Optimizing INtrinsic Capacity for Functional INdependence and to Impede FrailTY in Older Adults: Adaptation of the WHO-ICOPE for Healthy Ageing in Singapore

The goal of this intervention study is to screen and identify frailty and decline in intrinsic capacity (physical and mental capacities) in community-dwelling older adults in Singapore, and to evaluate whether early identification and targeted interventions can improve health outcomes and support healthy ageing. The main questions it aims to answer are: * Can combined frailty and intrinsic capacity screening with targeted interventions prevent or reduce functional decline in older adults, as measured by changes in life space mobility? * Will at least 80% of screened older adults adhere to recommended care pathways and interventions? * Can this screening and intervention programme demonstrate sustainability through continued community participation and recruitment of new partner organizations beyond the initial implementation phase? The investigators will compare an intervention group (receiving immediate assessment and clinical referrals based on identified needs) to a wait-list control group (receiving the same interventions 12 months later) to see if early intervention leads to better health outcomes and quality of life. Participants will: * Attend 4 study visits over 2 years (at 6-monthly intervals in the first year, with final assessment at end of year 2), each lasting up to 2 hours. * Undergo comprehensive screening assessments including mobility, cognition, mental health, hearing, vision, and nutritional status. * Receive 2 follow-up phone calls at 3-month and 9-month intervals to monitor progress. * If in the intervention group: receive personalized referrals for further care (which may include comprehensive geriatric assessment, primary care reviews, rehabilitation, or dietitian consultations) and guidance on using a mobile health monitoring application. * If in the wait-list control group: receive the same interventions after their 3rd study visit (12 months later).

The INFINITY-ICOPE programme integrates the concepts of frailty and intrinsic capacity - a person's physical and mental abilities essential for maintaining overall health and well-being. Since intrinsic capacity represents the physiological reserves whose decline can lead to frailty, monitoring intrinsic capacity trajectories enables timely intervention to address deteriorating physical and mental capacities. The programmme employs a tiered approach to provide comprehensive geriatric assessment for frail older adults, utilizing technology-enabled tools including the SCREENii algorithmic approach for objective physical frailty assessment and the ENGAGE app to empower older individuals through self-screening, remote intrinsic capacity monitoring, and behavioural nudges. The investigators primary aim is maintaining older adults' independence and community engagement, measured through life-space mobility. Secondary aims encompass promoting regular screening for frailty and intrinsic capacity decline, implementing early intervention strategies, enhancing quality of life, and developing a cost-effective healthcare delivery model. INFINITY-ICOPE follows the implementation research logic model to ensure rigorous and replicable research. The study comprises 4 phases: 1. Phase 1 (Proof-of-Concept) - 12 months. This preparatory phase focuses on 3 key areas: technology readiness, care pathway development, and stakeholder readiness assessment. * Technology development: The SCREENii platform will be enhanced to provide automated frailty screening through grip strength and gait speed measurements. The ENGAGE app will incorporate WHO-ICOPE Step 1 screening and deliver personalized care plans adapted for local needs. * Care pathway development: Personalized pathways will be developed for frailty management through regional hospital networks and intrinsic capacity domain-specific interventions based on WHO-ICOPE guidelines. Community assessors will receive training in Step 1 screening and individualized care planning, with 400 older adults recruited to test feasibility and assess intrinsic capacity decline prevalence. * Readiness assessment: Surveys and focus group discussions will evaluate attitudes and expectations of multidisciplinary care providers (eldercare staff, community nurses, family physicians, social workers) towards INFINITY-ICOPE implementation. Additional focus groups with 30 trained community assessors will capture their screening experiences. Usability testing with 15 older adults will assess SCREENii completion times and ENGAGE app quality using the mobile app rating scale. This phase will inform resource planning for Phase 2 and refine implementation strategies based on identified barriers and enablers. 2. Phase 2 (Proof-of-Value) - 12 months. This single-arm pre-post pilot study will evaluate INFINITY-ICOPE's potential impact by recruiting 60 older adults (aged 60 and above) from an existing mobile frailty screening platform, terme Покажи пълното описание...

Inclusion Criteria: (in Phases 1, 2 and 3): * Any Singaporean or Permanent Resident (PR) aged 60 years and above * Able to provide informed consent (or legally acceptable representative available) Exclusion Criteria (in Phases 1, 2 and 3): * Non-Singaporeans or non-PRs under 60 years of age * Residents of sheltered or nursing homes