December 2025
Study finds intrinsic capacity superior to frailty measures for predicting dementia risk
By Melanie Hinze
Intrinsic capacity (IC) may be a better measure for predicting dementia risk than traditional disability or frailty scales, new Australian research suggests.
Writing in the International Journal of Geriatric Psychiatry, the study authors explained that IC, proposed by the WHO, was a holistic concept that captured a range of both positive and negative physical and mental attributes that individuals could draw on over a lifetime to maintain health in late life.
Using comprehensive physical, psychological and cognitive assessments, the authors calculated IC scores for 400 participants across five domains (cognitive function, psychological health, locomotive ability, sensory function and vital function over a lifetime) and compared them with two established frailty measures: the Frailty Phenotype and the Frailty Index. The participants were older adults, aged 70 to 90 years, who had participated in the Sydney Memory and Ageing Study.
The authors found that individuals with higher IC scores had significantly lower risk of dementia over 10 years’ follow up and mortality over 12 years’ follow up, even after controlling for age, sex and education.
Dr Katya Numbers, Postdoctoral Researcher and Senior Lecturer at the Centre for Healthy Brain Ageing, UNSW Sydney, and first author of the study, said that this research flipped the script on how we think about ageing.
‘Instead of counting losses and deficits (for example measuring frailty), IC measures what is still working – cognition, mobility, mood, senses and vitality’, she said. ‘We found that people with higher capacity scores had a 43% lower risk of dementia and a 35% lower risk of death over 10 years, even after accounting for age and other factors,’ she added.
‘In short, it’s not just what’s gone that matters – it’s what remains,’ she said.
Furthermore, Dr Numbers said this study was the first to replicate the original five-factor model of IC in an older Australian cohort, and it built on the growing body of literature regarding the validation and standardisation of IC.
For GPs, she said, this means shifting from a deficit-focused model of ageing to one that celebrates capacity.
‘A quick check-in on how well a patient is thinking, moving, coping and connecting can reveal early warning signs long before disease sets in,’ she said.
‘The message is simple: by focusing on maintaining capacity rather than managing decline, we can keep people independent, healthier and at home for longer.’