Evaluation by the Basic Checklist and the risk of 3 years incident long‐term care insurance certification

Abstract

BackgroundA rapidly aging society needs effective approaches to support frail older people who have a high risk of requiring long‐term care. We investigated the validity of the Basic Checklist (the “Kihon Checklist”) as a tool to select candidates for a program to prevent long‐term care.MethodA survey with questions from the Basic Checklist was conducted with functionally independent older residents aged ≥65 years living in Takasaki City, Japan. Subjects who completed the questionnaire were followed over 3 years for the presence or absence of certification for long‐term care requirement. We used multiple logistic regression analysis to calculate the odds ratio (OR) and 95% confidence interval (95%CI) for long‐term care requirement certification.ResultsA total of 21 325 subjects were analyzed. The odds ratio was the highest when items number one‐20 had a total of ≥10 checked answers (OR, 2.71; 95%CI, 2.22‐3.32). Physical function (OR, 2.29; 95%CI, 2.05‐2.55), nutritional condition (OR, 1.85; 95%CI, 1.38‐2.48), oral function (OR, 1.40; 95%CI, 1.25‐1.57), whether patients were elected as a care prevention program candidate (OR, 1.90; 95%CI, 1.73‐2.08), Homebound state (OR, 1.91; 95%CI, 1.55‐2.37), the presence of dementia (OR, 1.97; 95%CI, 1.75‐2.20), and depression (OR, 1.96; 95%CI, 1.73‐2.22) were associated with a higher odds ratio.ConclusionIndividuals who were selected as long‐term care prevention program candidates based on the Basic Checklist had a higher risk of requiring long‐term care. Older residents who corresponded to 10 or more of the 20 Basic Checklist items are at the highest risk of becoming certified as needing long‐term care.

Non‐participation in health checkup and Kihon Checklist predicts loss of certification‐free survival in community‐dwelling older adults

“…Also, despite the well‐known capability of health checkups to reduce mortality, their efficacy for preventing long‐term care dependence in older adults has not been elucidated . Furthermore, the substantial characteristics of “hard‐to‐reach” older residents who did not participate in these health promotions could not be conjectured from the results of the above studies, as all the older adults enrolled in these studies, including even “non‐participants” in health checkups, were actually responders to invitations in field, outpatient clinic, postal, and home‐visit health‐promotion surveys.…”

“…The Kihon Checklist (KCL), a postal self‐reporting yes/no questionnaire survey consisting of simple 25‐item assessments, which has been shown to be an excellent tool for screening frailty status in older adults and for predicting support/care‐need certification, which was introduced in 2006, was mailed with the aim of reaching all uncertified older residents by municipalities from 2008. Secondary preventive care programs provided by municipalities to frail older adults were discontinued in 2015, because of the low participation rate in these programs, being 0.8% of total older adults in Japan and 1.7% in U‐town in 2011, compared with the objective of 5% .…”

“…Furthermore, the participation rates for annual health checkup among uncertified community‐dwelling older adults were just 25–30% . Despite the established predictability of frailty and future long‐term care dependence by KCL, the efficacy of the KCL survey itself for reducing mortality in community‐dwelling older adults has not been clarified . Also, despite the well‐known capability of health checkups to reduce mortality, their efficacy for preventing long‐term care dependence in older adults has not been elucidated .…”

Kihon Checklist for detecting frailty

“…3 A 1-year follow-up study found that AD patients who scored <16 on the Mini-Mental State Examination tended to have ADL disabilities 1 year later. 4 In this context, we focused on individuals with mild-to-moderate AD (mean Mini-Mental State Examination score 20.0 AE 3.5) and scores of ≥97.9 points (out of 100) on the Barthel Index. Therefore, a longer than 1-year follow-up period seemed to be required to increase the statistical power of the Letters to the Editor -Comments © 2020 Japan Geriatrics Society | 263…”

“…Finally, Kamegaya et al . carried out a 3‐year prospective study for detecting care requirement by KCL subscales . Adjusted odds ratios (95% confidence interval) of physical dysfunction, poor nutritional condition, oral dysfunction, homebound state, dementia and depression for subsequent care requirement were 2.29 (2.05–2.55), 1.85 (1.38–2.48), 1.40 (1.25–1.57), 1.91 (1.55–2.37), 1.97 (1.75–2.20) and 1.96 (1.73–2.22), respectively.…”