Declining healthy life expectancy due to functional disability is relevant and urgent not only because of its association with decreased quality of life but also for its enormous socioeconomic impact. Thus, we analyzed a population-based retrospective cohort study including 9,673 community dwelling Japanese adults (4,420, men) aged 39-98 years in 2012-2017. Functional disability was defined as a condition meeting Japan’s new long-term care insurance certification requirements for the need of assistance in the activities of daily living whether by caregivers or assistive devices. Cox proportional hazards regression model identified variables related to functional disability. Median follow-up was 3.7 years. During the study period, 165 disabilities occurred in the overall study population. Multivariate analysis showed that diabetes (hazard ratio [HR] 1.74 (95% CI: 1.12-2.68)), no physical activity habit (HR 1.83 (1.27-2.65)), and low BMI category (18.5 kg/m2 >) (HR 1.63 (1.02-2.63)) presented increased risks for disability. The prevalence ratio of 0, 1, 2, 3 and 4 conditions (diabetes, hypertension, dyslipidemia, and physical activity habits) was 12.8%, 40.0%, 32.6%, 12.9 and 1.7%, respectively. HR for disability increased with the number of risk factors (HR of individuals with 1, 2, 3 and 4 conditions, 1.34 (0.71-2.52), 1.95 (1.04-3.63), 2.11 (1.07-4.15), and 3.96 (1.59-9.99) vs. individuals with none of those conditions as a ref.). HR for disability among diabetes patients with and without a physical activity habit was 1.68 (0.70-4.04) and 3.19 (1.79-5.70), respectively, compared to individuals without diabetes with a physical activity habit. This shows that the combination of diabetes and lack of habitual physical activity is predictive of functional disability in Japanese. Habitual physical activity attenuates the risk of functional disability in patients with diabetes.
K. Fujihara: None. M.H. Yamada: None. Y. Matsubayashi: None. M. Kitazawa: None. M. Kaneko: None. M. Yamamoto: None. Y. Yaguchi: None. T. Yahiro: None. S. Kodama: None. K. Kato: None. H. Sone: Research Support; Self; Kyowa Hakko Kirin Co., Ltd., Novartis AG, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co.
Japan Society for the Promotion of Science (18K17897)