Five distinct intrinsic capacity trajectories were identified among home care recipients, demonstrating that longitudinal trajectory patterns capture clinically meaningful differences in ageing pathways not apparent from single assessments, with baseline IC level alone failing to fully capture subsequent outcome heterogeneity.
Five distinct intrinsic capacity (IC) trajectories were identified among Canadian home care recipients, demonstrating substantial heterogeneity in functional ageing patterns.
Baseline IC level alone did not fully capture subsequent outcome heterogeneity, as individuals with moderate baseline IC had higher long-term care (LTC) admission rates than those with low baseline IC who improved.
Cognitive impairment was strongly associated with adverse IC trajectories.
IC gains or improvements were most evident in the locomotion and psychological domains.
The study demonstrated that routinely collected interRAI Home Care data can be used to enable scalable, trajectory-informed care planning.
This research followed over 300,000 Canadians receiving home care services and tracked how their overall physical and mental health capacity (called 'intrinsic capacity') changed over time. Rather than just measuring health at a single point, the researchers used statistical modeling to identify five distinct patterns of how health capacity evolved — most people declined over time, but some remained stable and others actually improved. This suggests that older adults receiving home care are not a uniform group; they follow meaningfully different health trajectories. A particularly important finding was that knowing someone's health level at the start of care was not enough to predict what would happen to them later. For example, people who started with moderate health capacity were more likely to end up in long-term care (48.4%) than people who started with low capacity but then improved (38.1%). This means that tracking how a person's health changes over time — not just measuring it once — gives a much more accurate picture of their risk. The research also found that cognitive impairment was strongly linked to worse health trajectories, while improvements were most commonly seen in mobility and mental/emotional wellbeing. This research suggests that health systems could use the routine assessment data already being collected for home care clients to better identify who is at risk of needing long-term care or who might benefit most from early intervention. Rather than relying on a snapshot in time, care planning informed by these longitudinal patterns could lead to more targeted and timely support for older adults living at home.
Egbujie B, van Hout H, Heckman G, Geffen L, Morris J, Hirdes J. (2026). Intrinsic capacity trajectories and health outcomes in home care settings: a Canadian population-based cohort study.. Age and ageing. https://doi.org/10.1093/ageing/afag255