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Development of a risk assessment scale predicting incident functional disability among older people: Japan Gerontological Evaluation Study.

ABSTRACT: AIM:The aim of the present study was to develop a risk assessment scale for predicting incident functional disability among older adults. METHODS:We used prospective cohort data from the Japan Gerontological Evaluation Study, a nationwide survey of 90?889 functionally independent older people collected from 23 municipalities. The incidence of functional disability was determined from long-term care information obtained from municipal insurance databases. We constructed a Cox proportional hazards model with forward stepwise selection that used sex, age, and 12 of the essential items of the Public Survey of Long-Term Care Prevention and Needs in Spheres of Daily Life (the Needs Survey). We assigned a score based on the obtained non-standardized regression coefficients for each item and summed the scores to establish the risk assessment scale. The predictive validity was examined. RESULTS:The cumulative incidence of functional disability during the 3-year follow-up period was 9.7%. A risk assessment scale of 0-48 that used sex, age and the Needs Survey's 10 essential items was established. The area under the receiver operating characteristic curve was 0.804, and the sensitivity and specificity were both 0.733 (cut-off 16/17). There was no significant intermunicipality difference in the associations between the total scores calculated by using the scale and the risk of new incidence (P?=?0.135). CONCLUSIONS:We developed a risk assessment scale predicting incident functional disability composed of 10 essential items of the Needs Survey, sex and age. The scale had superior predictive validity, regardless of the level of urbanness. Geriatr Gerontol Int 2018; 18: 1433-1438.

SUBMITTER: Tsuji T

PROVIDER: S-EPMC6220974 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Development of a risk assessment scale predicting incident functional disability among older people: Japan Gerontological Evaluation Study.

Tsuji Taishi T Kondo Katsunori K Kondo Naoki N Aida Jun J Takagi Daisuke D

Geriatrics & gerontology international 20180814 10

<h4>Aim</h4>The aim of the present study was to develop a risk assessment scale for predicting incident functional disability among older adults.<h4>Methods</h4>We used prospective cohort data from the Japan Gerontological Evaluation Study, a nationwide survey of 90 889 functionally independent older people collected from 23 municipalities. The incidence of functional disability was determined from long-term care information obtained from municipal insurance databases. We constructed a Cox propo ...[more]

PMID: 30105800

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Project description:BackgroundUrbanization and population aging may affect prevalence of chronic pain from various causes. This cross-sectional study aimed to investigate the prevalence of chronic musculoskeletal pain, including some subtypes, in independent Japanese older people, and whether population density and population aging rate explained prevalence and differences in pain levels between municipalities.MethodsWe analyzed data from 12,883 independent older people living in 58 municipalities who completed mailed questionnaires and did not need support for daily living. We identified three types of pain: "chronic musculoskeletal pain" lasting ≥ 3 months (overall and in each part of the body), "chronic widespread-type pain" in the spinal and peripheral area, and "chronic multisite pain" in at least three sites. The latter two were measured using new definitions. These types of pain are correlated with depressive symptoms and we therefore examined the construct validity of the definitions by comparing the Geriatric Depression Scale score. We also used analysis of covariance to compare the prevalence of these three types of pain between municipalities. Odds ratios, median odds ratios, and the municipal variance in prevalence of chronic musculoskeletal pain were estimated by Bayesian multilevel logistic regression analysis using the Markov Chain Monte Carlo method.ResultsThe construct validity of the definitions of chronic widespread-type pain and chronic multisite pain was confirmed. The prevalence of the three types of pain (chronic musculoskeletal, widespread, and multisite pain) was 39.0%, 13.9%, and 10.3%, respectively. Chronic musculoskeletal pain showed a higher prevalence among older people and women. Individuals in underpopulated, suburban, or metropolitan areas tended to have more pain than those in urban areas, but this was not statistically significant (odds ratio [95% credible interval] 1.15 [0.86-1.51], 1.17 [0.93-1.43], 1.17 [0.94-1.46]). Population density and population aging rate did not explain the differences between municipalities.ConclusionsThe prevalence of chronic musculoskeletal pain was consistent with previous global reports. Areas with overpopulation and depopulation tended to have higher pain prevalence, but population density and population aging rate did not explain municipal variance. Further research is needed to identify other factors that contribute to regional variance.

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Development of a risk assessment scale predicting incident functional disability among older people: Japan Gerontological Evaluation Study.

Publications

Development of a risk assessment scale predicting incident functional disability among older people: Japan Gerontological Evaluation Study.

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