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Validation of Each Category of Kihon Checklist for Assessing Physical Functioning, Nutrition and Cognitive Status in a Community-Dwelling Older Japanese Cohort

Jun Hirose, Takehiro Nagata, Miki Ogushi, Nobukazu Okamoto, Takuya Taniwaki, Kiyoshi Oka, Wakana Togami-Tomiguchi, Hiroaki Koga, Kunio Hayashi, Koichiro Usuku, Hiroshi Mizuta

Background: Kihon Checklist is a self-reported comprehensive health checklist used as a screening tool to identify frailty. The Kihon Checklist is a 25-item questionnaire including seven categories: daily life, physical ability, nutrition, oral condition, the extent to which one is housebound, cognitive status, and depression risk. We aimed to clarify the consistency in assessments of three important categories: physical strength, nutritional status, and cognitive function of Kihon Checklist using assessments of actual physical, nutritional, and cognitive statuses.

Methods: The study sample consisted of 5341 elderly individuals aged ≥ 65 years who participated in the Japanese Long-Term Care Prevention Project. We evaluated the Kihon Checklist scores except the depression risk. Physical functioning was evaluated using handgrip strength, one-leg standing-balance time, the Timed Up & Go test, and a walking test at usual or maximum speed. Nutritional status was assessed using the Mini Nutritional Assessment questionnaire. Cognitive functioning was evaluated using Sweet 16. Associations between each category of Kihon Checklist and physical, nutritional, and cognitive functioning assessments were analyzed.

Results: There were significant differences in all categories of Kihon Checklist between participants with and without functional decline in physical, nutritional, and cognitive functioning. Multivariate analyses showed that the Kihon Checklist physical strength category correlated with physical functioning assessments, the Kihon Checklist nutritional status category correlated with the Mini Nutritional Assessment, and the Kihon Checklist physical strength category correlated with the Sweet 16 scores. Moreover, the analysis of receiver operating characteristic curve exhibited a moderately accurate relationship of the Kihon Checklist physical strength category with overall physical functioning assessments.

Conclusions: We found significant associations of the Kihon Checklist physical strength, nutritional status, and cognition categories, with assessments of physical, nutritional, and cognitive functioning, respectively. Especially, the Kihon Checklist physical strength category is a valid tool for predicting physical functioning for general frailty aspects in older adults.