Assessment of vulnerable older adults¡¯ physical function according to the Japanese Long-Term Care Insurance (LTCI) system and Fried's criteria for frailty syndrome
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- 作者：Miyuki Nemoto ; Noriko Yabushita ; Mi-ji Kim ; Tomoaki Matsuo ; Satoshi Seino ; Kiyoji Tanaka
- 关键词：Physical function ; Frailty ; Vulnerable older adults ; Japanese LTCI system ; Fried's definition
- 刊名：Archives of Gerontology and Geriatrics
- 出版年：2012
- 出版时间：September-October, 2012
- 年：2012
- 卷：55
- 期：2
- 页码：385-391
- 全文大小：286 K
文摘
This study aimed to evaluate the physical frailty status of vulnerable older adults as classified in the Japanese LTCI system and to compare this with Fried's definition. A total of 444 older adults were classified based on the LTCI system as independent, vulnerable, or dependent, and 400 of these participants also fit Fried's criteria for not frail, pre-frail or frail. We evaluated their physical function with a 12 item physical function test. We derived a physical function score (PFS) from these 12 items and a principal component analysis was used to make comparisons. The receiver operating characteristic (ROC) curve analysis was performed to identify the sensitivity and specificity of the PFS cut-off points to distinguish the dependent category from the other categories. We found significant differences and a hierarchical order for the PFSs among the three groups of the LTCI system (the independent, 0.41 ¡À 0.54; the vulnerable, ?0.40 ¡À 0.76; and the dependent, ?1.49 ¡À 0.73) and of Fried's definition (not frail, 0.50 ¡À 0.51; pre frail, ?0.11 ¡À 0.63; and frail, ?1.25 ¡À 0.98). The optimal cut-off value (OCV) was ?0.593. This study showed that the range of physical function of people considered frail category (pre-frail, vulnerable, and frail) is wide and overlapping. That is, the physical function of vulnerable older adults is worse than the pre-frail, but better than the frail. To better recognize older adults in need of greater support, the vulnerable should also receive assessment of their frailty status according to Fried's definition.