Early strong predictors of decline in instrumental activities of daily living in community-dwelling older Japanese people
by Yohei Masugi, Hisashi Kawai, Manami Ejiri, Hirohiko Hirano, Yoshinori Fujiwara, Tomoki Tanaka, Katsuya Iijima, Takashi Inomata, Shuichi P. Obuchi
ObjectiveOur aim is to determine the strong predictors of the onset of instrumental activities of daily living (IADL) decline in community-dwelling older people.
DesignA prospective cohort study with a two-year follow-up.
SettingKashiwa City, Chiba Prefecture, Japan and Toshima Ward, Tokyo Metropolitan, Japan.
ParticipantsThe data were acquired from two cohorts. The final sample comprised 1,523 community-dwelling older people aged 65–94 years (681 men, 842 women). They were individuals who were independent in IADL at baseline and participated in follow-up IADL assessments two years later.
MeasurementsAt baseline, comprehensive assessments were performed including: health interview, gait function, hand-grip strength, skeletal muscle mass, balance function, oral function, dietary lifestyle, cognitive function, quality of life, mental status, and social network. When the two-year follow-up was performed, IADL declines were observed in 53 out of 1,523 people. The association of each Z-transformed parameter with the occurrence of IADL decline was examined by employing a binominal logistic regression model adjusting for age, gender, body weight, body height, and medical history. An odds ratio (OR) and a 95% confidence interval were calculated and compared between different parameters.
ResultsA decrease in walking speed and one-legged stance time, whereas an increased timed up & go test time was associated with significant ORs for the occurrence of IADL decline.
ConclusionGait-related parameters appear to be the strong predictors of the onset of IADL decline in community-dwelling older people.