Classification of intrinsic capacity as overall preserved, functionally imbalanced, or overall impaired and associated factors in older patients with chronic obstructive pulmonary disease

Elderly patients with chronic obstructive pulmonary disease (COPD) often have limited respiratory function and multi-system decline. Traditional assessment methods cannot comprehensively reflect their overall functional status, and the characteristics of intrinsic capacity in this population remain unclear. This study aimed to identify latent classes of intrinsic capacity in elderly COPD patients and analyze influencing factors, providing a basis for early clinical identification and precise intervention.

A cross-sectional design was used. From July 2025 to January 2026, 423 elderly COPD patients hospitalized in the Department of Respiratory and Critical Care Medicine, Department of Geriatrics, and Department of Cardiology at the main campus and Binhu campus of Hefei First People’s Hospital were selected by convenience sampling. Face-to-face surveys were conducted using the Intrinsic Capacity Assessment Tool, a general information questionnaire, the Lubben Social Network Scale (LSNS-6), and the Chinese Adult Sedentary Behavior Questionnaire. Latent class analysis was used to identify intrinsic capacity categories, and univariate and multinomial logistic regression were used to analyze influencing factors.

The overall decline rate of intrinsic capacity in elderly COPD patients was 92.9%. Three latent classes were identified: overall preserved (n=145), functionally imbalanced (n=178), and overall impaired (n=100). Significant differences were found among the three groups in sex, age, smoking status, marital status, living arrangement, disease duration, number of comorbidities, medication use, number of hospitalizations for COPD in the past year, long-term home oxygen therapy, mMRC grade, LSNS-6 total score, family network score, friend network score, and total sedentary behavior score (P<0.05). Multinomial logistic regression analysis showed that family network score (OR=0.765, 95%CI: 0.598 to 0.978), friend network score (OR=0.561, 95% CI: 0.442 to 0.712), Chinese Adult Sedentary Behavior Questionnaire total score (OR=1.414, 95%CI: 1.030 to 1.940), age 70 to 79 years (OR=2.788, 95%CI: 1.093 to 7.111), having ≥2 other chronic diseases (OR=6.981, 95%CI: 1.701 to 28.643), long-term home oxygen therapy (OR=3.297, 95%CI: 1.147 to 9.478), and mMRC grade 2 to 4 (OR=4.060, 95%CI: 1.186 to 13.907) were independent influencing factors for the functionally imbalanced group (P<0.05). Family network score (OR=0.716, 95%CI: 0.542 to 0.945), friend network score (OR=0.396, 95%CI: 0.286 to 0.549), Chinese Adult Sedentary Behavior Questionnaire total score (OR=1.586, 95%CI: 1.121 to 2.245), age 70 to 79 years (OR=5.370, 95%CI: 1.400 to 20.598), age ≥80 years (OR=12.169, 95%CI: 2.042 to 72.511), and long-term home oxygen therapy (OR=4.695, 95%CI: 1.345 to 16.391) were independent influencing factors for the overall impaired class (P<0.05).

There is significant heterogeneity in the intrinsic capacity of elderly COPD patients, which can be classified into three latent classes. Social isolation, sedentary behavior, age, number of comorbidities, mMRC grade, and long-term home oxygen therapy are closely associated with intrinsic capacity. It is recommended that intrinsic capacity classification be incorporated into routine assessment for elderly COPD patients, and for those with functionally imbalanced and overall impaired group, comprehensive intervention strategies such as enhancing social support, reducing sedentary behavior, and optimizing oxygen therapy management should be prioritized to delay the decline of intrinsic capacity.