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• A cross-sectional and longitudinal study is presented in which participants were classified into four groups based on urinary incontinence (present/absent) and total score on the Active Mobility Index (AMI) (high/low). • Among community-dwelling older adults, having urinary incontinence was associated with lower physical and social activity accompanied by outings. • The combination of urinary incontinence and lower physical and social activity accompanied by outings was associated with an increased risk of incident disability after two years. To examine the associations of a combination of urinary incontinence (UI) and life-space activity/mobility with the risk of incident disability among community-dwelling older adults. The participants were 12,808 older adults for the cross-sectional study and 12,516 older adults who completed the follow-up assessment. UI was assessed using a questionnaire. Life-space activity/mobility was evaluated using total, physical, and social scores on the Active Mobility Index (AMI). Participants were classified into four groups (high AMI total score + no UI; high AMI total score + UI; low AMI total score + no UI; low AMI total score + UI). Incident disability was extracted from the Japanese Long-Term Care System. During the 24-month follow-up, 562 participants (4.5 %) developed disability. Those with a low AMI score + no UI (hazard ratio, 1.35; 95 % confidence interval, 1.07–1.71) and those with a low AMI score + UI (hazard ratio, 2.00; 95 % confidence interval, 1.56–2.56) had a higher risk of incident disability than those with a high AMI score + no UI in the follow-up analysis. A combination of UI and low AMI score was associated with an increased risk of incident disability, whereas having UI but a high AMI score was not associated with an increased risk of incident disability. Our findings may help identify older adults at high risk of developing disabilities. [ABSTRACT FROM AUTHOR]

Objectives To elucidate whether a combination of slow gait speed and depressive symptoms result in higher risk of incident disability in older adults than either symptom individually. Design Prospective cohort study. Setting Obu City, Aichi Prefecture, Japan. Participants Participants were 4038 older adults (48.7% male, mean age = 71 years) who met the study inclusion criteria. Measurements Longitudinal data on incident disability were collected up to 33 months [median 31 months (interquartile range 29–32 months)] after baseline. We monitored monthly incident disability, defined as Japanese long-term care insurance certification for personal support or care. Baseline measurements included covariates for incident disability, gait speed, and the Geriatric Depression Scale for assessing depressive symptoms. The associations between slow gait, depressive symptoms, or their co-occurrence, and incident disability were examined. Results Control participants were the reference in an adjusted Cox proportional hazard regression model. Participants with co-occurring slow gait and depressive symptoms showed a greater risk of incident disability [hazard ratio (HR) 3.08, confidence interval (CI) 95% 2.00–4.75]. Greater risk was also found for participants with slow gait speed alone (HR 2.44, CI 95% 1.71–3.47) and depressive symptoms alone (HR 1.60, CI 95% 1.01–2.53). Conclusions Older adults with both risk factors may require early detection and physical and psychological intervention. [ABSTRACT FROM AUTHOR]

Introduction Sarcopenia is associated with an increased risk of adverse outcomes. The aim of this study was to explore the relationship between severity of sarcopenia and incident activities of daily living (ADL) disability, institutionalization, and all-cause mortality among community-dwelling older men participating in the Concord Health and Ageing in Men Project (CHAMP). Methods Longitudinal analysis of 1705 participants aged 70 years or older at baseline (2005–2007) living in the community in Sydney, Australia. Measurements The main outcome measures were incident ADL disability, institutionalization, and mortality. Of the 1705 participants who completed the baseline assessments, a total of 1678 men (mean age 77 years) had complete measures by dual-energy x-ray absorptiometry, to assess sarcopenia in terms of low appendicular lean mass (ALM), using the Foundation for the National Institutes of Health (FNIH) criteria. To differentiate between severity of sarcopenia we used low ALM alone (sarcopenia I), low ALM with weakness (sarcopenia II), and sarcopenia with weakness and poor gait speed (sarcopenia III). Cox proportional hazard models and logistic regression models were used to assess the risk of mortality and institutionalization, and incidence of ADL disability. Results From baseline to follow-up, 103 (11.3%) men had incident ADL disability, 191 (11.2%) men were institutionalized, and 535 (31.9%) had died. At baseline, 14.2% had sarcopenia I, 5.3% had sarcopenia II, and 3.7% had sarcopenia III. Fully adjusted analysis (adjusted for demographics, lifestyle factors, comorbidities and health conditions, and blood measures) showed that sarcopenia I, II, and III were associated with increased risk of disability, institutionalization, and mortality. Associations between sarcopenia I, II, and III and risk of incident disability were as follows: odds ratio (OR) 2.77 95% confidence interval (CI) 1.30–5.87, OR 3.78 95% CI 1.23–11.64, and OR 4.53 95% CI 0.90–22.72; associations with institutionalization were hazard ratio (HR) 1.96 95% CI 1.14–3.35, HR 2.53 95% CI 1.31–4.90, and HR 2.27 95% CI 1.08–4.80; and with mortality were HR 1.65 95% CI 1.30–2.09, HR 1.50 95% CI 1.08–2.08, and HR 1.69 95% CI 1.17–2.44. Conclusions This study shows that, in community-dwelling older men, sarcopenia defined by the FNIH criteria is associated with increased risk of incident disability, institutionalization, and mortality. [ABSTRACT FROM AUTHOR]