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

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.

Changes in Kihon Checklist items and new Certification of long-term care needs among Japanese community-dwelling elders

“…In previous studies, the odds ratios of the KCL items over one year with respect to Certification were 1.25-2.71 15,16) , while the proportional HRs were 1.13-2.26 13,14) . The present study differs from previous studies since it identifies changes over a three-year period, with a subsequent twoyear follow-up on the incidence of new LTCI Certifications.…”

“…Recent systematic reviews identified the KCL as a reliable tool for predicting aspects of frailty, including elders’ overall vulnerability and functional disorders, Instrumental Activities of Daily Living (IADL) limitations, and sadness/depression 11 ) . Previous longitudinal studies investigated the correlations between KCL items and Certification over one year using “response/no response” to the KCL items 12 ) , with individual items as the independent variable 13 ) . Meanwhile, other longitudinal studies that investigated the correlation between KCL items and Certification over one year used individual dimensions 14 , 15 , 16 ) and total score 17 ) as the independent variable.…”

Risk Factors of Long-Term Care Insurance Certification in Japan: A Scoping Review

“…Satake et al found that KCL classification of physical frailty status could be a significant tool to predict the 3-year risk of functional disability [ 99 ]. Katsura et al showed that many, but not all, items were significantly associated with a 5-year risk of functional disability among both the young-old and old-old [ 100 ]. Shinkai et al validated the checklist against the original version for screening high-risk older adults [ 101 ].…”

Liver Fibrosis is Associated with a Decrease in Gait Speed in Older Men with Chronic Liver Disease: A Retrospective Cross-Sectional Study

“…It has also been reported that disability is associated with the risk of mortality in older people 21 ; in particular, a decrease in the normal walking speed in older people is associated with poor life expectancy. 22 A longitudinal study of risk factors among older people in the community reported that liver dysfunction is a risk factor for the need for nursing care, 23 and CLD is known to cause more disability and limitations in ADL than osteoarthritis, heart disease, and diabetes. 6 As the number of older patients with CLD has been increasing in recent years, further measures are imperative to increase the healthy life expectancy and reduce the burden of nursing care.…”