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Researchers from ���������¼� Sydney’s and School of Risk & Actuarial Studies have found that a new approach to measuring health in later life - known as Intrinsic Capacity - is a stronger predictor of dementia and mortality than traditional measures of frailty in older adults.

The study, published in the , is the first to validate the five-domain structure of Intrinsic Capacity (IC) in an older Australian cohort. Intrinsic Capacity, a concept developed by the World Health Organization as part of its Healthy Ageing framework, takes a holistic view of health, emphasising the abilities that support independence and wellbeing, such as cognition, mobility, psychological health, sensory function and vital capacity.

By contrast, most research uses frailty measures which focus on accumulated health deficits and physical decline to predict negative outcomes like dementia, disability and mortality.

“Our findings show that Intrinsic Capacity not only captures the core elements of healthy ageing but also provides unique predictive value for dementia and mortality over and above deficit-focused frailty measures,” said lead author and Senior Lecturer from CHeBA, Dr Katya Numbers.

The research drew on data from 400 older adults, aged 70 to 90, who participated in the Sydney Memory and Ageing Study. Using comprehensive physical, psychological and cognitive assessments, researchers calculated IC scores across five domains and compared them with two established frailty measures- the Frailty Phenotype and Frailty Index.

Results showed that individuals with higher IC scores had significantly lower risk of both dementia (43% reduced risk) and mortality (35% reduced risk) over 10 years of follow-up, even after controlling for age, sex and education.

Importantly, IC gave researchers extra insight beyond frailty scores - especially when it came to predicting who would go on to develop dementia. While frailty scores focus on counting the number of health problems that people have, Intrinsic Capacity provides an overall score for how well their bodies function and how they think, feel and move as they age.  

The researchers say the findings have significant implications for healthy ageing.

“This is a shift from focusing on deficits to focusing on capacity,” said senior author and Co-Director of CHeBA Professor Henry Brodaty. “Rather than seeing ageing as an inevitable decline, Intrinsic Capacity provides a more holistic and empowering way to monitor health, intervene early, and support older people to maintain independence.”

The study strengthens the case for Intrinsic Capacity as a core marker of healthy ageing, offering clinicians and policymakers a valuable tool to guide more person-centred, preventive approaches to dementia risk reduction and late-life care.