Predicting the risk of requiring long-term care based on three physical performance tests

Health centers across Japan conduct simple physical performance tests for older adults, including the single-leg balance and sit-to-stand tests. Based on a follow-up study of approximately 1,000 individuals, researchers at University of Tsukuba have developed an evaluation scale that uses the combined scores of three simple physical performance tests to predict high risk of requiring long-term care among older adults. The research is published in the journal Geriatrics & Gerontology International.

Decline in physical performance is a major factor in the onset of the need for long-term care among older adults. In Japan, physical performance tests are being promoted by local governments to motivate older adults to maintain and improve their physical performance; these tests also help governments evaluate the effectiveness of their long-term care prevention programs.

The timed up and go test, the chair sit-to-stand test, and the single-leg balance test have been adopted nationwide to effectively predict the need for long-term care among older adults; however, these tests are assessed individually, and no comprehensive assessment method has been proposed for use among Japanese older adults.

This study therefore aimed to create an evaluation scale based on a long-term follow-up study of Japanese older adults. The scale combines the results of multiple tests and can predict the need for long-term care among older adults with a high degree of accuracy.

The research participants were 975 older adults aged 65 years and above who had participated in physical performance tests in Kasama City, Ibaraki Prefecture, between 2009 and 2019 and who had no history of assessment of requiring long-term care. The evaluation scale (score range: 0–118) used scores of the single-leg balance with eyes open, timed up and go, and five-repetition sit-to-stand tests, together with values for age, gender, and body mass index.

Prediction accuracy analysis showed that the higher the total score of the developed scale, the more likely were participants to be certified as requiring long-term care during the follow-up period (averaging 8.6 years). Moreover, those with a score of 41 or more were found to be at particularly high risk of requiring long-term care.

This study found that the single-leg balance with eyes open, timed up and go, and five-repetition sit-to-stand tests conducted in various parts of Japan can effectively predict the need for long-term care among older adults. Using the combined scores of these three tests can help us identify older adults at high risk of requiring long-term care with greater accuracy compared with using the individual scores of each test.