Life-Space Mobility and Frailty in Older Japanese Adults: A Cross-Sectional Study

J Am Med Dir Assoc. 2024 Nov;25(11):105232. doi: 10.1016/j.jamda.2024.105232. Epub 2024 Aug 30.

Abstract

Objectives: Some studies reported a relationship between life-space mobility (LSM) and frailty assessed by physical aspects; however, a more comprehensive discussion of frailty is underdeveloped. In addition, previous studies have focused only on older Euro-American people. Therefore, we aimed to examine LSM-frailty relationships in community-dwelling older Japanese persons using physical and comprehensive frailty indices.

Design: A cross-sectional study.

Setting and participants: We used the data of 8898 older adults from a baseline survey of the Kyoto-Kameoka Study in Japan.

Methods: The validated life-space assessment (LSA) was used to evaluate LSM and categorized it into quartiles. Two validated indices were used to evaluate frailty: the Kihon Checklist (KCL) and the simple Frailty Screening Index (FSI). Multivariable logistic regression was used to determine the relationships between LSM scores and frailty.

Results: The mean age (SD) of the participants was 73.4 (6.3) years, and 53.3% were women. The mean LSM score of the study participants was 53.0. The prevalence of frailty by KCL and FSI was 40.7% and 16.8%, respectively. Significant differences between LSM score and frailty prevalence were observed [KCL: Q1, reference; Q2, odds ratio (OR) 0.53, 95% CI 0.45-0.62; Q3, OR 0.30, 95% CI 0.25-0.35; Q4: OR 0.22, 95% CI 0.18-0.26, P for trend <.001; FSI: Q1, reference; Q2, OR 0.57, 95% CI 0.48-0.68; Q3: OR 0.38, 95% CI 0.31-0.46; Q4: OR 0.35, 95% CI 0.28-0.42, P for trend <.001]. Similar results were observed when LSM scores were examined at 10-point intervals, with LSM and frailty exhibiting an L-shaped relationship. The LSM score dose-response curve at which the OR for frailty plateaued among older individuals was approximately 81-90 score.

Conclusions and implications: LSM score and frailty prevalence exhibited L-shaped relationships in community-dwelling older persons. This study's findings provide useful data for setting LSM targets for preventing frailty in community-dwelling older persons.

Keywords: Frailty; Japanese; Kihon Checklist; frailty screening index; life-space assessment.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • East Asian People
  • Female
  • Frail Elderly* / statistics & numerical data
  • Frailty* / epidemiology
  • Geriatric Assessment* / methods
  • Humans
  • Independent Living
  • Japan / epidemiology
  • Male
  • Mobility Limitation