Assessing intrinsic capacity in older adults using the ICOPE tool in a tertiary care setting in Karachi, Pakistan

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Background: Ageing in Pakistan highlights the urgent need to preserve intrinsic capacity. The WHO Integrated Care for Older People (ICOPE) tool provides a standardized framework for assessing intrinsic capacity. This study applied a translated version of the ICOPE tool in older adults in Karachi to assess intrinsic capacity and its association with sociodemographic and health-related factors. Methods: A cross-sectional study was conducted among older adults ≥60 years recruited consecutively from a tertiary care setting in Karachi. Intrinsic capacity was assessed using the WHO ICOPE tool, covering cognition, mobility, nutrition, sensory, and psychological well-being. Each domain scored 1 if any item indicated impairment; aggregated scores generated the overall ICOPE score. Sociodemographic and health-related data were collected using a structured questionnaire. Robust linear regression was performed in STATA 17 software. Ethical approval was obtained from the Aga Khan University Ethical Review Committee. Results: A total of 81 participants (mean age 69.1 ± 3.6 years; 58 % female) were included in the study analysis. Hearing loss (87.7 %), visual impairment (79.0 %), and limited mobility (63.0 %) were the most commonly reported conditions. The mean ICOPE score was 3.4 ± 1.2. Higher scores, reflecting greater impairment and reduced intrinsic capacity, were observed in individuals with hypertension (+0.70 units, 95 % CI: 0.21-1.19) and ischemic heart disease (+0.73 units, 95 % CI: 0.06-1.39). Conclusion: High rates of impairment across multiple domains of intrinsic capacity were identified among older adults in this setting. The study supports the feasibility of ICOPE in Pakistan and highlights the importance of its wider implementation to facilitate early decline in intrinsic capacity in ageing populations.

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