Mobility performance among healthy older adults eligible for long-term care in Japan: a prospective observational study

Otsuka, Hiromasa; Kobayashi, Hiroki; Suzuki, Katsushi; Hayashi, Yuta; Ikeda, Jin; Kushimoto, Masaru; Omoto, Wataru; Hara, Masaaki; Abe, Masanori; Kato, Kimitoshi; Soma, Masayoshi

doi:10.1007/s40520-019-01404-2

Cited by 9 publications

(5 citation statements)

References 31 publications

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“…Our findings of associations between physical functions and risk of functional disability are generally consistent with a limited number of Japanese cohort studies of usual or maximum gait speed [24,37,38], one-leg standing time [39], and handgrip strength [37,40], which assessed functional disability using the LTCI system. Although no significant association of one-leg standing time [24] or handgrip strength [39] with functional disability was reported, the relatively small sample sizes (n = 60 to 784) and short follow-up periods (5-6 years) may have limited the statistical power in these two earlier studies.…”

Section: Discussionsupporting

confidence: 87%

Potential utility of physical function measures to improve the risk prediction of functional disability in community-dwelling older Japanese adults: a prospective study

et al. 2021

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Background While gait speed, one-leg standing balance, and handgrip strength have been shown to be independent predictors for functional disability, it is unclear whether such simple measures of physical function contribute to improved risk prediction of functional disability in older adults. Methods A total of 1,591 adults aged ≥ 65 years and without functional disability at baseline were followed up for up to 7.9 years. Functional disability was identified using the database of Japan’s Long-term Care Insurance System. Maximum gait speed, one-leg standing time, and handgrip strength were measured at baseline. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association of physical function and functional disability incidence. The incremental predictive value of each physical function measure for risk prediction was quantified using the difference in overall C-statistic, category-free net reclassification improvement (NRI), and integrated discrimination improvement (IDI) index. Results During follow-up (median: 7.8 years), functional disability was identified in 384 participants. All of the physical function measures were inversely associated with the risk of functional disability, independent of potential confounding factors. The multivariable adjusted HRs (95 % CIs) for functional disability per one standard deviation increment of maximum gait speed, one-leg-standing time, and hand grip strength were 0.73 (0.65–0.83), 0.68 (0.59–0.79), and 0.72 (0.59–0.86), respectively. Incorporation of each of maximum gait speed, one-leg-stand time, and hand grip strength into a basic model with other risk factors significantly improved C-statistic from 0.770 (95 % CIs, 0.751–0.794) to 0.778 (0.759–0.803), 0.782 (0.760–0.805), and 0.775 (0.756–0.800), respectively (all p < 0.05). A model including all three measures had the highest C-statistic of 0.787 (0.765–0.810). The improvements in risk prediction were also confirmed by category-free NRI and IDI index. Conclusions Adding any of the three measures to a basic model with other known risk factors significantly improved the prediction of functional disability and addition of all three measures provided further improvement of the prediction in older Japanese adults. These data provide robust evidence to support the practical utility of incorporating these simple physical function measures into functional disability risk prediction tools.

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Section: Discussionsupporting

confidence: 87%

Potential utility of physical function measures to improve the risk prediction of functional disability in community-dwelling older Japanese adults: a prospective study

et al. 2021

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“…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.…”

Section: Discussionsupporting

confidence: 91%

“…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 ].…”

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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

Gomes,

Santos,

Vieira

et al. 2024

IJERPH

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A few studies on physical performance (PP) decline among community-dwelling older adults have simultaneously evaluated various outcomes in Brazil. This longitudinal cohort study aimed to verify the association between PP and health outcomes (negative health self-perception—NHSP; consultations with health professionals; disability; falls; and hospitalization) in older Brazilians (N = 476, 68 ± 6.7 years). PP assessments included Gait Speed (GS) and Timed Up and Go (TUG) tests, and changes were evaluated over time (2014 to 2019–2020). The association between the PP and the outcomes was estimated using Poisson’s regression with robust variance. The physical tests were not associated with NSPH or with the number of consultations with health professionals. However, after adjustment (economic level, diet quality, physical activity, multimorbidity, depression, polypharmacy, and BMI), low PP at baseline (TUG and GS) was associated with disability at follow-up. A low TUG performance at baseline was also associated with subsequent falls (PR = 1.57, p = 0.007). A decline in GS was associated with hospitalization (PR = 1.86, p = 0.033). PP was associated with disability, falls, and hospitalization over a five- to six-year period in older Brazilians. Regular PP assessments should be conducted and low PP should be used as an indicator of the need for preventative measures to avoid poor health outcomes.

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“…Motor function was mainly measured objectively and included assessments of grip strength [ 12 , 13 ], knee extension torque [ 12 ], usual gait speed (6-m walk) [ 12 ], chair stand time [ 12 ], muscle dysfunction [ 12 , 14 ], the timed up and go (TUG) test [ 13 ], and one-leg standing time with eyes open [ 14 ].…”

Section: Resultsmentioning

confidence: 99%

Risk Factors of Long-Term Care Insurance Certification in Japan: A Scoping Review

Takahashi

Yonekura

Takanashi

et al. 2022

IJERPH

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This study aimed to review evidence on future long-term care associated with pre-existing factors among community-dwelling Japanese older adults. We systematically searched cohort and nested case–control studies published between 2000 and 2019 that assessed long-term care certification using the PubMed, CINAHL, and EMBASE databases. The relationship between long-term care insurance information and risk factors was investigated. The protocol was registered with the Open Science Framework. We extracted 91 studies for synthesis, including 84 prospective cohort studies, 1 retrospective cohort study, and 6 nested case–control studies. Certification for long-term care was classified into two endpoints: onset of functional disability and dementia. There were 72 studies that used long-term care certification as a proxy for functional disability, and 22 used long-term care information to indicate the onset of dementia. Common risk factors related to functional disability were physical function, frailty, and oral condition. Motor function and nutritional status were common risk factors for dementia. We found consistent associations between premorbid risk factors and functional disability and dementia. The accumulation of evidence on the incidence of long-term care and associated factors can aid the development of preventive measures. Future studies should aim to integrate this evidence.

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Mobility performance among healthy older adults eligible for long-term care in Japan: a prospective observational study

Cited by 9 publications

References 31 publications

Potential utility of physical function measures to improve the risk prediction of functional disability in community-dwelling older Japanese adults: a prospective study

Potential utility of physical function measures to improve the risk prediction of functional disability in community-dwelling older Japanese adults: a prospective study

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

Risk Factors of Long-Term Care Insurance Certification in Japan: A Scoping Review

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