Functional classification and mortality in older people: a study based on the ICF and the Intrinsic Capacity
International Classification of Functioning, Disability and Health. Functional Capacity. Aging. Mortality.
Introduction: Both the International Classification of Functioning, Disability and Health (ICF) and the concept of intrinsic capacity (IC) aim to compile the main aspects of human functionality. Understanding the predictive capacity to identify more vulnerable people can inform health practices and policies. Aim: To analyze the capacity of an ICF core set and IC to predict mortality in community-dwelling older adults after a six-year follow-up. Methods: This is a longitudinal observational study, developed in the city of Santa Cruz (RN), with 101 older adults (≥60 years). Sociodemographic data, physical health assessment (ICF core set), and IC assessment in four domains were collected (cognitive: Leganés Cognitive Test; psychological: Center for Epidemiological Studies; locomotion: Short Physical Performance Battery; and vitality: grip strength manual). Occurrence of death up to 6 years after the initial assessment was obtained through the Mortality Information System. Data were analyzed using Spearman's correlation test and Mann-Whitney test. To assess the association between the impairment/problem index, CI, and mortality, logistic regression, adjusted for sex and age, was applied. In all analyses, a significant level of p< 0.05 was adopted. Results: 13 elderly individuals (12.9%) died over 6 years. There was a significant low to moderate correlation between all components of the ICF core set and the CI score,
except for the "Environmental Factors" domain. The results for CI and the core set were significantly worse among the participants who died. Considering the regression models, the total ICF index was positively associated with mortality (p = 0.02). CI showed a marginally significant result (p = 0.05). Conclusion: The results suggest that both strategies proved useful for assessment in clinical practice and research, allowing
for the early detection of modifiable factors that impact the functionality and mortality of older adults, reinforcing the importance of multidimensional assessment approaches for promoting healthy aging.