Abstract
Objectives
To explore comparability of Kihon Checklist (KCL) and Kaigo-Yobo Checklist (KYCL)
to Frailty Index (FI) in predicting risks of long-term care insurance (LTCI) certification
and/or mortality over 3 years.
Design
Prospective cohort study.
Setting and Participants
1023 Japanese community-dwelling older adults from the Kusatsu Longitudinal Study
of Aging and Health.
Measures
Frailty status was quantified at baseline using KCL, KYCL, and 32-deficit and 68-deficit
FI. Relationships of the measures were examined using Spearman rank correlation coefficients.
Cox regression models examined the risk of new certification of LTCI or mortality
according to KCL, KYCL, and FI. Predictive abilities of KCL and KYCL were compared
with FI using area under the receiver operating characteristic curve (AUC), C statistics,
net reclassification improvement (NRI), and integrated discrimination improvement
(IDI).
Results
Mean age was 74.7 years and 57.6% were women. KCL and KYCL were significantly correlated
to 32-FI (r = 0.60 and 0.36, respectively) and to 68-FI (r = 0.88 and 0.61, respectively).
During the follow-up period, 92 participants (9%) were newly certified for LTCI or
died. Fully adjusted Cox models showed that higher KCL, KYCL, 32-FI, and 68-FI were
all significantly associated with elevated risks [hazard ratio (HR) = 1.03, 95% CI =
1.01-1.04, P < .001; HR = 1.04, 95% CI = 1.02-1.05, P < .001; HR = 1.03, 95% CI = 1.01-1.05, P = .001; HR = 1.04, 95% CI = 1.02-1.06, P < .001, respectively, per 1/100 increase of max score]. AUC and C-statistics of KCL
and KYCL were not different statistically from those of 32-FI and 68-FI. Predictive
abilities of KCL were superior to 32-FI in NRI and IDI but inferior to 68-FI in category-free
NRI, and those of KYCL were superior to 32-FI in IDI but inferior to 68-FI in NRI.
Conclusions
Although KCL and KYCL include smaller numbers of items than standard FI, both tools
were shown to be highly correlated with FI, significant predictors of LTCI certification
and/or mortality, and compatible to FI in the risk prediction.
Keywords
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Article info
Publication history
Published online: July 03, 2018
Footnotes
The authors declare no conflicts of interest.
Funding sources: This study was supported by grants from Tokyo Metropolitan Institute of Gerontology, JST/RISTEX, Grants-In-Aid for Scientific Research (B) JP20390190, (B) JP21390212, (B) JP24390173, and (B) JP26310111 from the Ministry of Education, Culture, Sports, Science and Technology, Japan.
Identification
Copyright
© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
