Background: Several cross-sectional and short-term follow-up studies have reported that physical function is associated with disability and long-term care. However, little information is available on the relationship between physical function and risk of long-term care with long follow-up studies in Japan.
Purpose: The aim of the study was to examine the association between physical function and the risk of incident long-term care in community-dwelling nondisabled older people.
Methods: The subjects in this study included 159 men and 316 women, age 60 and over, living independently in a community. These subjects were assessed during the years from 2000 to 2006. Eight physical fitness performance tests consisting of upper limb strength, whole-body locomotion, and change of posture were measured at baseline. In addition, self-reported questionnaires including exercise habits, health status, visits to hospital, and so on were filled out. Multivariate Cox proportional hazards regression was used to model the relationship between six physical fitness performance tests (hand grip, arm curl, stand-up from lying position, functional reach, walking around two cones in a figure 8, and chair stand) at baseline and incident long-term care during the 6-year follow-up period.
Results: Twenty subjects (7 men and 13 women) started requiring long-term care during the 6-year follow-up period. At baseline, the eventual long-term care users were older and lower in physical fitness and had a greater frequency of going to hospital regularly than nondisabled subjects. However, no significant difference existed in exercise habituation and health-related quality of life between the two groups. In a proportional hazards model adjusted for age and sex, low scores in stand-up from a lying position predicted approximately twice the risk for eventually needing long-term care (hazard ratio = 1.81, 95% confidence interval = 1.28-2.55, <.001).
Conclusions: Stand-up from a lying position at baseline was found to be associated with a greater risk of long-term care among nondisabled older Japanese during the 6-year follow-up. Further investigations are needed to describe the association between the influence of the condition of a disease and incident long-term care during follow-up.