• Masayo Komatsu, Satoko Nezu, Kimiko Tomioka, Kan Hazaki, Akihiro Harano, Masayuki Morikawa, Masahiro Takagi, Masahiro Yamada, Yoshitaka Matsumoto, Junko Iwamoto, Rika Ishizuka, Keigo Saeki, Nozomi Okamoto, and Norio Kurumatani.
• Department of Community Health and Epidemiology, Nara Medical University School of Medicine.
• Nihon Eiseigaku Zasshi. 2013 Jan 1; 68 (1): 22-32.

ObjectivesTo investigate factors associated with activities of daily living in independently living elderly persons in a community.Subjects And MethodsThe potential subjects were 4,472 individuals aged 65 years and older who voluntarily participated in a large cohort study, the Fujiwara-kyo study. We used self-administered questionnaires consisting of an activities of daily living (ADL) questionnaire with the Physical Fitness Test established by the Ministry of Education, Culture, Sports, Science and Technology (12 ADL items) to determine the index of higher-level physical independence, demographics, Geriatric Depression Scale, and so on. Mini-mental state examination, measurement of physical fitness, and blood tests were also carried out. A lower ADL level was defined as having a total score of the 12 ADL items (range, 12-36 points) that was below the first quartile of a total score for all the subjects. Factors associated with a low ADL level were examined by multiple logistic regression.ResultsA total of 4,198 remained as subjects for analysis. The male, female and 5-year-old groups showed significant differences in the median score of 12 ADL items between any two groups. The highest odds ratio among factors associated with lower ADL level by multiple logistic regression with mutually adjusted independent variables was 4.49 (95%CI: 2.82-7.17) in the groups of "very sharp pain" or "strong pain" during the last month. Low physical ability, self-awareness of limb weakness, a BMI of over 25, low physical activity, cerebrovascular disorder, depression, low cognitive function, unable "to see normally", unable "to hear someone", "muscle, bone and joint pain" were independently associated with lower ADL level.ConclusionMultiple factors are associated with lower ADL level assessed on the basis of the 12 ADL items.

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