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Intrinsic Capacity & Osteosarcopenia & Aging
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Intrinsic Capacity Across 15 Countries in the Survey of Health, Aging, and Retirement in Europe
May 12, 2025
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A number of studies have proposed a structure for IC that includes a summary domain and 5 subdomains: psychological, sensory, cognitive, locomotor, and vitality.4-8 This structure has utility in estimating a range of outcomes, including declines in activities of daily living (ADL) and instrumental activities of daily living (IADL),6,7 mortality,9-11 disease,12 and care dependence,10 even after adjustment for age, demographic characteristics, and multimorbidity. However, while 1 multicountry study used a predetermined structure to assess the prognostic power of IC in low-income and middle-income countries,10 to our knowledge, no study has yet statistically validated the IC construct and its predictive validity using a cross-national dataset.
Our longitudinal analysis confirmed the IC power to estimate declines in ADL and IADL, even after adjusting for demographic variables (age, gender, educational attainment, income, and country) and multimorbidity. This suggests that IC provides unique insights into an individual’s health and functional status beyond traditional measures such as chronological age or the presence of diseases.
New indicators related to the osteosarcopenia in the elderly: assessment of intrinsic capacity
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Osteosarcopenia, a term first introduced by Duque, specifically characterizes a distinct subset of older individuals concurrently affected by both osteoporosis and sarcopenia, highlighting its status as a unique clinical syndrome [1]. A study has revealed that the prevalence of osteosarcopenia increases with age among older adults, with the prevalence in men rising from 14.3% at ages 60-64 to 59.4% at ages 75 and above, and in women from 20.3% at ages 60-64 to 48.3% at ages 75 and above [2]. Osteoporosis and sarcopenia, two interrelated pathological conditions, exhibit overlapping risk factors that collectively contribute to frailty progression [3]. Their synergistic effects significantly elevate risks of accidental falls, fragility fractures, and subsequent hospital admissions, ultimately leading to increased mortality rates and substantial financial burdens on healthcare systems [4, 5]. Patients with osteosarcopenia demonstrate significantly elevated risks compared to those without the condition, with hazard ratios of 1.60 (95% CI 1.07-2.38) for falls and 1.54 (95% CI 1.13-2.08) for fractures [6]. The condition is associated with a 2.6-fold higher mortality rate (15.9% vs. 6.1%) compared to non-affected individuals [6].
Results
In this cohort of 461 older adults (median age 80 years), osteosarcopenia prevalence reached 26%. Logistic regression analysis identified: cognitive [odds ratio (OR): 0.871, 95% confidence interval (CI): 0.808-0.933] and sensory (OR: 0.633, 95% CI: 0.417-0.950) impairments specifically predicted osteosarcopenia, while vitality deficits demonstrated dual risks for both sarcopenia (OR: 0.820, 95% CI: 0.725-0.920) and osteosarcopenia (OR: 0.736, 95% CI: 0.648-0.826). Locomotor impairment and psychological distress emerged as pan-risk factors across sarcopenia, osteoporosis, and osteosarcopenia. Total IC scores exhibited dose-dependent associations with all three musculoskeletal outcomes (P < 0.05), maintaining significance across age/sex subgroups and after confounding variables adjustment.
Conclusion
Total IC score serves as a significant predictor of osteosarcopenia in elderly patients. Cognition, mobility, vitality, psychological, and sensory domains were associated with osteosarcopenia.
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