Development and Psychometric Evaluation of the Physio-Cognitive Decline Syndrome Instrument for Community-Dwelling Middle-Aged and Older Adults
Fang-Wen HU, Kah Ying YAP, Pei-Lun HSIEHBackground:
Physio-cognitive decline syndrome, involving the simultaneous deterioration of physical and cognitive functions, poses a significant threat to healthy aging. The World Health Organization’s Integrated Care for Older People (ICOPE) framework emphasizes the importance of integrated, person-centered care in maintaining intrinsic capacity, making it important to understand physio-cognitive decline syndrome. However, there is a lack of validated instruments designed to assess this multidimensional condition from the perspective of older adults.
Purpose:
In this study, the physio-cognitive decline syndrome instrument (PCDSI) was developed and its measurement properties were evaluated psychometrically.
Methods:
The PCDSI, developed based on the ICOPE framework and qualitative findings, includes demographic items and a 63-item questionnaire comprising five subscales representing the key dimensions of physio-cognitive decline and adaptation. Six hundred community-dwelling adults aged older than or equal to 50 in Taiwan participated in the psychometric evaluation, which included assessments of internal consistency, construct validity, concurrent validity, and known-group validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). In addition, model fit was assessed using multiple indices.
Results:
The results of the EFA identified eight factors across five subscales, reflecting perceived physical and cognitive decline, emotional/social impact, and positive adaptation strategies. CFA supported the factor structure with acceptable fit indices, and internal consistency was high (ω=0.870–0.945). Although most subscales showed significant correlations with one another and with the ICOPE measures, the adaptive subscales demonstrated conceptual independence from decline perceptions. Known-group validity was demonstrated across sex, chronic disease status, educational level, and self-rated health, indicating the instrument is adequately sensitive to clinically relevant differences.
Conclusions:
The PCDSI demonstrated strong psychometric properties and effectively captures subjective and multidimensional aspects of physio-cognitive decline. It offers a practical tool for early identification and prevention, supporting healthy aging through community-based screening and personalized care planning.