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
N1 - Funding Information:
Funding and Acknowledgements: This work was partly supported by a Health and Labour Sciences Research Grant of the Ministry of Health, Labour and Welfare of Japan (2013-Ninchisho-Ippan-004) to SK, a research grant from the Mitsui Sumitomo Insurance Welfare Foundation to SC, a grant from Sasaguri Town to SK (2011–2016), and JSPS KAKENHI Grant Number JP17K09146 to KN, JP18K17925 to TH, and JP19K19474 to SC. None of the funding sources had any role in the study design, data analysis, data interpretation, writing of the manuscript, or decision about submission. We would like to thank Ms.Yuka Haeuchi, Dr. Yu Nofuji, Ms. Eri Shiokawa, and the municipal staff in the primary care-giving division in Sasaguri who helped us coordinate the survey in the community.
Publisher Copyright:
© 2019, Serdi and Springer-Verlag International SAS, part of Springer Nature.
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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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 -