The role of socioeconomic factors in sex differences in intrinsic capacity among older adults: A cross-sectional study in Taiwan

Mei-Tzu Huang; Ya-Hui Chang; Chung-Yi Li; Li-Jung Elizabeth Ku; Yu-Tsung Chou; Wen-Hsuan Hou; Hung-Yu Chen; Hui-Chen Su; Yi-Lin Wu; Chieh-Hsiu Liu; Yi-Ching Yang; Pei-Chun Chen

Preventive Medicine Reports (Nov 2024)

The role of socioeconomic factors in sex differences in intrinsic capacity among older adults: A cross-sectional study in Taiwan

Mei-Tzu Huang,
Ya-Hui Chang,
Chung-Yi Li,
Li-Jung Elizabeth Ku,
Yu-Tsung Chou,
Wen-Hsuan Hou,
Hung-Yu Chen,
Hui-Chen Su,
Yi-Lin Wu,
Chieh-Hsiu Liu,
Yi-Ching Yang,
Pei-Chun Chen

Affiliations

Mei-Tzu Huang: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Ya-Hui Chang: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Emergency Department, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan; Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan; Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan; Department of Neurology, National Cheng-Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan; Department of Family Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin, Taiwan
Chung-Yi Li: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan; Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Li-Jung Elizabeth Ku: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Yu-Tsung Chou: Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Wen-Hsuan Hou: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan; Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
Hung-Yu Chen: Clinical Medicine Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Hui-Chen Su: Department of Neurology, National Cheng-Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Yi-Lin Wu: Department of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan
Chieh-Hsiu Liu: Department of Family Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
Yi-Ching Yang: Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Corresponding author.
Pei-Chun Chen: National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin, Taiwan; Corresponding author at: National Center for Geriatrics and Welfare Research, National Health Research I nstitutes, No. 8, Xuefu W. Rd., Huwei Township, Yunlin County 632, Taiwan

Journal volume & issue: Vol. 47
p. 102897

Abstract

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Objectives: The World Health Organization’s Integrated Care for Older People (ICOPE) framework launched in 2019 is used to assess the intrinsic capacity of older individuals. Older women may face greater socioeconomic disadvantages, which can impact their physical and mental well-being. Therefore, we examined sex differences in intrinsic capacity and the influence of socioeconomic status. Methods: We conducted a cross-sectional study in Tainan, Taiwan, recruiting 1,268 adults aged 60 or older in 2022. The ICOPE screening assessed cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss, and depressive symptoms. Intrinsic capacity scores ranged from 0 to 6 and were categorized as impairment (1 or higher) or no impairment (0). Binary logistic regression models were used to analyze sex differences in intrinsic capacity, adjusting sequentially for demographics, lifestyle, and socioeconomic factors. Results: The prevalence of intrinsic capacity impairment was 34 %. Women had significantly higher odds of intrinsic capacity impairment (women vs. men, odds ratio [OR] = 1.39, 95 % CI = 1.10–1.75). After sequentially adjusting for demographic characteristics, lifestyle, and socioeconomic factors, the ORs were 1.46 (95 % CI = 1.12–1.90), 1.69 (95 % CI = 1.23–2.31), and 1.24 (95 % CI = 0.88–1.73), respectively. Stratified analyses showed that higher odds of impairment in women than in men was evident only in the financially dependent group (P for interaction = 0.059). Conclusions: Older women in Taiwan have poorer intrinsic capacity than men, a disparity largely attributable to women’s lower socioeconomic status. Strategies to promote healthy aging among women from disadvantaged socioeconomic backgrounds may help mitigate this sex difference in intrinsic capacity.

Published in Preventive Medicine Reports

ISSN: 2211-3355 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine
Website: http://www.journals.elsevier.com/preventive-medicine-reports/

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