Exploring the Relationship Between ICOPE Framework and Frailty Among Community-dwelling Elderly Individuals

Exploring the Relationship Between the Integrated Care for Older People (ICOPE) Framework and Frailty Among Community-dwelling Elderly Individuals

This study aims to (1) compare the assessment outcome of the ICOPE-I and ICOPE-S, and (2) investigate the correlation between both versions of the ICOPE step 1 screening tools and frailty in Taiwan.

Study Overview

• Status: Completed
• Conditions: Community-dwelling Elderly
• Intervention / Treatment: Behavioral: Montreal Cognitive Assessment (MoCA); Behavioral: Chinese ICOPE screening tool (self-administration and interview versions); Behavioral: Frailty status assessment (Edmonton frail scale and Frailty criteria by Dr. Fried)

Detailed Description

The prevalence of frailty among the elderly increases annually as the population ages. The World Health Organization (WHO) has introduced the Integrated Care for Older People (ICOPE) framework, which aims to support healthy aging by evaluating the intrinsic capacity (IC) of the elderly in six different areas. In Taiwan, two versions of the ICOPE step 1 screening tools are available: an interview-based version (ICOPE-I) and a self-administered version (ICOPE-S) based on the WHO's model. There are two main models for frailty status assessments: Dr. Fried's phenotype of frailty and Dr. Rockwood's accumulation of deficit models. A comparative study is necessary to assess the consistency of both versions of ICOPE in Taiwan and their associations with frailty.

• Study Type: Observational
• Enrollment (Actual): 135

Contacts and Locations

Study Locations

• Taiwan
  • Zhongzheng
    • Taipei, Zhongzheng, Taiwan, 100
      • School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Communities in Taipei city

Description

Inclusion Criteria:

• ≥ 65 years old
• Community-dwelling elderly
• Walking independently (with/without assistive devices)

Exclusion Criteria:

• Participants with a MoCA score < 26
• Being unable to give informed consent (e.g., aphasia, deafness, and blindness)
• Being unable to finish all the physical and screening assessment assessments

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Decline ICOPE group; The elderly individuals who have at least one impairment in ICOPE screening domains.	Behavioral: Montreal Cognitive Assessment (MoCA); MoCA would be used to assess participants cognitive functioning.; Behavioral: Chinese ICOPE screening tool (self-administration and interview versions); The ICOPE screening tool would be used to assess participants health status, including cognitive decline, auditory and visual capabilities, mobility restrictions, nutritional status, and depressive symptoms.; Behavioral: Frailty status assessment (Edmonton frail scale and Frailty criteria by Dr. Fried); The Edmonton frail scale and Frailty criteria by Dr. Fried would be used to assess participants frailty status.
Non-decline ICOPE group; The elderly individuals who do not have any impairment in ICOPE screening domains.	Behavioral: Montreal Cognitive Assessment (MoCA); MoCA would be used to assess participants cognitive functioning.; Behavioral: Chinese ICOPE screening tool (self-administration and interview versions); The ICOPE screening tool would be used to assess participants health status, including cognitive decline, auditory and visual capabilities, mobility restrictions, nutritional status, and depressive symptoms.; Behavioral: Frailty status assessment (Edmonton frail scale and Frailty criteria by Dr. Fried); The Edmonton frail scale and Frailty criteria by Dr. Fried would be used to assess participants frailty status.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intrinsic capacity	ICOPE screening tool (self-administration and interview version) would be used to evaluate the intrinsic capacity(IC), including cognitive decline, auditory and visual capabilities, mobility restrictions, nutritional status, and depressive symptoms) of the participants. Each question requires a binary response, either 'yes' or 'no'. A "total score" will be determined by summing the number of IC impairments, which have a score range of 0-6, with higher scores indicating a greater degree of impairment.	The ICOPE screening tool assessment would take about 10 minutes
Phenotype of frailty status	Frailty criteria by Dr. Fried would be used to evaluate the frail status of the participants.The Dr. Fried phenotype of frailty comprises five components, unintentional weight loss, exhaustion, weakness, slowness, and low activity. Individuals who exhibit three or more indicators are classified as frail, those with one to two indicators are categorized as pre-frail, and those with no indicators are characterized as robust.	The phenotype of frailty status assessment would take about 10 minutes
Accumulated frailty status	Edmonton frail scale(EFS) would be used to evaluate the frail status of the participants. EFS assesses a wide range of nine domains through 11 questions. These domains cover cognition, general health status, functional independence, social support, medication use, nutrition, mood, continence, and functional performance. The total score of EFS ranges from 0 to 17, where scores of 0-5 indicate not being frail, 6-7 indicate being vulnerable, 8-9 indicate mild frailty, 10-11 indicate moderate frailty and 12-17 indicate severe frailty.	The accumulated frailty status assessment would take about 10 minutes

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cognitive status	MoCA would be used to evaluate the cognitive functioning of the participants. MOCA comprises attention and concentration, executive function, memory, language ability, visuospatial construction, abstract concepts, calculation, and orientation. The cumulative score amounts to 30 points, with a minimum standard of 26 points or higher. 25-18 points indicate mild cognitive impairment, 17-10 points indicate moderate cognitive impairment, fewer than 10 points indicate severe cognitive impairment.	The cognitive status assessment would take about 10 minutes

Collaborators and Investigators

• Sponsor: National Taiwan University Hospital
• Investigators: Study Chair: Li-Ying Wang, PhD, National Taiwan University

Study record dates

Study Major Dates

• Study Start (Actual): December 2, 2023
• Primary Completion (Actual): June 25, 2024
• Study Completion (Actual): June 25, 2024

Study Registration Dates

• First Submitted: November 9, 2023
• First Submitted That Met QC Criteria: November 14, 2023
• First Posted (Actual): November 18, 2023

Study Record Updates

• Last Update Posted (Actual): August 12, 2024
• Last Update Submitted That Met QC Criteria: August 8, 2024
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: Frailty; Intrinsic capacity; Community-dwelling elderly; ICOPE
• Additional Relevant MeSH Terms: Pathologic Processes; Frailty
• Other Study ID Numbers: 202310067RINC

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No