Subgrouping Community-Dwelling Older Adults by Intrinsic Capacity Decline-A Cluster Analysis Based on the WHO ICOPE Framework in Rural Taiwan

This study applied the WHO ICOPE framework to identify patterns of intrinsic capacity (IC) decline among community-dwelling older adults in rural Taiwan. We conducted a cross-sectional survey of 1,367 adults aged 65 and above using the ICOPE Step 1 screening tool, assessing six IC domains. Cluster analysis (k-means and hierarchical) identified distinct IC profiles. Eight IC subgroups were identified, ranging from robust (17.0%) to severely frail (6.9%). Sensory impairments (vision 49.1%, hearing 46.0%) were most common and often co-occurred with cognitive and mood impairments. Older age and multimorbidity were significantly associated with greater IC decline (p < .01).Findings highlight the heterogeneity of aging and suggest that tailored, cluster-based care strategies can enhance community health planning. The results support the implementation of ICOPE-based risk stratification models in local aging policies.