Risk of Frailty Progression Among Users of Public Services for the Prevention of Long‐Term Frailty in Japan: A Two‐Year, Single‐Center, Retrospective Cohort Study Frailty

Aim The relationship between the frailty status after using public services in Japan provided to prevent frailty in older adults from needing long‐term care and nursing care costs is unclear. We identified changes in frailty and the cost of care during the first 2 years of use among users of public services for the prevention of long‐term frailty. Methods The participants were 151 individuals certified as requiring assistance who had used public services between April 2011 and March 2020, with 2‐year follow‐up data. Frailty was assessed using the Kihon Checklist (KCL); changes in frailty and level of support were investigated at the start of use and after 2 years; the cost of care was compared between the maintenance‐frailty (MF) and severe‐frailty (SF) groups; and receiver operating characteristic curve analysis was used to determine cutoff values that predicted SF. Results The mean participants' age was 80.5 ± 6.7 years (sex, 37 male and 114 female). Among the 117 patients who were frail at baseline, 94 remained frail for 2 years, of whom 17 showed progression of care level and 77 did not. We observed a significant interaction ( p = 0.036) for the cost of care, mainly between measures ( p < 0.001). The area under the curve was 0.72, and the cutoff KCL score was 11.5 points (sensitivity 0.82, specificity 0.56). Conclusions Among patients with frailty, those with progression of care level showed significantly increased nursing care costs. Therefore, the identification of SF at the start of service use may allow more effective measures.