Evaluating intrinsic capacity: A pilot implementation of ICOPE in Greece

Background

The ICOPE approach, developed by the WHO, promotes healthy ageing through early identification and management of declines in intrinsic capacity (IC). Integrating such approaches into primary care is a key public health priority. This study presents findings from a pilot implementation of two rounds of ICOPE assessments in Greece, conducted within the European JA PreventNCD project.

Methods

A prospective longitudinal study was conducted with a purposive sample of 342 older adults assessed in October 2025 and March 2026. Participants were recruited through the personal networks of 59 healthcare professionals during their training in ICOPE implementation. All IC domains (cognition, psychological status, hearing, vision, locomotion, and vitality) were initially screened (Step 1). Participants with identified declines underwent further evaluation (Step 2), followed by the development of individualized care plans. Statistical analyses were performed using SPSS v27.0, with significance set at p < 0.05.

Results

The mean age was 70.8 years (SD = 7.8), with 61.1% female participants. Most individuals presented no IC declines (63.2% in 2025; 61.6% in 2026). Hearing impairment had the highest prevalence (13.5% and 11.4%, respectively). Significant reductions in declines were observed in cognition (7.3% vs 12.3%; p < 0.001), vision (3.8% vs 10.2%; p < 0.001), and mobility (8.8% vs 11.7%; p = 0.031). Higher educational level was associated with fewer social declines (p = 0.048) in 2026 and fewer cognitive declines in both assessments (p < 0.001; p = 0.003). In Step 2, better cognitive status was positively correlated with mobility (rho=0.36; p = 0.006). Individualised care plans included counselling, referrals, and use of community resources.

Conclusions

The ICOPE approach appears to be a feasible and scalable tool for the early detection of IC decline in primary care. Its implementation supports preventive strategies, integrated care, and inform policies on healthy ageing.

Key messages

• A substantial proportion of older adults experience decline in IC; in-depth assessment and individualized care plan are essential to promote healthy ageing.

• IC assessment can shift care from reactive treatment to early, preventive, person-centred approaches in ageing populations.