequacy was assessed using Kaiser-Meyer-Olkin (KMO) measure and Bartlett’s test. Exploratory factor analysis was performed using principal axis factoring and oblimin rotation. Associations between the resulting IC index and FRAIL scores and differences across frailty categories were evaluated.

Results

The dataset was suitable for exploratory factor analysis (KMO=0.702; Bartlett’s χ²=1037, p<0.001). Two domains emerged, accounting for 62% of total variance: physical capacity (SARC-F, TUG, SPPB, OF-5) and psychological capacity (GDS-15, UCLA-3, PSQI). SNAQ and AMT did not load strongly onto either domain, indicating distinct nutrition and cognition constructs.

The resulting two-domain IC index correlated more strongly with FRAIL scores (r=-0.325, p<0.001) than a WHO-style index (r=-0.254, p<0.001). IC scores decreased progressively from robust to pre-frail to frail participants (ANOVA p<0.001).

Conclusion

IC-related measures clustered into physical and psychological domains, suggesting a two-domain IC framework may better fit community screening. Our IC index demonstrated stronger associations with frailty than a WHO-style index, suggesting a quicker screen for predicting adverse health outcomes in the community.

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