Diseases that precede disability among latter-stage elderly individuals in Japan
Diseases that precede disability among latter-stage elderly individuals in Japan
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DOI：
10.5582/bst.2015.01059
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发表时间：
2015-08-01
影响因子：
5.5
通讯作者：
Nagata, Satoko
中科院分区：
文献类型：
--
作者：
Naruse, Takashi;Sakai, Mahiro;Nagata, Satoko
了解老年人残疾的原因是一个重要的公共卫生问题，特别是因为老年人残疾率不断增加以及快速老龄化社会的社会成本。因此，我们的目的是描述日本 75 岁以上老年人中先于残疾的疾病，并调查与严重残疾相关的疾病类型。利用后期老年医疗保障体系和长期护理保险体系的理赔数据，我们筛选出2011年4月1日起不符合残疾人资格的75岁以上老年人76265人，其中2011年4月1日至2012年3月31日期间新认定残疾人资格的老年人3715人。收集了残疾前 6 个月内医疗索赔数据中的疾病代码。所有描述均按性别和残疾程度（低、中、高）划分为六组，分别制定。包括性别和年龄在内的序数逻辑分析结果显示，男性的残疾程度往往显着高于女性（β = 0.417，p < 0.001）。脑血管疾病（CVD）是几乎所有年龄和残疾水平组中最常见的疾病。在低度残疾群体中，男性癌症（12.8%）、女性关节病和骨折（分别为11.9%和13.5%）与脑血管疾病（男性和女性分别为12.2%和9.7%）一样常见。中风是所有性别和残疾程度的最常见疾病。导致低度残疾的疾病因性别而异。这项研究表明，为了预防残疾，需要考虑关节病、骨折以及心血管疾病。
Understanding causes of disability among elderly individuals is an important public health issue, particularly because of the increasing rate of disabled elderly individuals and the social costs in a rapidly aging society. Accordingly, we aimed to describe the diseases that precede disability and investigate the types of diseases that are related to severe disability among Japanese elderly individuals aged over 75 years. Using claim data from the latter-stage elderly healthcare system and long-term care insurance system, we identified 76,265 elderly individuals over 75 years old who did not qualify as disabled on April 1, 2011. Among them, 3,715 elderly individuals who had been newly qualified as disabled between April 1, 2011 and March 31, 2012 were selected. Disease codes from the medical claim data in the 6 months prior to disability were collected. All descriptions were developed separately for six groups divided by gender and disability level (low, middle, and high). The results of the ordinal logistic analysis including sex and age revealed that men tended to have significantly higher levels of disability (beta = 0.417, p < 0.001) than women. Cerebrovascular disorder (CVD) was the most common disease in almost all age and disability level groups. In low-level disability groups, cancer in men (12.8%) and arthropathy and fracture in women (11.9% and 13.5%, respectively) were as common as cerebrovascular disorder (12.2% and 9.7%, in men and women, respectively). Stroke was the most common disease for all genders and disability levels. The diseases preceding low-level disability differed by gender. This study demonstrated the need to consider arthropathy and fracture as well as CVD in order to prevent disability.