Ahead of print articles
Check out a preview articles to be published in the next issue.
JARLIFE Vol 15, 2026
EDITORIAL: ‘SCALING THE INTEGRATED CARE FOR OLDER PEOPLE APPROACH (ICOPE): TRANSLATING PILOT LEARNINGS INTO NATIONAL HEALTH POLICY AND PERSON-CENTRED SERVICE DELIVERY’
Yuka Sumi, Matteo Cesari, Ritu Sadana
J Aging Res & Lifestyle 2026;15
Show summaryHide summary
CITATION:
Yuka Sumi ; Matteo Cesari ; Ritu Sadana (2025): Editorial: ‘Scaling the integrated care for older people approach (ICOPE): Translating pilot learnings into national health policy and person-centred service delivery’. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100039
ADAPTING WHO INTEGRATED CARE FOR OLDER PEOPLE (ICOPE) MODELS TO THE KOREAN CONTEXT: POLICY RELEVANCE AND FEASIBILITY-A DELPHI SURVEY
Hee-Sun Kim, Chang Won Won, Yunhwan Lee
J Aging Res & Lifestyle 2026;15
Show summaryHide summaryBACKGROUND: Korea is projected to become a super-aged society by 2025, prompting the World Health Organization (WHO) to develop the Integrated Care for Older People (ICOPE) framework for person-centered, community-based care. Despite Korea’s efforts in translating ICOPE materials and launching pilot projects, evidence on their national policy alignment and feasibility for scale-up remains limited.
OBJECTIVE: This study assesses the policy relevance and feasibility of implementing the ICOPE framework in Korea through expert consensus and structural comparison with ongoing national and local initiatives.
METHODS: A three-round Delphi survey involved 31 experts in geriatrics, public health, and aging policy. Thirty-two ICOPE implementation items were evaluated across micro, meso, and macro levels using interquartile range (IQR) and content validity ratio (CVR). Results were compared with key Korean programs, including the Seoul Health Companion Center and Ministry of Health and Welfare’s Integrated Care Pilot Project.
RESULTS: Most ICOPE elements, particularly at the micro level (e.g., frailty screening in primary care: IQR = 0.93, CVR = 0.72), were deemed relevant and feasible. However, macro-level components like digital infrastructure and financing showed limited readiness.
CONCLUSION: The ICOPE framework is broadly compatible with Korea’s integrated care strategies, especially at the micro level. Macro-level implementation gaps persist. This study’s findings, particularly identified consensus priorities and policy-practice gaps, aim to directly inform future policy design and scale-up strategies for integrated care in Korea, guiding efforts in governance integration, ICT infrastructure development, and indicator standardization.
CITATION:
Hee-Sun Kim ; Chang Won Won ; Yunhwan Lee (2025): Adapting WHO integrated care for older people (ICOPE) models to the Korean context: Policy relevance and feasibility-a Delphi survey. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100031
EXPLORING BALANCE CHALLENGE IN FALL PREVENTION COMMUNITY EXERCISE PROGRAMS FOR OLDER ADULTS ACROSS CANADA: A CROSS-SECTIONAL ELECTRONIC SURVEY OF INSTRUCTOR PERCEPTIONS
Alison M Bulow, Alexie J Touchette, Alison R Oates, Kathryn M Sibley
J Aging Res & Lifestyle 2026;15
Show summaryHide summaryBACKGROUND: Exercise that challenges balance helps reduce falls in older people. Evaluating the intensity of balance challenge is difficult and no validated measures exist for group settings.
OBJECTIVE: To examine how instructors determine and perceive balance challenge at the program level, and explore relationships between estimates of program-level balance challenge.
DESIGN: Cross-sectional self-report study
SETTING: Electronic survey questionnaire approach.
PARTICIPANTS: Instructors of Canadian group exercise programs targeting community-dwelling older adults.
MEASUREMENTS: Instructors perceived program-level balance challenge and estimates of program-level balance challenge.
RESULTS: Most instructors (n = 108, 77%) perceived that their programs fully challenged balance among participants. However, no programs were identified as highly challenging. Most of the observed non-verbal balance challenge behaviours observed (n = 4, 80%) had no relationship to perception of balance challenge.
CONCLUSIONS: Findings suggest a misalignment between instructor perception and estimates of balance challenge at the program level. Further investigations of methods to assess balance challenge are warranted.
CITATION:
Alison M Bulow ; Alexie J Touchette ; Alison R Oates ; Kathryn M Sibley (2025): Exploring balance challenge in fall prevention community exercise programs for older adults across Canada: A cross-sectional electronic survey of instructor perceptions Author links open overlay panel. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100046
IMPLEMENTATION AND VALIDATION OF THE WHO ICOPE FRAMEWORK IN ANDORRA: A NATIONWIDE PILOT STUDY
Eva Heras, Jan Missé, Encarnació Ulloa, Gemma Ballester, Maria Anglada, Oliver Valero
J Aging Res & Lifestyle 2026;15
Show summaryHide summaryBACKGROUND: Healthy ageing relies on preserving intrinsic capacity (IC), the combination of an individual’s physical and mental capacities. The World Health Organization (WHO) developed the Integrated Care for Older People (ICOPE) framework as a person-centred care pathway to identify declines in IC and link older adults to appropriate interventions. The ICOPE model outlines a four-step approach involving basic community-based assessment, in-depth clinical evaluation, personalized care planning, and regular monitoring. However, evidence on large-scale implementation of this framework remains limited.
OBJECTIVE: To assess the feasibility and diagnostic accuracy of Step 1 screening across all seven municipalities of Andorra, and to link individuals to tailored interventions.
METHODS: From 2020 to 2025, 874 community-dwelling adults ≥ 60 years underwent Step 1 screening followed by full Step 2 assessment, using instruments from the WHO ICOPE Handbook.
Local adaptations included a clock-drawing test, the Montreal Cognitive Assessment (MoCA), Body Mass Index (BMI), and frequency-based scoring of the Patient Health Questionnaire-9 (PHQ-9). Diagnostic metrics (sensitivity, specificity, and Cohen’s kappa [κ]) were calculated for each domain. Referrals and interventions were tracked.
RESULTS: Of 857 participants analysed, Step 2 showed the highest prevalence of impairment in hearing (55 %) and cognition (39 %). Step 1 sensitivity improved notably after adaptations: cognition (+12 percentage points), mood (+30 percentage points), and nutrition (+6 percentage points), with vision specificity rising from 17 % to 99.5 %. Overall, 1 182 referrals were generated; 8 % joined a 12-week multicomponent programme including physical activity, nutrition and psychosocial support.
CONCLUSION: The ICOPE model is feasible at national scale. Local adaptations significantly enhanced screening accuracy without added burden. The Andorran experience offers a scalable and replicable model for other countries or regions and highlights the value of embedding healthy ageing in community care.
CITATION:
Eva Heras ; Jan Missé ; Encarnació Ulloa ; Gemma Ballester ; Maria Anglada ; Oliver Valero (2025): Implementation and validation of the WHO ICOPE framework in andorra: a nationwide pilot study. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100033
IMPLEMENTING ICOPE IN NEW MEXICO: A PROCESS-ORIENTED APPROACH TO PROMOTING HEALTHY AGING IN OLDER ADULTS
GM Rodriguez de Sosa, AL Shera, EY Jimenez, IA Patel, MB Greenwood-Erickson, KD Wilkins, L Vlietstra, AK Dancis, CK Bartsch, S Andrieu, JW Hwang, DS Scrase, DL Waters
J Aging Res & Lifestyle 2026;15
Show summaryHide summaryThe New Mexico Health Care Authority, the University of New Mexico Hospital, and the School of Medicine partnered in 2024 to implement the World Health Organization’s Independent Care for Older People (ICOPE) program. The program’s mission is to “empower New Mexico's seniors through prevention and person-centered care, enhancing health, independence, and quality of life by improving services, resources, and community support for healthy aging.”
Using the 2025 second edition of the ICOPE manual, the New Mexico ICOPE team has developed a strategic plan, an organizational structure reliant on community partnerships, a project plan, and algorithms to address the six ICOPE intrinsic capacities, as well as assessments of three key factors including urinary incontinence, social and carer support. The detailed process for algorithm development is described herein. These algorithms are the basis of the smartphone application developed to allow seniors to complete the ICOPE Basic Assessment and significant portions of the In-Depth Assessment at home. The algorithms are designed to enhance the use of community support resources and reduce the need for health care system visits when appropriate, while at the same time integrating primary care services whenever needed.
The system architecture and data and information flow are illustrated. The program's evaluation is structured according to the Practical, Robust Implementation and Sustainability Model (PRISM), used to identify the elements of implementation and effectiveness that will be measured. These include contextual factors such as institutional adoption, implementation, and maintenance of ICOPE, the program's reach, and the impact of ICOPE on patient experience of care, population health, and cost of care.
CITATION:
GM Rodriguez de Sosa ; AL Shera ; EY Jimenez ; IA Patel ; MB Greenwood-Erickson ; KD Wilkins ; L Vlietstra ; AK Dancis ; CK Bartsch ; S Andrieu ; JW Hwang ; DS Scrase ; DL Waters (2025): Implementing ICOPE in New Mexico: A process-oriented approach to promoting healthy aging in older adults. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100034
CHALLENGES TO TIMELY IDENTIFY AND TREAT ANOREXIA IN AGING IN THE CONTEXT OF THE INTEGRATED CARE FOR OLDER PEOPLE (ICOPE) PROGRAM
Kelly Virecoulon Giudici
J Aging Res & Lifestyle 2026;15
Show summaryHide summaryFrailty and sarcopenia represent harm to good longevity and are often related to inadequate dietary intake and to a decrease in appetite over the years, which are characteristics of a complex process also known as anorexia in aging. Understanding the factors leading to anorexia in aging is crucial for enabling the adequate development of public policies and clinical strategies to prevent and treat this condition and to help older adults to pursue healthy aging pathways. In the present article, a brief overview on the factors contributing to appetite loss and malnutrition among older adults is presented, and challenges to timely identifying and treating anorexia in aging are discussed. Major factors known to affect appetite and favor lower food intake in older people include physiological, pathological or social conditions. Trials testing treatments for anorexia in aging have focused on education, exercise, meal adjustments, nutritional supplementation and medications, but results are variable, partly due to the multitude of etiological factors and determinants of appetite loss in older adults, demanding further research. Routine screening in primary care with simple tools, as the Integrated Care for Older People (ICOPE) program, might important contribute for preserving intrinsic capacity and nutritional status, as also to early identifying the need for treating anorexia in aging.
CITATION:
Kelly Virecoulon Giudici (2025): Challenges to timely identify and treat anorexia in aging in the context of the Integrated Care for Older People (ICOPE) Program. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100035
COMPARATIVE PERFORMANCE OF ICOPE STEP 1 AND FRIED FRAILTY CRITERIA IN DETECTING FRAILTY PHENOTYPES: A CROSS-SECTIONAL STUDY
Clément Rimlawi, Marine Dexet, Abdoul R. Sawadogo, Gilles Kehoua, Myriam Le Goff, Olivier Villeneuve, Muriel Grau, Caroline Gayot, Achille Tchalla
J Aging Res & Lifestyle 2026;15
Show summaryHide summaryBACKGROUND: Frailty represents a significant public health challenge among aging populations. Early and accurate detection is vital for implementing timely interventions that may delay or prevent functional deterioration. Among the available assessment tools, The Fried frailty phenotype is widely recognized as a reference framework for assessing frailty. In parallel, the WHO’s ICOPE Step 1 has been developed as a tool to detect potential declines in intrinsic capacity. Considering its design and purpose, ICOPE Step 1 may be regarded as a feasible option for use as a screening tool in clinical and community settings; however, direct comparative analyses within the same population remain limited. This study aimed to evaluate the concordance between the ICOPE Step 1 tool and Fried criteria to inform and enhance frailty screening practices in both clinical and community-based settings.
METHODS: This cross-sectional study included 202 community-dwelling older adults aged ≥60 years (mean age 85.0 ± 4.5; 160 [79.2 %] females), categorized as non-frail, pre-frail, or frail based on Fried’s frailty phenotype and the WHO ICOPE Step 1 screening tool. The diagnostic performance of the ICOPE tool was assessed in comparison to Fried’s criteria by calculating sensitivity, specificity, and the area under the receiver operating characteristic (ROC) curve.
RESULTS: Compared to the reference Fried criteria, the ICOPE Step 1 tool identified a higher proportion of individuals as frail (63 % vs. 29 %) and fewer as robust (2 % vs. 18 %). Diagnostic performance analysis showed a sensitivity of 83.9 % and a specificity of 43.8 %, with an area under the ROC curve (AUC) of 0.639, indicating moderate discriminative ability.
CONCLUSION: ICOPE Step 1 demonstrated high sensitivity as a rapid, community-based screening tool for identifying older adults at risk of frailty. While it cannot replace the diagnostic utility of the Fried phenotype due to its limited specificity, it serves as a valuable first-line instrument to guide further comprehensive geriatric assessment, particularly via ICOPE Step 2.
CITATION:
Clément Rimlawi ; Marine Dexet ; Abdoul R. Sawadogo ; Gilles Kehoua ; Myriam Le Goff ; Olivier Villeneuve ; Muriel Grau ; Caroline Gayot ; Achille Tchall (2025): Comparative performance of ICOPE Step 1 and fried frailty criteria in detecting frailty phenotypes: A cross-sectional study. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100036
ASSESSING INTRINSIC CAPACITY IN OLDER ADULTS USING THE ICOPE TOOL IN A TERTIARY CARE SETTING IN KARACHI, PAKISTAN
Saniya Raghib Sabzwari, Samreen Fatima, Sonia Sameen, Noshi Maria
J Aging Res & Lifestyle 2026;15
Show summaryHide summaryBACKGROUND: 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.
CITATION:
Saniya Raghib Sabzwari ; Samreen Fatima ; Sonia Sameen ; Noshi Maria (2025): Assessing intrinsic capacity in older adults using the ICOPE tool in a tertiary care setting in Karachi, Pakistan. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100037
IDENTIFICATION OF INTRINSIC CAPACITY IMPAIRMENT: DIAGNOSTIC PERFORMANCE OF INTEGRATED CARE FOR OLDER PEOPLE (ICOPE) SCREENING TOOLS IN ZIMBABWE
Anthony Muchai Manyara, Tsitsi Bandason, Tadios Manyanga, Maureen Tshuma, Kate Mattick, Mandikudza Tembo, Rudo M.S. Chingono, Rashida A. Ferrand, Celia L Gregson
J Aging Res & Lifestyle 2026;15
Show summaryHide summaryINTRODUCTION: The World Health Organization (WHO) Integrated Care for Older People (ICOPE) framework proposes screening (Step-1) and subsequent in-depth assessment (Step-2) to inform personalised interventions to promote intrinsic capacity (IC) in older adults. We aimed to assess the diagnostic performance of screening approaches against in-depth assessments in Zimbabwe.
METHODS: This cross-sectional study recruited older adults age ≥65 years in urban Zimbabwe. For both Steps 1 and 2, IC was assessed using WHO ICOPE-proposed and/or alternative assessments for seven domains: cognition, locomotion, vitality, vision, hearing, psychological, and urinary continence. Diagnostic performance of screening approaches was assessed using metrics, including sensitivity and specificity categorised as good (≥0.80), fair (≥0.50–0.79), poor (<0.50).
RESULTS: The 763 adults were mean (standard deviation) age 74.5(7.2) years: 62.9 % female. Frequencies of IC impairments ranged from 18.1 % for hearing to 92.0 % for vision based on screening, and 13.4 % for urinary incontinence to 62.9 % for vision based on in-depth assessments. Performance of 37 different screening approaches and in-depth assessment comparisons were tested. Of the eight screening approaches with the best performance, sensitivity ranged from good (n = 7) to fair (n = 1), while five had fair and three had poor specificity. Sensitivity of screening approaches ranged from 0.65 (95 %CI: 0.58–0.71) for hearing to 0.93 (95 % CI: 0.89–0.96) for locomotion. Specificity ranged from 0.28 (0.22–0.33) for vision to 0.69 (0.65–0.73) for hearing.
CONCLUSION: Each domain had a screening approach with good or fair sensitivity and mostly fair specificity, supporting use in ICOPE implementation in Zimbabwe, which is urgently needed given the high prevalence of IC impairments.
CITATION:
Anthony Muchai Manyara ; Tsitsi Bandason ; Tadios Manyanga ; Maureen Tshuma ; Kate Mattick ; Mandikudza Tembo ; Rudo M.S. Chingono ; Rashida A. Ferrand ; Celia L Gregson ; ; (2025): Identification of intrinsic capacity impairment: diagnostic performance of integrated care for older people (ICOPE) screening tools in Zimbabwe. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100045>
INTRODUCING THE WHO ICOPE APPROACH INTO HIV CARE: A PERSPECTIVE ON HEALTHY AGEING IN PEOPLE LIVING WITH HIV
Giovanni Guaraldi, Jovana Milic, Licia Gozzi, Severino Ambrosio, Elisabetta Delmonte, Irene Avanzini, Barbara Castelnuovo, Cristina Mussini
J Aging Res & Lifestyle 2026;15
Show summaryHide summaryBACKGROUND: The ageing of people living with HIV (PWH) presents unique clinical and public health challenges that are not fully addressed by current care models.
OBJECTIVE: This Perspective paper aims to explore the feasibility and added value of introducing the World Health Organization (WHO) Integrated Care for Older People (ICOPE) framework and guidelines into HIV care models, using the lens of intrinsic capacity (IC) and functional ability to reframe how age-related conditions are managed. In particular, we discuss how HIV services can adopt intrinsic capacity (IC) assessments and function-centered care as a scalable strategy to promote healthy ageing.
METHODS: This is a narrative and conceptual Perspective based on literature review, expert consultation, and clinical case examples, including the Modena HIV Metabolic Clinic and experiences from resource-limited settings.
RESULTS: The ICOPE approach offers a feasible, person-centred framework for identifying and managing early declines of IC across six domains. ICOPE facilitates timely interventions at the primary health care level. HIV care services and systems, already oriented towards longitudinal and multidisciplinary management, are uniquely positioned to pioneer ICOPE implementation.
CONCLUSION: HIV medicine may serve as a model for expanding the integration of the ICOPE approach across chronic diseases, especially in low-resource settings where primary care structures must address age-related vulnerability. Adopting ICOPE can promote healthy ageing in PWH and beyond.
CITATION:
Giovanni Guaraldi ; Jovana Milic ; Licia Gozzi ; Severino Ambrosio ; Elisabetta Delmonte ; Irene Avanzini ; Barbara Castelnuovo ; Cristina Mussini (2025): Introducing the WHO ICOPE approach into HIV care: A perspective on healthy ageing in people living with HIV. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100047
FLAVOUR PERCEPTION IN ALZHEIMER’S DISEASE: A SYSTEMATIC REVIEW OF OLFACTORY AND GUSTATORY ASSESSMENT METHODS
Danel Ushkempirova, Louise Davis, Alan Chalmers
J Aging Res & Lifestyle 2026;15
Show summaryHide summaryDisruptions in flavour perception, due to olfactory dysfunction and gustatory dysfunction, may serve as early indicators of Alzheimer’s disease and contribute to reduced quality of life. Flavour perception is a multisensory process, yet no standardised tools currently exist to assess it comprehensively in Alzheimer’s disease. This systematic review examined current olfactory and gustatory assessments used to evaluate flavour function in individuals with Alzheimer’s. Six studies met the inclusion criteria, encompassing 471 participants, including 161 with Alzheimer’s. Olfactory function was most often assessed with the Sniffin’ Sticks test, while gustatory function was typically evaluated using Taste Strips. While olfactory dysfunction was consistently reported across studies, evidence for gustatory impairment was less uniform, reflecting methodological variability in taste assessment procedures. Only one study used a culturally adapted test, and none assessed umami. However, the small number of studies, heterogeneity in methodology, and limited cultural adaptation constrain the generalisability of these findings. These findings highlight the need for a culturally adaptable, combined flavour assessment tool that minimises cognitive and linguistic demands to support early detection and monitoring of Alzheimer’s disease.
CITATION:
Danel Ushkempirova ; Louise Davis ; Alan Chalmers (2025): Flavour perception in Alzheimer’s disease: A systematic review of olfactory and gustatory assessment methods. The Journal of Aging and Lifestyle (JARLife). https://doi.org/10.1016/j.jarlif.2025.100044