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ICOPE Connect
WHO Framework

The ICOPE framework

The WHO Integrated Care for Older People approach provides evidence-based guidance for community-level interventions to manage declines in intrinsic capacity. It shifts the focus from disease-based models to person-centred care that maintains functional ability in older adults.

ICOPE defines a step-by-step pathway: screen for declines, conduct in-depth assessment of flagged domains, create a personalised care plan, and monitor progress over time. ICOPE Connect digitises that entire pathway into a seamless clinical workflow.

Screening

The six ICOPE domains

Each domain represents a key area of intrinsic capacity. Decline in any domain can affect a person's overall functional ability and quality of life.

Cognitive Decline

Recall and orientation

Screened with three-word recall plus orientation in time and place, exactly as set out in the WHO ICOPE screening tool, 2nd edition. Responses score automatically and flagged results prompt in-depth cognitive assessment.

Limited Mobility

Chair-rise test

Screened with the timed chair-rise test: rising from a chair five times without using the arms, measured against the WHO threshold. Results flag fall risk and guide physical activity recommendations.

Malnutrition

Nutrition screen

Screened with the WHO standardised questions on recent unintentional weight loss and loss of appetite. Nutritional status is tracked over time, prompting dietary assessment when responses flag risk.

Hearing Loss

Hearing screen

Screened with the WHO standardised hearing check, including difficulty hearing in conversation and everyday settings. Flagged results prompt referral for audiometric assessment.

Visual Impairment

Vision screen

Screened with the WHO standardised vision check covering difficulty with distance vision, reading, and eye conditions. Patients reporting visual difficulty are flagged for ophthalmological referral.

Depressive Symptoms

PHQ-2 plus safety item

Screened with the two PHQ-2 questions on mood and loss of interest, plus the PHQ-9 self-harm question for safety. A positive safety response is escalated to the care team immediately.

Pathway

The ICOPE care pathway

A structured, evidence-based approach from initial screening to ongoing monitoring.

  1. Step 1

    Community Screening

    Universal screening of older adults in community settings to detect declines in intrinsic capacity. ICOPE Connect enables patient self-screening from any device, removing barriers to early detection. Screening takes roughly 10 to 15 minutes.

  2. Step 2

    Person-Centred Assessment

    In-depth clinical assessment of flagged domains. The clinician reviews detailed scoring, historical comparisons, and AI-generated trend summaries to understand the full picture of the patient capacity.

  3. Step 3

    Personalised Care Plan

    A multi-domain care plan tailored to the individual priorities, preferences, and clinical needs. ICOPE Connect auto-generates care plan drafts from assessment data and supports AI-assisted intervention recommendations.

  4. Step 4

    Monitor and Adjust

    Ongoing monitoring with periodic re-screening to track changes in intrinsic capacity. Longitudinal trend charts visualise progress across all domains, enabling clinicians to adjust care plans based on real trajectory data.

Key references and resources

Official WHO publications and the evidence underpinning the ICOPE framework.

WHO ICOPE Implementation Framework

Integrated care for older people (ICOPE): guidance for person-centred assessment and pathways in primary care.

World Health Organization, Geneva, 2019. ISBN 978-92-4-151489-4. Operational guidance for implementing ICOPE at the primary care level.

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WHO ICOPE Handbook

Integrated care for older people: guidelines on community-level interventions to manage declines in intrinsic capacity.

World Health Organization, Geneva, 2017. The foundational guideline defining evidence-based interventions for each ICOPE domain.

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Decade of Healthy Ageing 2021 to 2030

A global collaboration aligned with the Sustainable Development Goals.

ICOPE is a core component of the WHO strategy for optimising functional ability in older adults.

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Bring ICOPE to your practice

ICOPE Connect digitises the full WHO ICOPE pathway into a clinical workflow that fits your practice.

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