地域在住高齢者のIADLの「実行状況」と「能力」の1年後の変化

Abstract

We examined changes in ability- and performance-based instrumental activities of daily living (IADL) among community-dwelling elderly a year after a baseline survey was taken. Community-dwelling elderly in Otama village were interviewed in 2006 and followed for one year. Based on ability- and performance-based IADL assessments regarding 3 daily tasks from the Kihon Checklist (using public transportation, shopping for daily necessities, and managing bank accounts), each was assigned to one of three performance groups: good, borderline, or low. One year after the survey, the proportion of those assigned to the good performance group decreased, while those assigned to either the borderline or low performance groups increased. Among those assigned to the good performance group, 75.6% remained in that group, 21.1% shifted to the borderline performance group, and 3.3% shifted to the low performance group one year later. Compared to those remaining in the good performance group, those who shifted to the borderline performance group had significantly lower muscular strength, less healthy attitudes, and lower IADL as measured by the Tokyo metropolitan Institute of Gerontology (TMIG) Index of Competence. Fewer elderly were assigned to the good performance group and more were assigned to the borderline and low performance groups one year after the survey. Shifts from the good to borderline performance group were common among those with lower physical status and less healthy attitudes. We conclude that ability- and performance-based evaluations are important tools to screen those in the borderline performance group requiring preventive care.