ArticleThe journal of nutrition, health & aging2026
Intrinsic capacity impairment and incident dementia across three population-based cohorts: a harmonized individual participant data analysis.
Article in The journal of nutrition, health & aging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo examine whether intrinsic capacity impairment predicts incident dementia across three countries and to evaluate its value for risk stratification.
designHarmonized multicohort study with individual participant data meta-analysis. SETTING AND
participantsCommunity-dwelling adults aged ≥50 years without baseline dementia from CHARLS (n = 17,708), ELSA (n = 9,432), and HRS (n = 22,034). MEASURES: Intrinsic capacity was assessed across five domains: cognition, locomotion, vitality, sensory, and psychological functioning. Multidomain impairment was defined as deficits in ≥3 domains.
resultsPooled hazard ratios rose in graded fashion: 1.31 (95% CI 1.22-1.42) for one impaired domain, 1.65 (1.48-1.85) for two, and 2.41 (2.18-2.68) for ≥3 domains. A Psych-Cognitive impairment pattern approached Multidomain risk (HR 2.15 vs 2.68). Rapid IC decline predicted 42.3% cumulative dementia incidence over six years. Adding IC to a demographic model improved the C-index from 0.69 to 0.76 with net benefit on decision curve analysis. Associations persisted when the cognitive domain was excluded and with death as a competing event; psychological functioning was the most consistent independent domain.
conclusionsIntrinsic capacity impairment robustly predicts incident dementia across diverse populations. Its low cost and universal applicability support integration into geriatric assessment and primary care for early dementia risk stratification.
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