Development and Psychometric Evaluation of the Physio-Cognitive Decline Syndrome Instrument for Community-Dwelling Middle-Aged and Older Adults.

BACKGROUND

Physio-cognitive decline syndrome, involving the simultaneous deterioration of physical and cognitive functions, poses a significant threat to healthy aging. The World Health Organization's Integrated Care for Older People (ICOPE) framework emphasizes the importance of integrated, person-centered care in maintaining intrinsic capacity, making it important to understand physio-cognitive decline syndrome. However, there is a lack of validated instruments designed to assess this multidimensional condition from the perspective of older adults.

PURPOSE: In this study, the physio-cognitive decline syndrome instrument (PCDSI) was developed and its measurement properties were evaluated psychometrically.

METHODS

The PCDSI, developed based on the ICOPE framework and qualitative findings, includes demographic items and a 63-item questionnaire comprising five subscales representing the key dimensions of physio-cognitive decline and adaptation. Six hundred community-dwelling adults aged older than or equal to 50 in Taiwan participated in the psychometric evaluation, which included assessments of internal consistency, construct validity, concurrent validity, and known-group validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). In addition, model fit was assessed using multiple indices.

RESULTS

The results of the EFA identified eight factors across five subscales, reflecting perceived physical and cognitive decline, emotional/social impact, and positive adaptation strategies. CFA supported the factor structure with acceptable fit indices, and internal consistency was high (ω=0.870-0.945). Although most subscales showed significant correlations with one another and with the ICOPE measures, the adaptive subscales demonstrated conceptual independence from decline perceptions. Known-group validity was demonstrated across sex, chronic disease status, educational level, and self-rated health, indicating the instrument is adequately sensitive to clinically relevant differences.

CONCLUSIONS

The PCDSI demonstrated strong psychometric properties and effectively captures subjective and multidimensional aspects of physio-cognitive decline. It offers a practical tool for early identification and prevention, supporting healthy aging through community-based screening and personalized care planning.