Hoshi Kazuhiro, Shibasaki Koji, Yakabe Mitsutaka, Hosoi Tatsuya, Matsumoto Shoya, Yamada Shizuru, Hashimoto Seiji, Akishita Masahiro, Ogawa Sumito
Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Rehabilitation Medicine, Asahi Neurology and Rehabilitation Hospital, Matsudo City, Japan.
Geriatr Gerontol Int. 2025 Mar;25(3):418-424. doi: 10.1111/ggi.15097. Epub 2025 Feb 4.
Weight loss is among the diagnostic criteria for frailty and is associated with increased mortality among older people. This study aimed to identify factors associated with future weight loss among community-dwelling older people.
A multidimensional questionnaire-based prospective cohort study was carried out. The questionnaire included the Kihon Checklist, instrumental activities of daily living (IADL) scale, Activity Scale for the Elderly, Fall Risk Index-21 and Dietary Variety Score. The associations among the scores of the scales and the 3-year weight change from study entry were assessed. The participants were categorized into the non-weight loss group, <4.5-kg weight loss group and >4.5-kg weight loss group.
In total, 982 participants completed the follow up. Their mean age was 73.4 ± 5.1 years, and 545 (55.5%) participants were women. Among the IADL questionnaire subitems, depositing and withdrawing money from the bank, walking, interacting with people, taking medication, and cooking were associated with 3-year weight loss. Furthermore, cooking was strongly associated with weight loss. However, there was no association between eating frequency and weight loss. Finally, low IADL and physical function scores were associated with a doubled risk of future weight loss.
An association was found between 3-year weight loss and physical fitness and IADL, such as walking, among community-dwelling older people. Future weight loss in older people can be caused by a decline in IADL and physical fitness before a decline in dietary intake. Furthermore, maintaining IADL and physical fitness can prevent future weight loss and frailty. Geriatr Gerontol Int 2025; 25: 418-424.
体重减轻是衰弱的诊断标准之一，且与老年人死亡率增加相关。本研究旨在确定社区居住老年人未来体重减轻的相关因素。
开展了一项基于多维问卷的前瞻性队列研究。问卷包括基宏检查表、日常生活活动能力量表、老年人活动量表、跌倒风险指数 - 21和饮食多样性评分。评估了各量表得分与研究开始后3年体重变化之间的关联。参与者被分为非体重减轻组、体重减轻<4.5千克组和体重减轻>4.5千克组。
共有982名参与者完成了随访。他们的平均年龄为73.4±5.1岁，545名（55.5%）参与者为女性。在日常生活活动能力问卷子项目中，从银行存钱和取钱、行走、与人交往、服药和做饭与3年体重减轻有关。此外，做饭与体重减轻密切相关。然而，进食频率与体重减轻之间没有关联。最后，日常生活活动能力和身体功能得分低与未来体重减轻风险加倍有关。
在社区居住的老年人中，发现3年体重减轻与身体适应性和日常生活活动能力（如行走）之间存在关联。老年人未来体重减轻可能是由日常生活活动能力和身体适应性下降引起的，而非饮食摄入量下降。此外，维持日常生活活动能力和身体适应性可预防未来体重减轻和衰弱。《老年医学与老年病学国际杂志》2025年；25: 418 - 424。
