Katsura T, Fujimoto M, Shizawa M, Hoshino A, Usui K, Yokoyama E, Hara M. A retrospective cohort study on the risk assessment of newly certificated long-term care need of elderly individuals in a community: Basic checklist and specific health checkup.
J Rural Med 2017;
12:68-84. [PMID:
29255523 PMCID:
PMC5721290 DOI:
10.2185/jrm.2932]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 05/20/2017] [Indexed: 11/27/2022] Open
Abstract
Objective: This study aimed to examine the factors influencing the
requirement of a certificate of long-term care using a basic checklist and items listed in
the Special Health Checkup.
Method: This study included 7,820 individuals living in Uji city, who were
selected from among 8,000 elderly individuals who, in 2008, underwent a specific health
checkup (hereafter referred to as the ‘specific health checkup for the old-old elderly
individuals’) for those aged 75 years and above. They answered questions from basic
checklists at the time, and 180 individuals were excluded as they had already qualified
for requiring the certificate of long-term care at the time of the checkup. The follow-up
period extended from the day of the specific health checkup for the old-old elderly
individuals to March 31, 2013. The data were analyzed using the certificate of needing
long-term care as the response variable. The explanatory variables were the basic
attributes, items listed in the specific health checkup for the old-old elderly
individuals, interview sheets, and basic checklists. Cox proportional hazards regression
analysis was conducted.
Results: In total, 1,280 elderly individuals qualified for requiring the
certificate of needing long-term care. The risk factors for the young-old elderly
individuals aged 65 to 74 years were as follows: hepatic dysfunction (hazard ratio
{HR}=1.69), the presence of subjective symptoms (HR=1.41), an above-normal abdominal
circumference (HR=1.36), old age (HR=1.13), a reduced frequency of going out since the
previous year (HR=1.87), the use of support for standing up after being seated on a chair
(HR=1.86), no deposit or withdrawals made (HR=1.84), the anxiety of falling down
(HR=1.50), an inability to climb stairs without holding a railing or wall (HR=1.49), as
well as an increased difficulty in eating tough food items compared with 6 months prior
(HR=1.44). The risk factors for the old-old elderly individuals were as follows: a
positive reaction on proteinuria (HR=1.27), anemia (HR=1.18), old age (HR=1.10), inability
to travel on a bus or train by themselves (HR=1.53), the inability to climb stairs without
holding a railing or wall (HR=1.48), weight loss (HR=1.36), a reduced sense of
appreciation of the activities they had previously participated in, over a span of 2 weeks
(HR=1.30), the use of support for standing up after being seated on a chair (HR=1.23), and
the anxiety of falling down (HR=1.20).
Conclusion: The items listed in the specific medical checkup as well as the
basic checklists were found to be risk factors for both the young-old elderly individuals
and the old-old elderly individuals, indicating the need to utilize these lists for the
prevention of nursing even in the late stages of life. Moreover, these results suggest the
importance of screening elderly individuals suffering from hyperkinesis using the basic
checklist and conducting preventive interventions in order to maintain and improve their
physical functions.
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