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Long-Term Care Insurance System has been introduced to provide appropriate care for the elderly who needs nursing care in Japan. Physical function is one of most important function for the elderly to live independently. A previous study had established a Fitness Age Score (FAS) based on a theory for biomarker of aging. This study clarified whether the FAS could be used to predict the need for certification of long-term care (CLTC) in independent elderly people. We included 939 independent, community-dwelling-elderly (average age, 74.4 years) whose physical function was measured and for whom the CLTC was tracked for 24 months. The FAS comprised five physical fitness items: Walking time, grip strength, one-leg standing, vertical jump, and functional reach test. Based on the FAS, we calculated the odds ratio (OR) for the CLTC. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) was used for further analysis. We also used the Youden Index (YI), minimum distance method (MD), and two-graph ROC method (TG) to calculate cutoff values (CVs) for screening. We divided subjects into the low and high physical fitness group with CVs. We developed cumulative CLTC curves using the Kaplan-Meier method. Sixteen people could not be tracked for the full 24 months. The measurement of FAS was completed for 798 people, of whom 28 became CLTC. The measurement of FAS was not completed for 125 people, of whom 21 became CLTC. The CLTC OR for people with incomplete FAS was 5.553. The AUC was 0.72 (p < 0.001). The CVs for the FAS were -0.29 for YI (sensitivity, 92.9% and specificity, 40.4%), -1.23 for MD (57.1% and 73.4%), and -0.81 for TG (60.7% and 60.9%). The cumulative CLTC curves according to CVs all showed significant differences (p = 0.000 - 0.020). In conclusion, the FAS can be used to predict CLTC.

Fitness Age Score and the Risk of Long-Term Care Insurance Certification—The Kyoto-Kameoka Longitudinal Study