Disparity between capacity and performance in the International Classification of Functioning: implications for...

Area of Science:

• Gerontology
• Rehabilitation Science
• Public Health

Background:

• Functioning is a key health indicator and rehabilitation metric, assessed via capacity and performance.
• Understanding disability and cognitive impairment in older adults is crucial for effective healthcare and support.

Purpose of the Study:

• To determine the prevalence of disability and cognitive impairment in individuals aged 50 and older.
• To assess the reliability and clinical relevance of the International Classification of Functioning, Disability and Health (ICF) checklist's capacity and performance qualifiers.

Main Methods:

• A cross-sectional study in Aragón, Spain, surveyed 1707 participants aged 50+.
• Disability and cognitive impairment were measured using the WHODAS 12 and MMSE.
• A subsample (n=129) underwent detailed functional evaluation using the ICF checklist to compare capacity and performance.

Main Results:

• Over half (50.6%) of participants exhibited disability, with limitations in general tasks and domestic life being most common.
• Significant capacity-performance gaps were found in domestic life, self-care, and learning.
• Environmental factors influenced performance, with higher performance than capacity noted in community living and personal relationships.

Conclusions:

• Disability is highly prevalent in adults over 50, significantly affecting daily functioning.
• Discrepancies between capacity and performance point to environmental barriers, especially in home and learning settings.
• The ICF checklist demonstrates clinical value, supporting the integration of environmental factors into disability care strategies.