Intrinsic Capacity, Resilience, and Meaning in Life in Community-Dwelling Midlife and Older Adults

Condition(s) studied

Study summary

This prospective observational cohort (panel) study aims to understand how intrinsic capacity, resilience, and meaning in life are related and how they change over time in community-dwelling middle-aged and older adults who participate in community center programs in Taiwan. Intrinsic capacity is a concept proposed by the World Health Organization to describe an older person's overall physical and mental abilities, while resilience refers to the ability to bounce back from difficulties, and meaning in life refers to how people feel that their lives are valuable and purposeful. Participants aged 55 years and older will be recruited from collaborating community centers. They will be assessed twice: once at the beginning of their participation in community center programs (baseline) and again at the end of the current community center program (follow-up), which usually occurs about 3 to 6 months after baseline as part of the centers' usual schedule, without any intervention assigned by the study. At each time point, participants will complete assessments of intrinsic capacity, resilience, meaning in life, and sociodemographic background, and will undergo brief physical performance tests, such as walking-related and strength-related measures. At the follow-up assessment, a small number of participants will also be selected and invited to take part in semi-structured qualitative interviews about meaning in life. The main hypotheses are that intrinsic capacity, resilience, and meaning in life will change over time; that intrinsic capacity will be positively associated with meaning in life; and that resilience may mediate the relationship between intrinsic capacity and meaning in life. Sociodemographic information will be collected for descriptive analysis and to describe the sample, but it is not specified as a study variable in the hypothesis framework. In addition, the study will use supplementary physical function measures to better understand how the locomotion domain of intrinsic capacity is reflected by different mobility assessments. A small subsample of participants will be invited to take part in qualitative interviews to enrich and contextualize the observed associations between intrinsic capacity and meaning in life. These interviews are intended to provide a more complete understanding of this relationship and to reflect participants' lived experiences, rather than to establish causal relationships. This study seeks to address the limited longitudinal evidence on the association between intrinsic capacity and meaning in life in community-dwelling middle-aged and older adults. The findings are expected to help people better understand how these constructs are related over time and to provide useful information for planning community-based programs that support healthy aging.

Eligibility

Primary outcome measure(s)

• Intrinsic Capacity Score — Baseline (T0) and follow-up at approximately 3 to 6 months (T1)
  Intrinsic capacity will be assessed using the Integrated Care for Older People (ICOPE) function assessment tool adapted by the Health Promotion Administration in Taiwan. Each of the six intrinsic capacity domains will be converted into a binary score (1 = preserved or normal capacity; 0 = impaired capacity or requiring further assessment according to predefined criteria). The six unweighted domain scores will be summed to generate an overall intrinsic capacity score ranging from 0 to 6, with higher scores indicating better preservation of intrinsic capacity and lower scores indicating more domains with impairment or concern. This outcome will be used to examine the level and temporal stability of intrinsic capacity over the observation period.
• Meaning in Life Score — Baseline (T0) and follow-up at approximately 3 to 6 months (T1)
  Meaning in life will be assessed using the Traditional Chinese version of the Meaning in Life Questionnaire. The questionnaire contains 10 items and includes two 5-item subscales: presence of meaning and search for meaning. Items are rated on a 7-point Likert scale, and subscale scores range from 5 to 35, with higher scores indicating a greater level of the corresponding meaning in life dimension. This outcome will be used to examine the level and temporal stability of meaning in life over the observation period.
• Resilience Score — Baseline (T0) and follow-up at approximately 3 to 6 months (T1)
  Resilience will be assessed using the Chinese version of the Brief Resilience Scale. The scale contains 6 items rated on a 5-point Likert scale, and the mean item score will be calculated, with higher scores indicating greater resilience. This outcome will be used to examine the level and temporal stability of resilience over the observation period.
• Association of Baseline Intrinsic Capacity With Follow-up Meaning in Life — From baseline (T0) to follow-up at approximately 3 to 6 months (T1)
  This outcome will examine whether intrinsic capacity at T0 is associated with meaning in life at T1 after adjustment for baseline meaning in life. The strength and direction of this longitudinal association will be estimated using regression analysis.
• Association of Baseline Intrinsic Capacity With Follow-up Resilience — From baseline (T0) to follow-up at approximately 3 to 6 months (T1)
  This outcome will examine whether intrinsic capacity at T0 is associated with resilience at T1 after adjustment for baseline resilience. The strength and direction of this longitudinal association will be estimated using regression analysis.
• Association of Baseline Resilience With Follow-up Meaning in Life — From baseline (T0) to follow-up at approximately 3 to 6 months (T1)
  This outcome will examine whether resilience at T0 is associated with meaning in life at T1 after adjustment for baseline meaning in life. The strength and direction of this longitudinal association will be estimated using regression analysis.
• Association of Follow-up Resilience With Follow-up Meaning in Life — Follow-up at approximately 3 to 6 months (T1)
  This outcome is the correlation coefficient representing the cross-sectional relationship between resilience and meaning in life at T1. Resilience at T1 will be measured using the Brief Resilience Scale (BRS; 6 items, 5-point Likert scale, mean score range 1 to 5). Meaning in life at T1 will be measured using the Meaning in Life Questionnaire (MLQ; 10 items, 7-point Likert scale, subscale scores range 5 to 35). The strength and direction of the relationship between the BRS score and the MLQ scores at T1 will be estimated using correlation analysis.

Trial sites (1)

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