Intrinsic Capacity and Instrumental Activity of Daily Living Among Community Dwelling Elderly in China: The Mediating Effect of Two-Way Social Support and Sense of Coherence.

Objectives: To explore the influence of intrinsic capacity (IC) on instrumental activities of daily living (IADL) among community-dwelling elderly and to analyze the chain-mediated effects of two-way social support, and sense of coherence (SOC).

Design: This study was a cross-sectional research design. Participants were recruited from September 2023 to December 2023 from Hangzhou City, Zhejiang Province, China, using a multistage sampling method.

Sample: Participants in this study were at least 60 years old and had been currently living in the community for at least 1 year (n = 458).

Measurements: The Integrated Care for Older People screening tool, the Brief Two-Way Social Support Scale, the Sense of Coherence Scale-13, and the Functional Activities Questionnaire were used to collect relevant data, which were statistically tested using structural equation modeling and multiple mediation effects.

Results: There were correlations between IC, two-way social support, SOC and IADL in community-dwelling elderly (all p < 0.01). IC predicted two-way social support (β = 0.570, p < 0.001), SOC (β = 0.544, p < 0.001) and IADL (β = -0.492, p < 0.001); two-way social support had a positive predictive effect on SOC (β = 0.363, p < 0.001) but a negative predictive effect on IADL (β = -0.193, p < 0.001); SOC negatively predicted IADL (β = -0.150, p < 0.05).

Conclusions: To mitigate the impact of declining IC on IADL among community-dwelling elderly, to sustain independent living, and to reduce the risk of progression to illness and disability, this study proposes two-way social support and SOC as potential effective intervention targets. This conclusion holds implications for the assessment and intervention of elderly health, as well as the formulation of public health policies.