Identification of pre-frail/frail older adults using the Integrated Care for Older People WHO Step1 screening tool - a cross sectional study

Sep 28, 2026

Uploaded by Rowan

Background: The Integrated Care for Older People program is a WHO recommendation aimed at preventing functional decline through four steps, including Step1 screening for anomalies followed by further assessment, a prevention plan, and long-term follow-up of intrinsic capacity. Objective: to evaluate whether the WHO Step1 screener can distinguish pre-frail/frail from robust older adults in primary care. Method: cross-sectional analysis of ICOPE MONITOR participants using regression and classification and regression trees. Results: 3,118 participants; mobility and nutrition alerts were strongly linked; psychology alert added value for older adults. Conclusion: prioritize impaired mobility and/or nutrition at Step1 to guide next steps.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

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Background

Objective

Method

Results

Discussion

International Journal of Nursing Studies Advances 10 (2026) 100463 Contents lists available at ScienceDirect International Journal of Nursing Studies Advances journal [homepage:](homepage: www.sciencedirect.com/journal/international)[ www.sciencedirect.com/journal/international](homepage: www.sciencedirect.com/journal/international)journal-of-nursing-studies-advances | Identification of pre-frail/frail older adults using the Integrated Care for Older People WHO Step1 screening tool: a cross sectional study
Caroline Berbon a,b,* , Gabor Abellan Van Kana,b, Yves Rollanda,b,
Laurent Balardya,b, Catherine TAKEDA a, Ne´da Tavassolia, Ve´ronique Bezombesa, Bruno Vellasa,b, Sandrine Andrieua,b,c, Maria Eugenia Sotoa,b
a IHU HealthAge & WHO Collaborating Center for Frailty, Clinical & Geroscience Research, and Geriatric Training, Toulouse University Hospital, La Grave, 31 059 Toulouse, France
b Maintain Aging Research team, Centre d’Epid´emiologie et de Recherche en Sant´e des Populations, Universit´e de Toulouse, Inserm, Universit´e de Toulouse, 31 400 Toulouse
c Clinical Epidemiology and Public Health Department, Toulouse University Hospital, all´ees Jules-Guesde, 31000 Toulouse, France | | | | --- | --- | --- | | A R T I C L E I N F O | | A B S T R A C T | | Keywords: Frailty Integrated care Prevention
Healthcare professionals WHO | | Background: The Integrated Care for Older People program is a recommendation from the World Health Organization (WHO) to prevent functional decline. It is carried out in four steps, including Step1 screener, Step2 comprehensive assessment in case of anomalies detected in Step1, Step3, which is a prevention plan and Step4, involving long-term follow-up of intrinsic capacity and the implementation of the care plan. In order to meet this evaluation, need and given the constraints of healthcare professional, it is important to specify which older people are most at risk of decline (pre-frail/frail people according to Linda Fried’s score).
Objective: to assess if Integrated Care for Older People WHO Step1 can segregate pre-frail/frail older adults from robust in primary care setting.
Method: This cross-sectional study concerned participants registered on the ICOPE MONITOR platform of the Toulouse University Hospital. The results from Step1, which help identify participants most at risk of pre-frailty/frailty, were selected through regression analysis followed by a Classification and Regression Trees approach.
Results: Between January 1, 2020, and June 30, 2024, 3,118 participants were included in this study. Pre-frailty/frailty was associated with mobility alert alone (84.7 %), nutrition alert alone (88.9 %) and with the two associated (96.7 %). For the oldest participants (over 76 years), a psychology alert was also strongly associated with pre-frailty/frailty (63.9 %).
Discussion: This study allows healthcare professional to prioritize participants with impaired mobility and/or nutrition at Step1 for the next steps in Integrated Care for Older People program. This approach addresses the needs of participants by providing the appropriate response to the right clinical profile and facilitates the interpretation of Integrated Care for Older People Step1 in the community. | * Corresponding author. E-mail addresses: [berbon.c@chu-toulouse.fr](berbon.c@chu-toulouse.fr) (C. Berbon), [abellan.g@chu-toulouse.fr](abellan.g@chu-toulouse.fr) (G. Abellan Van Kan), [rolland.y@chu-toulouse.fr](rolland.y@chu-toulouse.fr)[ ](rolland.y@chu-toulouse.fr)(Y. Rolland), [balardy.l@chu-toulouse.fr](balardy.l@chu-toulouse.fr) (L. Balardy), [takeda.c@chu-toulouse.fr](takeda.c@chu-toulouse.fr) (C. TAKEDA), [tavassoli.n@chu-toulouse.fr](tavassoli.n@chu-toulouse.fr) (N. Tavassoli), [bezombes.v@chu-toulouse.fr](bezombes.v@chu-toulouse.fr) (V. Bezombes), [vellas.b@chu-toulouse.fr](vellas.b@chu-toulouse.fr) (B. Vellas), [andrieu.s@chu-toulouse.fr](andrieu.s@chu-toulouse.fr) (S. Andrieu), [

FAQs

What is the purpose of the Integrated Care for Older People program in this study?

It is a WHO-recommended approach to prevent functional decline in adults aged 60 and over by using a structured pathway starting with Step1 screening, followed by assessment, a prevention plan, and long-term follow-up.

How did the researchers assess pre-frail/frail status using WHO Step1?

They conducted a cross-sectional study among participants in the ICOPE MONITOR platform and selected Step1 results using regression analysis followed by a Classification and Regression Trees approach.

Which alerts on Step1 were most associated with pre-frailty/frailty?

Pre-frailty/frailty was linked with mobility alert alone and nutrition alert alone, and even more strongly when both were present. For participants over 76 years, a psychology alert was also strongly associated.

Sep 28, 2026

Uploaded by Rowan