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

Abstract

Background: Preventing 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. Methods: The 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. Results: Among 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). Conclusions: The 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.

Low Physical Performance Could Be Associated with Adverse Health Outcomes over Time: Results from a Cohort of Older Adults

“…In our study, PP assessed by both the GS and TUG at baseline increased the risk of physical disability, with similar practical results (PR = 1.60 and PR = 1.57, respectively), which coincides with previous studies on community-dwelling older adults [ 44 , 45 , 46 , 47 , 49 , 50 ]. Impairments in performing ADLs can be understood as a consequence of a decline in PP.…”

“…However, PP tests were not associated with a NHSP or the number of consultations with health professionals. Low PP is widely recognized as a risk factor for adverse health outcomes, including disability, falls, and hospitalization among community-dwelling older adults in Brazil [ 12 ], United States [ 6 , 15 ], Australia [ 27 ], Japan [ 44 , 45 , 46 , 47 ], Korea [ 48 ], and European countries [ 49 , 50 ], in agreement with our findings. PP integrates different physiological systems (cardiac, respiratory, and neuromuscular) in coordinated and efficient movements, reflecting the function of the entire body, and is objectively measured in relation to the individual’s ability to move [ 51 ].…”

Relationship between walking speed, respiratory muscle strength, and dynamic balance in community-dwelling older people who required long-term care or support and used a daycare center

“…Walking speed declines approximately 10 years before death, leading to basic/instrumental ADL limitations later in life ( Sabia et al, 2014 ). Because of the decline in walking speed, older people who need long-term care or support may be reluctant to leave home and engage in social activities ( Busch et al, 2015 ; Srithumsuk et al, 2020 ; Kuys et al, 2014 ). This leads to social isolation and physical activity limitations, decreasing quality of life and increasing the likelihood of premature death ( Studenski et al, 2011 ; Lyons et al, 2016 ; Kuang, Huisingh-Scheetz & Miller, 2023 ).…”

Long-term participation in community-based group resistance exercises delays the transition from robustness to frailty in older adults: a retrospective cohort study

“…Previous research reported that resistance training increased strength and gait speed in frail adults [ 21 ]. Another study found that gait speed could be a useful indicator to classify older people at high risk of requiring long-term care [ 22 ]. Community-based initiatives where older people proactively gather together and exercise in their neighborhoods have been shown to delay functional decline associated with aging, which should motivate the government, older individuals, and their families to work on long-term care prevention.…”