S Chen1, T Honda, K Narazaki, T Chen, H Kishimoto, S Kumagai. 1. Dr. Shuzo Kumagai, Center for Health Science and Counseling, Kyushu University, 744 Motooka Nishi-ku, Fukuoka, Fukuoka Prefecture 819-0315, Japan, Telephone number: +81 92-802-5112, Fax number: +81 922-802-5112, E-mail: shuzo@ihs.kyushu-u.ac.jp.
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.
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.
Entities:
Keywords:
Physical frailty; elderly; long-term care needs; prospective study
Authors: Rathi Ravindrarajah; David M Lee; Stephen R Pye; Evelien Gielen; Steven Boonen; Dirk Vanderschueren; Neil Pendleton; Joseph D Finn; Abdelouahid Tajar; Matthew D L O'Connell; Kenneth Rockwood; György Bartfai; Felipe F Casanueva; Gianni Forti; Aleksander Giwercman; Thang S Han; Ilpo T Huhtaniemi; Krzysztof Kula; Michael E J Lean; Margus Punab; Frederick C W Wu; Terence W O'Neill Journal: Arch Gerontol Geriatr Date: 2013-07-18 Impact factor: 3.250
Authors: Sanmei Chen; Tao Chen; Takanori Honda; Yu Nofuji; Hiro Kishimoto; Kenji Narazaki Journal: Int J Environ Res Public Health Date: 2022-02-11 Impact factor: 3.390