scholarly journals Validation of the Integrated Care for Older People Screening Tool: Focus on the Chair Rise Test to Assess Locomotion

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 73-73
Author(s):  
Emmanuel Gonzalez-Bautista ◽  
Philipe de Souto Barreto ◽  
Aaron Salinas-Rodriguez ◽  
Sandrine Sourdet ◽  
Yves Rolland ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Integrated Care ◽  
Rise Time ◽  
Screening Tool ◽  
World Health ◽  
Characteristic Analysis ◽  
Cut Points ◽  
Chair Rise ◽  
Care For Older People

Abstract The Integrated Care for Older People (ICOPE) is a function- and person-centered healthcare pathway developed by the World Health Organization (WHO). ICOPE's first step (Step 1) consists of screening for impairments in the intrinsic capacity (IC) domains (namely sensorial, cognition, nutrition, psychological, and locomotion). For instance, the ICOPE Step1 tool suggests a cut-point of 14 seconds for five-repetition chair rise time as a marker of impaired locomotion. Given the lack of validation of this tool in the literature, we aimed to validate the ICOPE screening tool concerning incident health outcomes, focusing on the locomotion assessment. First, we analyzed the five-domain screening tool's ability to identify older adults (OA) at higher risk of incident outcomes (frailty, disability, dementia) using longitudinal data from the Multidomain Alzheimer Preventive Trial (MAPT). For the locomotion assessment (chair rise test), we derived and cross-validated age-specific cut points from two population-based cohorts using ROC (receiver operating characteristic) analysis. We further verified those cut points among OA real-life users of the health system and clinical trial participants. In conclusion, the ICOPE Step 1 screening tool was able to identify OA at higher risk of incident frailty, disability, and dementia. New chair-rise-time cut points for age groups 70-79 years old and 80 years and older were valid in populations from different settings. The ICOPE Step 1 tool provides a practical and integrative way of screening older adults for impairments in IC and detecting those at higher risk of functional decline.

Frequency of conditions associated with declines in intrinsic capacity according to a screening tool in the context of Integrated care for older people

2020 ◽  
pp. 1-8
Author(s):  
E. González-Bautista ◽  
P. de Souto Barreto ◽  
K. Virecoulon Giudici ◽  
S. Andrieu ◽  
Y. Rolland ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Depressive Symptoms ◽  
Older People ◽  
Screening Tool ◽  
Limited Mobility ◽  
Memory Complaints ◽  
Intrinsic Capacity ◽  
With Memory ◽  
Care For Older People

Background: The screening tool of the Integrated Care for Older People (ICOPE Step 1), designed to detect declines in the domains of intrinsic capacity, has been incipiently investigated in older adult populations. Objectives: To retrospectively estimate the frequency of priority conditions associated with declines in intrinsic capacity according to an adaptation of the screening tool ICOPE Step 1 among participants of the Multidomain Alzheimer Preventive Trial (MAPT). Design: A cross-sectional retrospective analysis from the baseline assessment of the MAPT. Setting: The data was gathered during a preventive consultation for cardiovascular risk factors in memory clinics in France. Participants : Seven hundred fifty-nine older adults aged 70-89 years with memory complaints, allocated to the multidomain groups of the MAPT study. Measurements: Five domains of intrinsic capacity (cognition, locomotion, nutrition, sensorial, and psychological) were assessed using a screening tool similar to the ICOPE Step 1 (MAPT Step 1). The frequency of six conditions associated with declines in intrinsic capacity (cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss, and depressive symptoms) was obtained for older adults with memory complaints participating in the MAPT study. Results: Overall, 89.3% of the participants had one or more conditions associated with declines in intrinsic capacity. The overall frequency of each condition was: 52.2% for cognitive decline, 20.2% for limited mobility, 6.6% for malnutrition, 18.1% for visual impairment, 56.2% for hearing loss, and 39% for depressive symptoms. Conclusion: After being screened with an adaptation of the ICOPE step 1 (MAPT step 1) tool, 9/10 older adults had one or more conditions associated with declines in intrinsic capacity. The relative frequency differs across conditions and could probably be lower in a population without memory complaints. The frequency of screened conditions associated with declines in IC highlights how relevant it is to develop function-centered care modalities to promote healthy aging.

scholarly journals INTEGRATED CARE FOR OLDER PEOPLE AND THE IMPLEMENTATION IN THE INSPIRE CARE COHORT

2020 ◽  
pp. 1-5
Author(s):  
C. Takeda ◽  
S. Guyonnet ◽  
Y. Sumi ◽  
B. Vellas ◽  
I. Araujo de Carvalho
Keyword(s):  
Older People ◽  
Integrated Care ◽  
New Technologies ◽  
Healthy Ageing ◽  
World Health ◽  
Integrative Approach ◽  
Age Related ◽  
Study Results ◽  
Care For Older People

Backgrounds: The World Health Organization has published the Integrated Care for Older People, ICOPE handbook Guidance on person-centred assessment and pathways in primary care. This is an integrated individual care tool focused on the individual and healthy ageing. The ICOPE tool proposes step by step, a screening, a fine assessment, the development of a personalized care plan, its implementation and follow up and finally the consideration of the caregivers and community. The new Geroscience field is focusing on preventing age-related diseases, and should now investigate with the ICOPE tool the optimal maintenance of intrinsic capacity (IC) through mobility, cognition, psychology, vitality, hearing and vision. This article aims to present this new tool and to presents its innovative implementation at the Toulouse University Hospital through the INSPIRE study. We believe that the ICOPE integrated care program will also be a pragmatic way to maintain cognitive functions and detect early Alzheimer. Objectives: The main objective of the INSPIRE study is to build a Bio-resource Research Platform for Healthy Ageing gathering biological, clinical and digital resources in order to identify markers of ageing, age-related diseases and IC evolution. The study will be also testing the implementation and follow up of the ICOPE tool. Methods: The Inspire Platform will gather clinical data and bio-specimens from 1000 subjects in the Occitania Region, of different ages (from 30 years and over) over 10 years. Data will be collected annually. Using the ICOPE tool IC domains will be monitored every 4 months. Once IC decline is identified, participants will have a thorough clinical assessment and blood sampling to investigate the response of markers of ageing at the time of decline. The French ethic committee approved the study. Results: The Inspire platform aims to develop an integrative approach to promote novel new technologies for the assessment and monitoring of functional capacities.

scholarly journals Integrated Care for Older People Screening Tool for Measuring Intrinsic Capacity: Preliminary Findings From ICOPE Pilot in China

2020 ◽  
Vol 7 ◽  
Author(s):  
Lina Ma ◽  
Jagadish K. Chhetri ◽  
Yaxin Zhang ◽  
Pan Liu ◽  
Yumeng Chen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Activities Of Daily Living ◽  
Integrated Care ◽  
Daily Living ◽  
Screening Tool ◽  
Psychological Capacity ◽  
Intrinsic Capacity ◽  
Care For Older People

Objectives: The World Health Organization (WHO) proposed the Integrated Care for Older People (ICOPE) screening tool to identify older people with priority conditions associated with declines in intrinsic capacity (IC). We aimed to determine the clinical utility of the WHO ICOPE screening tool in a Chinese population.Method: A total of 376 adults aged 68.65 ± 11.41 years participated in the study. IC was assessed with the WHO ICOPE screening tool, covering five domains: cognitive, locomotor, sensory, vision, and psychological capacity. We assessed the activities of daily living (ADL); instrumental activities of daily living (IADL); the Fried frailty phenotype; FRAIL scale; Strength, Assistance With Walking, Rising From chair, Climbing Stairs, and Falls (SARC-F) scale; Mini-mental State Examination (MMSE); Geriatric Depression Scale (GDS); social frailty; and quality of life.Results: There were 260 (69.1%) participants who showed declines in one or more IC dimensions. The percentages of decline in mobility, cognition, vitality, hearing, vision, and psychological capacity were 25.3, 46.8, 16.2, 15.4, 11.7, and 12.0%, respectively. IC decreased with increasing age. After adjusting for age, sex, and multimorbidity, participants with declines in IC were more likely to be older, frail, and disabled. They also had worse physical, mental, and overall health. There was a higher prevalence of declines in IC in participants with frailty. After adjusting for age, IC was positively correlated with walking speed, resilience score, and MMSE score and negatively correlated with frailty, SARC-F score, IADL score, GDS score, and physical and mental fatigue. The IC score was not associated with body composition variables such as fat-free mass, body fat percentage, or visceral fat area. Higher IC was associated with better quality of life. The area under the curve of the receiver operating characteristic (AUC-ROC) for the ICOPE screening tool vs. Fried phenotype, FRAIL, ADL disability, IADL disability, and SARC-F were 0.817, 0.843, 0.954, 0.912, and 0.909, respectively.Conclusion: Our research affirms that the ICOPE screening tool is useful to identify adults with poor physical and mental function in a Chinese sample. This tool may assist in identifying declines in IC in an integrative care model and help slow down function decline and onset of care dependence.

Achieving person-centredness through technologies supporting integrated care for older people living at home: an integrative review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Julie MacInnes ◽  
Jenny Billings ◽  
Alexandra Lelia Dima ◽  
Chris Farmer ◽  
Giel Nijpels
Keyword(s):  
Older People ◽  
Integrated Care ◽  
Digital Technologies ◽  
Healthcare Management ◽  
Integrative Review ◽  
Scientific Publications ◽  
Content Type ◽  
Range Type ◽  
Care For Older People ◽  
At Home

PurposeThe purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the context of integrated care at home. We also discuss key emergent themes relevant to the use of person-centred technology for older people in integrated care and propose recommendations for policy and practice.Design/methodology/approachAn integrative review methodology was used to identify and describe recent scientific publications in four stages: problem identification, literature search, data evaluation and data analysis.FindingsTwelve studies were included in the review. Three studies described remote consultations, particularly telemedicine; five studies described tools to support self-management; three studies described the use of healthcare management tools, and one study described both remote consultation and self-care management. Emergent themes were: acceptability, accessibility and use of digital technologies; co-ordination and integration of services; the implementation of digital technologies; and safety and governance. Several recommendations are proposed relevant to integrated care teams, technology developers and researchers.Originality/valueThis review uniquely considers the extent to which novel digital technologies used in integrated care for older people are person-centred.

scholarly journals Screening Community-Living Older Adults for Protein Energy Malnutrition and Frailty: Update and Next Steps

2019 ◽  
Vol 45 (3) ◽  
pp. 640-660 ◽  
Author(s):  
Johanna T. Dwyer ◽  
Jaime J. Gahche ◽  
Mary Weiler ◽  
Mary Beth Arensberg
Keyword(s):  
Older Adults ◽  
Predictive Validity ◽  
Screening Tool ◽  
Protein Energy Malnutrition ◽  
The United States ◽  
Community Dwelling ◽  
Screening Tools ◽  
World Health ◽  
Community Settings ◽  
Protein Energy

Abstract Protein-energy malnutrition (PEM)/undernutrition and frailty are prevalent, overlapping conditions impacting on functional and health outcomes of older adults, but are frequently unidentified and untreated in community settings in the United States. Using the World Health Organization criteria for effective screening programs, we reviewed validity, reliability, and feasibility of data-driven screening tools for identifying PEM and frailty risk among community-dwelling older adults. The SCREEN II is recommended for PEM screening and the FRAIL scale is recommended as the most promising frailty screening tool, based on test characteristics, cost, and ease of use, but more research on both tools is needed, particularly on predictive validity of favorable outcomes after nutritional/physical activity interventions. The Malnutrition Screening Tool (MST) has been recommended by one expert group as a screening tool for all adults, regardless of age/care setting. However, it has not been tested in US community settings, likely yields large numbers of false positives (particularly in community settings), and its predictive validity of favorable outcomes after nutritional interventions is unknown. Community subgroups at highest priority for screening are those at increased risk due to prior illness, certain demographics and/or domiciliary characteristics, and those with BMI < 20 kg/m2 or < 22 if > 70 years or recent unintentional weight loss > 10% (who are likely already malnourished). Community-based health professionals can better support healthy aging by increasing their awareness/use of PEM and frailty screening tools, prioritizing high-risk populations for systematic screening, following screening with more definitive diagnoses and appropriate interventions, and re-evaluating and revising screening protocols and measures as more data become available.

Integrated Care for Older People

2018 ◽  
pp. 185-195 ◽  
Author(s):  
Islène Araujo de Carvalho ◽  
Joanne Epping-Jordan ◽  
John R. Beard
Keyword(s):  
Older People ◽  
Integrated Care ◽  
Care For Older People
Sign in / Sign up

Export Citation Format

Share Document