Intrinsic capacity decline and its associations in community-dwelling older adults in Kedah, Malaysia

Objectives: Intrinsic capacity (IC) is the composite of physical and mental capacities, reflecting the overall functional ability in older adults. Evidence on IC decline in Malaysia remains limited; therefore, this study examined the prevalence of decline across six IC domains and identified key sociodemographic and clinical associations. Methods: This cross-sectional study recruited 329 older adults from three Pusat Aktiviti Warga Emas centers in Kedah, Malaysia. Their IC was assessed using the World Health Organization-Integrated Care for Older People Step 1 screening tool across six domains (Mini-Mental State Examination, Short Physical Performance Battery, Mini Nutritional Assessment–Short Form, Geriatric Depression Scale–15, visual acuity self-report, and whisper test self-report). Data were analyzed using multivariable logistic regression adjusted for weight, body mass index, and gender, and expressed as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: IC decline was most common in vision (69.6%) and cognition (52.6%), followed by locomotion (40.1%), vitality (30.4%), hearing (23.1%), and psychological function (17.9%). Overall, 77.2% had impairment in at least one domain. Significant associations were observed between walking-aid use and decline in locomotion (aOR = 7.75), vitality (aOR = 1.99), and hearing (aOR = 3.55). Non-Malay ethnicity was associated with higher odds of psychological decline (aOR = 4.09) but lower odds of vitality decline (aOR = 0.28). Multimorbidity was associated with increased odds of vitality and psychological decline, while higher education was associated with lower odds of cognitive impairment (aOR = 0.35). Conclusion: IC decline was highly prevalent, particularly in vision and cognition. These findings suggest the need for early, community-based, multidisciplinary strategies to preserve function and promote healthy aging.