Physical Function Trajectory among High-Functioning Long-Term Care Facility Residents: Utilizing Japanese National...

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Health Services Research

Background:

• Physical function trajectory (PFT) is a significant predictor of mortality and hospitalization in older adults.
• Understanding PFTs in the initial phase of long-term care (LTC) is essential for proactive health management.
• High-functioning older adults represent a distinct cohort requiring specific attention upon admission to LTC facilities.

Purpose of the Study:

• To identify and compare the physical function trajectories (PFTs) of newly admitted high-functioning older adults within their first six months in Japanese long-term care (LTC) facilities.
• To explore factors associated with different PFTs in this population.
• To inform the development of tailored care plans and interventions to maintain physical independence.

Main Methods:

• Multicenter retrospective cohort study involving 718 high-functioning older adults (Barthel index > 60) from 47 Japanese LTC facilities.
• Utilized data from the Long-Term Care Information System for Evidence (LIFE) for residents admitted between January 1, 2021, and January 31, 2022.
• Employed a group-based trajectory model and binomial logistic regression to analyze physical function changes and associated factors.

Main Results:

• Four distinct PFTs were identified: maintenance (66.0%), improvement (9.5%), slight decline (16.6%), and large decline (7.9%).
• The improvement group showed significantly lower odds of lacking interest in daily activities compared to the maintenance group (OR 0.45).
• The large decline group had higher odds of low BMI at admission (OR 2.42) and lower odds of not using dentures (OR 0.49) compared to the maintenance group.

Conclusions:

• Physical function trajectories in high-functioning older adults entering LTC vary significantly.
• Factors such as engagement in daily activities, BMI, and denture use are associated with different functional outcomes.
• Leveraging existing data to understand PFTs can guide personalized care strategies, promoting physical independence and enhancing the quality of care in LTC settings.