Multi-Domain Intrinsic Capacity Decline and Fall History Among Community-Dwelling Older Adults in Rural Taiwan: Implications for ICOPE-Based Community Screening

Background While WHO ICOPE screening is routine, the association between multi-domain intrinsic capacity (IC) decline and falls remains understudied in community-based gerontology practice. Methods This study analysed 775 rural older adults (mean age 79.4) with ≥1 IC abnormality using multivariable logistic regression and dose–response analysis to evaluate fall risk. Results Nutrition (aOR = 5.10), mobility (aOR = 2.60), depression (aOR = 2.34), and vision (aOR = 2.21) impairments were independently associated with falls. Fall rates rose monotonically from 4.6% (one domain) to 29.1% (≥4 domains; p trend <.001). Clusters involving depression with mobility or vision identified the highest-risk subgroups (34–36% fall rate). Conclusion An IC impairment count of ≥3, or specific clusters (nutrition, mobility, depression), provides practical triage criteria for community-based fall-prevention. These findings facilitate person-centred risk stratification and resource allocation within integrated care systems for super-aging societies.