Effects of community-based frailty-preventing intervention on all-cause and cause-specific functional disability in older adults living in rural Japan: A propensity score analysis

Preventing frailty is crucial in aging societies. We examined the effectiveness of a community-based frailty -prevention program for delaying the onset of functional disability among community-dwelling older adults. From 2014 to 2019, 48 community-based frailty prevention classes (FPC, 60 min/session, once a week), comprising resistance exercise and nutritional or psychosocial programs, were established in Yabu City, Japan. We con-ducted a baseline survey in 2012 and followed up with participants for up to 6.8 years (4.8 years from estab-lishing the first FPC). We analyzed data from 3350 older people. The primary and secondary outcomes were the onset of functional disability and cause-specific functional disability (including dementia and cardiovascular and orthopedic diseases), respectively. In addition to crude Cox proportional hazard regression, inverse probability of treatment weighting (IPTW) and propensity score matching (PSM; 918 nonparticipants and 459 participants) were used to adjust for confounders. Participants were more likely to be female and have a healthy lifestyle than nonparticipants. During the follow-up, 690 individuals developed a functional disability. The hazard ratio of incident functional disability in the participants was significantly lower than that in nonparticipants in the IPTW (hazard ratio 0.53, 95% confidential interval 0.38-0.75) and PSM (0.52, 0.37-0.71) analyses. In age-stratified analysis, significant associations were observed only in the >= 75-year-old subgroup. In a cause-specific anal-ysis, participation significantly and consistently reduced incident functional disability caused by dementia (IPTW 0.47, 0.25-0.86; PSM 0.45, 0.25-0.83). Community-based FPC may be effective for preventing functional disability, especially caused by dementia, in this population.