Incidence of Disability in Frail Older Persons With or Without Slow Walking Speed

Abstract

Objective: To identify the differences of incidence of disability between frail older persons with and without slow walking speed.

Design: Prospective cohort study.

Setting: Japanese community.

Participants: A total of l4,081 older adults aged ≥65 years living in the community, participated in a baseline assessment and were followed for incidence of disability for 29.5 months.

Measurements: Care-needs certification in the national long-term care insurance system of Japan, physical frailty (slow walking speed, muscle weakness, exhaustion, low activity, weight loss), adjusted for several potential confounders such as demographic characteristics; Kaplan-Meier survival curves for incident disability by physical frailty with and without slow walking speed.

Results: During the follow-up period, 198 participants (4.9%) were certified as requiring long-term care insurance in accordance with incident disability. Participants who had prefrailty without slow walking speed (hazard ratio 1.86, 95% confidence interval 1.19-2.92), prefrailty with slow walking speed (3.62, 2.19-5.96), frailty without slow walking speed (4.33, 2.00-9.39), and frailty with slow walking speed (4.68, 2.72-8.05) at the baseline assessment had an increased risk of incident disability compared with nonfrail participants. In stratified analyses, frail older men and frail participants with low cognitive performance had the highest risk of incidence of disability.

Conclusion: The presence of frailty or even prefrailty when older adults showed slow walking speed increased the risk of future disability in community-dwelling older adults.

Keywords: Frailty; activities of daily living; aged; gait; physical performance.