FrailtySPICENCT07525583
Implementation of Decade of Healthy Ageing Action Plan to Screen and Prevent Decline in Intrinsic Capacity in Elders (SPICE) Through Multisectoral Collaboration in Singapore
An observational study of Frailty and Intrinsic Capacity, run by National University Hospital, Singapore at 1 site in Singapore.
Trial summary
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. Read more about this study
- Who is it for?
- Ages 60 years and olderHealthy volunteers can take part
- Conditions the study is for
- Frailty, Intrinsic Capacity, Lifestyle
- What is being tested?
- ICOPE-Based Digital Intrinsic Capacity Monitoring and Triggered Follow-up (SPICE Pathway)
- How many people
- 2,500 participants
- Where
- 1 siteSingapore
- Study dates
- 1 Apr 2025to 30 Sep 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 60 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Study population: Recruitment will be conducted from Active Ageing Centre and Community Centres.
Who may be able to join
- pre-frail or robust older adults who can provide consent and follow instructions
Who cannot join
- frail or with terminal illness
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Singapore1 site, 1 recruiting
- Recruiting
National University Hospital
Singapore
Sophie Swe Mar Tun, +6589129558, mdcv613@partner.nus.edu.sg
Reshma Merchant, MBChB
About this study
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.
Read the detailed description
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
- Screening using WHO ICOPE Monitor tools. Step 2: In-Depth Assessment
- Participants screening positive for decline undergo structured assessment of affected domains.
Step 3: Risk Stratification \& Care Planning
- Traffic-light classification (low, moderate, high risk) with personalised care plans.
Step 4: Intervention \& Referral
- Multidomain community interventions (exercise, nutrition, cognitive stimulation, psychosocial engagement) or escalation to medical services when required.
Step 5: Monitoring \& Follow-up
- Longitudinal follow-up with repeat IC assessments at defined intervals. The study will evaluate implementation feasibility, prevalence of IC decline, adherence to care pathways, functional outcomes, and cost-effectiveness within a real-world community system.
In addition, blood and digital biomarkers will be collected from a subgroup of study participants.
- Conditions
- Frailty, Intrinsic Capacity, Lifestyle
- Being tested
- ICOPE-Based Digital Intrinsic Capacity Monitoring and Triggered Follow-up (SPICE Pathway)
- Keywords
- intrinsic capacity, personalized intervention, frailty, geroscience
- Medical subject headings
- Frailty
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ICOPE-Based Digital Intrinsic Capacity Monitoring and Triggered Follow-up (SPICE Pathway)Other
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:
- Scheduled follow-up at predefined intervals (e.g., every 3, 6-12 months) for repeat IC assessment and outcome data collection; and
- 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.
| Study group | Role | What they receive |
|---|---|---|
| Screen and Prevent Intrinsic Capacity Decline in Elders (SPICE) | 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. Receives: Other: ICOPE-Based Digital Intrinsic Capacity Monitoring and Triggered Follow-up (SPICE Pathway) |
What is being measured
The primary outcome is the main question the study is designed to answer.
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).
Measured: 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).
Measured: Up to 3 months post-recommendation
Secondary outcomes (7)
Identification of (a set of) biomarkers of aging
Both blood biomarkers and digital markers associated with various intrinsic capacity
Measured: 30 months
Feasibility and reach
Proportion of individuals in each community setting complete both Step 1 and Step 2 assessment.
Measured: 30 months
Change in intrinsic capacity and function over time
Change in number of impaired IC domains (0-5) from baseline to follow-up.
Measured: 12 months from enrolment
Frailty progression
Proportion transitioning from robust → pre-frail/frail; pre-frail → frail
Measured: 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.
Measured: 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.
Measured: 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.
Measured: 3 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Apr 2026
- Study start1 Apr 2025
- Primary completion30 May 2027 (estimated)
- Study completion30 Sep 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for FrailtyStudies of the same condition, open and under way.
- More trials run by National University Hospital, SingaporeThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 2,500 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National University Hospital, Singapore
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07525583
- Sponsor's protocol ID
- NICTran2023-0013
- Other IDs
- NICTran2023-0013
- Acronym
- SPICE
- Status last verified
- Mar 2026
- First submitted
- 3 Mar 2026
- Last updated
- 13 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided: It will not be individual level data but rather a group data.
Study at a glance
From the registry record, last updated by the sponsor on 13 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Implementation of Decade of Healthy Ageing Action Plan to Screen and Prevent Decline in Intrinsic Capacity in Elders (SPICE) Through Multisectoral Collaboration in Singapore
- ClinicalTrials.gov ID
- NCT07525583
- Acronym / sponsor ID
- SPICE / NICTran2023-0013
- Conditions
- Frailty, Intrinsic Capacity, Lifestyle
- Keywords
- intrinsic capacity, personalized intervention, frailty, geroscience
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 2,500 participants (estimated)
- Lead sponsor
- National University Hospital, SingaporeUniversity, hospital or other
- Study start
- 1 Apr 2025 (actual)
- Primary completion
- 30 May 2027 (estimated)
- Study completion
- 30 Sep 2027 (estimated)
- First posted
- 13 Apr 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed description
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
- Screening using WHO ICOPE Monitor tools. Step 2: In-Depth Assessment
- Participants screening positive for decline undergo structured assessment of affected domains.
Step 3: Risk Stratification \& Care Planning
- Traffic-light classification (low, moderate, high risk) with personalised care plans.
Step 4: Intervention \& Referral
- Multidomain community interventions (exercise, nutrition, cognitive stimulation, psychosocial engagement) or escalation to medical services when required.
Step 5: Monitoring \& Follow-up
- Longitudinal follow-up with repeat IC assessments at defined intervals. The study will evaluate implementation feasibility, prevalence of IC decline, adherence to care pathways, functional outcomes, and cost-effectiveness within a real-world community system.
In addition, blood and digital biomarkers will be collected from a subgroup of study participants.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Screen and Prevent Intrinsic Capacity Decline in Elders (SPICE) | – | Other: ICOPE-Based Digital Intrinsic Capacity Monitoring and Triggered Follow-up (SPICE Pathway)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. |
Who may qualify
- Ages
- 60 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
- Study population
- Recruitment will be conducted from Active Ageing Centre and Community Centres.
Key inclusion criteria (1 listed)
- pre-frail or robust older adults who can provide consent and follow instructions
Key exclusion criteria (1 listed)
- frail or with terminal illness
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| 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. | Other | Screen and Prevent Intrinsic Capacity Decline in Elders (SPICE) |
Primary outcome
Prevalence of intrinsic capacity decline at baseline (robust / pre-frail)
Time frame: Baseline
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).
Uptake of recommended actions (implementation effectiveness)
Time frame: Up to 3 months post-recommendation
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).
7 secondary outcomes
Identification of (a set of) biomarkers of aging
Time frame: 30 months
Feasibility and reach
Time frame: 30 months
Change in intrinsic capacity and function over time
Time frame: 12 months from enrolment
Frailty progression
Time frame: over 12 months follow up
Cost per participant screened
Time frame: 3 years
Number of participants with at least one unscheduled emergency department visit or hospital admission
Time frame: 12 months
Implementation outcomes assessed using RE-AIM framework
Time frame: 3 years
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Apr 2026.
- Description of the WHO ICOPE FrameworkLink provided by the sponsor.
- Individual participant dataSharing planned: Undecided. It will not be individual level data but rather a group data.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Frailty and Intrinsic Capacity, run by National University Hospital, Singapore at 1 site in Singapore.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 13 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Reshma Merchant (Associate Professor), MBChB (Edin) (+6567724368, mdcram@nus.edu.sg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Prevalence of intrinsic capacity decline at baseline (robust / pre-frail) (time frame: Baseline). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Apr 2026.