Risk factors of functional disability among community-dwelling elderly people by household in Japan: a prospective cohort study

Abstract

BackgroundAlthough the number of elderly people needing care is increasing rapidly in the home setting in Japan, family size and ability to provide such support are declining. The purpose of this study was to identify the risk factors of functional disability by household composition among community-dwelling elderly people.MethodsA total of 1347 elderly people aged 70 years and over participated in a baseline geriatric health examination for this prospective cohort study. In the health examination, we conducted an interview survey using a questionnaire in July 2004 and July 2005. Questionnaire items covered the following: age, sex, household, medical history, instrumental activities of daily living, intellectual activity, social role, Motor Fitness Scale, falls experienced during the past year, Dietary Variety Score, frequency of going outdoors, cognitive impairment, and depressive status. We defined the occurrence of functional disability as certification for long-term care needs of the subjects. The certification process started with a home visit for an initial assessment to evaluate nursing care needs using a questionnaire on current physical and mental status. The onset of functional disability was followed from July 2004 to March 2011. Cox proportional hazard regression analysis was used to estimate the risk factors related to the onset of functional disability, adjusted for age and sex.ResultsOf the 1084 participants, 433 were male (39.9%), and the average age was 77.8 (standard deviation, 5.4). Up to March 2011, functional disabilities occurred in 226 participants (20.9%). Elderly people living only with their children demonstrated a significantly higher risk for functional disability than the three-generation household group (hazard ratio, 1.61; 95% confidence interval, 1.08–2.40). The risk factors for functional disability varied according to household group.ConclusionsIn Japan, the number of vulnerable households with elderly people in need of care has increased steadily over the years. Appropriately identifying the risks related to functional disability requires a means of assessment that takes the household composition into consideration.

Area-Level and Individual-Level Factors for Teenage Motherhood: A Multilevel Analysis in Japan

“…Taking these related factors into account, the effect by high college enrollment (representing least social deprivation) might be inversely associated with the first element (teenage pregnancy) [21, 23, 25] and high proportions of three-generation households, low juvenile crime rates, and a high per capita income at an area level might be associated with the latter element (decision to pursuing pregnancy), which may provide teenage pregnant women with their motivation to continue with the pregnancy and ensure child rearing in a safe environment with rich social support [27, 28]. …”

“…At the same time, we also hypothesized that an area where single-mother households are more common may be associated with higher proportion of teenage motherhood because girls may have more opportunities to consider diverse family structures as their future choices. Similarly, living in a society where three-generation households account for a large proportion of households may provide a socially supportive environment which leads a sense of relief for young women [27, 28]. …”

Assessment of potential clinical cascade between oral hypofunction and physical frailty: Covariance structure analysis in a cross‐sectional study

“…Currently, the number of older people is increasing worldwide, and this tendency is especially prominent in Japan, which has the highest rate of population ageing in the world . With the increase in the older population, medical care costs will increase accordingly, and the need for preventative nursing care is becoming a critical Japanese social problem .…”

Functional disability and morbidities among the elderly people, according to socio-demographic conditions and indicative of depression

“…2 The prevalence of functional disability for basic activities (BADLs) and instrumental (IADLs) of daily life varies in national studies [3][4][5] and international studies. 6,7 As for its determinant factors, research have controversies. [8][9][10] In a study in Bahia, functional disability in IADLs was related to income, marital status, occupation during free time, age, health problems and sequels.…”

“…10 In Japan, the elderly living with their children alone had a significantly greater risk of functional disability than the three-generation family group. 7 It should also be pointed out that the elderly may present an unsuccessful aging, with associated comorbidities and dependence on activities of daily living (ADLs). 9 Also, the literature has described that some socioeconomic conditions such as female, older and lower income are related to the greater number of morbidities.…”