| Dose-response Association between Hand Dexterity and Functional Disability: A Longitudinal Study from the Kasama Study |
Namhoon Lim1, Kenji Tsunoda2 
, Jaehoon Seol2,3,4, Yujiro Asano1,3,5, Koki Nagata6,7, Taishi Tsuji2, Keisuke Fujii8, Yuya Fujii9, Kaori Teraoka10, Tomohiro Okura2,4,7 |
1Doctoral Program in Physical Education, Health and Sport Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
2Institute of Health and Sport Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
3Department of Frailty Research, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
4International Institute for Integrative Sleep Medicine (WPI-IIIS), Tsukuba Institute for Advanced Research (TIAR), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
5Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, KENTO Innovation Park NK Building, 3–17, Senriokashinmachi, Settsu, Osaka, Japan
6Institute for General Education, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga, Japan
7R&D Center for Tailor-Made QOL, University of Tsukuba, 1-2 Kasuga, Tsukuba, Ibaraki, Japan
8Faculty of Health Science, Suzuka University of Medical Science, 1001-1 Kishioka, Suzuka, Mie, Japan
9Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, 150 Tobuki, Hachioji, Tokyo, Japan
10Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte, Saitama, Japan |
Correspondence:
Kenji Tsunoda,
Email: tsunoda.kenji.ga@u.tsukuba.ac.jp
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Received: 17 May 2025 • Revised: 30 July 2025 • Accepted: 5 September 2025 |
| Abstract |
Background
Poor hand dexterity may increase the risk of functional disability; however, few studies have examined the relationship between hand dexterity and incident functional disability. The aim of this study was to prospectively investigate the dose-response association of hand dexterity with incident functional disability in community-dwelling older adults.
Methods
This study included 1,069 older adults aged ≥65 years in Kasama City, Japan. Peg-moving and circle-drawing tasks were used to evaluate hand dexterity. Functional disability was identified using the Japanese Long-Term Care Insurance System database. Restricted cubic spline analysis was performed to investigate the dose-response association between hand dexterity and incident functional disability.
Results
During a mean follow-up of 8.5 years (maximum 14.0 years), 248 participants (23.2%) developed functional disability. The lowest performance group in each hand dexterity test had a significantly higher risk of functional disability than the highest performance group (peg-moving: HR = 1.92, 95% CI = 1.29–2.87; circle drawing: HR = 1.66, 95% CI = 1.15–2.41). Spline analysis confirmed curvilinear dose-response associations between hand dexterity and incident functional disability. Increased risk was observed when participants performed worse than the cut points (peg-moving: 37.9/38.0 seconds; circle drawing: 21/20 points), and no decreased risk was observed for those who performed better than these cut points.
Conclusion
Easily evaluated hand dexterity tests may be valuable for predicting functional disability in older adults. Curvilinear dose-response associations suggest that maintaining adequate hand dexterity could be a key strategy to support functional independence. |
| Key Words:
Long-term care, Physical fitness, Geriatric assessment, Healthy life expectancy, Aging |
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