Agreement and Discriminative Ability of the Intrinsic Capacity Tool-10 among Older Adults in Northern India
Swarup Das, Akshata Rao, Abhijith Rajaram Rao, Venugopal Mantry, Maroof Ahmad Khan, Avinash Chakrawarty, Naveet Wig, Prasun ChatterjeeAbstract
Background:
Intrinsic capacity (IC) underpins the World Health Organization healthy aging framework, yet comprehensive IC assessment is often impractical in routine outpatient care. The Integrated Care Tool 10 (ICT-10) was developed as a brief questionnaire for rapid IC screening among older adults. This study evaluated the agreement and discriminative ability of ICT-10 against standard domain-specific assessments among older adults in India.
Materials and Methods:
A cross-sectional study was conducted among adults aged ≥60 years attending a geriatric outpatient clinic in northern India. Participants completed the ICT-10, followed by blinded assessment using validated tools across sensory, cognitive, psychological, vitality, and locomotion domains. Agreement was assessed using simple agreement proportions and Cohen’s kappa (κ). Discriminative ability was evaluated using receiver operating characteristic curves and area under the curve (AUC).
Results:
A total of 137 participants (mean age: 69.5 ± 5.6 years; 52.5% male) were included. Agreement varied across domains. Hearing impairment showed substantial agreement (87.6%; κ =0.66) with good discriminative ability (AUC = 0.835). Fall risk (94.2%; κ =0.40; AUC = 0.699) and depressive symptoms (71.5%; κ =0.27; AUC = 0.690) demonstrated fair agreement and fair discriminative ability. Vision, cognition, vitality, locomotion, and psychological restlessness showed poor, slight, or fair agreement (κ ≤0.23) and poor discriminative ability (AUC: 0.41–0.59). ICT-10 overestimated cognitive and mobility concerns and underestimated sensory and nutritional impairments.
Conclusions:
ICT-10 showed the strongest performance for hearing impairment, with comparatively better performance for falls and depression. Refinement with clearer wording, cultural adaptation, validation of newly developed items, and assisted administration is required before use as a screening tool.