Evaluation of multimodal factors for the certification of long-term care insurance among community-dwelling elderly: a four-year follow-up study.

Abstract

The aim of this study was to examine risk factors for the certification of long-term care insurance (hereafter reffered to as "certification") in the community-dwelling elderly individuals. At baseline, 4,503 community-dwelling elderly responded to a self-completed questionnaires including items for "certification". Among the respondents, we analyzed 4,213 individuals with a non-support status who provided data regarding sex. The endpoint was the onset of "certification". At the end of the four-year follow-up period, 313 subjects had received "certification" (support-transition group), while the remaining 3,639 subjects continued to exhibit a non-support status (non-support group). The support-transition group contained a higher proposion of subjects with chronic disease than the non-support group. The presence of chronic disease, a poor condition of the eyes or teeth, infrequent medical checkups, a high BMI, changes in body weight within one year, sleep disturbances, poor appetite, impaired ambulation, a slow speed while walking and a history of fall(s) within the previous one year were found to be significantly related to an increased risk of "certification". These items differed between men and women. This longitudinal study demonstrated that risk factors related to "certification" among community-dwelling elderly are multimodal and differ between men and women. The presence of chronic disease, the level of health management and the ability to engage in physical activity at baseline exhibited significant correlations with the need for "certification" over the four-year study period.