PMID- 36438281
OWN - NLM
STAT- MEDLINE
DCOM- 20221129
LR  - 20230127
IS  - 2296-2565 (Electronic)
IS  - 2296-2565 (Linking)
VI  - 10
DP  - 2022
TI  - Approaching person-centered clinical practice: A cluster analysis of older 
      inpatients utilizing the measurements of intrinsic capacity.
PG  - 1045421
LID - 10.3389/fpubh.2022.1045421 [doi]
LID - 1045421
AB  - BACKGROUND: Maintaining the intrinsic capacity (IC) of older inpatients is a 
      novel view in providing person-centered treatments in clinical practice. 
      Uncertainty remains regarding the primary nature of IC among older hospitalized 
      patients. OBJECTIVES: We aimed to understand the status of IC among older 
      inpatients by a cluster analysis based on IC measurements. METHODS: This is a 
      cross-sectional study conducted in the geriatric department of Beijing Hospital 
      in China. Older inpatients who were older than 60 years and who underwent 
      comprehensive geriatric assessments were included. The inpatients were classified 
      into subgroups based on 13 measurements of IC according to unsupervised methods 
      (K-means cluster analysis and t-SNE). Subgroup differences were investigated for 
      domains of IC, age, sex, frailty, activities of daily living, and falls. RESULTS: 
      A total of 909 inpatients with a mean age of 76.6 years were included. Almost 98% 
      of the inpatients showed IC impairment. Locomotion impairment was the most 
      prevalent problem (91.1%), followed by sensory impairment (61.4%), psychological 
      impairment (57.3%), cognition decline (30.7%), and vitality problem (29.2%). A 
      total of five clusters were obtained by classification: Cluster 1 (56.6% of the 
      participants) showed high IC with fair impairment of locomotion and vision; 
      clusters 2 and 3 (37.8 % of the participants) had additional impairment of sleep 
      in the psychological domain; clusters 4 and 5 (5.6% of the participants) 
      represented a severe loss of all the IC domains; and clusters 1-5 showed a 
      gradual decline in the IC score and were significantly associated with increased 
      age, frailty, decreased activities of daily living, and falls. Significant 
      correlations among the domains were observed; the locomotion domain showed the 
      strongest links to the others in network analysis. CONCLUSIONS: Great declines in 
      IC and disparities between IC domains were found in older inpatients. IC-based 
      primary assessment and classification enabled us to identify the variation of 
      functional abilities among the older inpatients, which is pivotal for designing 
      integrated treatment or care models in clinical practice.
CI  - Copyright (c) 2022 Wu, Sun, Li, Zhang, Shen, Li and Zhou.
FAU - Wu, Wenbin
AU  - Wu W
AD  - Department of Geriatrics, Beijing Hospital, National Center of Gerontology, 
      Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 
      China.
FAU - Sun, Liang
AU  - Sun L
AD  - The Key Laboratory of Geriatrics, National Center of Gerontology of National 
      Health Commission, Beijing Institute of Geriatrics, Institute of Geriatric 
      Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China.
FAU - Li, Hong
AU  - Li H
AD  - Department of Geriatrics, Beijing Hospital, National Center of Gerontology, 
      Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 
      China.
FAU - Zhang, Jie
AU  - Zhang J
AD  - Department of Geriatrics, Beijing Hospital, National Center of Gerontology, 
      Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 
      China.
FAU - Shen, Ji
AU  - Shen J
AD  - Department of Geriatrics, Beijing Hospital, National Center of Gerontology, 
      Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 
      China.
FAU - Li, Jing
AU  - Li J
AD  - Department of Geriatrics, Beijing Hospital, National Center of Gerontology, 
      Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 
      China.
FAU - Zhou, Qi
AU  - Zhou Q
AD  - The Key Laboratory of Geriatrics, National Center of Gerontology of National 
      Health Commission, Beijing Institute of Geriatrics, Institute of Geriatric 
      Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221111
PL  - Switzerland
TA  - Front Public Health
JT  - Frontiers in public health
JID - 101616579
SB  - IM
MH  - Humans
MH  - Aged
MH  - *Inpatients
MH  - Activities of Daily Living
MH  - *Frailty/epidemiology
MH  - Cross-Sectional Studies
MH  - Cluster Analysis
PMC - PMC9692078
OTO - NOTNLM
OT  - clinical practice
OT  - healthcare
OT  - hospitalized older adults
OT  - intrinsic capacity
OT  - unsupervised classification
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/11/29 06:00
MHDA- 2022/11/30 06:00
PMCR- 2022/11/11
CRDT- 2022/11/28 04:14
PHST- 2022/09/15 00:00 [received]
PHST- 2022/10/21 00:00 [accepted]
PHST- 2022/11/28 04:14 [entrez]
PHST- 2022/11/29 06:00 [pubmed]
PHST- 2022/11/30 06:00 [medline]
PHST- 2022/11/11 00:00 [pmc-release]
AID - 10.3389/fpubh.2022.1045421 [doi]
PST - epublish
SO  - Front Public Health. 2022 Nov 11;10:1045421. doi: 10.3389/fpubh.2022.1045421. 
      eCollection 2022.