Risk factors for disability progression among Japanese long-term care service users: A 3-year prospective cohort study.
OBJECTIVE
To examine the predictive ability of memory deterioration and grip strength for disability progression among those who utilized the home-help service.


METHODS
We prospectively followed a cohort of community-dwelling older people who were aged 65 years or older, certified support level 1-2 or care level 1-2 and home-help service users provided by Consumers' Cooperatives in Aichi and Kanagawa prefecture. Memory capability, grip strength, chronic conditions and other indices were surveyed at baseline. Disability progression was defined as being certified care level 3 or higher, or institutionalization during 3-year follow up.


RESULTS
We assessed 417 older adults, of which 386 were included (7.4% excluded). In multivariate Cox regression analyses, a higher eligibility level and memory deterioration were independently associated with a higher hazard ratio. When chronic conditions were entered in the model, cancer and low grip strength were additionally associated.


CONCLUSIONS
The findings of the present study show that memory deterioration is a risk factor for disability progression. Also, grip strength might be a risk factor with consideration of chronic conditions. The cause-effect relationship of those factors and disability progression would be a future challenging issue. Geriatr Gerontol Int 2017; 17: 568-574.
Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Kuniyasu
K
Kamiya
Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Takuji
T
Adachi
Welfare Department, CO-OP AICHI Consumer Co-operative Society, Toyokawa, Japan.
Kenji
K
Sasou
Welfare Department, U CO-OP Consumer Co-operative Society, Yokohama, Japan.
Tadashi
T
Suzuki
Department of Rehabilitation Science, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Sumio
S
Yamada
D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D018737:Hand Strength; D006304:Health Status; D006699:Home Care Services; D006801:Humans; D057187:Independent Living; D007564:Japan; D008134:Long-Term Care; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
chronic conditions; disability; grip strength; long-term care; memory impairment