Suboptimal 24-hour movement behavior profiles and domain-specific intrinsic capacity impairment in older adults: A community-based cross-sectional study

BACKGROUND: This study aimed to identify suboptimal 24-hour movement behavior (24HMB) profiles among community-dwelling older adults and examine their associations with domain-specific intrinsic capacity (IC) impairment. METHODS: This cross-sectional study recruited older adults from seven community health service centers. IC was evaluated using validated instruments across five domains, including cognition, mobility, psychology, vitality and sensory. 24HMB, including physical activity, sedentary behavior, and sleep, was measured through self-reported questionnaires. We first performed factor analysis to reduce the dimensionality of 24HMB-related variables, followed by k-medoids clustering to identify distinct 24HMB profiles. Multivariable logistic regression models were used to estimate the odds ratios for domain-specific IC impairment with Bonferroni correction for pairwise comparisons across clusters. RESULTS: A total of 3356 older adults with suboptimal 24HMB patterns were included in clustering analysis. 24HMB-related variables were reduced into five latent factors, and then were further clustered into four distinct clusters: the physically inactive but high-quality sleep group (n = 1148, 34.21%), the short sleep group (n = 950, 28.31%), the sleep dysfunction and physically inactive group (n = 490, 14.60%), the relatively active but highly sedentary group (n = 768, 22.88%). Following Bonferroni correction for multiple cluster comparisons, logistic regression indicated higher odds of IC impairment across multiple domains in the sleep dysfunction and physically inactive group. Conversely, participants in the relatively active but highly sedentary group showed lower odds of cognitive and mobility impairment, while those in the physically inactive but high-quality sleep profile exhibited lower odds of psychological impairment. CONCLUSIONS: This study revealed four distinct 24HMB profiles and their unique associations with domain-specific IC impairment among older adults with suboptimal 24HMB. These findings provide important references for developing personalized 24HMB interventions to preserve IC in older adults.