Potential of the 25-Question Geriatric Locomotive Functional Scale to Improve Prediction of Nursing-Care Requirement: A 4-Year Cohort Study

AIM: To improve and simplify the predictive ability of the 25-question Geriatric Locomotive Function Scale (GLFS-25) for nursing-care need, using nursing-care certification status over a 4-year period as an indicator. METHODS: This study included 320 individuals aged ≥ 65 years (mean age 76.3 ± 6.6 years, 62.8% male) who had undergone health checkups in 2018 and had never been certified for nursing-care need. The GLFS-25, GLFS-5, and Kihon checklists were examined in 2018. Participants were followed up for 4 years to assess nursing-care certification status. Each GLFS-25 item was statistically selected using the Cox proportional hazards model. The akaike information criterion (AIC) was used to compare the goodness of fit of the selected items to that of other screening tools. RESULTS: Using the GLFS-25 items as explanatory variables, which showed significant differences after adjustment for age and sex, analysis was conducted using stepwise and forced-entry methods, showing that questions #15 (How far can you walk without resting?) and #21 (Difficulty performing sports activities) were significant predictors of nursing-care need across methods. Therefore, the total score (#15 + #21) was selected as the screening tool. In the age- and sex-adjusted model, the selected screening tool was a significant risk factor, with an AIC of 514, lower than that of the other screening tools. CONCLUSION: The total score of questions #15 and #21 was suitable for nursing-care risk assessment within 4 years. This is also recommended for use in subanalysis of locomotive syndrome screening.