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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

INTRODUCTION: 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>