Exploring 2.5-Year Trajectories of Functional Decline in Older Adults by Applying a Growth Mixture Model and Frequency of Outings as a Predictor: A 2010–2013 JAGES Longitudinal Study

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Author(s)

    • Saito Junko
    • Department of Health and Social Behavior, Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo
    • Kondo Naoki
    • Department of Health and Social Behavior, Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo
    • Takagi Daisuke
    • Department of Health and Social Behavior, Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo
    • Tani Yukako
    • Department of Global Health Promotion, Tokyo Medical and Dental University|Research Fellow of Japan Society for the Promotion of Science
    • Haseda Maho
    • Department of Health and Social Behavior, Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo
    • Kondo Katsunori
    • Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University|Center for Well-being and Society, Nihon Fukushi University|Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology

Abstract

<p><b>Background:</b> We explored the distinct trajectories of functional decline among older adults in Japan, and evaluated whether the frequency of outings, an important indicator of social activity, predicts the identified trajectories.</p><p><b>Methods:</b> We analyzed data on 2,364 adults aged 65 years or older from the Japan Aichi Gerontological Evaluation Study. Participants were initially independent and later developed functional disability during a 31-month follow-up period. We used the level of long-term care needs certified in the public health insurance system as a proxy of functional ability and linked the fully tracked data of changes in the care levels to the baseline data. A low frequency of outings was defined as leaving one's home less than once per week at baseline. We applied a growth mixture model to identify trajectories in functional decline by sex and then examined the association between the frequency of outings and the identified trajectories using multinomial logistic regression analysis.</p><p><b>Results:</b> Three distinct trajectories were identified: "slowly declining" (64.3% of men and 79.7% of women), "persistently disabled" (4.5% and 3.7%, respectively), and "rapidly declining" (31.3% and 16.6%, respectively). Men with fewer outings had 2.14 times greater odds (95% confidence interval, 1.03–4.41) of being persistently disabled. The association between outing frequency and functional decline trajectory was less clear statistically among women.</p><p><b>Conclusions:</b> While the majority of older adults showed a slow functional decline, some showed persistent moderate disability. Providing more opportunities to go out or assistance in that regard may be important for preventing persistent disability, and such needs might be greater among men.</p>

Journal

  • Journal of Epidemiology

    Journal of Epidemiology 29(2), 65-72, 2019

    Japan Epidemiological Association

Codes

  • NII Article ID (NAID)
    130007590314
  • Text Lang
    ENG
  • ISSN
    0917-5040
  • Data Source
    J-STAGE 
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