Both conventional indices of cognitive function and frailty predict levels of care required in a long‐term care insurance program for memory clinic patients in Japan

Takechi, Hajime; Sugihara, Yuriko; Kokuryu, Atsuko; Nishida, Maiko; Yamada, Hiroko; Arai, Hidenori; Hamakawa, Yoko

doi:10.1111/j.1447-0594.2011.00828.x

Cited by 15 publications

(18 citation statements)

References 28 publications

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“…Takechi et al . examined 201 cognitively impaired patients and found that their mean grip strength was 16.9 kg, much lower than the healthy older adults . We have also observed that cognitively impaired older adults had lower muscle mass, slower gait speed and weaker grip strength .…”

Section: Introductionmentioning

confidence: 68%

Age‐associated decline of muscle mass, grip strength and gait speed: A 4‐year longitudinal study of 3018 community‐dwelling older Chinese

Auyeung

Lee

Leung

et al. 2014

Geriatrics Gerontology Int

166

125

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Aims: Studies about sarcopenia in Asia are fewer, and started later than in Europe and America. We attempted to examine the decline in muscle mass, grip strength and gait speed in a cohort of older Chinese prospectively over 4 years. Methods:We recruited 4000 community-living Chinese older than 64 years, and measured their appendicular skeletal mass (ASM) by dual-energy X-ray absorptiometry, grip strength, and gait speed at baseline and after 2 years. Muscle mass and gait speed were additionally measured after 4 years.Results: After 4 years, 3018 participants completed all the measurements. The annualized decline in grip strength (−0.798 kg/year vs −1.239 kg/year) and gait speed (−0.019 m/s/year vs -0.025 m/s/year) was faster in women than in men. Muscle mass was relatively preserved in comparison with grip strength and gait speed. The percentage loss of ASM in 4 years was −1.59% and −2.02% in men and women, respectively. The percentage decline in gait speed after 4 years was −8.2% in men and −9.0% in women. However, the decline in grip strength was more rapid, particularly in women, which was −10.0% in 2 years and less so in men, −3.85% in 2 years. Conclusion:Compared with black people and white people, the older Chinese have less muscle mass, weaker grip strength and slower gait speed. Although the rate of loss of ASM was modest, the decline in gait speed was rapid and the decline in grip strength was particularly fast in older Chinese women. Geriatr Gerontol Int 2014; 14 (Suppl. 1): 76-84.

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Section: Introductionmentioning

confidence: 68%

Age‐associated decline of muscle mass, grip strength and gait speed: A 4‐year longitudinal study of 3018 community‐dwelling older Chinese

Auyeung

Lee

Leung

et al. 2014

Geriatrics Gerontology Int

166

125

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“…Nursing care services are offered based on the support‐need or care‐need level. However, there are substantial numbers of people with dementia and family caregivers who do not wish to use social care services or apply for certification . These participants were classified in the “did not apply” group, and they were assumed to have met the lowest level of care required in the present study, because they did not use social care services.…”

Section: Methodsmentioning

confidence: 99%

“…However, there are substantial numbers of people with dementia and family caregivers who do not wish to use social care services or apply for certification. 16,17 These participants were classified in the "did not apply" group, and they were assumed to have met the lowest level of care required in the present study, because they did not use social care services. Participants who required nursing care for conditions other than AD or in combination with AD, such as cerebrovascular disease or musculoskeletal disorders, were excluded from this study.…”

Section: Ltci Service Use and Monthly Costsmentioning

confidence: 99%

Increase in direct social care costs of Alzheimer's disease in Japan depending on dementia severity

Takechi

Kokuryu

Kuzuya

et al. 2019

Geriatrics Gerontology Int

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Aim With the aging population, costs of direct social support for patients with Alzheimer's disease have grown and will continue to increase. The purpose of the present study was to estimate the cost of direct social support for Alzheimer's disease under long‐term care insurance in Japan. Methods This cross‐sectional study included 169 patients with Alzheimer's disease or mild cognitive impairment who visited a memory clinic and were followed over time. Dementia severity, use of care services and costs were analyzed. Results The use of direct social support and costs increased significantly between patients with mild, moderate and severe dementia (P < 0.001). In particular, the use of day services and short stay services increased with the severity of dementia (P < 0.001). Similar findings were obtained when participants were stratified by long‐term care insurance care levels. Of 169 participants, 49 had not applied for long‐term care insurance, although their dementia severity was not different from support‐need level 1 and care‐need level 1. Logistic regression analysis of “did not apply” and “applied and certified” groups showed significant differences not only in dementia severity, but also in age (odds ratio 1.112, 95% confidence interval 1.037–1.193, P = 0.003) and living arrangements (odds ratio 0.257, 95% confidence interval 0.076–0.862, P = 0.028). Conclusions As the number of patients with Alzheimer's disease increases, direct social costs will increase. The findings of this study might help standardize the type of direct social support provided after diagnosis of Alzheimer's disease and contribute to the development of cost‐effective care for these patients. Geriatr Gerontol Int 2019; 19: 1023–1029.

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“…Functional measures included ADLs, IADLs, gait disorders, disability measures, and impairment measures that relate to the World Health Organization’s International Classification of Functioning [24–26]. Other areas of function included measures of cognitive performance, memory, and communication disorders [12, 27–29]. Physical related parameters included sensory loss, hearing loss, communication deficits, pain and other chronic clinical complications [27, 30, 31].…”

Section: Introductionmentioning

confidence: 99%

Development of the interRAI home care frailty scale

2016

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BackgroundThe concept of frailty, a relative state of weakness reflecting multiple functional and health domains, continues to receive attention within the geriatrics field. It offers a summary of key personal characteristics, providing perspective on an individual’s life course.There have been multiple attempts to measure frailty, some focusing on physiologic losses, others on specific diseases, disabilities or health deficits. Recently, multidimensional approaches to measuring frailty have included cognition, mood and social components. The purpose of this project was to develop and evaluate a Home Care Frailty Scale and provide a grounded basis for assessing a person’s risk for decline that included functional and cognitive health, social deficits and troubling diagnostic and clinical conditions.MethodsA secondary analysis design was used to develop the Home Care Frailty Scale. The data set consisted of client level home care data from service agencies around the world. The baseline sample included 967,865 assessments while the 6-month follow-up sample of persons still being served by the home care agencies consisted of 464,788 assessments. A pool of 70 candidate independent variables were screened for possible inclusion and 16 problem outcomes referencing accumulating declines and clinical complications served as the dependent variables. Multiple regression techniques were used to analyze the data.ResultsThe resulting Home Care Frailty Scale consisted of a final set of 29 items. The items fall across 6 categories of function, movement, cognition and communication, social life, nutrition, and clinical symptoms. The prevalence of the items ranged from a high of 87% for persons requiring help with meal preparation to 3.7% for persons who have experienced a recent decline in the amount of food eaten.ConclusionsThe interRAI Home Care Frailty Scale is based on a strong conceptual foundation and in our analysis, performed as expected. Given the use of the interRAI Home Care Assessment System in multiple, diverse countries, the Home Care Frailty Scale will have wide applicability to support program planning and policy decision-making impacting home care clients and their formal and informal caregivers throughout the world.

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Both conventional indices of cognitive function and frailty predict levels of care required in a long‐term care insurance program for memory clinic patients in Japan

Cited by 15 publications

References 28 publications

Age‐associated decline of muscle mass, grip strength and gait speed: A 4‐year longitudinal study of 3018 community‐dwelling older Chinese

Age‐associated decline of muscle mass, grip strength and gait speed: A 4‐year longitudinal study of 3018 community‐dwelling older Chinese

Increase in direct social care costs of Alzheimer's disease in Japan depending on dementia severity

Development of the interRAI home care frailty scale

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