Mapping the diverse trajectories of intrinsic capacity and their key drivers in China’s aging population
- 1Department of Public Health and Preventive Medicine, School of Medicine, Jinan University
- 2School of Public Health, Fudan University
- 3China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University
Abstract
Background: Intrinsic capacity (IC) is central to healthy aging. Understanding its longitudinal change is crucial for proactive health planning. Yet evidence on distinct IC trajectories and their determinants in China remains limited, constraining targeted interventions.
Methods: We analyzed cohort data from participants aged 50 years and older in the World Health Organization’s Study on Global AGEing and Adult Health (WHO-SAGE) China cohort. A composite IC score was constructed based on the WHO framework, encompassing locomotion, cognition, psychological, sensory, and vitality domains. We employed Latent Class Growth Analysis (LCGA) and Growth Mixture Modeling (GMM) to identify distinct IC trajectories. Multinomial logistic regression was then used to investigate associations between these trajectories and a comprehensive set of socio-demographic, individual health-related, and environmental factors. The relative importance of identified factors was evaluated using SHapley Additive exPlanations (SHAP) values.
Results: Four IC trajectories were identified: High and Stable IC (HSI), High and Slowly Declining IC (HSDI), Moderate and Rapidly Declining IC (MRDI), and Low and Rapidly Declining IC (LRDI). Older age (OR = 5.79, 95% CI 4.73–7.10), female sex (OR = 2.86, 95% CI 2.18–3.75), comorbidity (OR = 8.15, 95% CI 5.07–13.10), low income (OR = 4.11, 95% CI 2.82–5.99), low paternal education (OR = 2.04, 95% CI 1.41–2.94), and higher physical risk scores (OR = 1.18, 95% CI 1.02–1.37) were associated with a greater likelihood of belonging to the LRDI trajectory and were also associated with other unfavorable profiles. Clean cooking fuel use (OR = 0.17, 95% CI 0.11–0.26) and being married (OR = 0.53, 95% CI 0.34–0.82) were associated with a lower likelihood of belonging to the LRDI trajectory. SHAP identified age as the most influential contributor across all trajectories, while income, cooking fuel, ambient temperature, relative humidity, sex, education, and comorbidity also showed substantial contributions across different trajectory patterns.
Conclusion: The study identified substantial heterogeneity in IC trajectories among Chinese middle-aged and older adults. Socio-demographic, individual health-related, and environmental factors were associated with distinct trajectory patterns. Potentially modifiable contextual factors, particularly household cooking fuel and environmental conditions, may warrant greater attention in future healthy ageing strategies.
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BibTeX
@article{liang2026mapping,
title = {{Mapping the diverse trajectories of intrinsic capacity and their key drivers in China’s aging population}},
author = {Ziyi Liang and Zhirou Liang and Linlin Xie and Keqing Liang and Jianxiong Hu and Sujuan Chen and Tao Liu and Jiagui Liang and Guanhao He and Fan Wu and Wenjun Ma},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1923924},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1923924/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Mapping the diverse trajectories of intrinsic capacity and their key drivers in China’s aging population
AU - Ziyi Liang
AU - Zhirou Liang
AU - Linlin Xie
AU - Keqing Liang
AU - Jianxiong Hu
AU - Sujuan Chen
AU - Tao Liu
AU - Jiagui Liang
AU - Guanhao He
AU - Fan Wu
AU - Wenjun Ma
PY - 2026
DA - 2026/10/15
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1923924
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1923924/full
AB - Background: Intrinsic capacity (IC) is central to healthy aging. Understanding its longitudinal change is crucial for proactive health planning. Yet evidence on distinct IC trajectories and their determinants in China remains limited, constraining targeted interventions. Methods: We analyzed cohort data from participants aged 50 years and older in the World Health Organization’s Study on Global AGEing and Adult Health (WHO-SAGE) China cohort. A composite IC score was constructed based on the WHO framework, encompassing locomotion, cognition, psychological, sensory, and vitality domains. We employed Latent Class Growth Analysis (LCGA) and Growth Mixture Modeling (GMM) to identify distinct IC trajectories. Multinomial logistic regression was then used to investigate associations between these trajectories and a comprehensive set of socio-demographic, individual health-related, and environmental factors. The relative importance of identified factors was evaluated using SHapley Additive exPlanations (SHAP) values. Results: Four IC trajectories were identified: High and Stable IC (HSI), High and Slowly Declining IC (HSDI), Moderate and Rapidly Declining IC (MRDI), and Low and Rapidly Declining IC (LRDI). Older age (OR = 5.79, 95% CI 4.73–7.10), female sex (OR = 2.86, 95% CI 2.18–3.75), comorbidity (OR = 8.15, 95% CI 5.07–13.10), low income (OR = 4.11, 95% CI 2.82–5.99), low paternal education (OR = 2.04, 95% CI 1.41–2.94), and higher physical risk scores (OR = 1.18, 95% CI 1.02–1.37) were associated with a greater likelihood of belonging to the LRDI trajectory and were also associated with other unfavorable profiles. Clean cooking fuel use (OR = 0.17, 95% CI 0.11–0.26) and being married (OR = 0.53, 95% CI 0.34–0.82) were associated with a lower likelihood of belonging to the LRDI trajectory. SHAP identified age as the most influential contributor across all trajectories, while income, cooking fuel, ambient temperature, relative humidity, sex, education, and comorbidity also showed substantial contributions across different trajectory patterns. Conclusion: The study identified substantial heterogeneity in IC trajectories among Chinese middle-aged and older adults. Socio-demographic, individual health-related, and environmental factors were associated with distinct trajectory patterns. Potentially modifiable contextual factors, particularly household cooking fuel and environmental conditions, may warrant greater attention in future healthy ageing strategies.
SN - 2296-2565
ER -