Criterion validity of brief, comprehensive, and latent measures of intrinsic capacity against frailty, disability, and mortality in older adults.
5 affiliations
- 1Department of Family Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea; Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School Affiliate, Boston, MA, USA.
- 2Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School Affiliate, Boston, MA, USA.
- 3Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School Affiliate, Boston, MA, USA; Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
- 4Department of Health Sciences and Technology, College of Medicine, Kyung Hee University, Seoul, South Korea. Electronic address: [email protected].
- 5Department of Family Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea. Electronic address: [email protected].
Abstract
Background
Intrinsic capacity (IC), the composite of physical and mental capacities, underpins the WHO Integrated Care for Older People (ICOPE) program. IC may be measured as a brief screen, a comprehensive assessment, or a latent factor score; whether the simpler measures retain the prognostic information of the complex ones remains untested within a single population.Methods
In the nationwide Korean Frailty and Aging Cohort Study, 3011 community-dwelling adults aged 70-84 years (mean age, 76.0 [SD, 3.9] years; 52.5% women) were assessed for frailty and for activities of daily living (ADL) and instrumental ADL (IADL) disability and followed for mortality (median, 8.0 years). IC was measured by a Korean ICOPE screening score (K-ICOPE), a comprehensive clinical score (CIC), and a bifactor latent score (LIC); differences in discrimination were tested formally.Results
Discrimination for frailty rose with measurement intensity (area under the curve, 0.82, 0.86, 0.90; all pairwise P < .001) but not for ADL or IADL disability (all P ≥ .25). There were 500 deaths. Adjusted for sociodemographics and multimorbidity, each 1-SD higher IC was associated with lower mortality (hazard ratio 0.83 [95% CI, 0.75-0.91], 0.71 [0.64-0.78], 0.65 [0.58-0.73]), with closely similar discrimination (C statistic, 0.723, 0.731, 0.736; largest difference, 0.013 [0.005-0.021]). Discrimination from IC alone was lower and similar across measures (0.583, 0.604, 0.585).Conclusions
Measurement intensity improved the characterization of frailty but added little to the ranking of long-term mortality risk. Because K-ICOPE was aligned by construction to the latent structure, these findings support the potential feasibility of brief ICOPE-style screening rather than validating the WHO instrument.
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BibTeX
@article{kim2026criterion,
title = {{Criterion validity of brief, comprehensive, and latent measures of intrinsic capacity against frailty, disability, and mortality in older adults.}},
author = {Sunyoung Kim and Lan Luo and Sandra M Shi and Chan Mi Park and Kevin T Pritchard and Miji Kim and Chang Won Won and Dae Hyun Kim},
journal = {The journal of nutrition, health \& aging},
year = {2026},
month = oct,
doi = {10.1016/j.jnha.2026.101002},
url = {https://europepmc.org/article/MED/42843119},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Criterion validity of brief, comprehensive, and latent measures of intrinsic capacity against frailty, disability, and mortality in older adults.
AU - Sunyoung Kim
AU - Lan Luo
AU - Sandra M Shi
AU - Chan Mi Park
AU - Kevin T Pritchard
AU - Miji Kim
AU - Chang Won Won
AU - Dae Hyun Kim
PY - 2026
DA - 2026/10/07
JO - The journal of nutrition, health & aging
DO - 10.1016/j.jnha.2026.101002
UR - https://europepmc.org/article/MED/42843119
AB - Background Intrinsic capacity (IC), the composite of physical and mental capacities, underpins the WHO Integrated Care for Older People (ICOPE) program. IC may be measured as a brief screen, a comprehensive assessment, or a latent factor score; whether the simpler measures retain the prognostic information of the complex ones remains untested within a single population.Methods In the nationwide Korean Frailty and Aging Cohort Study, 3011 community-dwelling adults aged 70-84 years (mean age, 76.0 [SD, 3.9] years; 52.5% women) were assessed for frailty and for activities of daily living (ADL) and instrumental ADL (IADL) disability and followed for mortality (median, 8.0 years). IC was measured by a Korean ICOPE screening score (K-ICOPE), a comprehensive clinical score (CIC), and a bifactor latent score (LIC); differences in discrimination were tested formally.Results Discrimination for frailty rose with measurement intensity (area under the curve, 0.82, 0.86, 0.90; all pairwise P < .001) but not for ADL or IADL disability (all P ≥ .25). There were 500 deaths. Adjusted for sociodemographics and multimorbidity, each 1-SD higher IC was associated with lower mortality (hazard ratio 0.83 [95% CI, 0.75-0.91], 0.71 [0.64-0.78], 0.65 [0.58-0.73]), with closely similar discrimination (C statistic, 0.723, 0.731, 0.736; largest difference, 0.013 [0.005-0.021]). Discrimination from IC alone was lower and similar across measures (0.583, 0.604, 0.585).Conclusions Measurement intensity improved the characterization of frailty but added little to the ranking of long-term mortality risk. Because K-ICOPE was aligned by construction to the latent structure, these findings support the potential feasibility of brief ICOPE-style screening rather than validating the WHO instrument.
SN - 1760-4788
ER -