Department of Frailty Research, Research Institute, National Center for Geriatrics and Gerontology, Obu City, Aichi, Japan.
Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba city, Chiba, Japan.
Geriatr Gerontol Int. 2022 Aug;22(8):667-674. doi: 10.1111/ggi.14439. Epub 2022 Jul 17.
The original Kihon Checklist, validated to predict the incidence of functional disability, has been modified to capture both functional ability (can/cannot) and performing state (do/do not). However, the predictive validity of the modified Kihon Checklist remains unverified. Therefore, this study intends to verify the predictive validity of the modified Kihon Checklist and to clarify whether predictive discrimination differs between the classification method of functional ability and performing state.
The participants comprised 67 398 older people who responded to the Japan Gerontological Evaluation Study (2016). They were followed for 3.1 years on average. Cox's proportional hazards model with incidence of functional disability as the endpoint was used to calculate the hazard ratio, adjusted for sex and age. The independent variables were judged by two classification methods, functional ability and performing state, using nine indicators based on the modified Kihon Checklist. Additionally, we examined whether the two classification methods produced different C-index estimates.
Incidence of functional disability occurred in 6232 participants (9.2%). The adjusted hazard ratio of those to whom the nine indicators applied was significantly higher than that of those to whom they did not. The range of the hazard ratio was 1.50-3.82 for both classification methods. The C-index was slightly higher when the classification was based on performing state than when it was based on on functional ability.
Although predictive discrimination was slightly higher for the performing state than for functional ability, the predictive validity of the modified Kihon Checklist was confirmed for both. Geriatr Gerontol Int 2022; 22: 667-674.
经过验证可预测功能障碍发生率的原始 Kihon 清单已进行修改，以同时捕捉功能能力（能/不能）和执行状态（做/不做）。然而，修改后的 Kihon 清单的预测有效性尚未得到验证。因此，本研究旨在验证修改后的 Kihon 清单的预测有效性，并阐明功能能力和执行状态的分类方法之间的预测区分是否存在差异。
参与者包括 67398 名对日本老年评估研究（2016 年）做出回应的老年人。他们的平均随访时间为 3.1 年。使用 Cox 比例风险模型，以功能障碍的发生为终点，计算风险比，调整性别和年龄因素。使用基于修改后的 Kihon 清单的九个指标，通过两种分类方法（功能能力和执行状态）判断自变量。此外，我们还检查了两种分类方法是否产生不同的 C 指数估计值。
有 6232 名参与者（9.2%）发生了功能障碍。应用九个指标的参与者的调整后风险比明显高于未应用的参与者。两种分类方法的风险比范围均为 1.50-3.82。基于执行状态的分类时，C 指数略高于基于功能能力的分类。
尽管基于执行状态的分类的预测区分略高于基于功能能力的分类，但修改后的 Kihon 清单的预测有效性得到了两者的证实。老年医学与老年病学杂志 2022；22：667-674。
