Day Care Service Use Is Associated with Lower Mortality in Community‐Dwelling Frail Older People

Kuzuya, Masafumi; Masuda, Yoshika; Hirakawa, Yoshihisa; Iwata, Mitsunaga; Enoki, Hiromi; Hasegawa, Jun; Iguchi, Akihisa

doi:10.1111/j.1532-5415.2006.00860.x

Cited by 70 publications

(65 citation statements)

References 24 publications

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“…We did not measure inflammation markers and were unable to determine interrelationships between serum albumin and inflammation. Several studies showed that ADL is a key predictor of mortality (Takeda 2004;Kuzuya et al 2006). In the present study, the Barthel index was a significant predictor of mortality in bivariate analysis but not in multivariate analysis.…”

Section: Discussionsupporting

confidence: 53%

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Low Body Mass Index and Low Serum Albumin Are Predictive Factors for Short-Term Mortality in Elderly Japanese Requiring Home Care

Kitamura

Nakamura

Nishiwaki

et al. 2010

Tohoku J. Exp. Med.

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Japan has a rapidly growing elderly population. The proportion of citizens aged 65 years and over was 22.1% in 2008, and is projected to as high as 27% by 2015 (Health and Welfare Statistics Association 2009). In accordance, elderly individuals requiring care are also increasing. To cope with this situation, the long term care service system was implemented in Japan in 2000. Since then, the number of elderly requiring care doubled from 2.2 to 4.4 million (Health and Welfare Statistics Association 2008).One of the important challenges for people requiring care is how to prevent a decrease in activities of daily living (ADL). To address this issue, we initiated the Yamato Study, a population-based study of individuals utilizing the long term care service system, to develop preventive methods for diminishing ADL levels (Nishiwaki et al. 2005(Nishiwaki et al. , 2007.Another critical risk for people requiring care is increased mortality. Kuzuya et al. (2006) demonstrated that decreased ADL is associated with higher mortality rates while Takeda (2004) showed that higher requisite care levels are associated with higher mortality rates. These studies suggest that ADL level is an important predictor of mortality in elderly requiring care. A number of studies targeting independent elderly people in the community have also indicated that body stature (Grabowski and Ellis 2001;Al Snih et al. 2007), muscle strength (Al Snih et al. 2002), and serum albumin levels (Sahyoun et al. 1996;Okamura et al. 2008) are significant predictors of mortality. To date, however, only a few studies have explored risk factors for mortality other than ADL in elderly people requiring care to date (Enoki et al. 2007a(Enoki et al. , 2007b. This study aimed to clarify multiple risk factors for two-year mortality through follow-up of the Yamato Study elderly cohort who utilize the long term care service system.

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Section: Discussionsupporting

confidence: 53%

“…Kuzuya et al (2006) demonstrated that decreased ADL is associated with higher mortality rates while Takeda (2004) showed that higher requisite care levels are associated with higher mortality rates. These studies suggest that ADL level is an important predictor of mortality in elderly requiring care.…”

mentioning

confidence: 99%

Low Body Mass Index and Low Serum Albumin Are Predictive Factors for Short-Term Mortality in Elderly Japanese Requiring Home Care

Kitamura

Nakamura

Nishiwaki

et al. 2010

Tohoku J. Exp. Med.

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“…This is an important finding because it provides evidence for the importance of providing community care services for this vulnerable client population living with dementia. The literature has agreed that use, more use, and more frequent use of some types of community care services can significantly reduce the risk of death later [18]. …”

Section: Discussionmentioning

confidence: 99%

“…Based on previous studies [6,14,18,20], and available information of the original project, our study included the following baseline variables for Cox regression analysis:…”

Section: Methodsmentioning

confidence: 99%

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Risk of death or hospital admission among community-dwelling older adults living with dementia in Australia

et al. 2014

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BackgroundOlder people living with dementia prefer to stay at home to receive support. But they are at high risk of death and/or hospital admissions. This study primarily aimed to determine risk factors for time to death or hospital admission (combined) in a sample of community-dwelling older people living with dementia in Australia. As a secondary study purpose, risk factors for time to death were also examined.MethodsThis study used the data of a previous project which had been implemented during September 2007 and February 2009. The original project had recruited 354 eligible clients (aged 70 and over, and living with dementia) for Extended Aged Care At home Dementia program services during September 2007 and 2008. Client information and carer stress had been collected from their case managers through a baseline survey and three-monthly follow-up surveys (up to four in total). The principal data collection tools included Global Deterioration Scale, Modified Barthel Index, Instrumental-Dependency OARS, Adapted Cohen-Mansfield Agitation Inventory, as well as measures of clients’ socio-demographic characteristics, service use and diseases diagnoses. The sample of our study included 284 clients with at least one follow-up survey. The outcome variable was death or hospital admission, and death during six, nine and 16-month study periods. Stepwise backwards multivariate Cox proportional hazards analysis was employed, and Kaplan-Meier survival analysis using censored data was displayed.ResultsHaving previous hospital admissions was a consistent risk factor for time to death or hospital admission (six-month: HR = 3.12; nine-month: HR = 2.80; 16-month: HR = 2.93) and for time to death (six-month: HR = 2.27; 16-month: HR = 2.12) over time. Previously worse cognitive status was a consistent risk factor over time (six- and nine-month: HR = 0.58; 16-month: HR = 0.65), but no previous use of community care was only a short-term risk factor (six-month: HR = 0.42) for time to death or hospital admission.ConclusionsPrevious hospital admissions and previously worse cognitive status are target intervention areas for reducing dementia clients’ risk of time to death or hospital admission, and/or death. Having previous use of community care as a short-term protective factor for dementia clients’ time to death or hospital admission is noteworthy.

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Day care vs home care: Effects on functional health outcomes among long‐term care beneficiaries with dementia in Korea

Lee

Yim

Choi

et al. 2018

Int J Geriat Psychiatry

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Objectives First, to compare changes in cognitive function, behavioral symptoms, and physical function for Korean Long‐Term Care Insurance (LTCI) beneficiaries with dementia in day care (DC) and home care (HC) settings over 1 year. Second, to examine the association between LTCI service type and the aforementioned health outcomes. Methods A retrospective matched cohort study was conducted using the national data set of the National Health Insurance Service in Korea. We identified 7822 beneficiaries with dementia who received either DC or HC services consistently for 1 year from 2008 to 2009. The propensity score matching method was used, yielding 416 participants in each group. Paired samples t‐tests and logistic regression analyses were conducted. Results Baseline differences between the two groups are present. According to multiple regression models, DC, when compared with HC, was related to less deterioration in cognitive and physical function but was associated with less improved behavioral symptoms 1 year after the LTCI enrollment. In the comparison between matched cohorts, DC, when compared with HC, was associated with less cognitive decline, less disability progression, and similar decrease in behavioral symptoms. Conclusions Cognitive function and disability declined less in the DC group, compared with the HC group. Conversely, behavioral symptoms showed a similar decrease between the two groups after 1‐year follow‐up. Further research is necessary to examine key features of DC services that have helped delay functional deterioration and alleviate behavioral symptoms.

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Day Care Service Use Is Associated with Lower Mortality in Community‐Dwelling Frail Older People

Abstract: Among community-dwelling frail older people, day care service use two or more times per week was associated with 44% to 63% lower 21-month mortality.

Cited by 70 publications

References 24 publications

Low Body Mass Index and Low Serum Albumin Are Predictive Factors for Short-Term Mortality in Elderly Japanese Requiring Home Care

Low Body Mass Index and Low Serum Albumin Are Predictive Factors for Short-Term Mortality in Elderly Japanese Requiring Home Care

Risk of death or hospital admission among community-dwelling older adults living with dementia in Australia

Day care vs home care: Effects on functional health outcomes among long‐term care beneficiaries with dementia in Korea

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