Abstract
The present prospective study investigated the regional differences and trajectories of new-onset disabilities among older adults in the districts within a city in Japan. We analyzed data from 5050 Japanese residents aged ≥75 years old (men/women: 2512/2538) who completed the Kihon Checklist (a self-reported questionnaire on frailty) and a questionnaire on medical history and social capital in Ikoma city in 2015. The incidence of disability was determined using the new certification of long-term care insurance and was followed-up on 4 years after the primary outcome. A Cox proportional hazards regression model was used to determine the factors related to the risk of incident disability. During the 4-year follow-up period, 567 participants (11.2%) were newly certified to have a disability. The disability incidence rate ranged from 8.1% to 14.6%, depending on the district. After adjustment for the covariates of: older, women, stroke, prefrail, frail, participation in multiple social activities (hazard ratio [HR] = 0.72, 95% confidence interval [CI] = 0.56–0.91), and one of the districts (HR = 1.67, 95% CI = 1.06–2.61) were significantly associated with disability incidence. The findings of this longitudinal study suggest that there could be a regional difference in disability incidence among older adults in Japan. Thus, community-based approaches should be designed to prevent disability in older adults.
Highlights
Accepted: 21 June 2021By 2050, the worldwide population of individuals aged ≥60 years old is expected to reach 2 billion from the estimated 900 million individuals in 2015
A postal survey was conducted by the community-based integrated care division of Ikoma City using the Kihon Checklist (KCL), which was sent to people over the age of 75 in 2015 who were not certified as requiring long-term care
Compared with those who remained independent, participants who developed disability were older, more often women, lived alone, and had a higher prevalence of hypertension, heart disease, stroke, fracture, and arthritis. Those with incident disability showed a higher risk in all domains of the KCL than those in the independent group at baseline
Summary
By 2050, the worldwide population of individuals aged ≥60 years old is expected to reach 2 billion from the estimated 900 million individuals in 2015. People worldwide are living longer; the pace at which the population is aging is much faster than before [1]. The percentage of the population over the age of 65 was 26.7% in. The percentage of those aged ≥75 years is expected to reach 26.9% in 2060. A major challenge of aging in society is the associated high rate of disability [3,4]; public health action on the prevention of disability is urgently needed in almost all countries. The identification of high-risk groups and areas where people are prone to disability is important for public health and clinical medicine [5]
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