title: Performance-based assessments and demand for personal care in older Japanese people: a cross-sectional study.
abstract: OBJECTIVE
  To identify appropriate clinical tests for determining the demand for personal care in older Japanese people.
  
  
  METHODS
  Cross-sectional observation study.
  
  
  METHODS
  Obu Study of Health Promotion for the Elderly (Obu, Aichi) and Tsukui Ordered Useful Care for Health (241 day-care centres) cohorts in Japan.
  
  
  METHODS
  A total of 10 351 individuals aged 65 years or older (6791 with personal care and 3560 without personal care) participated in the study.
  
  
  METHODS
  Physical performance tests included grip strength, the chair stand test, walking speed at a comfortable pace, and the timed up-and-go test. Personal care was defined as participants who had been certified in the national social long-term care insurance in Japan.
  
  
  RESULTS
  Individuals who received personal care showed a significantly poorer performance than those without personal care for all physical performance tests (p<0.001). Gait speed was the most useful of the physical performance tests to determine the demand for personal care (receiver operating characteristic curve statistics: men, 0.92; women, 0.94; sensitivity: men, 86; women, 90; specificity: men, 85; women, 85). After adjustment for age, sex, cognitive impairment and other physical tests, all physical performance tests were individually associated with the demand for personal care. A slow gait speed (<1 m/s) was more strongly correlated with the demand for personal care than other performance measures (gait speed OR: 5.9; 95% CI: 5.0 to 6.9).
  
  
  CONCLUSIONS
  Clinical tests of physical performance are associated with the demand for personal care in older people. Preventive strategies to maintain physical independence may be required in older adults who show a gait speed slower than 1 m/s. Further research is necessary to confirm these preliminary results.
authors.affiliation: Section of Health Promotion, Department of Support for Independence, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimada
authors.forename: Takao
authors.initials: T
authors.lastname: Suzuki
authors.forename: Megumi
authors.initials: M
authors.lastname: Suzukawa
authors.forename: Hyuma
authors.initials: H
authors.lastname: Makizako
authors.forename: Takehiko
authors.initials: T
authors.lastname: Doi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoshida
authors.forename: Kota
authors.initials: K
authors.lastname: Tsutsumimoto
authors.forename: Yuya
authors.initials: Y
authors.lastname: Anan
authors.forename: Kazuki
authors.initials: K
authors.lastname: Uemura
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ito
authors.forename: Sangyoon
authors.initials: S
authors.lastname: Lee
authors.forename: Hyuntae
authors.initials: H
authors.lastname: Park