Integrated care for older people screening tool for measuring intrinsic capacity: Findings from national ICOPE...

The World Health Organization (WHO) developed the Integrated Care for Older People (ICOPE) screening tool to detect declines in intrinsic capacity (IC). However, its psychometric properties based on nationwide real-world data remain unclear. This study examined the validity and reliability of the Taiwanese version (ICOPES-TW-6) of the WHO ICOPE Screening Tool (WIST) across six IC domains during Taiwan's national ICOPE implementation.

This cross-sectional study included three groups: national ICOPE participants from 2023 (n = 185,287) linked to Taiwan's National Health Insurance database; regional participants from southern Taiwan (n = 716); and a community subsample (n = 53) completing a 2024 test-retest reliability assessment. Exploratory factor analysis was conducted to assess structure validity. Convergent and hypothesis-testing construct validity were examined using nonparametric tests and logistic regression, respectively. Predictive validity was evaluated by the area under the receiver operating characteristic curve (AUC). Reliability was estimated using KR-20, intraclass correlation coefficients, and Cohen's Kappa.

A two-factor structure emerged: body functionality (BF; cognition, locomotion, vision, hearing), and physical and mental vitality (PMV; vitality, psychological well-being). Greater impairments in ICOPES-TW-6, BF, and PMV were associated with frailty, emergency visits, and unplanned hospitalizations, while only ICOPES-TW-6 and BF impairments were associated with fall risk. Predictive validity was strongest for frailty and dependency in daily living for ICOPES-TW-6 and BF. Reliability was moderate, with kappa values varying across domains.

The ICOPES-TW-6 demonstrates good validity and moderate reliability, strengthening WIST's evidence base and supporting its application in the functional assessment of older people.