Predictive Value of Frailty Scores for Healthy Life Expectancy in Community-Dwelling Older Japanese Adults

Objective: Frailty is one of many serious problems in countries with aging populations, such as Japan. The aim of this study was to examine whether higher scores on the newly developed self-report questionnaire for frailty are associated with adults being certified as needing care under the new long-term care insurance (LTCI) service requirement, over 2 years in community-dwelling older Japanese adults.

Design: A prospective cohort study.

Setting and participants: We analyzed the cohort data for older adults (65 years and older) from a prospective study. We followed 5852 older individuals for 2 years and analyzed the association between higher frailty scores at baseline and new LTCI service requirement certifications.

Outcome: The outcome was new certifications for LTCI services in a 2-year period.

Measurements: We developed the 5-item frailty screening index, which included nutrition/shrinking, physical function, physical activity, forgetfulness, and emotions/exhaustion.

Results: The prevalence values for frailty and prefrailty using our frailty screening index were 12.5% and 54.1%, respectively. During the 2-year follow-up period, 2.3% died and 8.5% individuals became newly certified as needing LTCI services. Prefrail older adults (adjusted hazard ratio: 8.4 [95% CI 5.0-14.2]) and frail older adults (adjusted hazard ratio: 22.7 [95% CI 13.3-38.8]) had a significantly higher risk of needing LTCI services than robust older adults as determined by multivariate analyses.

Conclusion: The newly developed 5-item self-report questionnaire for frailty can predict disability in older Japanese adults.