老年人内在能力筛查与综合评估中国专家共识

doi:10.12114/j.issn.1007-9572.2025.0401

摘要/Abstract

摘要： 随着全球人口老龄化进程的加速，内在能力作为健康老龄化的核心指标日益受到学界关注。内在能力是个体全部生理和心理能力的总和，具体涵盖认知、运动、活力（营养代谢）、感觉（视力与听力）和心理5个维度。内在能力下降与衰弱、失能、跌倒、住院以及死亡等多种不良结局显著相关。建立科学有效的内在能力早期筛查与评估体系，对于维护老年人功能状态、促进健康老龄化具有重要意义。目前，我国尚缺乏内在能力筛查与综合评估规范化共识。为此，中华医学会老年医学分会、国家老年疾病临床医学研究中心（宣武医院）牵头组织本共识的制订工作。本共识基于循证医学证据，采用推荐意见分级评估、制订与评价（GRADE）证据分级，系统整合国内外前沿研究证据，旨在构建科学、规范的内在能力筛查与综合评估体系，建立早期识别和动态监测方案，以期为延缓老年人内在能力下降和维持功能独立性提供参考。

关键词: 内在能力, 老年人, 健康老龄化, 筛查, 评估, 专家共识

Abstract:

With the accelerating trend of global population aging, intrinsic capacity has gained increasing attention as a core metric of healthy aging. Intrinsic capacity encompasses the composite of an individual's physical and mental abilities, specifically comprising five dimensions: cognition, locomotion, vitality (nutrition and metabolism), sensory (vision and hearing), and psychology. Decline in intrinsic capacity is strongly associated with adverse outcomes such as frailty, disability, falls, hospitalization, and death. Establishing a scientifically valid and effective system for the early screening and assessment of intrinsic capacity is therefore crucial for maintaining functional status in older adults and promoting healthy aging. Currently, China lacks standardized consensus on intrinsic capacity screening and comprehensive assessment protocols. To address this gap, the Chinese Geriatrics Society and the National Clinical Research Center for Geriatric Diseases (Xuanwu Hospital) spearheaded the development of this consensus. Based on evidence-based medicine and utilizing the GRADE framework for evidence grading this consensus systematically integrates the latest research. It aims to establish a scientific and standardized screening and comprehensive assessment system for intrinsic capacity, implement strategies for early identification and dynamic monitoring, and ultimately provide a reference for delaying the decline of intrinsic capacity and maintaining functional independence.

Key words: Intrinsic capacity, Aged, Healthy aging, Screening, Assessment, Expert consensus

中图分类号:

R 339.34

中华医学会老年医学分会,国家老年疾病临床医学研究中心（宣武医院）. 老年人内在能力筛查与综合评估中国专家共识[J]. 中国全科医学, 2026, 29(10): 1225-1238. DOI: 10.12114/j.issn.1007-9572.2025.0401.
Chinese Geriatrics Society,National Clinical Research Center for Geriatric Diseases (Xuanwu Hospital). Chinese Expert Consensus on Screening and Comprehensive Assessment of Intrinsic Capacity in Older Adults[J]. Chinese General Practice, 2026, 29(10): 1225-1238. DOI: 10.12114/j.issn.1007-9572.2025.0401.

图/表 3

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级别	分级标准
推荐强度
强推荐（Ⅰ）	充分考虑了证据质量和可操作性，推荐在大多数情况下应予实施
弱推荐（Ⅱ）	证据价值存在一定不确定性，或由于操作性和结果解读的不足，倾向于低级推荐
证据等级
高质量（A）	非常确信真实值接近观察值
中质量（B）	对观察值有中等程度信心：真实值有可能接近观察值，但仍存在两者不同的可能性
低质量（C）	对观察值的确信程度有限：真实值可能与观察值不同
极低质量（D）	对观察值几乎没有信心：真实值很可能与观察值不同

级别	分级标准
推荐强度
强推荐（Ⅰ）	充分考虑了证据质量和可操作性，推荐在大多数情况下应予实施
弱推荐（Ⅱ）	证据价值存在一定不确定性，或由于操作性和结果解读的不足，倾向于低级推荐
证据等级
高质量（A）	非常确信真实值接近观察值
中质量（B）	对观察值有中等程度信心：真实值有可能接近观察值，但仍存在两者不同的可能性
低质量（C）	对观察值的确信程度有限：真实值可能与观察值不同
极低质量（D）	对观察值几乎没有信心：真实值很可能与观察值不同

条目	问题	下降	正常
认知	1.记住3个词汇：例如花朵、门、米饭	不计分	不计分
	2.时间及空间定向力：今天的日期是？现在身处何处（家、诊所等）	错误或不知道	回答正确
	3.回忆第一问中的3个词汇（花朵、门、米饭）	无法回忆全部词汇	正确回忆全部词汇
运动	起坐测试：不借助上肢力量，从坐位站起5次，是否能在14 s内完成	否	是
活力	1.体质量下降：过去3个月内是否在非刻意减重的情况下体质量下降>3 kg	是	否
活力	2.食欲减退：是否有过食欲减退	是	否
视力	您的眼睛是否有以下问题：看远处或阅读有困难，眼疾病，或目前正在接受药物治疗（例如糖尿病、高血压）	是	否
听力	耳语测试闻及耳语，或测听筛查结果≤35 dB，或通过自动化数字噪声测试	否	是
心理	在过去的两周内，您是否受到以下任何情况困扰： 1.感到压抑、沮丧或绝望 2.对做事缺乏兴趣或乐趣	是	否

条目	问题	下降	正常
认知	1.记住3个词汇：例如花朵、门、米饭	不计分	不计分
	2.时间及空间定向力：今天的日期是？现在身处何处（家、诊所等）	错误或不知道	回答正确
	3.回忆第一问中的3个词汇（花朵、门、米饭）	无法回忆全部词汇	正确回忆全部词汇
运动	起坐测试：不借助上肢力量，从坐位站起5次，是否能在14 s内完成	否	是
活力	1.体质量下降：过去3个月内是否在非刻意减重的情况下体质量下降>3 kg	是	否
活力	2.食欲减退：是否有过食欲减退	是	否
视力	您的眼睛是否有以下问题：看远处或阅读有困难，眼疾病，或目前正在接受药物治疗（例如糖尿病、高血压）	是	否
听力	耳语测试闻及耳语，或测听筛查结果≤35 dB，或通过自动化数字噪声测试	否	是
心理	在过去的两周内，您是否受到以下任何情况困扰： 1.感到压抑、沮丧或绝望 2.对做事缺乏兴趣或乐趣	是	否