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Risk Factors of Long-Term Care Insurance Certification in Japan: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042162. [PMID: 35206350 PMCID: PMC8872097 DOI: 10.3390/ijerph19042162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/25/2022] [Accepted: 02/11/2022] [Indexed: 02/06/2023]
Abstract
This study aimed to review evidence on future long-term care associated with pre-existing factors among community-dwelling Japanese older adults. We systematically searched cohort and nested case–control studies published between 2000 and 2019 that assessed long-term care certification using the PubMed, CINAHL, and EMBASE databases. The relationship between long-term care insurance information and risk factors was investigated. The protocol was registered with the Open Science Framework. We extracted 91 studies for synthesis, including 84 prospective cohort studies, 1 retrospective cohort study, and 6 nested case–control studies. Certification for long-term care was classified into two endpoints: onset of functional disability and dementia. There were 72 studies that used long-term care certification as a proxy for functional disability, and 22 used long-term care information to indicate the onset of dementia. Common risk factors related to functional disability were physical function, frailty, and oral condition. Motor function and nutritional status were common risk factors for dementia. We found consistent associations between premorbid risk factors and functional disability and dementia. The accumulation of evidence on the incidence of long-term care and associated factors can aid the development of preventive measures. Future studies should aim to integrate this evidence.
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Takahashi S, Tanno K, Yonekura Y, Ohsawa M, Kuribayashi T, Ishibashi Y, Omama S, Tanaka F, Onoda T, Sakata K, Koshiyama M, Itai K, Okayama A. Low educational level increases functional disability risk subsequent to heart failure in Japan: On behalf of the Iwate KENCO study group. PLoS One 2021; 16:e0253017. [PMID: 34101763 PMCID: PMC8186788 DOI: 10.1371/journal.pone.0253017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/27/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives The risk factors that contribute to future functional disability after heart failure (HF) are poorly understood. The aim of this study was to determine potential risk factors to future functional disability after HF in the general older adult population in Japan. Methods The subjects who were community-dwelling older adults aged 65 or older without a history of cardiovascular diseases and functional disability were followed in this prospective study for 11 years. Two case groups were determined from the 4,644 subjects: no long-term care insurance (LTCI) after HF (n = 52) and LTCI after HF (n = 44). We selected the controls by randomly matching each case of HF with three of the remaining 4,548 subjects who were event-free during the period: those with no LTCI and no HF with age +/-1 years and of the same sex, control for the no LTCI after HF group (n = 156), and control for the LTCI after HF group (n = 132). HF was diagnosed according to the Framingham diagnostic criteria. Individuals with a functional disability were those who had been newly certified by the LTCI during the observation period. Objective data including blood samples and several socioeconomic items in the baseline survey were assessed using a self-reported questionnaire. Results Significantly associated risk factors were lower educational levels (odds ratio (OR) [95% confidence interval (CI)]: 3.72 [1.63–8.48]) in the LTCI after HF group and hypertension (2.20 [1.10–4.43]) in no LTCI after HF group. Regular alcohol consumption and unmarried status were marginally significantly associated with LTCI after HF (OR [95% CI]; drinker = 2.69 [0.95–7.66]; P = 0.063; unmarried status = 2.54 [0.91–7.15]; P = 0.076). Conclusion Preventive measures must be taken to protect older adults with unfavorable social factors from disability after HF via a multidisciplinary approach.
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Affiliation(s)
- Shuko Takahashi
- Division of Medical Education, Iwate Medical University, Shiwa-gun, Iwate, Japan
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Department of Health and Welfare, Iwate Prefectural Government, Morioka, Iwate, Japan
- * E-mail:
| | - Kozo Tanno
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Shiwa-gun, Iwate, Japan
| | | | - Masaki Ohsawa
- Morioka Tsunagi Onsen Hospital, Morioka, Iwate, Japan
| | - Toru Kuribayashi
- Faculty of Humanities and Social Sciences, Iwate University, Morioka, Japan
| | - Yasuhiro Ishibashi
- Department of Neurology and Gerontology, Iwate Medical University, Shiwa-gun, Iwate, Japan
| | - Shinichi Omama
- Department of Neurosurgery, Iwate Medical University, Shiwa-gun, Iwate, Japan
| | - Fumitaka Tanaka
- Division of Nephrology and Hypertension, School of Medicine, Iwate Medical University, Shiwa-gun, Iwate, Japan
| | | | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Shiwa-gun, Iwate, Japan
| | | | - Kazuyoshi Itai
- Department of Nutritional Sciences, Morioka University, Takizawa, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
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Taniguchi Y, Kitamura A, Kaito S, Yokoyama Y, Yokota I, Shinozaki T, Seino S, Murayama H, Matsuyama Y, Ikeuchi T, Fujiwara Y, Shinkai S. Albumin and Hemoglobin Trajectories and Incident Disabling Dementia in Community-Dwelling Older Japanese. Dement Geriatr Cogn Disord 2020; 47:233-242. [PMID: 31315125 DOI: 10.1159/000499837] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 03/21/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Serum albumin and hemoglobin levels are independently associated with subsequent cognitive deterioration in older adults. This prospective study used repeated measures analysis to identify aging trajectories in serum albumin and hemoglobin levels and investigated if these trajectories were associated with incident disabling dementia among community-dwelling older Japanese. METHODS A total of 2,005 adults aged 65-90 years participated in annual geriatric health assessments during the period from June 2002 through July 2017; the total number of observations was 9,330. A review of a municipal database of the Japanese public long-term care insurance system identified 1,999 of 2,005 adults without dementia at baseline, 278 (13.9%) of whom developed disabling dementia during the follow-up period (June 2002 through December 2017). RESULTS We identified three trajectory patterns (high, moderate, and low) for serum albumin and hemoglobin levels for the age period 65 through 90 years. After controlling for potential confounders, participants with moderate and low trajectories for serum albumin level had hazard ratios of 1.27 (95% confidence interval 0.94-1.72) and 2.07 (1.37-3.11), respectively, for the development of incident disabling dementia, with the high trajectory group as reference. The respective hazard ratios for hemoglobin level were 1.31 (0.93-1.85) and 1.58 (1.04-2.40), respectively. CONCLUSION Dementia risk was higher for individuals with low trajectories for serum albumin and hemoglobin levels. This finding highlights the importance of interventions that improve nutritional status and control relevant diseases in middle-aged and older adults with low serum albumin and hemoglobin levels.
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Affiliation(s)
- Yu Taniguchi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Sho Kaito
- Department of General Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Yuri Yokoyama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Tomohiro Shinozaki
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Yutaka Matsuyama
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Tomoko Ikeuchi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shoji Shinkai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Taniguchi Y, Watanabe Y, Osuka Y, Kitamura A, Seino S, Kim H, Kawai H, Sakurai R, Inagaki H, Awata S, Shinkai S. Characteristics for gait parameters of community-dwelling elderly Japanese with lower cognitive function. PLoS One 2019; 14:e0212646. [PMID: 30917138 PMCID: PMC6436685 DOI: 10.1371/journal.pone.0212646] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 02/06/2019] [Indexed: 12/02/2022] Open
Abstract
Objectives Recent studies reported that several gait parameters were associated with lower cognitive function or cognitive decline, however, known gait parameters were limited and no study has used large-scale data. We identified the characteristics for gait parameters of community-dwelling elderly Japanese with lower cognitive function. Methods 1,240 community-dwelling adults (mean [SD] age, 77.2 [4.8] years; women, 59.4%) aged 70 or older participated in geriatric health assessments in 2016. We measured comprehensive gait parameters using resistive pressure platform. Cognition was assessed by Mini-Mental State Examination (MMSE). Results There are possible correlations between gait measures (gait speed, stride length, step length, step width, average foot pressure, double support duration, and single support duration) and CVs (CV of stride length, step length, average foot pressure, and single support duration) with MMSE score, respectively. After adjustment for important confounders, multiple regression models showed that gait speed (β = .080, p = 0.006), stride length (β = .123, p<0.001), step length (β = .123, p<0.001), average foot pressure (β = .060, p = 0.040), double support duration (β = -.082, p = 0.004), single support duration (β = .086, p = 0.003), CV of stride length (β = -.091, p<0.001), CV of step length (β = -.090, p<0.001), and CV of single support duration (β = -.058, p = 0.037) had significant association with MMSE score, respectively. Conclusions Our findings suggest that person with lower cognitive function tend to have unsteady gait such as erratic length and time of one step, in addition to decreasing the vertical displacement of the center of gravity and slower speed.
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Affiliation(s)
- Yu Taniguchi
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- * E-mail:
| | - Yutaka Watanabe
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yosuke Osuka
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Satoshi Seino
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ryota Sakurai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hiroki Inagaki
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shuichi Awata
- Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shoji Shinkai
- Research on Social and Human Science, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Kitamura K, Watanabe Y, Nakamura K, Takahashi A, Takachi R, Oshiki R, Kobayashi R, Saito T, Tsugane S, Sasaki A. Weight loss from 20 years of age is associated with cognitive impairment in middle-aged and elderly individuals. PLoS One 2017; 12:e0185960. [PMID: 28982190 PMCID: PMC5628924 DOI: 10.1371/journal.pone.0185960] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/24/2017] [Indexed: 12/21/2022] Open
Abstract
Background Few empirical studies have been conducted to identify modifiable factors that may affect cognitive impairment in Japanese individuals. The present study aimed to clarify whether body mass and lifestyle are associated with cognitive impairment in Japanese middle-aged and elderly individuals. Methods Subjects were 1814 community-dwelling individuals aged 44–79 years, all of whom were participants of the Murakami Cohort Study baseline survey conducted in 2011–2013. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) in 2014–2016, and cognitive impairment, the outcome measure, was defined as an MMSE score <24. Predictor variables were body mass index (BMI), long-term weight changes from 20 years of age, and lifestyle factors, such as smoking, drinking, and physical activity levels, which were obtained from a self-administered questionnaire in the baseline survey. Covariates were sex, age, education level, and histories of stroke and diabetes. Multiple logistic regression analysis was used to calculate the adjusted odds ratios (ORs). Results The prevalence of overall cognitive impairment was 6.2%. The adjusted ORs of cognitive impairment in the lowest (<[-4]kg) (OR = 2.70, 95%CI, 1.18–6.20) and second ([-4]-[0]kg) (OR = 2.37, 95%CI, 1.04–5.37) quintiles for long-term weight change were significantly higher than the reference 4th quintile ([+4]-[+7]kg). The adjusted OR in the highest quintile (≥[+8]kg) was 2.24 (95%CI, 0.99–5.04). Current BMI was not associated with cognitive impairment. Conclusions Long-term weight loss is associated with cognitive impairment in Japanese middle-aged and elderly individuals. Because the present study was retrospective in nature, prospective studies should also be conducted for further characterization of this association.
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Affiliation(s)
- Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- * E-mail:
| | - Akemi Takahashi
- Department of Physical Therapy, Niigata University of Rehabilitation, Murakami, Niigata, Japan
| | - Ribeka Takachi
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Food Science and Nutrition, Nara Women’s University Graduate School of Humanities and Sciences, Nara, Japan
| | - Rieko Oshiki
- Department of Physical Therapy, Niigata University of Rehabilitation, Murakami, Niigata, Japan
| | - Ryosaku Kobayashi
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Toshiko Saito
- Department of Health and Nutrition, Niigata University of Health and Welfare, Niigata, Japan
| | - Shoichiro Tsugane
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Ayako Sasaki
- Murakami Public Health Center, Murakami, Niigata, Japan
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Taniguchi Y, Kitamura A, Murayama H, Amano H, Shinozaki T, Yokota I, Seino S, Nofuji Y, Nishi M, Yokoyama Y, Matsuyama Y, Fujiwara Y, Shinkai S. Mini-Mental State Examination score trajectories and incident disabling dementia among community-dwelling older Japanese adults. Geriatr Gerontol Int 2017; 17:1928-1935. [DOI: 10.1111/ggi.12996] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/30/2016] [Accepted: 12/07/2016] [Indexed: 12/25/2022]
Affiliation(s)
- Yu Taniguchi
- Research Team for Social Participation and Community Health; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | | | - Hidenori Amano
- Research Team for Social Participation and Community Health; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Tomohiro Shinozaki
- Department of Biostatistics, School of Public Health; The University of Tokyo; Tokyo Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medical Science; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Satoshi Seino
- Research Team for Social Participation and Community Health; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Yu Nofuji
- Institute of Community Medical Practice, Health Promotion Research Center; Tokyo Japan
| | - Mariko Nishi
- Research Team for Social Participation and Community Health; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Yuri Yokoyama
- Research Team for Social Participation and Community Health; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Yutaka Matsuyama
- Department of Biostatistics, School of Public Health; The University of Tokyo; Tokyo Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
| | - Shoji Shinkai
- Research Team for Social Participation and Community Health; Tokyo Metropolitan Institute of Gerontology; Tokyo Japan
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