Declined intrinsic capacity is associated with one-year functional disability in older hypertensive inpatients.

Background: Hypertension is one of the prominent modifiable risk factors for cardiovascular diseases (CVD), and its prevalence is continuously increasing each year, contributing significantly to mortality and disability in older adults in China and even worldwide. The aim of this study was to evaluate the impact of declined intrinsic capacity (IC) on the risk of 1-year functional disability in older hypertensive inpatients.

Methods: A total of 233 hypertensive elderly from Zhejiang Hospital in China were included in this retrospective observational study. Five domains of IC including cognition, locomotion, vitality, psychology, and sensory capacity were assessed at admission. Functional disability was defined as new dependencies in activities of daily living (ADL) over a 1-year follow-up period. Multivariate logistic regression models were used to investigate the relationships between IC domains at baseline and 1-year functional disability.

Results: The incidence of decline in five domains of IC, including cognition, locomotion, vitality, psychology, sensory (vision and hearing status) capacity were 28.8%, 55.8%, 27.9%, 12.4%, 42.9% and 63.1% respectively. Both systolic blood pressure (SBP) and pulse pressure (PP) were negatively linked to the IC composite score, and specifically with two domains of IC, including cognition and locomotion (P < 0.05). During the 1-year follow-up, 50 participants (21.5%) experienced functional disability. After adjusting for confounding factors, multivariate logistic regression analysis showed that a higher IC composite score on admission was associated with a lower one-year risk of functional disability (odds ratio [OR] = 0.57, 95% confidence interval [CI]: 0.40-0.80, P = 0.001); cognitive decline and locomotion impairment predicted 1-year functional disability in older hypertensive inpatients (OR = 3.08, 95% CI: 1.41-6.69, P = 0.005; OR = 3.35, 95% CI: 1.30-8.63, P = 0.012).

Conclusions: Declined cognition and locomotion increased the risk of functional disability 1 year after discharge, early prevention and management of declined intrinsic capacity is critically important among hypertensive elderly.