Assessment of vulnerable older adults%26apos; physical function according to the Japanese Long-Term Care Insurance (LTCI) system and Fried%26apos;s criteria for frailty syndrome

作者：Nemoto Miyuki^*; Yabushita Noriko; Kim Mi ji; Matsuo Tomoaki; Seino Satoshi; Tanaka Kiyoji

来源：Archives of Gerontology and Geriatrics, 2012, 55(2): 385-391.

DOI：10.1016/j.archger.2011.10.004

• Physical function
• Frailty
• Vulnerable older adults
• Japanese LTCI system
• Fried%26apos
• s definition

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%26apos;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%26apos;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 +/- 0.54; the vulnerable, -0.40 +/- 0.76; and the dependent, -1.49 +/- 0.73) and of Fried%26apos;s definition (not frail, 0.50 +/- 0.51; pre frail, -0.11 +/- 0.63; and frail, -1.25 +/- 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%26apos;s definition.

• 出版日期2012-10