ABSTRACT
The purpose of the present study was to investigate the baseline characteristics related to the participation status in a longitudinal epidemiological study for the elderly. Nine hundred twenty-six self-supporting older adults lived in a local city located southwest in Japan were classified into the following 3 groups; non-participants (NP, n=170), participants for the baseline measurements (PB, n=278), and participants for both the baseline and follow-up measurements after two-years (PBF, n=478). The basic attributes including socioeconomic status, depressive symptoms, cognitive function, sleep quality, fitness, objectively- measured physical activity, habitual behavior, psychosocial characteristics and functional problems in daily life were assessed. Regarding the NP group, data were collected by questionnaire or home visits. According to the results of a multinomial logistic regression analysis adjusted for age, sex and years of education, significant odds ratios which indicate a poor status in most of the assessment items were observed in both the NP and PB groups in comparison to the PBF group. We concluded that sex (female), a higher age, fewer years of education, a cognitive function decline, depressive symptoms, a low fitness level, physical activity and daily living function, and poor psychosocial backgrounds were related to the non-participation and dropouts. These results should be considered in a longitudinal data analysis of the present study, as well as in the design setting of epidemiological studies dealing with physical activity indexes and care risk factors. Furthermore, these findings are also considered to be useful as basic data for such care prevention activities in the community.
ABSTRACT
This prospective study was designed to clarify the association between the incidence of falls and physical fitness in healthy community-dwelling elderly people without history of fall-related injuries within 1-5 years before the baseline assessment. Six hundred and one elderly subjects aged 60-79 years who lived independently participated in baseline assessments from March 2002 to March 2004, and were followed up for one year to detect falling. Demographic items (age and sex), chronic disease, self-rated health, difficulty in performing any activity, tendency to stay at home, body mass index (BMI), %vital capacity, handgrip and knee extension strength, stepping rate, one-leg standing with eyes opened, trunk flexion at sitting position, maximum walking speed, instrumental activity of daily living (IADL), and General Health Questionnaire (GHQ30) were assessed at baseline. Four hundred and eighty-one participants (80.0%) completed the 1-year follow-up.The fall incidence was 13.1%. In men, fallers had lower BMI and decreased maximum walking speed, however, neither showed significant odds ratio (OR) for fall. In women, fallers had lower knee extension strength and the ratio of weak side to strong side (WS/SS ratio) in knee extension strength compared to non-fallers. The age-adjusted OR for fallers in the lowest quartile (knee extension strength＜0.681kg/BW) was 3.07 (95%CI : 1.02-9.22) compared to highest quartile (＞0.980 kg/BW), while the multiple-adjusted OR was not significant (OR＝2.88, 95%CI : 0.94-8.79). However, the multiple-adjusted OR for fallers in the lowest quartile of the WS/SS ratio in knee extension strength (＜0.771) was 4.49 (95%CI : 1.40-14.37) compared to highest quartile (＞0.947).As for conclusion, without history of fall-related injuries, only a weak association between falls and physical fitness was observed in men. In women, the unbalanced knee extension strength was associated with falls. The WS/SS ratio in knee extension strength might be a key factor in predicting falls in women.