Incidence and Course of Activities of Daily Living Disability Over 6 Years in Community-Dwelling Older Adults: Examination Stratified by Frailty, Age, and Gender

We investigated characteristics and differences in activities of daily living (ADL) disability incidence according to gender, age, and frailty status in 4,985 community-dwelling older adults aged ≥ 65 years living in Japan. ADL disability is care level ≥ 2 in long-term care insurance. The cumulative care incidence over 6 years was compared. In the 6-year period, 654 older adults exhibited ADL disability. Age effect was most strongly related to ADL disability occurrence, followed by frailty status. Gender differences were observed in the 75–84-year-old pre-frail and robust groups. ADL disability incidence was higher in men, with a higher prevalence of low cognitive function and depression risk; at 75–84 years of age, men became ADL disabled, which was earlier than women. Therefore, gender differences must be considered for older adults in the 75–84-year age group when examining risk of long-term care and frailty as an outcome.