Diagnostic performance analysis of the ICOPE screening tool for identifying decline in intrinsic capacity

Background: Intrinsic capacity (IC) is a comprehensive indicator of an individual's positive attributes. The World Health Organization (WHO) recommends a two-step approach to assess IC decline among older people. The first step involved using the Integrated Care for Older People (ICOPE) screening tool to identify potential issues, and the second step involved using detailed assessments for confirmation. This study aimed to assess the diagnostic performance of ICOPE screening tool as a simple preliminary screening to identify IC decline among community-dwelling older adults, which was rarely reported in China. Methods: : This cross-sectional study included 228 community-dwelling older individuals aged ≥75 (mean age, 84.0±4.4 years; 131 [57.5%] females) who completed the IC evaluation according to the WHO IC assessment pathway. The diagnostic performance of the ICOPE screening tool were calculated using a 2 × 2 table and a receiver operating characteristic curve. Results: : The proportion of possible IC decline identified by the ICOPE screening tool was 79.4%, whereas the actual IC decline assessed by the detailed assessment was 73.2%, mainly in locomotion. The ICOPE screening tool showed a sensitivity of 94.6% and specificity of 62.3% for identifying IC decline, with an overall diagnostic accuracy of 86.0%. With the exception of the sensory dimension, the sensitivity of the ICOPE screening tool for diagnosing impairments in each dimension of the IC was highest in the cognition domain (100%) and lowest in the vitality domain (51.3%), whereas the specificity was highest in vitality (94.7%) and lowest in cognition (55.6%). Conclusions: : The ICOPE screening tool has high sensitivity and can be used as an IC screening tool in community-dwelling older people. However, further improvements are needed in the vitality dimension of the ICOPE screening tool to enhance its sensitivity in identifying individuals at risk of malnutrition.