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Effect of the WHO ICOPE prevention program on falls and mobility functions : a retrospective study in France
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DOI：10.1186/s12877-026-08073-7.png)
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Abstract
En 中文
World Health Organization developed the Integrated Care for Older People (ICOPE) prevention program in order to promote the maintenance of intrinsic capacities for older adults, based on six key domains. Each key domain is a risk factor for falls in older adults, they are accessible to interventions. The ICOPE prevention program involves screening test, in-depth assessment and development of an interventional personalized care plan for the participant. As the aim of the ICOPE program, fall risk evaluation and management must be multidomain and personalized. The objective of this study was to evaluate the association between the completion of an in-depth assessment followed by a personalized care plan, and the occurrence of falls in older adults, within the approximate interval of one year. This is an observational retrospective cohort study including 357 participants, as part of the Toulouse Gérontopôle’s frailty prevention and management actions (France). They all had a personalized care plan following an initial in-depth assessment, and a second in-depth assessment conducted approximately one year later. During these assessments, data were collected during an in-person individual evaluation conducted by a nurse, using tools as questionnaires, scales, stopwatches, measuring tapes and handgrip dynamometers. We collected data on self-reported falls within the three months preceding the assessments, and clinical mobility-related elements such as the Short Physical Performance Battery (SPPB), self-reported concerns about falling, and frailty criteria according to Fried’s score including gait speed. We compared the initial status between self-reported fallers in the last 3 months versus non-fallers, using a multivariate logistic regression model to examine the factors associated with a history of falls at the initial assessment. We compared the proportion of self-reported fallers and participant’s mobility-related elements approximately one year after the personalized care plan was proposed, using McNemar test, Student’s T-test or the Wilcoxon rank-sum test, depending on the variables. We compared the participants’ results based on their level of adherence to the care plan, using the Chi-square test or Fisher’s exact test for categorical variables, for continuous variables analysis of variance (ANOVA) or the Kruskal-Wallis test was used. Approximately one year after the first in-depth assessment, there were not statistically significant difference in the occurrence of falls in the last three months (20.5% reported a fall in the past three months at the first in-depth assessment versus 15.7% at the second in-depth assessment, p = 0.07). There were significantly different results based on the level of care plan adherence regarding the SPPB score (median 11 (8–12), 10 (7–12) and 11 (9–12) ; respectively for care plan not implemented, partially implemented and fully implemented p = 0.008), gait speed expressed in time to walk 4 m in seconds (mean 4.8 +/- 2.3, 5.3 +/- 2.2 and 4.6 +/-1.5 ; respectively for care plan not implemented, partially implemented and fully implemented, p < 0.01), Fried score (median 2 (1–2), 1 (0.5-3) and 1 (0–2) ; respectively for care plan not implemented, partially implemented and fully implemented, p = 0.001), and concerns about falling (26.8%, 44.4% and 27.4% ; respectively for care plan not implemented, partially implemented and fully implemented, p = 0.003). The group that partially implemented the care plan seems to stand out negatively in comparison to both not implemented and fully regarding the SPPB score, gait speed, Fried status and concerns about falling. Subgroup analyses revealed significant differences one year after the submission of the care plan concerning mobility parameters based on the level of plan implementation, highlighting the importance of this parameter. A secondary analysis suggests that those who were initially more robust (with a lower Fried frailty score) appear to have fully adhered to the recommended measures.
Keywords:
Older adults
Fall
ICOPE program
Intrinsic capacity
Multifactorial intervention
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