Abstract 018 | Interplay of sensory function, mobility and cognition within the intrinsic capacity framework

Stefano Cacciatore | Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, FL, USA.

Aging is characterized by progressive decline across multiple functional domains, which rarely deteriorate in isolation, particularly in very old adults (≥ 80 years) (1). The World Health Organization introduced the concept of intrinsic capacity to capture the composite of physical and mental capacities, including physical function, cognition, psychological well-being, vitality, and sensory function (2,3). However, how these domains interact, and the role of sensory function within this system, remain incompletely understood. The aims of this study were: (i) to characterize interrelationships among intrinsic capacity domains in very old adults using network analysis; (ii) to evaluate the independent associations of vision, hearing, and psychological domains with physical function and cognition using multivariable regression models; and (iii) to further examine the relationships among sensory function, locomotion, and cognition through exploratory mediation analysis. We conducted a cross-sectional analysis of 322 community-dwelling adults aged 80 years or older (mean age 85.5 ± 4.8 years; 67% women) from the population-based ilSIRENTE study. Intrinsic capacity domains were assessed using validated instruments, rescaled to a 0–100 metric, and summarized into an overall intrinsic capacity score. Vision and hearing were analyzed as separate sensory domains. Interdomain relationships were examined using partial correlation network analysis. Multivariable linear regression models evaluated associations of sensory and psychological domains with locomotion and cognition, adjusting for age, sex, education, physical activity, and number of chronic diseases. Exploratory mediation analyses assessed whether locomotion statistically mediated the association between sensory function and cognition. Network analysis (Figure 1) identified a central cluster linking vitality, psychological well-being, and cognition, with the strongest partial correlations observed between psychological and vitality domains (partial r = 0.49) and between cognition and vitality (partial r = 0.41). Locomotion showed moderate connections with vitality (partial r = 0.21), while sensory domains were peripheral and did not form a distinct cluster, displaying only weak connections with other domains. In regression analyses, higher hearing domain scores were independently associated with better locomotion (β = 0.58; 95% CI, 0.04 to 1.13 per 10-point increase), whereas vision was not. No direct associations were observed between sensory domains and cognition. Exploratory mediation analyses showed a small but significant indirect association between sensory function and cognition through locomotion (ACME = 0.04; 95% CI, 0.01 to 0.09), with similar findings in reverse-pathway analyses. Overall, intrinsic capacity domains in very old adults form a tightly interconnected system, with sensory function, mobility, and cognition being strongly related. These findings suggest the domains are interdependent and highlight the importance of integrated approaches to understanding and potentially slowing functional decline in advanced age.