An observational study in Frailty, Intrinsic Capacity and Lifestyle, sponsored by National University Hospital, Singapore. Recruiting at 1 site in Singapore. Open to participants aged 60 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-04-13.
Sponsored by National University Hospital, Singapore · Observational
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
Step 3: Risk Stratification \& Care Planning
Step 4: Intervention \& Referral
Step 5: Monitoring \& Follow-up
In addition, blood and digital biomarkers will be collected from a subgroup of study participants.
1,199 studies on the registry are indexed under Frailty; 430 are open to participants now.
This study's planned enrollment of 2,500 is above the median of 223 across 496 observational studies indexed under Frailty.
Browse Frailty studies →National University Hospital, Singapore is the lead sponsor of 444 studies on the registry; 96 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Recruitment will be conducted from Active Ageing Centre and Community Centres.
Exclusion Criteria:
Community-dwelling adults robust or pre-frail aged 60 years and above who undergo WHO ICOPE-aligned digital intrinsic capacity screening, structured risk stratification, personalised multidomain community-based interventions, and longitudinal follow-up.
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 intercurrent clinical events are reported/identified, prompting in-depth assessment, care plan adjustment, and referral to Community Health Posts, primary care, or specialist services as appropriate.
Prevalence of intrinsic capacity decline at baseline (robust / pre-frail)
Proportion of participants (restricted to robust and pre-frail at baseline) with ≥1 impaired IC domain on screening; and proportion impaired by each domain (mobility, cognition, vitality, psychological, sensory).
Time frame: Baseline
Uptake of recommended actions (implementation effectiveness)
Proportion of participants who initiate at least one recommended action within a defined window after screening/plan (e.g., enrolment in a prescribed community programme, completion of recommended assessment, or attendance at a referred service).
Time frame: Up to 3 months post-recommendation
Identification of (a set of) biomarkers of aging
Both blood biomarkers and digital markers associated with various intrinsic capacity
Time frame: 30 months
Feasibility and reach
Proportion of individuals in each community setting complete both Step 1 and Step 2 assessment.
Time frame: 30 months
Change in intrinsic capacity and function over time
Change in number of impaired IC domains (0-5) from baseline to follow-up.
Time frame: 12 months from enrolment
Frailty progression
Proportion transitioning from robust → pre-frail/frail; pre-frail → frail
Time frame: over 12 months follow up
Cost per participant screened
Programme delivery cost from the provider/programme perspective, calculated as total programme delivery cost divided by the number of participants screened; costs include personnel, training, digital platform/monitoring, screening and assessment delivery, and intervention coordination.
Time frame: 3 years
Number of participants with at least one unscheduled emergency department visit or hospital admission
Number and proportion of participants with at least one unscheduled emergency department visit or unplanned hospital admission during follow-up, based on participant report and/or clinical records where available.
Time frame: 12 months
Implementation outcomes assessed using RE-AIM framework
Reach: Proportion of eligible older adults screened, characteristics of participants. Effectiveness: Proportion of participants with identified IC impairment who receive recommended follow-up actions, including referral to community services, primary care, or multidisciplinary assessment. Adoption: Provider-reported acceptability and perceived usefulness of the screening pathway (measured using an adapted 8-item questionnaire based on the Theoretical Framework of Acceptability (TFA)). Implementation: Adherence to screening protocols among providers, completion of Step 1 and Step 2 assessments, and referral processes. Implementation strategies, barriers, and facilitators will also be documented by qualitative method. Maintenance: Continued delivery of IC screening at participating sites, and Integration of the programme into routine community health services. The 23-item Normalization Measure Development questionnaire (NoMAD) and the 12-item SCIROCCO tool will be used.
Time frame: 3 years
Plan to share: Undecided — It will not be individual level data but rather a group data.
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National University Hospital, Singapore