Health Characteristics of Elderly Japanese Requiring Care at Home

Self Cite

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.

“…Psychological assessments were conducted by trained nurses. Details of the baseline evaluations were described previously (Nishiwaki et al 2005). …”

Section: Measurements At the Baseline Examinationmentioning

confidence: 99%

“…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.…”

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

Self Cite

“…Details of the methods used to obtain these measurements were described previously (Nishiwaki et al 2005).…”

Section: Measurementsmentioning

confidence: 99%

The Usefulness of Day-Service in Maintaining General Nutritional Status in Elderly Japanese: A Longitudinal Study

Nishiwaki

Ueno

Hasegawa

et al. 2007

Self Cite

Day-service, commuting service for elderly people requiring care at home, is one healthcare option in Japan. To date, however, there exist no studies that have examined the effects of day-service use on health outcomes in Japan. The objective of the present longitudinal study was to determine whether there is an association between day-service use and various physical and mental health outcomes in elderly people requiring care. The subjects were 61 elderly persons who required between 25 and 49 min of assistance per day and used long-term care insurance. Measurements included demographic characteristics, activities of daily living, frequency of day-service use, body weight, height, grip strength, thigh muscle volume, degree of depression (Geriatric Depression Scale), the mini-mental state examination, and serum albumin and blood hemoglobin levels in the baseline and follow-up surveys two years later. In the day-service user group, the mean changes in serum albumin concentrations using day-service once, twice and three times/week were −0.2, −0.3, and 0 g/dl, respectively, and the mean changes in blood hemoglobin were −0.7, −0.5, and 0.2 g/dl, respectively. The two-year change in serum albumin concentrations was less ( p = 0.024) in subjects using day-service "three times" (0 g/dl) than "twice" (−0.3 g/dl). The two-year change in blood hemoglobin was also less ( p = 0.043) in subjects using day-service "three times" (0.2 g/dl) than "twice" (−0.5 g/dl). The present study has shown that frequent use of day-service is useful in maintaining general nutritional status in elderly people.albumin; community health services; cohort studies; elderly; hemoglobin © 2007 Tohoku University Medical PressDay-service, commuting service for elderly people requiring care at home, is one healthcare option, administered by local governments throughout Japan. Day-service consists of a number of services, including bathing and meal service (with assistance when needed), consultation,

“…As for mobility, dependency was most severe with respect to standing up from a sitting position, standing on one foot, sitting up in bed, walking, maintaining a sitting position, turning over in bed, and standing on both feet. Nishiwaki et al (2005) studied subjects who required low levels of care, and noted that there was a significant increase in the dependence level for bathing and using stairs. In the present study, we found increased dependence in standing up from a sitting position and standing on one foot in the earlier stages of disability.…”

Section: Discussionmentioning

confidence: 99%

Clinical Status and Dependency of the Elderly Requiring Long-Term Care in Japan

Imahashi¹,

Kawagoe

Eto

et al. 2007

IMAHASHI, K., KAWAGOE, M., ETO, F. and HAGA, N. Clinical More than 4 million of the elderly receive long-term care services using the public long-term care insurance in Japan. In order to use the insurance system, the insured person needs to be classified in one of the six care levels according to his/her clinical status. Though each level is defined in terms of the total amount of estimated care time needed per day, the clinical status of each level is not precisely defined. This study aimed to compare the clinical status of the six levels in order to suggest indicators of deterioration for each care level. We analyzed the clinical status for 7,222 cases who applied for careneed certification in a rural area of Japan. Sixty-seven items were used to determine physical function, activities of daily living, and cognitive and sensory status. Even in the mildest care level (Support Required), more than 50% of the individuals were dependent with regard to standing and sitting, while weakness of the lower extremities and dependency in walking were identified in Care Level 1, dependency in dressing and toilet habits in Care Level 2, dependency in grooming and transferring in Care Level 3, dependency in communication and feeding in Care Level 4, and dependency in swallowing, orientation and limitations of joint movement in Care Level 5. Care providers should be tracking these changes to estimate and prevent the decline of care level because more than 20% of the individuals assessed in 2004 belonged to the worse care level one year later.longterm care insurance; eligibility determination; disability evaluation; health services for the aged; activities of daily living