Implementation of Decade of Healthy Ageing Action Plan to Screen and Prevent Decline in Intrinsic Capacity in Elders (SPICE) Through Multisectoral Collaboration in Singapore

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.

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.