Exploring the Relationship Between ICOPE Framework and Frailty Among Community-dwelling Elderly Individuals

Study Overview
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Brief Summary
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This study aims to compare the results obtained from the self-administration and interview version of the Chinese ICOPE screening tools and examine the relationship between ICOPE and frailty among community-dwelling elderly in Taiwan.

Detailed Description
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The elderly population is increasing rapidly in the world. The prevalence of frailty is directly correlated with advancing age in community- dwelling elderly. The World Health Organization (WHO) published the Integrated Care for older people (ICOPE) screening tool rapid screening health state of the elderly for early prevention and delay the onset of disability. However, there is still insufficient research on the correlation between the interview version and self-administration of Chinese ICOPE screening tools and ICOPE and frailty. Therefore, this study aims to compare the results obtained from the self-administration and interview version of the Chinese ICOPE screening tools and examine the relationship between ICOPE and frailty among community-dwelling elderly in Taiwan.

Official Title
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Exploring the Relationship Between the Integrated Care for Older People (ICOPE) Framework and Frailty Among Community-dwelling Elderly Individuals

Conditions
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Community-dwelling Elderly

Intervention / Treatment
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* Behavioral: Montreal Cognitive Assessment (MoCA)
* Behavioral: Chinese ICOPE screening tool (self-administration and interview versions)
* Behavioral: Frailty status assessment (Edmonton frail scale and Frailty criteria by Dr. Fried)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ≥ 65 years old Community-dwelling elderly Walking independently (with/without assistive devices) Exclusion Criteria: Participants with a MoCA score < 25 Being unable to give informed consent (e.g., aphasia, deafness, and blindness) Being unable to finish all the physical and screening assessment assessments

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Decline ICOPE group<br>The elderly individuals who have at least one impairment in ICOPE screening domains. | Behavioral: Montreal Cognitive Assessment (MoCA)<br>* MoCA would be used to assess participants cognitive functioning.<br>Behavioral: Chinese ICOPE screening tool (self-administration and interview versions)<br>* The ICOPE screening tool would be used to assess participants health status, including cognitive decline, auditory and visual capabilities, mobility restrictions, nutritional status, and depressive symptoms.<br>Behavioral: Frailty status assessment (Edmonton frail scale and Frailty criteria by Dr. Fried)<br>* The Edmonton frail scale and Frailty criteria by Dr. Fried would be used to assess participants frailty status.<br>|
| Non-decline ICOPE group<br>The elderly individuals who do not have any impairment in ICOPE screening domains. | Behavioral: Montreal Cognitive Assessment (MoCA)<br>* MoCA would be used to assess participants cognitive functioning.<br>Behavioral: Chinese ICOPE screening tool (self-administration and interview versions)<br>* The ICOPE screening tool would be used to assess participants health status, including cognitive decline, auditory and visual capabilities, mobility restrictions, nutritional status, and depressive symptoms.<br>Behavioral: Frailty status assessment (Edmonton frail scale and Frailty criteria by Dr. Fried)<br>* The Edmonton frail scale and Frailty criteria by Dr. Fried would be used to assess participants frailty status.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intrinsic capacity | ICOPE screening tool (self-administration and interview version) would be used to evaluate the intrinsic capacity(IC), including cognitive decline, auditory and visual capabilities, mobility restrictions, nutritional status, and depressive symptoms) of the participants. Each question requires a binary response, either 'yes' or 'no'. A total score will be determined by summing the number of IC impairments, which have a score range of 0-6, with higher scores indicating a greater degree of impairment. | The ICOPE screening tool assessment would take about 10 minutes | 
| Phenotype of frailty status | Frailty criteria by Dr. Fried would be used to evaluate the frail status of the participants.The Dr. Fried phenotype of frailty comprises five components, unintentional weight loss, exhaustion, weakness, slowness, and low activity. Individuals who exhibit three or more indicators are classified as frail, those with one to two indicators are categorized as pre-frail, and those with no indicators are characterized as robust. | The phenotype of frailty status assessment would take about 10 minutes | 
| Accumulated frailty status | Edmonton frail scale(EFS) would be used to evaluate the frail status of the participants. EFS assesses a wide range of nine domains through 11 questions. These domains cover cognition, general health status, functional independence, social support, medication use, nutrition, mood, continence, and functional performance. The total score of EFS ranges from 0 to 17, where scores of 0-5 indicate not being frail, 6-7 indicate being vulnerable, 8-9 indicate mild frailty, 10-11 indicate moderate frailty and 12-17 indicate severe frailty. | The accumulated frailty status assessment would take about 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cognitive status | MoCA would be used to evaluate the cognitive functioning of the participants. MOCA comprises attention and concentration, executive function, memory, language ability, visuospatial construction, abstract concepts, calculation, and orientation. The cumulative score amounts to 30 points, with a minimum standard of 26 points or higher. 25-18 points indicate mild cognitive impairment, 17-10 points indicate moderate cognitive impairment, fewer than 10 points indicate severe cognitive impairment. | The cognitive status assessment would take about 10 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Frailty, ICOPE, Intrinsic capacity (IC)