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.
Highlights
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
This study found that the children-only household group demonstrated a higher risk for functional disability than the three-generation household group, and the factors associated with functional disability differed depending on household composition
We examined how risk factors of functional disability among elderly people differed according to four types of household composition
Summary
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 proportion of the population in the 65 or older age-group amounted to 24.1% in 2012, with the ratio of the elderly to the as of 2000; 2.31 million households, 21.4%, as of 1990). The number of three-generation households with an elderly person aged 65 or older has decreased: 3.20 million households (15.3%) as of 2012. The number of single-person household has increased: 4.87 million households (23.3%) as of 2012 [2]. It has been predicted that the proportion of coupleonly and single-person households will account for approximately 70% of all households with an elderly person aged 65 or older [1]. The risk factors related to the functional decline of elderly people in different households are still not fully clear
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