Abstract
BackgroundSeveral types of cardiovascular diseases (CVDs) impair the physical and mental status. The purpose of this study was to assess the predictive ability of several cardiovascular biomarkers for identifying the incidence of disability as future recipients of public long-term care (LTC) service.MethodsThe subjects of this study were community-dwelling elderly individuals ≥ 65 years of age without a history of CVD (n = 5,755; mean age, 71 years). The endpoint of this study was official certification as a recipient of LTC. The cohort was divided into quartiles (Qs) based on the levels of three CVD biomarkers: the urinary albumin-creatinine ratio (UACR), plasma B-type natriuretic peptide concentration (BNP), and serum high-sensitivity C-reactive protein concentration (hsCRP). A time-dependent Cox proportional hazard model was used to determine the multi-adjusted relative hazard ratios (HRs) for incident LTC among the quartiles of each biomarker.ResultsDuring the follow-up (mean 5.6 years), 710 subjects were authorized as recipients of LTC. The HR was only significantly increased in the higher Qs of UACR (Q3, p < 0.01; Q4, p < 0.001). However, other biomarkers were not significantly associated with the endpoint. The risk predictive performance for the incidence of LTC as evaluated by an essential model (i.e. age- and sex-adjusted) was significantly improved by incorporating the UACR (net reclassification improvement = 0.084, p < 0.01; integrated discrimination improvement = 0.0018, p < 0.01).ConclusionsThese results suggest that an increased UACR is useful for predicting physical and cognitive dysfunction in an elderly general population.
Highlights
The high prevalence of disabled elderly individuals who require long-term care (LTC) for physical and cognitive functional impairments is a significant public health problem in aging societies
The cohort was divided into quartiles (Qs) based on the levels of three cardiovascular diseases (CVDs) biomarkers: the urinary albumin-creatinine ratio (UACR), plasma B-type natriuretic peptide concentration (BNP), and serum high-sensitivity C-reactive protein concentration
The funders had no role in study design, data collection and During the follow-up, 710 subjects were authorized as recipients of LTC
Summary
The high prevalence of disabled elderly individuals who require long-term care (LTC) for physical and cognitive functional impairments is a significant public health problem in aging societies. To help elderly individuals with disabilities successfully manage their daily life, the Japanese government has recently implemented an LTC support system based on several previous European programs [1] This system is a form of social support for those !65 years of age who cannot manage their daily life due to physical and mental disability, and the type and degree of the support was determined by structural questionnaires and a medical interview to evaluate their physical and cognitive dysfunctions [2]. In Japan, the number certified for LTC was estimated to be 4.9 million in 2015 and is predicted to increase to 5.3 million in 2025. The purpose of this study was to assess the predictive ability of several cardiovascular biomarkers for identifying the incidence of disability as future recipients of public long-term care (LTC) service.
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