Predictors for functional decline among nondisabled older Japanese living in a community during a 3-year follow-up

OBJECTIVES: To examine predictors for functional decline in basic activitie s of daily living (BADL) as well as predictors for decline in instrumental activities of daily living (IADL) among nondisabled older Japanese people l iving in a community during a 3-year interval from 1992 to 1995. DESIGN: A prospective cohort study. SETTING: A community-based environment. PARTICIPANTS: A total of 583 men and women aged 65 to 89 at baseline who we re independent in both BADL and IADL. MEASUREMENTS: Independent variables regarding various factors potentially a ssociated with functional decline were obtained from an interview survey an d medical examinations at baseline. Dependent variables were functional sta tus in BADL and IADL obtained at the time of the 3-year follow-up. RESULTS: During the 3-year follow-up, significant predictors for functional decline in BADL and only IADL decline included (1) age of greater than or equal to 75, (2) less hand-grip strength, and (3) a history of hospitalizat ion during the past I year. In addition, having poor intellectual activitie s and having poor social roles were identified as significant predictors fo r functional decline in only IADL during the 3-year follow-up. Furthermore, not having the habit of taking a walk was identified as a significant pred ictor of functional decline in BADL during the 3-year interval. CONCLUSION: Having a high level hand-grip strength, good intellectual activ ities, and good social roles are strongly associated with remaining indepen dence in IADL for the nondisabled Japanese persons aged greater than or equ al to 65.