Comprehensive geriatric functional analysis of elderly populations in four categories of the long-term care insurance system in a rural, depopulated and aging town in Japan
Comprehensive geriatric functional analysis of elderly populations in four categories of the long-term care insurance system in a rural, depopulated and aging town in Japan
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DOI：
10.1111/j.1447-0594.2012.00859.x
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发表时间：
2013-01-01
影响因子：
3.3
通讯作者：
Matsubayashi, Kozo
中科院分区：
文献类型：
--
作者：
Chen, Wenling;Fukutomi, Eriko;Matsubayashi, Kozo
目的：本研究的目的是在日本一个人口稀少的农村老龄化城镇，通过对现行长期护理保险制度（LTCI）的四个不同认证级别的社区居住老年参与者的功能维度进行分析，并特别考虑LTCI的优势和劣势。方法：研究人群包括1077名年龄在65岁及以上的社区居住老年参与者，其中542名未获得LTCI认证的老年人437名特定老年人（德亭是社）、57名支助级老年人（友仙园是社）和41名护理级老年人（友会后仁德社）。每个参与者都被评估他们的健康状况，问题主题包括日常生活基本活动（ADL），东京都立老年学研究所能力指数（TMIG-IC），15项老年抑郁量表（GDS-15），21项跌倒风险指数（FRI-21），定量主观生活质量（QOL），当前医疗状况，既往病史和社会背景。结果：根据认证级别，基本ADL、TMIG-IC各项目和定量主观生活质量5个项目的得分显著降低，GDS-15和FRI-21得分显著升高，支持水平和护理水平的老年人在剂量反应的方式。运动和饮酒习惯显着不太常见的支持或护理水平的老年人比指定或无证老年人。服用抗高血压，抗高脂血症，抗抑郁或安眠药的患病率显着高于支持或护理水平的老年人比未认证或指定的老年人。支持或护理水平的老年人也有一个显着较高的患病率，过去的病史中风，骨折，骨关节病，心脏病和癌症比未经认证或指定的老年people.Conclusion：实际标准化的定量和定性老年功能的四个类别之间的新修订的LTCI系统中显示在人口减少和老龄化的城镇在日本。根据老年人功能的实际情况，对现行LTCI系统的优缺点进行了重新思考。需要进一步研究防止特定和支助级别老年人今后依赖他人的措施。Geriatr Gerontol Int 2013; 13：63-69.
Aim: The aim of this study was to show which dimensions of functions differ among community-dwelling elderly participants in four different certification levels of the current long-term care insurance system (LTCI) in a rural, depopulated and aging town in Japan, with special consideration for strengths and weaknesses of the LTCI.Methods: The study population consisted of 1077 community-dwelling elderly participants aged 65 years and older, with LTCI certification comprising 542 uncertified elderly (Ippan-Koureisya), 437 specified elderly (Tokutei-Koreisha), 57 support-level elderly (Youshien-Koureisha) and 41 care-level elderly (Youkaigo-Ninteisha). Each participant was rated regarding their health status, with question topics including basic activities of daily living (ADL), the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), the 15-item Geriatric Depression Scale (GDS-15), 21-item Fall Risk Index (FRI-21), the quantitative subjective quality of life (QOL), current medical situation, past medical histories and social backgrounds.Results: The scores in basic ADL, each item of the TMIG-IC and five items of the quantitative subjective QOL were significantly lower, and the scores in GDS-15 and in FRI-21 were significantly higher according to certification level, in order of uncertified, specified, support-level and care-level elderly in a dose-response manner. Exercise and drinking habits were significantly less common in support- or care-level elderly than in specified or uncertified elderly. The prevalence of taking antihypertensive, antihyperlipidemia, antidepressant or sleeping medications was significantly higher in the support- or care-level elderly than in uncertified or specified elderly people. Support- or care-level elderly also had a significantly higher prevalence of past medical histories of stroke, bone fractures, osteoarthropathy, heart disease and cancer than uncertified or specified elderly people.Conclusion: Actual standardized quantitative and qualitative geriatric functions of the elderly among four categories in newly revised LTCI system were shown in a depopulated and aging town in Japan. Based on the actual situation of functions of the elderly, the strengths and weaknesses of the current LTCI system were reconsidered. Further research on the measures to prevent future dependency among the specified and support-level elderly is required. Geriatr Gerontol Int 2013; 13: 63-69.