Intrinsic capacity and survival among older adults in India: LASI-DAD study (wave 1 and wave 2)

Background With increasing longevity, the focus of healthcare for older adults is shifting from a disease-centric model to a more holistic view of functional capacity.This study investigates the relationship between intrinsic capacity (IC)-a measure of combined physical and mental abilities-and survival among older adults in India. MethodsWe analysed data from 4096 community-dwelling individuals aged 60 and older who participated in the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (LASI-DAD).IC was evaluated across six domains: cognition, mood, nutrition, locomotion, vision, and hearing.An overall IC score was created by aggregating the z-scores from these domains.Cox Model was used to determine if IC was a predictor of mortality, adjusting for confounding factors.Findings During the follow-up period, 951 participants (23.2%) died.A higher IC score was associated with a lower risk of death (Hazard Ratio (HR): 0.89; 95% CI: 0.86-0.91).The risk of mortality increased progressively with the number of impaired intrinsic capacity domains: participants with one impaired domain had a HR of 1.48 (95%CI 1.26-1.75);two impaired domains, HR: 2.10 (95%CI 1.67-2.65);three impaired domains, HR: 1.71 (95%CI 1.14-2.57);and four impaired domains, HR: 3.15 (95%CI 1.53-6.46).Of the six domains, cognition, nutrition, and locomotion were identified as the strongest predictors of survival.Vision impairment did not show a independent association with mortality.Interpretation Older adults in India with higher overall intrinsic capacity-particularly better cognition, good nutrition, and better locomotor capacity-had a lower risk of death.These findings highlight the importance of looking at functional abilities, not just diseases, when planning health care and interventions for ageing populations.