The correlation between changes in intrinsic capacity of older adults in Chinese communities and adverse health-related outcomes: A prospective longitudinal Cohort study

BACKGROUNDS: Preserving intrinsic capacity (IC) is essential for healthy aging. This study examined the associations between longitudinal changes in IC and subsequent adverse health outcomes. METHODS: Participants were community-dwelling adults aged ≥60 years from the China Health and Retirement Longitudinal Study (CHARLS). Changes in IC between 2011 and 2013 were classified as consistently well, improved, worsened, or consistently declined. Logistic regression assessed associations with falls and hospitalization (2015), and Cox models evaluated all-cause mortality (2020). RESULTS: Changes in IC were significant predictors of adverse outcomes. Worsened (OR = 1.674, 95 % CI: 1.163-2.411, P = 0.006) and consistently declined changes in IC (OR = 1.914, 95 % CI: 1.373-2.668, P < 0.001) were both associated with an increased risk of falls, while domain-specific changes, such as worsened locomotion, consistently declined in cognition and fluctuations in psychology or vision, were also linked to increased fall risk (all P < 0.017). Both consistently declined IC (OR = 1.513, 95 % CI: 1.079-2.122, P < 0.017) and worsened locomotion were independent predictors of hospitalization (OR = 1.837, 95 % CI: 1.265-2.670, P = 0.001). Declines in locomotion were also strongly associated with mortality, with higher risk observed in the worsened group (HR = 1.571, 95 % CI: 1.088-2.267, P < 0.017). CONCLUSIONS: Monitoring intrinsic capacity changes, especially locomotion decline, enables early identification of vulnerable older adults and supports timely, targeted interventions to reduce adverse outcomes.