A systematic review of randomised controlled trials examined whether multidomain interventions structured around the WHO Integrated Care for Older People framework preserve intrinsic capacity — the composite of locomotor, cognitive, vitality, psychological, and sensory function that predicts loss of independence. Programmes combining physical training with nutritional and cognitive components were the most frequently trialled approach, with measurable effects concentrated in mobility and cognitive domains. Because intrinsic capacity decline precedes functional dependence, it represents a modifiable upstream target rather than a downstream endpoint.
Key Points
- Intrinsic capacity decline predicts later loss of functional independence
- Multidomain programmes outperform single-domain interventions on mobility and cognition
- Trial heterogeneity limits firm conclusions on optimal intervention design
Longevity Analysis
Intrinsic capacity functions as an integrative readout rather than a single measurement — muscular strength and gait speed, cognitive processing, mood, appetite and nutritional adequacy, and sensory acuity each contribute, and each responds to different inputs. The consistent advantage of combined over isolated interventions reflects how these capacities depend on one another: strength training loses its effect without adequate protein and energy availability, and cognitive gains are difficult to sustain amid depressed mood or social withdrawal. For clinical application, the operative variables are the breadth of domains addressed and the duration over which the programme is actually maintained, since the trials showing benefit relied on sustained participation rather than short bursts of intensity.
Original published by SAGE Research on Aging, by Nurhazrina Noordin, Chye Wah Yu, Maria Justine1Centre for Physiotherapy Studies, Faculty of Health Sciences, 54703Universiti Teknologi MARA Selangor, Puncak Alam, Selangor Malaysia2Kulliyah of Allied Health Sciences, Department of Physical Rehabilitations Sciences, International Islamic University of Malaysia, Kuantan, Malaysia3School of Physiotherapy, Faculty of Allied Health Professions, 60605AIMST University, Bedong, Kedah, Malaysia.