| The World Health Organization Integrated Care for Older People (ICOPE) Framework and the Association with Frailty in Older Adults |
Wan-Yun Chou1, Kun-Pei Lin2,3, Chiung-Jung Wen2,4, Ding-Cheng (Derrick) Chan2,3,5 
, Su-I Hou1
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1School of Global Health Management and Informatics, College of Community Innovation and Education, University of Central Florida, Orlando, FL, USA
2Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
3Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
4Department of Family Medicine, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
5Superintendent Office, Bei-Hu Branch, National Taiwan University Hospital, Taipei, Taiwan |
Correspondence:
Ding-Cheng (Derrick) Chan,
Email: doctord6226@yahoo.com
Su-I Hou,
Email: su-i.hou@ucf.edu
|
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Received: 9 August 2025 • Revised: 26 November 2025 • Accepted: 29 November 2025 |
| Abstract |
Background
The World Health Organization published the 2019 Integrated Care for Older People (ICOPE) framework to guide, assess, and promote the intrinsic capacity (IC) of older adults, referring to their physical and mental health. This study aims to investigate the relationship between IC and frailty among older adults.
Methods
This cross-sectional study was conducted in a medical center in Taiwan in 2021. Two hundred ten patients over 65 admitted to the geriatric ward were invited to participate. The questionnaire included an IC measure, Fried Frailty Scale, and demographic items. The IC measure was ascertained using the six domains of ICOPE (cognition, mobility, nutrition, visual, hearing, and depressive symptoms). The Fried Frailty Scale was used to categorize participants as robust (Fried Frailty Scale=0), prefrail (Fried Frailty Scale=1-2), or frail (Fried Frailty Scale ≥3). Multinomial logistic regression was used to analyze the association between individual ICOPE domains and frailty stages, while adjusting for confounders.
Results
Among the participants, 39.0% were prefrail, and 28.6% were frail. Mobility loss and depressive symptoms were significantly associated with prefrail (adjusted odds ratio [aOR]=4.44, 95% confidence interval [CI] 1.82–10.82; aOR=8.41, 95% CI 1.75–40.37) and frail (aOR=11.57, 95% CI 3.63–36.93; aOR=13.77, 95% CI 2.62–72.49) individuals, respectively. Malnutrition (aOR=4.01, 95% CI 1.18–13.62) and hearing loss (aOR=4.37, 95% CI 1.09–19.66) were significantly associated with frail older adults.
Conclusion
Mobility loss and depressive symptoms occurring at the prefrail stage could be used as assessment items for early detection of prefrail. |
| Key Words:
Intrinsic capacity, Frailty, Screening, Aged |
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