Intrinsic Capacity: Validation of a New WHO Concept for Healthy Aging in a Longitudinal Chinese Study
Intrinsic Capacity: Validation of a New WHO Concept for Healthy Aging in a Longitudinal Chinese Study
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内在能力：世界卫生组织健康老龄化新概念在中国纵向研究中的验证
DOI：
10.1093/gerona/glab226
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发表时间：
2021-08-03
影响因子：
5.1
通讯作者：
Hanewald, Katja
中科院分区：
文献类型：
--
作者：
Beard, John R.;Si, Yafei;Hanewald, Katja
背景资料：世界卫生组织提出了一个健康老龄化模型，该模型围绕功能能力的概念建立，包括个人的内在能力、他们所处的物质和社会环境以及两者之间的相互作用。然而，这些结构的定义很差。我们研究了60岁及以上中国人群的代表性样本的内在能力结构，并评估了其在预测工具性日常生活活动（IADL）和日常生活活动（ADC）能力下降方面的价值，方法与之前在英语队列中进行的结构验证相似。方法：我们对2011年和2013年中国健康与退休纵向研究的7643名参与者进行了身份识别数据访问。采用增量相关结构方程模型，包括探索性和验证性因素分析，路径分析。多元线性回归测试结构效度，简单和串行调解模型评估预测validity.Results：因素负荷模型显示了一个明确的结构，为内在的能力：1个一般因素与5个子因素运动，认知，心理和感觉能力，和活力（反映潜在的生理变化）。在考虑了年龄、性别、教育、财富和慢性疾病数量后，内在能力预测了IADL（标准化系数（SE）-0.324（0.02），p <0.001）和ADL（-0.227（0.03），p <0.001）的下降。每个特征都与内在能力，提供强大的结构validity.Conclusions：内在能力的评估提供了有价值的信息，一个人的后续功能超出了年龄，其他个人因素，和multimorphies。
Background: The World Health Organization has proposed a model of healthy aging built around the concept of functional ability, comprising an individual's intrinsic capacity, the physical and social environment they occupy, and interactions between the two. However, these constructs have been poorly defined. We examined the structure of intrinsic capacity in a representative sample of the Chinese population aged 60 years and older and assessed its value in predicting declining performance in instrumental activities of daily living (IADLs) and activities of daily living (ADCs) using similar methods to a construct validation previously undertaken in an English cohort.Methods: Deidentified data were accessed on 7 643 participants of the China Health and Retirement Longitudinal Study 2011 and 2013 waves. Incrementally related structural equation modeling was applied, including exploratory and confirmatory factor analysis, and path analysis. Multiple linear regression tested construct validity, and simple and serial mediation models assessed predictive validity.Results: Factor loadings for the models showed a clear structure for intrinsic capacity: 1 general factor with 5 subfactors-locomotor, cognitive, psychological and sensory capacities, and vitality (reflecting underlying physiologic changes). Intrinsic capacity predicted declining performance in both IADLs (standardized coefficient (SE) -0.324 (0.02), p < .001) and ADLs (-0.227 (0.03), p < .001), after accounting for age, sex, education, wealth, and number of chronic diseases. Each characteristic was associated with intrinsic capacity, providing strong construct validity.Conclusions: Assessment of intrinsic capacity provides valuable information on an individual's subsequent functioning beyond that afforded by age, other personal factors, and multimorbidity.