Implementation of Decade of Healthy Ageing Action Plan to Screen and Prevent Decline in Intrinsic Capacity in Elders (SPICE) Through Multisectoral Collaboration in Singapore
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: ICOPE-Based Digital Intrinsic Capacity Monitoring and Triggered Follow-up (SPICE Pathway).
- Who it may be relevant to
- Registry conditions: Frailty, Intrinsic Capacity, Lifestyle. Basic parameters: from 60 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Singapore
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
This study evaluates the implementation of a structured community-based pathway to screen, risk stratify, and prevent decline in intrinsic capacity (IC) among adults aged 60 years and above in Singapore. Using the World Health Organization (WHO) Integrated Care for Older People (ICOPE) framework and digital screening tools, participants will undergo IC domain screening in community settings. Individuals identified with early decline will receive targeted multidomain interventions and/or referral to primary or specialist care as indicated. Participants will be followed longitudinally to assess feasibility, uptake, functional trajectories, and implementation outcomes.
Detailed description
Population ageing is associated with progressive decline in intrinsic capacity (IC), defined by WHO as the composite of physical and mental capacities across mobility, cognition, vitality (nutrition), psychological, and sensory domains. Early detection of IC decline enables preventive, person-centred interventions to delay frailty, disability, and long-term care dependency.
The SPICE study operationalises the WHO ICOPE framework within Singapore's community ageing ecosystem through a coordinated hub-and-spoke model linking:Community screening platforms (e.g., Active Ageing Centres), Community Health Posts, Regional health system services and other social service organisations.
The pathway consists of:
Step 1: IC Screening
* Screening using WHO ICOPE Monitor tools. Step 2: In-Depth Assessment * Participants screening positive for decline undergo structured assessment of affected domains.
Step 3: Risk Stratification \& Care Planning
* Traffic-light classification (low, moderate, high risk) with personalised care plans.
Step 4: Intervention \& Referral
* Multidomain community interventions (exercise, nutrition, cognitive stimulation, psychosocial engagement) or escalation to medical services when required.
Step 5: Monitoring \& Follow-up
* Longitudinal follow-up with repeat IC assessments at defined intervals. The study will evaluate implementation feasibility, prevalence of IC decline, adherence to care pathways, functional outcomes, and cost-effectiveness within a real-world community system.
In addition, blood and digital biomarkers will be collected from a subgroup of study participants.
Interventions
- Other ICOPE-Based Digital Intrinsic Capacity Monitoring and Triggered Follow-up (SPICE Pathway)
Participants will undergo baseline intrinsic capacity (IC) screening using WHO ICOPE-aligned tools in community settings. Follow-up contacts/visits will occur over the study period and include: 1. Scheduled follow-up at predefined intervals (e.g., every 3, 6-12 months) for repeat IC assessment and outcome data collection; and 2. Triggered (non-scheduled) follow-up that is initiated when remote/digital monitoring indicates decline in one or more IC domains, poor adherence, or when major intercur
Primary outcome measures
- Prevalence of intrinsic capacity decline at baseline (robust / pre-frail) [Time frame: Baseline]
- Uptake of recommended actions (implementation effectiveness) [Time frame: Up to 3 months post-recommendation]
Secondary outcome measures (7)
- Identification of (a set of) biomarkers of aging [Time frame: 30 months]
- Feasibility and reach [Time frame: 30 months]
- Change in intrinsic capacity and function over time [Time frame: 12 months from enrolment]
- Frailty progression [Time frame: over 12 months follow up]
- Cost per participant screened [Time frame: 3 years]
- Number of participants with at least one unscheduled emergency department visit or hospital admission [Time frame: 12 months]
- Implementation outcomes assessed using RE-AIM framework [Time frame: 3 years]
Eligibility criteria
Inclusion criteria
- pre-frail or robust older adults who can provide consent and follow instructions
Exclusion criteria
- frail or with terminal illness
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Observational model
- Cohort
Study locations
Singapore · 1 center
- National University Hospital — Singapore
Identifiers
NCT: NCT07525583 · NICTran2023-0013 · NICTran2023-0013