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Exploring the natural history of intrinsic capacity impairments: longitudinal patterns in the 10/66 study

Lookup NU author(s): Professor Matthew Prina

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Backgroundintrinsic capacity (IC) is a construct encompassing people’s physical and mental abilities. There is an implicit link amongst IC domains: cognition, locomotion, nutrition, sensory and psychological. However, little is known about the integration of the domains.Objectivesto investigate patterns in the presentation and evolution of IC domain impairments in low-and-middle-income countries and if such patterns were associated with adverse outcomes.Methodssecondary analyses of the first two waves of the 10/66 study (population-based surveys conducted in eight urban and four rural catchment areas in Cuba, Dominican Republic, Puerto Rico, Venezuela, Peru, Mexico and China). We applied latent transition analysis on IC to find latent statuses (latent clusters) of IC domain impairments. We evaluated the longitudinal association of the latent statuses with the risk of frailty, disability and mortality, and tested concurrent and predictive validity.Resultsamongst 14,923 participants included, the four latent statuses were: high IC (43%), low deterioration with impaired locomotion (17%), high deterioration without cognitive impairment (22%), and high deterioration with cognitive impairment (18%). A total of 61% of the participants worsened over time, 35% were stable, and 3% improved to a healthier status.Participants with deteriorated IC had a significantly higher risk of frailty, disability and dementia than people with high IC. There was strong concurrent and predictive validity. (Mortality Hazard Ratio = 4.60, 95%CI 4.16; 5.09; Harrel’s C = 0.73 (95%CI 0.72;0.74)).Conclusionshalf of the study population had high IC at baseline, and most participants followed a worsening trend. Four qualitatively different IC statuses or statuses were characterised by low and high levels of deterioration associated with their risk of disability and frailty. Locomotion and cognition impairments showed other trends than psychological and nutrition domains across the latent statuses.


Publication metadata

Author(s): Gonzalez-Bautista E, Llibre-Guerra JJ, Sosa AL, Acosta I, Andrieu S, Acosta D, Llibre-Rodríguez JJ, Prina M

Publication type: Article

Publication status: Published

Journal: Age and Ageing

Year: 2023

Volume: 52

Issue: 7

Print publication date: 29/07/2023

Online publication date: 29/07/2022

Acceptance date: 02/04/2018

Date deposited: 07/02/2024

ISSN (print): 0002-0729

ISSN (electronic): 1468-2834

Publisher: Oxford University Press

URL: https://doi.org/10.1093/ageing/afad137

DOI: 10.1093/ageing/afad137

Data Access Statement: The data underlying this study are restricted, as participants did not consent to sharing their information publicly. Data underlying the results presented in the study are available from the 10/66 Dementia Research Group public data archive for researchers who meet the criteria for access to confidential data. Information on procedures to request access is available at https://www.alz.co.uk/1066/1066_public_archive_baseline.php, or by contacting dementiaresearchgroup1066@kcl.ac.uk


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Funding

Funder referenceFunder name
Alzheimer’s Association
Foundation for Barnes-Jewish Hospital
FONACIT/CDCH/UCV
McDonnell Academy
NIH-NIA (K01AG073526)
Programme des Investissements d’Avenir grant EUR CARe N◦ANR18-EURE-0003
Wellcome Trust [GR08002]
WHO
US Alzheimer’s Association

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