Subjective geriatric complaints as predictors of disability and mortality in community-dwelling older adults: a 5-year cohort study

Abstract

Background: Various health-related concerns experienced daily by older adults, designated here as subjective geriatric complaints (SGCs), and are suspected to be early signs of the decline in quality of life (QOL). This study aims to test the hypothesis that SGCs are significant predictors of future disability and mortality among older adults. Methods: This prospective cohort study was conducted in Japan. A health-related questionnaire was mailed to community-dwelling older adults, and data on the certification of long-term care needs and mortality that occurred over the subsequent 5 years were analysed. The analysis included 10 199 individuals. Thirteen SGCs were classified into six groups. The primary outcome was a composite end point of disability and mortality. Survival time analysis was conducted using Kaplan–Meier analysis and Cox proportional hazard regression models. Results: The mean age (standard deviation) of participants (52.4% female) at baseline was 73.7 (6.0) years. Over the 5-year study period, 1793 participants (17.6%) were newly certified as requiring long-term care and 931 (9.1%) died. After adjusting for age, sex, depressive mood, and presence of multimorbidity, the hazard ratios (95% confidence intervals) for SGC 1b (circulatory/respiratory complaints) and SGC 3 (neurological complaints) were 1.558 (1.316–1.884, P < 0.001) and 1.355 (1.14–1.61, P = 0.001), respectively. Conclusion: These findings suggest that SGCs are independent risk factors for a decline in QOL. Additionally, risk varied across different symptom groups within SGCs. These differences should be carefully considered in the management of health for older adults.