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

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.

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Actions required to implement integrated care for older people in the community using the World Health Organization's ICOPE approach: A global Delphi consensus study

PLoS ONE ◽

10.1371/journal.pone.0205533 ◽

2018 ◽

Vol 13 (10) ◽

pp. e0205533 ◽

Cited By ~ 17

Author(s):

Andrew M. Briggs ◽

Islene Araujo de Carvalho

Keyword(s):

Older People ◽

Integrated Care ◽

World Health ◽

Delphi Consensus ◽

The World ◽

Care For Older People

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Intrinsic capacity as a framework for Integrated Care for Older People (ICOPE); insights from the 10/66 Dementia Research Group cohort studies in Latin America, India and China

10.1101/19006403 ◽

2019 ◽

Author(s):

Martin J. Prince ◽

Daisy Acosta ◽

Mariella Guerra ◽

Yueqin Huang ◽

KS Jacob ◽

...

Keyword(s):

Older People ◽

Cohort Studies ◽

Integrated Care ◽

Healthy Ageing ◽

Target Group ◽

Needs For Care ◽

Intrinsic Capacity ◽

Urban Sites ◽

India And China ◽

Care For Older People

AbstractBackgroundThe World Health Organization has reframed health and healthcare for older people around achieving the goal of healthy ageing. Recent evidence-based guidelines on Integrated Care for Older People focus on maintaining intrinsic capacity, addressing declines in mobility, nutrition, vision and hearing, cognition, mood and continence aiming to prevent or delay the onset of care dependence. The target group (with one or more declines in intrinsic capacity) is broad, and implementation at scale may be challenging in less-resourced settings.Planning can be informed by assessing the prevalence of intrinsic capacity, characterising the target group, and validating the general approach by evaluating risk prediction for incident dependence and mortality.MethodsPopulation-based cohort studies in urban sites in Cuba, Dominican Republic, Puerto Rico, Venezuela, and rural and urban sites in Peru, Mexico, India and China. Sociodemographic, behaviour and lifestyle, health, healthcare utilisation and cost questionnaires, and physical assessments were administered to all participants, with ascertainment of incident dependence, and mortality, three to five years later.ResultsIn the 12 sites in eight countries, 17,031 participants were surveyed at baseline. Intrinsic capacity was least likely to be retained for locomotion (71.2%), vision (71.3%), cognition (73.5%), and mood (74.1%). Only 30% retained full capacity across all domains, varying between one quarter and two-fifths in most sites. The proportion retaining capacity fell sharply with increasing age, and declines affecting multiple domains were more common. Poverty, morbidity (particularly dementia, depression and stroke), and disability were concentrated among those with DIC, although only 10% were frail, and a further 9% had needs for care. Hypertension and lifestyle risk factors for chronic disease, healthcare utilization and costs were more evenly distributed in the general older population. 15,901 participants were included in the mortality cohort (2,602 deaths/ 53,911 person years of follow-up), and 12,965 participants in the dependence cohort (1900 incident cases/ 38,377 person-years). DIC (any decline, and number of domains affected) strongly and independently predicted incident dependence and death. Relative risks were higher for those who were frail, but were also substantially elevated for the much larger sub-groups yet to become frail. Mortality was mainly concentrated in the frail and dependent sub-groups.ConclusionsOur findings support the strategy to optimize intrinsic capacity in pursuit of healthy ageing. Most needs for care arise in those with declines in intrinsic capacity who are yet to become frail. Implementation at scale requires community-based screening and assessment, and a stepped-care approach to intervention. Community healthcare workers’ roles would need redefinition to engage, train and support them in these tasks. ICOPE could be usefully integrated into community programmes orientated to the detection and case management of chronic diseases including hypertension and diabetes.

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World Health Organization Integrated Care for Older People (ICOPE) and the Integrated Care of Older Patients with Frailty in Primary Care (ICOOP_Frail) Study in Korea

Annals of Geriatric Medicine and Research ◽

10.4235/agmr.21.0025 ◽

2021 ◽

Author(s):

Chang Won Won ◽

Eunmi Ha ◽

Eunjin Jeong ◽

Miji Kim ◽

Juhyun Park ◽

...

Keyword(s):

Primary Care ◽

Older People ◽

World Health Organization ◽

Integrated Care ◽

Older Patients ◽

World Health ◽

Health Organization ◽

Care For Older People

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

Innovation in Aging ◽

10.1093/geroni/igab046.277 ◽

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.

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

Journal of Integrated Care ◽

10.1108/jica-03-2021-0013 ◽

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.

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