Abstract
Objective: To examine the association between physical frailty and risk of needing long-term care, and compare the predictive value and clinical usefulness of a simple frailty scale (FRAIL) with that of the original Cardiovascular Health Study (CHS) criteria. Design and Setting: A 6-year prospective cohort study of community-dwelling older adults in a west Japanese suburban town. Participants: 1,554 older adults aged 65 years and over who were initially free of long-term care needs at baseline. Measurements: Physical frailty was defined by the CHS criteria and the FRAIL scale. The onset of needing long-term care was ascertained using national records of certification of long-term care needs. Cox proportional hazard models were used to estimate the association between physical frailty and risk of needing long-term care. Decision curve analysis was performed to compare the clinical usefulness of the two physical frailty criteria. Results: During a median follow-up of 5.8 years, 244 were ascertained as needing long-term care. Baseline physical frailty was significantly associated with elevated risk of needing long-term care, with a multivariable-adjusted hazard ratio (HR) of 2.00 (95% confidence interval [CI], 1.32–3.02) for being frail and 1.50 (95% CI, 1.10–2.03) for being pre-frail as defined by the CHS criteria, compared with being robust (p for trend = 0.001). Similar results were found for physical frailty defined by the FRAIL scale, with a multivariable-adjusted HR (95% CIs) of 2.11 (1.25–3.56) for being frail and 1.73 (1.28–2.35) for being pre-frail vs. being robust (p for trend < 0.001). The two physical frailty criteria had similar net benefits in identifying individuals at high risk for needing long-term care. Conclusions: Physical frailty is significantly associated with an increased risk of needing long-term care in community-dwelling older adults in Japan. Compared with the original CHS criteria, the simple FRAIL scale has comparable predictive value and clinical usefulness for identifying individuals at risk for needing long-term care.
| Original language | English |
|---|---|
| Pages (from-to) | 856-861 |
| Number of pages | 6 |
| Journal | Journal of Nutrition, Health and Aging |
| Volume | 23 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - Nov 1 2019 |
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All Science Journal Classification (ASJC) codes
- Medicine (miscellaneous)
- Nutrition and Dietetics
- Geriatrics and Gerontology
Cite this
Physical Frailty and Risk of Needing Long-Term Care in Community-Dwelling Older Adults : A 6-Year Prospective Study in Japan. / Chen, S.; Honda, T.; Narazaki, Kenji; Chen, T.; Kishimoto, H.; Kumagai, Shuzo.
In: Journal of Nutrition, Health and Aging, Vol. 23, No. 9, 01.11.2019, p. 856-861.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Physical Frailty and Risk of Needing Long-Term Care in Community-Dwelling Older Adults
T2 - A 6-Year Prospective Study in Japan
AU - Chen, S.
AU - Honda, T.
AU - Narazaki, Kenji
AU - Chen, T.
AU - Kishimoto, H.
AU - Kumagai, Shuzo
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objective: To examine the association between physical frailty and risk of needing long-term care, and compare the predictive value and clinical usefulness of a simple frailty scale (FRAIL) with that of the original Cardiovascular Health Study (CHS) criteria. Design and Setting: A 6-year prospective cohort study of community-dwelling older adults in a west Japanese suburban town. Participants: 1,554 older adults aged 65 years and over who were initially free of long-term care needs at baseline. Measurements: Physical frailty was defined by the CHS criteria and the FRAIL scale. The onset of needing long-term care was ascertained using national records of certification of long-term care needs. Cox proportional hazard models were used to estimate the association between physical frailty and risk of needing long-term care. Decision curve analysis was performed to compare the clinical usefulness of the two physical frailty criteria. Results: During a median follow-up of 5.8 years, 244 were ascertained as needing long-term care. Baseline physical frailty was significantly associated with elevated risk of needing long-term care, with a multivariable-adjusted hazard ratio (HR) of 2.00 (95% confidence interval [CI], 1.32–3.02) for being frail and 1.50 (95% CI, 1.10–2.03) for being pre-frail as defined by the CHS criteria, compared with being robust (p for trend = 0.001). Similar results were found for physical frailty defined by the FRAIL scale, with a multivariable-adjusted HR (95% CIs) of 2.11 (1.25–3.56) for being frail and 1.73 (1.28–2.35) for being pre-frail vs. being robust (p for trend < 0.001). The two physical frailty criteria had similar net benefits in identifying individuals at high risk for needing long-term care. Conclusions: Physical frailty is significantly associated with an increased risk of needing long-term care in community-dwelling older adults in Japan. Compared with the original CHS criteria, the simple FRAIL scale has comparable predictive value and clinical usefulness for identifying individuals at risk for needing long-term care.
AB - Objective: To examine the association between physical frailty and risk of needing long-term care, and compare the predictive value and clinical usefulness of a simple frailty scale (FRAIL) with that of the original Cardiovascular Health Study (CHS) criteria. Design and Setting: A 6-year prospective cohort study of community-dwelling older adults in a west Japanese suburban town. Participants: 1,554 older adults aged 65 years and over who were initially free of long-term care needs at baseline. Measurements: Physical frailty was defined by the CHS criteria and the FRAIL scale. The onset of needing long-term care was ascertained using national records of certification of long-term care needs. Cox proportional hazard models were used to estimate the association between physical frailty and risk of needing long-term care. Decision curve analysis was performed to compare the clinical usefulness of the two physical frailty criteria. Results: During a median follow-up of 5.8 years, 244 were ascertained as needing long-term care. Baseline physical frailty was significantly associated with elevated risk of needing long-term care, with a multivariable-adjusted hazard ratio (HR) of 2.00 (95% confidence interval [CI], 1.32–3.02) for being frail and 1.50 (95% CI, 1.10–2.03) for being pre-frail as defined by the CHS criteria, compared with being robust (p for trend = 0.001). Similar results were found for physical frailty defined by the FRAIL scale, with a multivariable-adjusted HR (95% CIs) of 2.11 (1.25–3.56) for being frail and 1.73 (1.28–2.35) for being pre-frail vs. being robust (p for trend < 0.001). The two physical frailty criteria had similar net benefits in identifying individuals at high risk for needing long-term care. Conclusions: Physical frailty is significantly associated with an increased risk of needing long-term care in community-dwelling older adults in Japan. Compared with the original CHS criteria, the simple FRAIL scale has comparable predictive value and clinical usefulness for identifying individuals at risk for needing long-term care.
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UR - http://www.scopus.com/inward/citedby.url?scp=85072032206&partnerID=8YFLogxK
U2 - 10.1007/s12603-019-1242-6
DO - 10.1007/s12603-019-1242-6
M3 - Article
C2 - 31641736
AN - SCOPUS:85072032206
VL - 23
SP - 856
EP - 861
JO - Journal of Nutrition, Health and Aging
JF - Journal of Nutrition, Health and Aging
SN - 1279-7707
IS - 9
ER -