Intrinsic capacity as an indicator of the risk of depression and anxiety: a prospective cohort study based on the UK Biobank

BackgroundThe World Health Organization has proposed the concept of intrinsic capacity (IC) as a crucial component of healthy aging. Nevertheless, prospective evidence on the association between IC and incident depression and anxiety remains limited.MethodsThis cohort study involved 403,018 participants from the UK Biobank between 2006 and 2010, with 127,431 completing subsequent online follow-ups. We analyzed seven factors reflecting the functional status of four IC domains to calculate a composite IC deficit score. Depression, anxiety and depression/anxiety were assessed using hospital diagnoses and mental health questionnaires. Cox proportional hazards models and logistic regression models were employed to elucidate the relationship between IC deficit scores and the incidence of outcomes.ResultsThe analysis included 18,893 participants with incident depression, 22,320 participants with incident anxiety, and 76,361 participants with incident depression/anxiety, over 12.7 years of follow-up. Participants with an IC score of 4 + had a higher risk of developing depression, anxiety, and depression/anxiety than those with an IC score of 0. The hazard ratios (HRs) [95% confidence intervals (CIs)] were 3.70 (3.48, 3.95), 3.01 (2.84, 3.20), and 3.14 (2.98, 3.32), respectively. The 7-year follow-up mental health questionnaires also confirmed this prospective relationship.ConclusionIn summary, this large prospective cohort study supports a significant association between reduced IC and a higher subsequent risk of incident depression and anxiety. Reduced IC may serve as a useful risk indicator, although further studies are needed to validate its predictive utility and to determine whether interventions targeting IC can improve mental health outcomes.