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Purpose <p>The World Health Organization (WHO) defines Intrinsic Capacity (IC) as the integration of an individual’s physiological and psychological capacities. Encompassing five dimensions— locomotion, cognitive, vitality, psychological, and sensory function—it plays a central role in the assessment of healthy ageing. This study aimed to evaluate the association between IC and hip fractures among community-dwelling older adults in China.</p> Patients and methods <p>This population-based longitudinal study analyzed data from 3102 community-dwelling residents aged ≥ 60 years in the China Health and Retirement Longitudinal Study (CHARLS), with baseline assessments conducted in 2011 and a 4-year follow-up through 2015. IC was assessed across five domains: cognitive, psychology, vitality, locomotion, and sensory function. The outcome measure was self-reported hip fracture, while demographic characteristics and other covariates were analyzed as potential confounders. Multivariable logistic regression models were employed to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CI). The relationship between IC and hip fracture was further evaluated using restricted cubic splines and subgroup analyses.</p> Results <p>A total of 3,102 older adults (57.16% male) with a median age of 65.00 years were included. Over the 4-year follow-up, 96 participants (3.09%) experienced hip fractures. Regarding IC, the total IC score for the entire cohort was 1.56 ± 1.07(range 0–5, a total score of ≥ 2 is defined as IC impairment). The hip fracture group exhibited significantly higher IC scores compared to the non-fracture group (2.14 ± 1.06 vs.1.14 ± 1.06, <i>p</i> &lt; 0.001). Baseline IC impairment (observed in 48.42% of participants) was associated with a 2.34-fold higher incidence of hip fracture compared to those without impairment (4.39% vs.1.88%). Analysis revealed that each 1-point increase in IC score among individuals aged ≥ 60 years was associated with a 55% elevated risk of hip fracture (adjusted OR = 1.55, 95% CI 1.25–1.94, <i>p</i> &lt; 0.001). When stratified by IC status, the effect was more pronounced with IC-impaired. Compared to without impaired group, individuals with IC impairment had 87% higher risk of fracture (adjusted OR = 1.87, 95% CI 1.72–2.98, <i>p</i> = 0.009). Additionally, a linear relationship was demonstrated between IC and hip fracture risk.</p> Conclusion <p>Among community-dwelling older adults, the composite IC score demonstrated a significant independent association with an elevated risk of hip fracture. Regular monitoring of individual IC scores may serve as an early warning indicator to initiate preventive interventions.</p>

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Intrinsic capacity and risk of hip fracture in community-dwelling elderly people in China: A 4-year longitudinal cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月4日

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  • Youting Wang,
  • Qingqing Su,
  • Hongyi Wu,
  • Xueyang Gan,
  • Dan Kong,
  • Nan Tang,
  • Jingru Chen,
  • Mengqi Shao,
  • Xiaojie Fu,
  • Jie Song,
  • Yuan Gao

摘要

Purpose

The World Health Organization (WHO) defines Intrinsic Capacity (IC) as the integration of an individual’s physiological and psychological capacities. Encompassing five dimensions— locomotion, cognitive, vitality, psychological, and sensory function—it plays a central role in the assessment of healthy ageing. This study aimed to evaluate the association between IC and hip fractures among community-dwelling older adults in China.

Patients and methods

This population-based longitudinal study analyzed data from 3102 community-dwelling residents aged ≥ 60 years in the China Health and Retirement Longitudinal Study (CHARLS), with baseline assessments conducted in 2011 and a 4-year follow-up through 2015. IC was assessed across five domains: cognitive, psychology, vitality, locomotion, and sensory function. The outcome measure was self-reported hip fracture, while demographic characteristics and other covariates were analyzed as potential confounders. Multivariable logistic regression models were employed to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CI). The relationship between IC and hip fracture was further evaluated using restricted cubic splines and subgroup analyses.

Results

A total of 3,102 older adults (57.16% male) with a median age of 65.00 years were included. Over the 4-year follow-up, 96 participants (3.09%) experienced hip fractures. Regarding IC, the total IC score for the entire cohort was 1.56 ± 1.07(range 0–5, a total score of ≥ 2 is defined as IC impairment). The hip fracture group exhibited significantly higher IC scores compared to the non-fracture group (2.14 ± 1.06 vs.1.14 ± 1.06, p < 0.001). Baseline IC impairment (observed in 48.42% of participants) was associated with a 2.34-fold higher incidence of hip fracture compared to those without impairment (4.39% vs.1.88%). Analysis revealed that each 1-point increase in IC score among individuals aged ≥ 60 years was associated with a 55% elevated risk of hip fracture (adjusted OR = 1.55, 95% CI 1.25–1.94, p < 0.001). When stratified by IC status, the effect was more pronounced with IC-impaired. Compared to without impaired group, individuals with IC impairment had 87% higher risk of fracture (adjusted OR = 1.87, 95% CI 1.72–2.98, p = 0.009). Additionally, a linear relationship was demonstrated between IC and hip fracture risk.

Conclusion

Among community-dwelling older adults, the composite IC score demonstrated a significant independent association with an elevated risk of hip fracture. Regular monitoring of individual IC scores may serve as an early warning indicator to initiate preventive interventions.