Patterns and Factors of Intrinsic Capacity Impairment in Older Adults with Chronic Diseases: A Latent Class Analysis

Due to the increase in life expectancy, the prevalence of older adults with chronic diseases is gradually increasing. Intrinsic capacity (IC) is an important indicator for assessing the physical condition of older adults. Older adults often experience a decline in IC before serious illness develops. Early screening for IC decline and timely interventions are essential. The goal of this study was to explore the patterns of IC impairment and their influencing factors in older adults with chronic diseases, and to provide a reference for the development of interventions to enhance their IC.

We conducted a cross-sectional study of 8427 older adults (≥60 years) in Zunyi City, China. A composite score for IC, covering the cognitive, sensory, locomotion, vitality, and psychological domains, was calculated using a weighting method. Data were collected on demographics, chronic conditions, and a battery of standardized assessments. These included measures of functional capacity (BADL, IADL), cognitive status (CMMS), physical performance (SPPB), nutritional risk (MNA-SF), depressive symptoms (GDS-15), and sensory function (vision, hearing).

Overall, 87.56% of participants showed IC impairment. Latent class analysis identified three distinct patterns of IC impairment: a "Higher IC group", a "Cognitive-locomotion domain-impaired mid-IC group", and a "Locomotion-impaired predominantly low-IC group", which comprised 23.2%, 59.96%, and 16.84% of the sample, respectively; age, BMI, BADL, IADL, sex, educational level, marital status, type of medical insurance, average household monthly income, drinking, annual physical examination, socialization, and exercise were all influential factors in the patterns of IC (P<0.05).

The impairment of IC in older adults is group heterogeneous and affected by different factors; using IC as a multi-categorical variable is beneficial to refine the patterns of IC impairment; healthcare professionals should carry out early targeted interventions for different patterns of older adults to enhance their IC and promote healthy aging.