title: Multiple somatic symptoms and frailty: cross-sectional study in Japanese community-dwelling elderly people.
abstract: Physical frailty is relevant to adverse outcomes, but appropriate procedures for screening populations are lacking. We hypothesized that frailty is associated with multiple somatic symptoms because frail elderly people might have several somatic symptoms attributed to deterioration of multiple organs.
  
  
  
  To examine the association between multiple somatic symptoms and frailty.
  
  
  
  We conducted a cross-sectional study and enrolled 1818 participants aged ≥60 years from Japanese national medical check-up in 2015. Frailty status was categorized into frail, pre-frail or non-frail based on the definition of the Fried frailty phenotype model. Sixteen self-reported subjective somatic symptoms were recorded at the timing of medical check-up. Odds ratio (OR) and 95% confidence interval (CI) of frail or pre-frail were analyzed using number of somatic symptoms.
  
  
  
  Out of total of 1818 subjects, 44 (2.4%) frail subjects, 635 (34.9%) pre-frail subjects and 1139 (62.7%) non-frail subjects were detected. More than two somatic symptoms were significantly associated with the frail phenotype (OR 6.20, 95% CI 2.95, 13.03, P < 0.001) and were associated with the pre-frail phenotype (OR 2.06, 95% CI 1.69, 2.51, P < 0.001). Associations remained significant after multi-adjustment for age, sex, past medical cardiovascular diseases and depressive mood The number of somatic symptoms ≥2 was thought to be the optimal cut-off point to predict frail with a sensitivity of 79.6%, specificity of 61.5%.
  
  
  
  Our study shows that multiple somatic symptoms are independently associated with frailty. Using more than two multiple somatic symptoms as a prescreening tool for frailty may be appropriate.
authors.affiliation: Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Goto, Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki and yamanashi@nagasaki-u.ac.jp.
authors.forename: Hirotomo
authors.initials: H
authors.lastname: Yamanashi
authors.affiliation: Department of Community Medicine and.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shimizu
authors.affiliation: Department of Community Medicine and.
authors.forename: Jun
authors.initials: J
authors.lastname: Koyamatsu
authors.affiliation: Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Goto.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nobuyoshi
authors.affiliation: Department of Community Medicine and.
authors.forename: Mako
authors.initials: M
authors.lastname: Nagayoshi
authors.affiliation: Department of Community Medicine and.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kadota
authors.affiliation: Department of Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Mami
authors.initials: M
authors.lastname: Tamai
authors.affiliation: Department of Island and Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Goto, Department of Community Medicine and.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Maeda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications; D005260:Female; D016330:Frail Elderly / Q000523:psychology / Q000706:statistics & numerical data*; D000073496:Frailty / Q000453:epidemiology*; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D057187:Independent Living; D007564:Japan / Q000453:epidemiology; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D000071896:Medically Unexplained Symptoms; D008875:Middle Aged; D016017:Odds Ratio
keywords: Aging; at-risk groups; community medicine; geriatrics; medically unexplained symptoms; screening.