Abstract
Health evaluation and promotion among the elderly have become major social issues worldwide, especially in Japan. The New Elderly Citizens Association was launched in 2000 at the Life Planning Center Foundation under the direction of Dr. Shigeaki Hinohara. The main objectives of the society are to enhance physical and psycho-social activities among the elderly, promoting social contribution. Here, we summarize the results of a single-cohort, prospective, observational study (the Health Research volunteer Study [HRVS]) to explore the progress of frailty syndrome during a 5-year follow-up period; 407 people over the age of 70 years volunteered to participate in the study. A modified comprehensive geriatric assessment was performed for each participant. The 5-year outcomes were as follows: dropout, 8.4%; death, 5.4%; frailty, 16%; and non-frailty, 70.2%. A univariate analysis revealed significant differences between the frail and non-frail groups for 18 items. Of these items, timed walk, pulse pressure, cognition deficits, and auditory deficits were significant predictors of frailty in a multivariate analysis. Since the odds ratios for these four items were similar, a simple additive formula was used to create a prediction model for frailty (present = 1, absent = 0). A score of 0 had a 90% negative predictive value, while a score of 4 had a 70% positive predictive value for frailty. Interestingly, relations between these independent items and dementia are suspected, and an association between hypertension and dementia has long been discussed. Since no guidelines for hypertension have examined the issue of pulse pressure, the relevance of this topic to the diagnosis and treatment of frailty should be examined. The results of the HRVS will be useful in future studies examining the prediction of frailty in apparently healthy elderly, and further study to confirm our results as well as interventional research are needed.
