Is Upper Extremity Performance Associated With Frailty In Community-dwelling Older Women?

要旨

Although a standardized test battery for assessing lower extremity performance (LEP) can reflect health-related outcomes, it has yet to be determined whether upper extremity performance (UEP) is associated with frailty. PURPOSE: To define a summary score of UEP, and to determine the association between UEP and frailty in older women. METHODS: Cross-sectional analysis was conducted on the data from 502 community-dwelling older Japanese women, aged 65-92 years (74.3 ± 6.5 yr). The participants were classified as non-frail, pre-frail, and frail based on the definition of Fried et al. (2001). Trained testers assessed UEP using standardized measures of hand-grip strength (HG), functional reach (FR), and hands working with pegboard (PB). A summary UEP score (UEPS) equation was developed by principal component analysis. Participants were divided into quartile levels according to UEPS (Q1 to Q4) and multiple logistic regression was used to evaluate whether UEPS was independently associated with frailty, adjusting for potential confounders. The cut-off points for pre-frail and frail were determined by receiver-operating characteristic curves. RESULTS: The following equation was developed to estimate UEPS based on the first principal component coefficient of each variable: UEPS = 0.086HG + 0.060FR + 0.063PB - 5.793. In the logistic regression models, the odds ratios (95% confidence interval) of frailty compared with Q1 were 0.37 (0.19-0.70), 0.20 (0.10-0.40), and 0.21 (0.10-0.45) in Q2, Q3, and Q4, respectively, after controlling age, gait speed, vascular risk burden, joint pain, activities of daily living, and instrumental activities daily living (P for trend < 0.05). From the sensitivity and specificity curves, UEPSs of 0.23 (AUC 0.74, sensitivity and specificity 69%, for pre-frail) and -1.24 (AUC 0.89, sensitivity and specificity 83%, for frail) were defined as optimal cut-off points that maximize sensitivity and specificity. CONCLUSION: Among community-dwelling older women, UEP is significantly associated with frailty. Current results suggest that not only LEP but also UEP may be useful items for assessing frailty and other adverse-health outcomes. Supported by a Grant-in-Aid for Scientific Research (A) #19200047.

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