Abstract

South Korea recently expanded its coverage rate of long-term care insurance (LTCI) by adding a “dementia special grade” in 2014 to improve care service accessibility and extend health life for older adults with dementia. In this study, we propose a multifaceted policy to reduce the suicide risk among older adults with dementia by evaluating the effectiveness of using the long-term care services (LTCS). A sample of 62,282 older adults was selected from the “Older Adults Cohort DB” of the National Health Insurance Service. We conducted Kaplan–Meier and Cox regression to represent the yearly survival curve from 2002 to 2015 according to the individual characteristics. Difference-in-difference estimation was conducted to identify the effect of LTCS on suicide rates by using LTCS before and after 2014. The suicide risk of older adults using LTCS was about 0.256-times lower than those who did not use it (OR = 0.296, 95% CI = 0.183–0.478), whereas it increased after the expansion of the dementia grading (OR = 2.131, 95% CI = 1.061–4.280). To prevent the risk of suicide among older adults with dementia, not only did the mortality rate vary depending on the sex, activities of daily living (ADL), and type of caregiver at the individual level but appropriate national intervention and management, such as improving the accessibility of LTCS, are also needed.

Highlights

  • IntroductionPublisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations

  • This study found that at the individual level, suicide rates were more statistically significant among men, older adults with mild dementia symptoms who had no caregivers or had family/neighbor caregivers

  • We confirmed that the use of long-term care services (LTCS) could reduce the suicide rate of older adults with dementia

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Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. A prolonged lifespan does not necessarily imply an improved quality of life. The average life expectancy is increasing worldwide, social and health problems, such as dementia and suicide, have been on the rise. Considering the rapidly increasing proportion of older adults in the global population, the increasing number of older adults with dementia will soon become a national concern [1]. Dementia is a condition in which an individual’s memory or cognitive functioning deteriorates and progressively interferes with their daily life [2]

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