Eight-year Progression of Locomotive Syndrome in Community-dwelling Older Adults: The Obuse Study

Longitudinal evidence on Locomotive Syndrome (LoS) progression in community-dwelling older adults remains limited. We examined 8-year transitions in LoS stages in a population-based Japanese cohort.

Between 2014 and 2017, 415 residents aged 50-89 years were randomly enrolled. LoS stage (0-3) was assessed at baseline and at follow-up using Japanese Orthopaedic Association criteria, based on the 25-question Geriatric Locomotive Function Scale and standard performance tests. Follow-up data were available for 169 participants (40.7%) after a mean interval of 8.46 years. Baseline characteristics were compared between participants and non-participants. Stage transitions were analyzed according to baseline age, sex, and LoS stage. To address attrition bias, a multivariable model for follow-up participation, inverse probability weighting (IPW), and scenario-based sensitivity analyses were applied.

Advanced LoS (Stage 2 or 3) increased from 8.8% to 30.2%, indicating significant overall progression (P <0.001). Transitions were heterogeneous, with some improvement. The proportion of participants with worsening increased with age, ranging from 19.0% [95% confidence interval (CI) 10.2%-30.9%] among those aged 50-59 years to 66.7% (95% CI 34.9%-90.1%) among those aged 80-89 years. Among participants with baseline Stages 0-2, baseline Stage 0 (vs Stage 1) and older age were independently associated with worsening. Participants were younger and fitter than non-participants. Worsening was 37.3% in complete cases and 40.1% after IPW; advanced LoS at follow-up increased from 30.2% to 42.2% after IPW.

LoS stages progressed substantially over 8 years, with a marked increase in advanced LoS. Because follow-up participation was selective, these estimates likely underestimate the true burden in the original cohort.