Validity of Total Kihon Checklist Score for Predicting the Incidence of 3-Year Dependency and Mortality in a Community-Dwelling Older Population
Validity of Total Kihon Checklist Score for Predicting the Incidence of 3-Year Dependency and Mortality in a Community-Dwelling Older Population
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DOI：
10.1016/j.jamda.2017.03.013
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发表时间：
2017-06-01
影响因子：
7.6
通讯作者：
Toba, Kenji
中科院分区：
文献类型：
--
作者：
Satake, Shosuke;Shimokata, Hiroshi;Toba, Kenji
目的：验证总基洪检查表（t-KCL）评分预测社区居住老年人3年内依赖或死亡发生率的能力。设计：基于人群的纵向观察研究。背景：日本东村镇。研究对象：东村镇5542名独立老人。测量方法：将KCL问卷发给独立的老年居民。根据我们之前的报告，那些t-KCL得分为0-3的人被分类为健壮，4-7为虚弱前期，8 +为虚弱。3年内观察依赖或死亡的发生率。依赖性被定义为长期护理保险（LTCI）服务需求的新认证。从市政府获得了有关LTCI认证或死亡的信息。结果：8091名独立老年人中，5542名老年人完成了KCL问卷。根据t-KCL评分，将其分为3组：健全型2962人（53.4%），预虚弱型1625人（29.3%），虚弱型955人（17.2%）。在三年内，510名（9.2%）老年人获得了新的LTCI认证，170名（3.1%）老年人死亡。经年龄和性别校正的Cox回归分析显示，t-KCL评分对虚弱状态的分类与体弱前和体弱者的依赖发生率显著相关[危险比（hr）： 2.027和4.768；95%置信区间（ci）分别为1.575 ~ 2.608和3.733 ~ 6.089]。另一方面，预测死亡的能力是显著的，但仅在虚弱组（HR: 2.830; 95% CI: 1.952-4.104）。结论：t-KCL评分对老年人衰弱状态的分类可作为预测老年人依赖发生率和死亡率的重要工具。(C) 2017 AMDA -急性和长期护理医学学会。
Objectives: To validate the ability of the total Kihon checklist (t-KCL) score to predict the incidence of dependency or death within 3 years in a community-dwelling older population.Design: Population-based longitudinal observational study.Setting: Town of Higashi-ura, Japan.Participants: A total of 5542 independent seniors who were residents in the town of Higashi-ura.Measurements: The KCL questionnaire was sent to independent older residents. Based on our previous report, those with a t-KCL score of 0-3 were classified as robust, 4-7 as pre-frail, and 8 + as frail. The incidence of dependency or death was observed over 3 years. Dependency was defined as a new certification for long-term care insurance (LTCI) service need. Information regarding LTCI certification or death was obtained from the municipal government.Results: Of 8091 independent older adults, 5542 seniors completed the KCL questionnaire. Based on the t-KCL score, they were classified into 3 groups: 2962 (53.4%) as robust, 1625 (29.3%) as pre-frail, and 955 (17.2%) as frail. Over the 3 years, 510 seniors (9.2%) had new LTCI certifications and 170 (3.1%) died. Cox regression analysis adjusted for age and sex showed that the classification of frailty status by t-KCL score was significantly associated with the incidence of dependency both in the pre-frail and the frail [hazard ratios (HRs): 2.027 and 4.768; 95% confidence intervals (CIs): 1.575-2.608 and 3.733-6.089, respectively]. On the other hand, the ability to predict death was significant, but only in the frail group (HR: 2.830; 95% CI: 1.952-4.104).Conclusion: The classification of frailty status by t-KCL score could be a significant tool to predict the incidences of dependency and mortality in older adults. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.