[Functional status of community-dwelling frail elderly in the Japanese long-term care insurance system].

Objective: To clarify exercise habits, self-rated functional fitness, activities of daily living (ADL) and fear of falling in community-dwelling elderly who are classified as frail by the eligibility decision process of the Japanese long-term care insurance system.

Methods: Subjects aged 75 years and older were classified into a frail elderly group (n = 126; male = 29, female = 97) and a healthy elderly group (n = 262; male = 114, female = 148). We had carried out an interview survey using questionnaire asking about exercise habits, self-rated functional fitness, ADL, fear of falling and activity curtailment. The survey was carried out by door-to-door method and data were collected from November to December 2000.

Results: Respondents who answered no practice of exercise were more likely to be in the frail elderly group. Among the self-rated functional fitness items, endurance, muscular strength and flexibility were comparatively low in the frail elderly group. The rates of basic ADL dependence were higher for bathing (males = 34.5%, females = 15.5%) and walking (males = 27.6%, females = 20.6%), for both sexes of the frail elderly group. Also, the rate of instrumental ADL dependence was much higher in the frail elderly group than in the healthy elderly group. Among frail elderly, 93.1% of males and 93.8% of females had fear of falling. Of those who were afraid, 66.7% of males and 60.4% of females curtailed going out due to this fear.

Conclusions: Our findings suggest that intervention programs are needed to improve bathing and walking ability as well as to provide social support for the frail elderly. Self-rated fear of falling is significantly associated with activity curtailment in this population.