Association between changes in physical function and progression of locomotive syndrome in community-dwelling older adults: a 2-year longitudinal study

Abstract

Objective: Japan is one of the most rapidly aging societies in the world, and preventing mobility decline in older adults remains a critical public health priority. This study aimed to examine the association between changes in physical function and the progression of locomotive syndrome (LS) over a 2-year period in community-dwelling older adults. Materials and Methods: The participants were community-dwelling older adults aged ≥60 years who participated in a municipal preventive care program. Among them, 58 participants who completed the 2-year follow-up assessment were analyzed. LS was assessed using the 25-question Geriatric Locomotive Function Scale (GLFS-25) and the two-step test. Participants were categorized according to LS stage, and changes over 2 years were defined as progression, maintenance, or improvement. Physical function was evaluated using grip strength, the sit-and-reach test (SRT), and the 30-second chair stand test (CS-30). Logistic regression analysis was used to examine the associations between changes in physical function and LS progression, with adjustment for age. Results: Over 2 years, 16 participants (27.6%) exhibited LS progression. Compared with those with progression, participants who maintained or improved their LS stage showed greater increases in CS-30 and SRT performance. In age-adjusted logistic regression models, increases in CS-30 (odds ratio [OR] 0.81, 95% confidence interval [CI] 0.66–0.99) and SRT (OR 0.91, 95% CI 0.83–0.99) were significantly associated with reduced risk of LS progression. Conclusion: Changes in lower-limb muscle endurance and flexibility were significantly associated with LS progression in community-dwelling older adults. Maintaining or improving these physical functions may help prevent mobility decline in this population.