Regional Differences in Disability Incidence among Japanese Adults Aged 75 Years and Older: A 4-Year Prospective Cohort Study

Abstract

The present prospective study investigated the regional differences and trajectories of new-onset disabilities among older adults in the districts within a city in Japan. We analyzed data from 5050 Japanese residents aged ≥75 years old (men/women: 2512/2538) who completed the Kihon Checklist (a self-reported questionnaire on frailty) and a questionnaire on medical history and social capital in Ikoma city in 2015. The incidence of disability was determined using the new certification of long-term care insurance and was followed-up on 4 years after the primary outcome. A Cox proportional hazards regression model was used to determine the factors related to the risk of incident disability. During the 4-year follow-up period, 567 participants (11.2%) were newly certified to have a disability. The disability incidence rate ranged from 8.1% to 14.6%, depending on the district. After adjustment for the covariates of: older, women, stroke, prefrail, frail, participation in multiple social activities (hazard ratio [HR] = 0.72, 95% confidence interval [CI] = 0.56–0.91), and one of the districts (HR = 1.67, 95% CI = 1.06–2.61) were significantly associated with disability incidence. The findings of this longitudinal study suggest that there could be a regional difference in disability incidence among older adults in Japan. Thus, community-based approaches should be designed to prevent disability in older adults.

Association between neighborhood walkability and social participation in community‐dwelling older adults in Japan: A cross‐sectional analysis of the keeping active across generations uniting the youth and the aged study

“…Many studies have reported that social participation has a strong relationship with health outcomes such as functional disability 3,4 and mortality 5 . We reported that there were regional differences in disability incidence among districts within a city and social participation preventive effects on disability 6 . Our findings highlight the importance of targeting smaller districts in this study.…”

“…5 We reported that there were regional differences in disability incidence among districts within a city and social participation preventive effects on disability. 6 Our findings highlight the importance of targeting smaller districts in this study.…”

Decrease in the usual walking speed and body fat percentage associated with a deterioration in long-term care insurance certification levels

“…In this study, handgrip strength, usual walking speed, and skeletal muscle mass, which are essential for assessing sarcopenia, showed that a decrease in usual walking speed over time reflected worsening certification levels, with a cutoff value of 0.14 m/s decrease. Previous studies have searched for factors in the occurrence of new LTCI certification by older adults who are not eligible for LTCI or in the deterioration of LTCI levels by institutionalized residents ( Shimada et al, 2023 ; Ashida, Kondo & Kondo, 2016 ; Shimizu, Ide & Kondo, 2023 ; Matsumoto & Takatori, 2021 ; Jin et al, 2018 ). Our study is unique in that it focuses on older adults living “at home” while receiving LTCI services–that is, those whose functional ability is between that of healthy individuals who are not eligible for LTCI and those who live in institutions, and uses changes in LTCI certification levels as the main outcome.…”

“…Previous studies on the factors contributing to LTCI have mainly followed older adults with no applicable LTCI for several years, searching for factors that contribute to the development of new LTCI needs ( Shimada et al, 2023 ; Ashida, Kondo & Kondo, 2016 ; Shimizu, Ide & Kondo, 2023 ; Matsumoto & Takatori, 2021 ). Previous studies analyzing changes in certification levels among LTCI recipients have several limitations regarding the assessment items and target individuals, including analyses focusing solely on basic characteristics ( Kumai & Ikeda, 2021 ; Ohnuma et al, 2016 ), analyses based on several basic characteristics and one functional assessment ( Kamiya et al, 2017 ), analyses combined participants with no applicable LTCI and those who already had LTCI certification ( Kawamura et al, 2021 ), and analyses of institutionalized residents ( Jin et al, 2018 ).…”