背景:2015年,世界卫生组织(WHO)引入了内在能力(IC)的概念,以根据功能能力定义健康的衰老。在这次范围审查中,我们总结了关于IC指数评分的发展和验证的可用证据,IC与健康相关因素的关系,以及它的生物学基础。审查特别侧重于确定当前的研究差距,提议的利用生物库数据集的策略,以及研究IC潜在遗传机制和基因-环境相互作用的机会。
方法:文献检索在六个数据库中进行,包括PubMed,CINAHL,WebofScience,Scopus,AgeLine,和PsycINFO,使用与IC相关的关键字。
结果:这篇综述包括84篇文章,他们中的大多数(n=38)采用了5域方法来操作IC,利用相关的五个因素或双因素结构。内在能力一直显示出与社会人口和健康相关结果的显著关联,包括年龄,性别,财富指数,营养,锻炼,吸烟,酒精使用,ADL,IADL,脆弱,多浊度,和死亡率。虽然对复合IC的生物学基础的研究是有限的,只有一项研究发现与ApoE基因变异有显著关联,对特定IC域的研究-运动,活力,认知,心理,和感官表明IC的遗传力为20-85%,并且已经鉴定出与这些子域相关的几种遗传变异。然而,关于遗传和环境因素如何影响IC的证据仍然缺乏,到目前为止还没有可用的研究。
结论:我们的审查发现,标准化IC测量工具和指标的使用存在不一致,但IC指数显示出良好的结构和预测效度。仍然缺乏对IC潜在的遗传和基因与环境相互作用的研究,这要求将来使用大型生物库数据集的资源。
BACKGROUND: In 2015, the World Health Organization (WHO) introduced the concept of intrinsic capacity (IC) to define healthy aging based on functional capacity. In this scoping review, we summarized available evidence on the development and validation of IC index scores, the association of IC with health-related factors, and its biological basis. The review specifically focused on identifying current research gaps, proposed strategies to leverage biobank datasets, and opportunities to study the genetic mechanisms and gene-environment interactions underlying IC.
METHODS: The literature search was conducted across six databases, including PubMed, CINAHL, Web of Science, Scopus, AgeLine, and PsycINFO, using keywords related to IC.
RESULTS: This review included 84 articles, and most of them (n=38) adopted the 5-domains approach to operationalize IC, utilizing correlated five factors or bifactor structures. Intrinsic capacity has consistently shown significant associations with socio-demographic and health-related outcomes, including age, sex, wealth index, nutrition, exercise, smoking, alcohol use, ADL, IADL, frailty, multimorbidity, and mortality. While studies on the biological basis of the composite IC are limited, with only one study finding a significant association with the ApoE gene variants, studies on specific IC domains - locomotor, vitality, cognitive, psychological, and sensory suggest a heritability of 20-85% of IC and several genetic variants associated with these subdomains have been identified. However, evidence on how genetic and environmental factors influence IC is still lacking, with no available study to date.
CONCLUSIONS: Our review found that there was inconsistency in the use of standardized IC measurement tools and indicators, but the IC indices had shown good construct and predictive validity. Research into the genetic and gene-to-environment interactions underlying IC is still lacking, which calls for the use of resources from large biobank datasets in the future.