Association of self-perception and perception gap in walking speed with frailty: The Otassha study

To examine associations among the self-perception of age-related walking-speed decline, perception gap (discrepancy between objective and subjective walking-speed assessments), and frailty in older adults.

We included 467 older adults (age: 74.7 ± 6.3 years; female: 62 %) who participated in the 2019 (T1) and 2020 (T2) comprehensive health-checkup surveys conducted among community-dwelling adults aged ≥ 65 years. As a subjective walking-speed assessment, participants rated their perception of walking-speed change at T2 compared to before (negative/positive). As an objective assessment, they were classified as having a decline in or maintaining a stable walking speed based on whether their walking speed at T2 declined by > 0.1 m/s compared to T1. Accordingly, participants were grouped into negative+decline (ND), negative+stable (NS), positive+decline (PD), and positive+stable (PS) groups. NS and PD groups had a perception gap. Frailty was assessed using the Kihon Checklist at T2. Covariates included sex, age, health conditions, and mental status. Associations between self-perception, perception gap, and frailty were examined using analysis of covariance and binary logistic regression analysis.

Prevalences of negative self-perception and a perception gap were 66.6 % and 58.7 %, respectively. Negative self-perception groups had higher frailty scores and prevalence than those in the positive groups; no significant difference was observed between perception-gap and no-gap groups. In the four-group comparison, ND and NS groups had higher KCL scores than PD and PS groups.

Negative self-perception was associated with frailty, regardless of a perception gap. Addressing negative perceptions may help prevent frailty. Further research is needed on perception-related factors.