Community-Based ICOPE Screening Identifies Intrinsic Capacity Impairment and Supports Integrated Health and Social Care.

OBJECTIVES

Preserving intrinsic capacity (IC) and delaying functional decline are central goals of the World Health Organization (WHO) Decade of Healthy Aging (2021-2030). We evaluated the implementation of a WHO Integrated Care for Older People (ICOPE) aligned pathway within routine community systems and described the prevalence and pattern of IC impairment among community-dwelling older adults.

DESIGN

Pragmatic prospective multisite implementation study.

SETTING AND

PARTICIPANTS

Community-dwelling adults aged ≥60 years who were robust or prefrail, recruited through routine activities and outreach at active aging centers and community centers in Singapore.

METHODS

Participants underwent step 1 ICOPE screening and step 2 IC assessment across 6 domains, followed by geriatrician-led multidisciplinary review, risk stratification, individualized care planning, structured referral, and longitudinal follow-up embedded within routine workflows. Descriptive analyses summarized participant characteristics, IC impairment, risk distribution, and referral patterns.

RESULTS

Over 9 months, 649 community-dwelling older adults completed IC screening and assessment. Overall, 81.5% had impairment in at least 1 IC domain and 55.5% had multidomain impairment despite preserved functional independence. Vitality (46.8%), cognitive (37.4%), and vision impairments (38.2%) were most prevalent, with variation in risk profiles observed across community sites. Multidisciplinary review enabled risk stratification and linkage to community, primary care, and social services.

CONCLUSIONS AND IMPLICATIONS: Community-based implementation of the WHO ICOPE pathway within routine systems is feasible and identified substantial multidomain IC impairment among otherwise independent older adults. Variation across sites highlights the need for context-specific service planning and targeted resource allocation. Embedding IC screening within community platforms, with coordinated referral pathways, supports earlier identification and management of functional decline and advances integrated health and social care for aging populations.