Prevalence and outcome of low ADL and incontinence among the elderly: five years follow-up in a Japanese urban community

Activities of daily living (ADL) and state of incontinence in 2,567 elderly community residents aged 65 years and over, living in Koganei City (a suburb of Tokyo) were longitudinally investigated through two mail surveys at the beginning and end of a five-year period. At the entry, only 6% of total subjects were classified as low ADL, 3% as incontinent. 30% of the low ADL were classified as incontinent. While the majority of the high ADL and the non-incontinent subjects maintained their conditions during the 5-year period, 66% of the low ADL, 70% of the incontinent, and 81% of the low ADL accompanied by incontinence died during the 5-year period. These mortality rates in low ADL and/or incontinent subjects were 2 times higher than the age-sex standardized mortality rate in the population investigated.