Associations Of Physical Activity And Sedentary Behavior With The Onset Of Long-Term Care Need In Community-Dwelling Independent Japanese Older Adults: The Tsuru Study

Limited data are available for the examination of the associations of physical activity (PA) and sedentary behavior (SB) with the onset of long-term care need (OLCN) in older adults. PURPOSE: The purpose of this study is to investigate the independent and joint associations of moderate PA (MPA) and SB on the OLCN among Japanese elderly in the local municipality. METHODS: A cohort of 3937 Japanese elderly men [median (IQR) age 74 (65−99) years] and 2048 women [median (IQR) age 74 (65−99) years] without certification of long-term care need have reported on PA and SB in 2016. The participants were divided into three categories (0 min/week: MPA-none, 1-299 min/week; MPA-M1, ≥ 300 min/week; MPA-M2) based on MPA and two groups based on median (200min/week) of SB (SB-M1, SB-M2). The OLCN was defined as the time of the certification of long-term care need by the Certification Committee of Needed Long-Term Care in the municipality. The information of the OLCN during follow-up from 2016 to 2018 was obtained from the person in charge of Tsuru city. Hazard ratios (HR) and 95% confidence intervals (95% CI) for the OLCN were obtained using proportional hazard models while adjusting for sex, age, educational level, marital status, activities of daily living, and history of current illness. RESULTS: During the 2-year follow-up period, 517 participants obtained certification of needed long-term care. With the independent effects of MPA and SB, using the MPA-none as reference, HRs and 95% CIs for MPA-M1 and MPA-M2 were 0.67 (0.51−0.86) and 0.48 (0.35−0.66), respectively (P for trend < 0.001) and using lower SB (SB-M1) as reference, HR and 95% CI for higher SB (SB-M2) was 0.74 (0.58−0.94). With the joint effects of MPA and SB, using MPA-none & SB-M1 as reference, HRs and 95% CIs for MPA-none & SB-M2, MPA-M1 & SB-M1, MPA-M1 & SB-M2, MPA-M2 & SB-M1, and MPA-M2 & SB-M2 were 0.62 (0.44−0.87), 0.58 (0.42−0.82), 0.50 (0.34−0.74), 0.39 (0.26−0.60), and 0.39 (0.25−0.62), respectively. CONCLUSIONS: These results suggest that MPA and SB might be independent factors for the onset of long-term care need and that these factors might have a strong joint effect on the onset.