Association between the 25-question Geriatric Locomotive Function Scale score and the incidence of certified need of care in the long-term care insurance system: The TOEI study

Abstract

Background: The Geriatric Locomotive Function Scale is a screening tool to identify the risk of locomotive syndrome in the elderly. We aimed to clarify the association of Geriatric Locomotive Function Scale scores with the incidence of certified need of care in the long-term care insurance system in a prospective longitudinal observational study (the TOEI Study).

Methods: Participants were individuals aged ≥50 years from a mountainous area who had undergone medical check-ups by the National Health Insurance in Toei. The Geriatric Locomotive Function Scale questionnaire, physical performance tests, and radiographs were completed by participants. The primary endpoint was the incidence of certified need of care in the long-term care insurance system. The secondary endpoint was the incidence of either one of the following events: certified need of care or death.

Results: We enrolled 681 subjects (271 men and 410 women). The mean age was 72.9 (range, 50-92) years. The incidences of certified need of care and either one of the two events were 104 and 130, respectively, during the average 4.9-year follow-up. The cumulative incidence rates of certified need of care by groups of the Geriatric Locomotive Function Scale, namely, Group 0 (score 0-6), Group 1 (score 7-15), and Group 2 (score 16-) were 7.5%, 14%, and 35%, respectively. The cumulative incidence rates of either one of the two events by group were 11%, 18%, and 39%, respectively. There was a significant association between higher Geriatric Locomotive Function Scale scores and survival rates (not achieved at each endpoint) for the primary and secondary endpoints.

Conclusions: Higher Geriatric Locomotive Function Scale score was associated with greater incidence of certified need of care in the long-term care insurance system as well as either one of the two aforementioned events. This scale might enable prediction of prognosis among elderly patients.