Association between physical function and long-term care in community-dwelling older and oldest people: the SONIC study

Werayuth Srithumsuk,Mai Kabayama,Koichi Yamamoto,Yasushi Takeya,Nonglak Klinpudtan,Hiroshi Akasaka,Hiroshi Shimokata,Yukie Masui,Saori Yasumoto,Yoichi Takami,Tatsuro Ishizaki,Yasumichi Arai,Hiromi Rakugi,Yasuyuki Gondo,Ken Sugimoto,Kayo Godai,Kei Kamide

doi:10.1186/s12199-020-00884-3

Abstract

BackgroundPreventing the need for long-term care (LTC) by identifying physical function risk factors are important to decrease the LTC burden. The objective of this study was to investigate whether grip strength and/or walking speed, which are components of the frailty definition, are associated with LTC in community-dwelling older and oldest people.MethodsThe participants were 1098 community-dwelling older and oldest people who had not received LTC at the baseline. The endpoint was receiving LTC after the baseline survey. The independent variables were grip strength and walking speed, and participants were divided into two groups based on these variables. The confounding factors were age, sex, the Japanese version of the Montreal Cognitive Assessment (MoCA-J), hypertension, diabetes mellitus, stroke, joint diseases, living alone, body mass index, and serum albumin. We calculated the hazard ratio of receiving LTC using the Cox proportional hazard model.ResultsAmong the 1098 participants, 107 (9.7%) newly received LTC during the follow-up. Regarding the physical function, only slow walking speed was significantly correlated with LTC after adjusting for all confounding factors except the MoCA-J score (HR = 1.74, 95% CI = 1.10–2.75, P = .018). However, slow walking speed was still a risk factor for LTC after adjusting for the MoCA-J score and other confounding factors (HR = 1.64, 95% CI = 1.03–2.60, P = .037).ConclusionsThe findings from this study may contribute to a better understanding of slow walking speed as a factor related to LTC, which might be a criterion for disability prevention and could serve as an outcome measure for physical function in older people.

Highlights

Preventing the need for long-term care (LTC) by identifying physical function risk factors are important to decrease the LTC burden
Fried et al [7] proposed the phenotype model, which measures frailty using the components of the Cardiovascular Health Study (CHS) to describe the age-related decline in physical capacities based on the following criteria: (1) unintentional weight loss, (2) self-reported exhaustion, (3) low grip strength, (4) low physical activity, and (5) slow walking speed
In a study by Lee et al [10], it was demonstrated that the combined use of grip strength and walking speed was accurate, precise, specific, and more sensitive for the Fried frailty phenotype than other possible combinations and suggested that these measures could be applied in a primary care setting

Summary

Introduction

Preventing the need for long-term care (LTC) by identifying physical function risk factors are important to decrease the LTC burden. Fried et al [7] proposed the phenotype model, which measures frailty using the components of the Cardiovascular Health Study (CHS) to describe the age-related decline in physical capacities based on the following criteria: (1) unintentional weight loss, (2) self-reported exhaustion, (3) low grip strength, (4) low physical activity, and (5) slow walking speed. According to this model, the presence of three or more indicates frailty with regard to Japan; Satake et al [8] advocated a Japanese version of CHS (J-CHS) criteria, which can identify frailty. Grip strength and walking speed measurements do not require special equipment, they are not time-consuming or intrusive, and they are helpful in making decisions about interventions and care allocation [11]

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