A senior citizen contemplates the multifaceted aspects of their well-being.

ICECAP-O: Is This the Key to Better Care for Seniors?

Kai Mendoza in Health & Wellness July 2025 • 4 min read.

"New UK research questions how well a popular quality of life measure truly captures the health of older adults."

As the global population ages, ensuring the well-being of older adults becomes increasingly critical. Economic evaluations play a vital role in determining the effectiveness of care services, helping to allocate resources where they'll have the greatest impact. One such evaluation measure is the ICECAP-O (ICEpop CAPability measure for Older people), designed to assess the quality of life and well-being of seniors.

However, questions have arisen regarding the ICECAP-O's ability to fully capture the multifaceted nature of health, particularly physical health, as it doesn't directly ask seniors about their health status. Does it adequately reflect the nuances of older adults' well-being, or are important aspects being overlooked?

A recent study from the UK delves into this very issue, examining how well the ICECAP-O covers the physical, mental, and social functioning of older adults. The findings have important implications for how we evaluate care services and ensure they truly meet the needs of our aging population.

Unpacking ICECAP-O: What Does It Really Measure?

A senior citizen contemplates the multifaceted aspects of their well-being.

The UK study, published in Quality of Life Research, used exploratory factor analysis (EFA) to assess the overlap between the ICECAP-O and the EQ-5D-5L, a more traditional health measure. Researchers analyzed data from 516 participants aged 70 and older, exploring how the different measures correlated with physical, mental, and social functioning.

The results revealed a fascinating, and potentially concerning, picture:

Limited Overlap: The ICECAP-O and EQ-5D-5L items largely loaded on separate factors, indicating they capture different underlying constructs.
Mental and Social Strengths: The ICECAP-O demonstrated strong correlations with mental and social functioning measures, and it could differentiate between individuals with varying scores in these areas.
Physical Functioning Gap: The correlation between the ICECAP-O and the Barthel Index, a measure of physical functioning, was only moderate, suggesting the ICECAP-O might not fully capture this crucial aspect of health.

These findings suggest that while the ICECAP-O effectively assesses mental and social well-being, it may fall short in comprehensively reflecting the physical health of older adults. This raises concerns about its use as a sole measure in economic evaluations of care services.

The Future of Senior Care Evaluation: A More Holistic Approach

The study's authors recommend that a complementary health measure should be used alongside the ICECAP-O to capture the full spectrum of benefits from care interventions for older people. Relying solely on the ICECAP-O may lead to an incomplete or even skewed understanding of an intervention's true impact.

This research underscores the importance of adopting a more holistic approach to evaluating care services for seniors. By considering both capability well-being (as measured by ICECAP-O) and direct health measures, we can gain a more accurate and comprehensive understanding of the effectiveness of different interventions.

Ultimately, this will enable better-informed decisions about resource allocation and ensure that care services are truly meeting the diverse needs of our aging population, leading to improved quality of life and well-being for all seniors.

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This article is based on research published under:

DOI-LINK: 10.1007/s11136-018-2042-x, Alternate LINK

Title: Does The Icecap-O Cover The Physical, Mental And Social Functioning Of Older People In The Uk?

Subject: Public Health, Environmental and Occupational Health

Journal: Quality of Life Research

Publisher: Springer Science and Business Media LLC

Authors: Mariska Q. N. Hackert, Job Van Exel, Werner B. F. Brouwer

Published: 2018-11-11

Everything You Need To Know

What exactly is the ICECAP-O, and what does it aim to measure in older adults?

The ICECAP-O (ICEpop CAPability measure for Older people) is a tool designed to evaluate the quality of life and well-being specifically in older adults. It's used to assess the impact of care services and inform resource allocation by measuring a senior's capabilities across different dimensions, such as attachment, security, role, enjoyment, and control. However, a recent study suggests it might not fully capture physical health aspects, focusing more on mental and social well-being.

According to the UK study, what are the main limitations of using the ICECAP-O to assess the health of older adults?

The study revealed that while the ICECAP-O effectively measures mental and social functioning, its correlation with physical health measures, such as the Barthel Index, is only moderate. This suggests that ICECAP-O might not fully reflect the physical capabilities and limitations of older adults. The research also found that ICECAP-O and EQ-5D-5L capture different underlying constructs, emphasizing the potential for a gap in assessing overall health when relying solely on ICECAP-O.

What are the potential consequences of relying solely on the ICECAP-O in economic evaluations of care services for seniors?

If the ICECAP-O is the only measure used, economic evaluations of care services for seniors may not accurately reflect the impact of those services on their physical health. This could lead to an incomplete or skewed understanding of an intervention's true impact, potentially resulting in misallocation of resources and a failure to address critical physical health needs. Ignoring physical health factors could undervalue interventions that improve mobility, reduce pain, or enhance physical independence.

What solution do the study's authors propose to address the limitations of the ICECAP-O in evaluating senior care?

The researchers suggest combining the ICECAP-O with a complementary health measure to provide a more holistic evaluation of care interventions for older people. By incorporating a measure that specifically assesses physical health, such as the EQ-5D-5L or the Barthel Index, it's possible to gain a more complete understanding of the benefits of care, ensuring that both physical and mental/social well-being are adequately addressed. This combined approach would offer a more balanced and accurate assessment for better decision-making in senior care.

How does the ICECAP-O's focus on 'capability' affect its ability to comprehensively assess the health of older adults?

The ICECAP-O focuses on 'capability' – what a person is able to do or be – rather than directly assessing their health status. This approach prioritizes an individual's potential and opportunities for well-being, but this also raises a concern that it might not fully capture the actual physical health conditions experienced by older adults. While capability is vital, the absence of direct health questions could lead to overlooking important health-related challenges and needs. This highlights a need for an approach to include direct measures of health when evaluating care for seniors.