Factors associated with self-care in older adults with heart failure presenting with composite and domain-specific intrinsic capacity impairment

Objective This study aimed to characterize intrinsic capacity (IC) impairment in older adults with heart failure and to investigate its association with self-care across composite and domain-specific domains. Methods This cross-sectional study recruited 215 patients with heart failure from two tertiary hospitals in Wuxi, China. IC was assessed across five domains in line with WHO guidelines: cognition, locomotion, vitality, sensory, and psychological. Self-care was evaluated using the Self-Care Heart Failure Index version 6.2. Data were analyzed using descriptive statistics, Pearson correlation coefficients, multiple linear regression, and exploratory interaction analyses. Results Our study found that 99.5% of participants exhibited impairment in at least one IC domain, with the most common co-occurring impairment in cognition, vitality, and locomotor domains. Older age was significantly associated with poorer self-care maintenance (B = −0.37, 95% CI [−0.67, −0.07], P = 0.014), self-care management (B = −0.64, 95% CI [−1.02, −0.26], P = 0.001), and self-care confidence (B = −0.38, 95% CI [−0.77, −0.0004], P = 0.049). Higher educational level was significantly associated with better self-care maintenance (B = 9.80, 95% CI [3.87, 15.73], P = 0.001). A higher composite IC score was significantly associated with poorer maintenance (B = −2.81, 95% CI [−4.68, −0.95], P = 0.003) and lower confidence (B = −3.53, 95% CI [−5.95, −1.11], P = 0.004), but not with management. Domain-specific analyses showed that cognitive, psychological, and sensory impairments were associated with poorer self-care maintenance, whereas cognitive, locomotor, and psychological impairments were associated with lower self-care confidence. No IC domain was significantly associated with self-care management. Exploratory interaction analyses identified several potential moderating effects involving age, New York Heart Association class and education for associations between IC impairments and self-care. Conclusion Healthcare professionals should routinely assess IC in older adults with heart failure. Addressing multimodal intrinsic capacity impairment, particularly among the oldest patients and those with lower educational attainment, may help improve self-care.