The Feasibility of Implementing the WHO Integrated Care for Older People (ICOPE) Framework in Singapore

Background: The World Health Organization (WHO) introduced the Integrated Care for Older People (ICOPE) approach to assist communities in evaluating the intrinsic capacities of older adults and proposing strategies to prevent, mitigate, or reverse declines. This study represents the inaugural attempt to assess intrinsic capacities among older adults in Singapore, aligning with the nation’s Healthier Singapore (Healthier SG) initiative aimed at enhancing quality of life. Objectives: This study aims to investigate the feasibility of implementing Step 1 screening of the ICOPE framework, which assesses cognition, locomotion, vitality, psychological state, visual and auditory functions, within the Singapore context. Design, Setting, and Participants: Using a mixed-method approach, this cross-sectional study established a baseline understanding of the levels of intrinsic capacity in 367 community-dwelling older adults in Singapore (mean age 71.8 years), elucidated the experiences of administering the ICOPE Step 1 screening tool and the formulation of personalized care plans from the perspective of 25 assessors. Measurements: Participants completed ICOPE Step 1 screening, providing basic demographic and health profiles, while assessors engaged in focus group discussions. Results: Among older participants, 284 exhibited signs of decline in intrinsic capacity. The primary areas of decline were visual impairment (42.0%), hearing loss (33.5%), and cognitive deterioration (31.3%), followed by limited mobility (24.3%), malnutrition (16.1%), and depressive symptoms (16.1%). Assessors found the ICOPE screening tool user-friendly and appreciated its person-centred approach, noting its integration with care plans, which many other tools lacked. They were confident in Singapore’s capacity to adopt the ICOPE approach, citing existing practices in assessing intrinsic capacity domains and integrated care models. Conclusion: Critical steps for successful implementation of the ICOPE framework include follow-up interventions like self-management strategies for declining intrinsic capacity, diagnostic assessments, and routine monitoring. Coordination between healthcare clusters and community care networks is essential for its success.