世界卫生组织老年整合照护筛查工具诊断内在能力下降的灵敏度和特异度分析研究

doi:10.12114/j.issn.1007-9572.2024.0227

中国全科医学 ›› 2026, Vol. 29 ›› Issue (22): 3199-3205.DOI: 10.12114/j.issn.1007-9572.2024.0227

世界卫生组织老年整合照护筛查工具诊断内在能力下降的灵敏度和特异度分析研究

李夏夏, 潘一鸣, 刘盼, 宋雨, 李碧汐, 张亚欣, 张婉淑, 李静, 马丽娜^*()

100053　北京市，首都医科大学宣武医院老年医学科　国家老年疾病临床医学研究中心

收稿日期:2025-04-10 修回日期:2025-11-24 出版日期:2026-08-05 发布日期:2026-07-08
通讯作者: 马丽娜
作者贡献：
李夏夏负责实验设计、数据收集整理与统计分析、文章撰写；潘一鸣、刘盼、宋雨、李碧汐、张亚欣、张婉淑、李静进行数据收集；马丽娜进行研究设计、研究指导、论文修订，负责文章的质量控制与审校，对文章整体负责，监督管理。
基金资助:
国家重点研发计划(2023YFC3605200); 首都医科大学临床专科学院（系）培养基金开放课题(CCMU2022ZKYXZ007)

The Sensitivity and Specificity Analysis of the WHO Integrated Care for Older People Screening Tool for Intrinsic Capacity Decline

LI Xiaxia, PAN Yiming, LIU Pan, SONG Yu, LI Bixi, ZHANG Yaxin, ZHANG Wanshu, LI Jing, MA Lina^*()

Department of Geriatrics, Xuanwu Hospital, Capital Medical University/China National Clinical Research Center for Geriatric Medicine, Beijing 100053, China

Received:2025-04-10 Revised:2025-11-24 Published:2026-08-05 Online:2026-07-08
Contact: MA Lina

摘要/Abstract

摘要： 背景内在能力是指个体生理和心理能力的总和。内在能力下降在老年人中患病率较高，且与老年人多种不良健康结局有关。早期识别和干预内在能力下降对老年人健康具有重要意义。WHO老年整合照护（ICOPE）筛查工具是WHO推荐的用于筛查老年人内在能力下降的工具，中文版WHO ICOPE筛查工具具有良好的信效度。目的探讨中文版WHO ICOPE筛查工具对内在能力下降诊断的灵敏度和特异度，以及其与躯体功能下降、衰弱、社会衰弱和肌少症的关系。方法于2019年12月—2023年6月，采用方便抽样方法选取首都医科大学宣武医院老年医学科老年人为研究对象。分别采用中文版WHO ICOPE筛查工具和内在能力评估方法对老年人进行内在能力的筛查和评估，并进行躯体功能、衰弱、社会衰弱、肌少症的评价。采用配对四格表χ2检验和受试者工作特征（ROC）曲线评价中文版WHO ICOPE筛查工具的诊断效能。结果本研究共纳入769例老年人，年龄60~97岁，平均年龄（71.0±8.2）岁。中文版WHO ICOPE筛查工具对内在能力下降诊断老年人内在能力下降的灵敏度为95.96%、特异度为51.80%、准确性为80.34%。ROC曲线显示，中文版WHO ICOPE筛查工具诊断的ROC曲线下面积（AUC）为0.739（95%CI=0.699~0.779，P<0.001）。不同躯体功能、肌少症筛查、衰弱和社会衰弱情况的老年人中文版WHO ICOPE筛查工具内在能力下降率及内在能力下降维度数量比较，差异有统计学意义（P<0.05）。结论中文版WHO ICOPE筛查工具对内在能力下降诊断的灵敏度和准确性较高，可作为筛查工具用于早期识别高风险老年人，从而启动全面评估和干预措施。

关键词: 老年人保健服务, 老年整合照护筛查工具, 内在能力, 灵敏度, 特异度

Abstract:

Background

Intrinsic capacity (IC) is the sum of an individual's physical and mental capacities. IC decline is highly prevalent and associated with a variety of adverse outcomes in older adults. Early identification and intervention of IC decline is important for the health of older individuals. The World Health Organization (WHO) recommends screening for IC decline with the Integrated Care for Older People (ICOPE) Screening Tool. The Chinese version of the WHO ICOPE Screening Tool has a good level of reliability and validity.

Objective

To investigate the sensitivity and specificity of the Chinese version of the WHO ICOPE Screening Tool for IC decline, and its association with physical function decline, frailty, social frailty, and sarcopenia.

Methods

From December 2019 to December 2023, older adults from the Geriatric Medicine Department of Xuanwu Hospital, Capital Medical University, were selected using convenience sampling. The Chinese version of the WHO ICOPE Screening Tool and IC assessment were respectively used to screen and assess the IC. As well as to assess physical function, frailty, social frailty, and sarcopenia. Paired Chi-square test and receiver operating characteristic (ROC) curves were used to analysis the sensitivity and specificity of WHO ICOPE Screening Tool.

Results

This study included a total of 769 older adults aged 60 to 97 years, with a mean age of (71.0±8.2) years.The Chinese version of the WHO ICOPE Screening Tool has a sensitivity of 95.96%, a specificity of 51.80%, an accuracy of 80.34% for the diagnosis of IC decline, and the ROC curve showed the AUC for diagnosis was 0.739 (95% confidence interval 0.699-0.779, P<0.001). A statistically significant differences (P<0.05) were observed in the prevalence of intrinsic capacity decline and the number of domains for intrinsic capacity decline among older adults with varying physical functions, sarcopenia screening results, frailty and social frailty when assessed using the Chinese version of the WHO ICOPE Screening Tool.

Conclusion

the Chinese version of the WHO ICOPE Screening Tool has high sensitivity and accuracy, and can be used as a Screening Tool for early identification of high-risk older adults to initiate comprehensive assessment and intervention.

Key words: Health services for the aged, ICOPE Screening Tool, Intrinsic capacity, Sensitivity, Specificity

李夏夏,潘一鸣,刘盼,等. 世界卫生组织老年整合照护筛查工具诊断内在能力下降的灵敏度和特异度分析研究[J]. 中国全科医学, 2026, 29(22): 3199-3205. DOI: 10.12114/j.issn.1007-9572.2024.0227.
LI Xiaxia,PAN Yiming,LIU Pan, et al. The Sensitivity and Specificity Analysis of the WHO Integrated Care for Older People Screening Tool for Intrinsic Capacity Decline[J]. Chinese General Practice, 2026, 29(22): 3199-3205. DOI: 10.12114/j.issn.1007-9572.2024.0227.

图/表 6

表1 内在能力正常组和内在能力下降组的社会人口学特征比较[例（%）]

Table 1 Comparison of sociodemographic characteristics between the group with normal intrinsic capacity and intrinsic capacity decline

指标	例数	内在能力正常组（n=272）	内在能力下降组（n=497）	χ²值	P值
年龄				74.42	<0.001
60~64岁	185	93（50.3）	92（49.7）
65~69岁	207	96（46.4）	111（53.6）
70~74岁	149	51（34.2）	98（65.8）
≥75岁	228	32（14.0）	196（86.0）
性别				0.00	0.974
男	436	154（35.3）	282（64.7）
女	333	118（35.4）	215（64.6）
现居住地^a				4.22	0.040
城市	747	269（36.0）	478（64.0）
农村	21	3（14.3）	18（85.7）
居住情况^a				5.55	0.018
独居	57	12（21.1）	45（78.9）
非独居	700	256（36.6）	444（63.4）
文化程度^a				4.32	0.038
文盲	25	4（16.0）	21（84.0）
非文盲	740	268（36.2）	472（63.8）
婚姻状况^a				16.68	<0.001
无配偶	103	18（17.5）	85（82.5）
有配偶	663	253（38.2）	410（61.8）
健康自评^a				41.94	<0.001
好	474	203（42.8）	271（57.2）
一般	193	54（28.0）	139（72.0）
差	95	10（10.5）	85（89.5）
吸烟				0.05	0.828
是	307	110（35.8）	197（64.2）
否	462	162（35.1）	300（64.9）
饮酒^a				0.35	0.557
是	216	80（37.0）	136（63.0）
否	552	192（34.8）	360（65.2）

表2 老年人内在能力下降的筛查和评估结果[例（%）]

Table 2 Screening and assessment results of declining internal capacity in the older adults

项目	WHO ICOPE筛查	内在能力评估
内在能力下降	608（79.1）	497（64.6）
内在能力维度下降
运动	243（31.6）	270（35.1）
认知	378（49.2）	72（9.4）
心理	112（14.6）	76（9.9）
活力	134（17.4）	158（20.5）
感觉	307（39.9）	307（39.9）
视力	244（31.7）	244（31.7）
听力	108（14.0）	108（14.0）

图1 中文版WHO ICOPE筛查工具对老年人内在能力下降风险预测的ROC曲线注：WHO ICOPE=世界卫生组织老年整合照护，ROC=受试者工作特征，AUC=ROC曲线下面积。

Figure 1 The ROC curve for predicting the risk of intrinsic capacity decline in older adults using the Chinese version of the WHO ICOPE Screening Tool

表3 中文版WHO ICOPE筛查工具对老年内在能力下降风险预测价值的灵敏度、特异度及准确性

Table 3 The sensitivity, specificity and accuracy of the Chinese version of the WHO ICOPE Screening Tool in predicting the risk of intrinsic capacity decline in older adults

项目	真阳性[例（%）]	假阴性[例（%）]	假阳性[例（%）]	真阴性[例（%）]	灵敏度（%）	特异度（%）	准确性（%）
内在能力下降	477（62.0）	20（2.6）	131（17.0）	141（18.3）	95.98	51.84	80.36
内在能力各维度
运动功能下降	203（26.4）	67（8.7）	40（5.2）	459（59.7）	75.19	91.98	86.09
认知功能下降	66（8.6）	6（0.8）	312（40.6）	385（50.1）	91.67	55.24	58.65
心理功能下降	59（7.7）	17（2.2）	53（6.9）	640（83.2）	77.63	92.35	90.90
活力功能下降	83（10.8）	75（9.8）	51（6.6）	560（72.8）	52.53	91.65	83.62

图2 不同老年人群的中文版WHO ICOPE筛查工具内在能力下降情况比较注：a为P<0.05，b为P<0.001；A为躯体功能正常和下降老年人内在能力下降率的比较，B为肌少症筛查阴性和阳性老年人内在能力下降率的比较，C为非衰弱和衰弱老年人内在能力下降率的比较，D为非社会衰弱和社会衰弱老年人内在能力下降率的比较，E为躯体功能正常和下降老年人内在能力下降维度数量的比较，F为肌少症筛查阴性和阳性老年人内在能力下降维度数量的比较，G为非衰弱和衰弱老年人内在能力下降维度数量的比较，H为非社会衰弱和社会衰弱老年人内在能力下降维度数量的比较。

Figure 2 The comparison of intrinsic capacity decline among different groups of older adults using the Chinese version of the WHO ICOPE Screening Tool

表4 中文版WHO ICOPE筛查工具的内在能力下降维度数量与Barthel指数、衰弱表型、HALFT和SARC-F得分的相关性

Table 4 Correlation between the number of intrinsic capacity decline domains in the Chinese version of the WHO ICOPE Screening Tool and scores on the Barthel Index, Frailty Phenotype, HALFT, and SARC-F

项目	r_s值	P值
Barthel指数	-0.436	<0.001
衰弱表型	0.378	<0.001
HALFT	0.215	<0.001
SARC-F	0.443	<0.001

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世界卫生组织老年整合照护筛查工具诊断内在能力下降的灵敏度和特异度分析研究

The Sensitivity and Specificity Analysis of the WHO Integrated Care for Older People Screening Tool for Intrinsic Capacity Decline

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