Differences of locomotive syndrome and frailty in community-dwelling middle-aged and elderly people: Pain, osteoarthritis, spinal alignment, body balance, and quality of life

Purpose: To identify differences between locomotive syndrome (LS) and frailty. Methods: A total of 1016 subjects (males 427, females 589, mean age 64 years) were prospectively examined in the Yakumo study. LS was defined as >= 16 on the GLFS-25 questionnaire. Frailty was diagnosed as >= 3 of unintentional weight loss, grip strength weakness, low walking speed, exhaustion, and low physical activity. Results: LS (14.4%) and frailty (10.8%) were more significant in older, female subjects with weaker muscle strength, lower gait speed, severer pain, poorer spinal alignment, and poor quality of life (QOL). LS strongly reflected musculoskeletal and neuropathic pain, knee and lumbar degeneration with poor spinal alignment, and poorer body balance, whereas frailty reflected muscle weakness. In multivariate analysis adjusted for age and gender, the significant independent risk factors were LS (odds ratio (OR) 10.6), frailty (OR 3.6), pain (OR 1.02) for poor physical QOL, and LS (OR 4.4) and lower gait speed (OR 1.6) for poor mental QOL. Conclusion: LS is more strongly related to musculoskeletal factors and may be more important than frailty for poor physical and mental QOL. LS should be checked early especially in independent elderly people to maintain activities of daily living and QOL.