Avoidance of FD and the deterioration of care level needs leading to a decline in ADL and increased medical costs is urgent. We aimed to clarify the association between lifestyle habits, non-communicable diseases (i.e., DM, HT, and dyslipidemia) and their combinations and the incidence of severe FD and deterioration of the care-level. Followed for a median of 3.7 years were 9673 people who underwent health checkups. Care-level ≥2 (total assistance needed) indicates severe FD and worsening from the initial examination indicates deterioration. During the study period, 111 cases of severe FD occurred. Multivariate analysis showed that aging (per 5y) (OR 2.24 [1.95-2.56]), male (1.76 [1.16-2.66]), BMI<18.5 (2.46 [1.40-4.35]), DM (1.81 [1.06-3.08]), HT (1.58 [1.05-2.38]), and lack of physical activity (PA) (2.17 [1.37-3.45]) were associated with severe FD. Prevalence of DM additively associated with severe FD. DM and ≥2 risk factors had a 10 times greater association than non-DM and no risk factor. Of 85 cases with worsening care needs, only DM was significantly associated with deterioration (2.88 [1.08-7.65]). DM is a significant risk factor for with double the increased risk of severe FD and triple care-need deterioration compared with those without DM. Also, in DM patients, low BMI, HT, and lack of PA greatly increased the risk of severe FD, suggesting the need for comprehensive treatment strategies.

Disclosure

I. Ikeda: None. K. Fujihara: None. H. Shiozaki: None. S.Y. Morikawa: None. K. Tsuruoka: None. Y. Yuko: None. L. Khin: None. S. Wu: None. N. Yagyuda: None. C. Horikawa: None. H. Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Eisai Inc., Sumitomo Dainippon Pharma Co., Ltd.

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