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Aim: To enhance health services that can address multifaceted issues, the Questionnaire for Medical Checkup of Old‐Old (QMCOO) was strategically developed to ascertain frailty status. Using the National Health Insurance database system, we aimed to clarify whether the QMCOO can predict new certifications for long‐term care for disabilities. Method: Of 20 151 adults aged ≥75 years who underwent health checkups in Kashiwa City, Japan, in fiscal year 2020 (examination rate 36.8%), 18 130 persons were included (mean age 80.1 ± 4.1 years, 55.1% women). The outcome was the new certification of long‐term care until January 2022. From the medical care receipt data, QMCOO, age, sex, living arrangement, body mass index, comorbidity, and musculoskeletal and connective tissue diseases were evaluated. Result: During the follow‐up period, 727 (4.0%) participants had an incident disability (median follow up 457 days [quartile range 408–519 days]). The QMCOO's predictive accuracy for new long‐term care needs was optimal when the total score of 3/4 was used as the threshold. Older adults with scores ≥4 had a higher adjusted hazard ratio for incident disability (adjusted hazard ratio 2.5, 95% confidence interval 2.1–2.9). Furthermore, the adjusted hazard ratio was greatly enhanced with comorbidity (6.6, 95% confidence interval 4.8–8.9). Conclusion: The QMCOO, which reflects multifaceted frailty, might be predictive of incident disability, and its predictive accuracy could be improved by considering comorbidities. The comprehensive QMCOO could contribute to extending healthy life expectancy through efficiently assessing health care and preventing long‐term care, even among the old‐old in the latter stage who tended to suffer from multimorbidity. Geriatr Gerontol Int 2023; 23: 124–130. [ABSTRACT FROM AUTHOR]