Intrinsic capacity and resilience in hospitalized older adults: a gender-stratified analysis of the PRIFOR score

The Physical Resilience Instrument for Older Adults (PRIFOR) was developed to assess recovery potential in older adults facing acute stressors. However, its core domains such as positive thinking, coping, and hopeful mindset suggest strong psychosocial underpinnings. The aim of this study is to evaluate association of PRIFOR with intrinsic capacity (IC) and length of stay (LOS) amongst hospitalized older adults stratified by gender. We conducted a cross-sectional study involving 307 hospitalized adults aged ≥65 years. Data on IC domains, EuroQol 5-Dimension index (EQ-5D), EuroQoL Visual Analogue Scale (EQ-VAS), Charlson Comorbidity Index (CCI), and length of stay (LOS) was collected. Gender-stratified quantile regression models were used to assess associations across PRIFOR percentiles. Mean age was 76.5 ± 6.9 years and 50.8% were female. Decline in mobility domain was prevalent in 64.8%, psychological domain in 9.4%, cognition domain in 58.3% and vitality in 25.6%. Median LOS was 4 days. Association of PRIFOR quantiles(Q) with IC, QoL, and CCI was influenced by gender and nonlinear. Across both genders, PRIFOR was significantly associated with psychological domain (Q25th-75th) and EQ-5D index (Q75th). For mobility domain, the significance was only observed in male (Q25th-75th). In female, association was significant with CCI (Q50th,75th) and EQ-VAS (Q25th). PRIFOR appears to capture broader resilience constructs beyond the physical domain, with distinct gender-related patterns in hospitalised older patients. Longitudinal studies are needed to determine the predictive value of PRIFOR in recovery and functional outcomes.