Associations between intrinsic capacity, subjectively perceived environmental support and functional status among...

Global population ageing poses significant challenges to economic development and long-term care systems, making the health and well-being of older adults an urgent social issue.

To comprehensively investigate the intrinsic capacity, subjectively perceived environmental support, and functional status of rural disabled older adults, clarify the available resources, health conditions, and care needs of this population, and explore factors associated with the interaction between intrinsic capacity and environmental support in relation to functional status.

A questionnaire survey was conducted among rural disabled older adults in natural villages in Henan Province using the WHO Quality of Life Scale (domains of environment and social relationships), Intrinsic Capacity Assessment Tool, Physical Self-Maintenance Scale, and the Instrumental Activities of Daily Living scale.

Among 343 rural disabled older adults, the mean intrinsic capacity score was 5.68 ± 1.62. Domain-specific scores were as follows: mobility (4.51 ± 2.72), vitality (22.27 ± 4.02), cognition (17.31 ± 7.09), psychological status (6.68 ± 5.69), and sensory ability (1.22 ± 0.52). The highest impairment rates were observed in mobility (99.1%) and cognition (91.0%). The mean item score of the environment domain was 3.44 ± 0.50, and that of the social relationship domain was 3.59 ± 0.50, both at a moderate level; the highest scores were found in physical environment (3.87 ± 0.45) and healthcare and social security services (3.82 ± 0.44). The mean functional status score was 29.57 ± 11.67. Multiple linear regression analysis showed that age, education (junior high school, high school and above), living arrangement (living with children only, living with spouse only, living with spouse and children, living in institution), type of medication taken, monthly income(500~), duration of disability, cause of disability(aging), grip strength level, frailty status, and intrinsic capacity level (declined intrinsic capacity, high and stable intrinsic capacity)were significantly associated with functional status among rural disabled older adults (all P < 0.05). The path analysis results showed that subjectively perceived environmental support was positively associated with intrinsic capacity (β = 0.406, P < 0.001), while intrinsic capacity (β = -0.580, P < 0.001) and subjectively perceived environmental support (β = -0.414, P < 0.001) were negatively associated with functional status.

Rural disabled older adults present with significant impairments in intrinsic capacity and functional status. Subsequent intervention studies may focus on optimizing subjectively perceived environmental support and improving intrinsic capacity, ultimately aiming to prevent or delay disability and promote healthy aging in this population.