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Survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in Japan

BACKGROUND: Japan is known for its long life expectancy and rapidly aging society that there are various demands of older adults need to be fulfilled with, and one of them is long-term care needs. Therefore, Japan implemented the Long-Term Care Insurance in year 2000 for citizens who are above 65-ye...

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Autores principales: Lin, Huei-Ru, Otsubo, Tetsuya, Imanaka, Yuichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5559793/
https://www.ncbi.nlm.nih.gov/pubmed/28814271
http://dx.doi.org/10.1186/s12877-017-0555-8
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author Lin, Huei-Ru
Otsubo, Tetsuya
Imanaka, Yuichi
author_facet Lin, Huei-Ru
Otsubo, Tetsuya
Imanaka, Yuichi
author_sort Lin, Huei-Ru
collection PubMed
description BACKGROUND: Japan is known for its long life expectancy and rapidly aging society that there are various demands of older adults need to be fulfilled with, and one of them is long-term care needs. Therefore, Japan implemented the Long-Term Care Insurance in year 2000 for citizens who are above 65-year old and citizens who are above 40-year old in needs of long-term care services. This study was undertaken to longitudinally examine the influence of dementia and living alone on care needs increases among older long-term care insurance service users in Japan. METHODS: Long-term care insurance claims data were used to identify enrollees who applied for long-term care services between October 2010 and September 2011, and subjects were tracked until March 2015. A Kaplan-Meier survival analysis was conducted to examine increases in care needs over time in months. Cox regression models were used to examine the effects of dementia and living alone on care needs increases. RESULTS: The cumulative survival rates before care needs increased over the 4.5-year observation period were 17.6% in the dementia group and 31.9% in the non-dementia group. After adjusting for age, sex, care needs level, and status of living alone, the risk of care needs increases was found to be 1.5 times higher in the dementia group. Living alone was not a significant risk factor of care needs increases, but people with dementia who lived alone had a higher risk of care needs increases than those without dementia. CONCLUSION: Dementia, older age, the female sex, and lower care needs levels were associated with a higher risk of care needs increases over the study period. Among these variables, dementia had the strongest impact on care needs increases, especially in persons who lived alone.
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spelling pubmed-55597932017-08-18 Survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in Japan Lin, Huei-Ru Otsubo, Tetsuya Imanaka, Yuichi BMC Geriatr Research Article BACKGROUND: Japan is known for its long life expectancy and rapidly aging society that there are various demands of older adults need to be fulfilled with, and one of them is long-term care needs. Therefore, Japan implemented the Long-Term Care Insurance in year 2000 for citizens who are above 65-year old and citizens who are above 40-year old in needs of long-term care services. This study was undertaken to longitudinally examine the influence of dementia and living alone on care needs increases among older long-term care insurance service users in Japan. METHODS: Long-term care insurance claims data were used to identify enrollees who applied for long-term care services between October 2010 and September 2011, and subjects were tracked until March 2015. A Kaplan-Meier survival analysis was conducted to examine increases in care needs over time in months. Cox regression models were used to examine the effects of dementia and living alone on care needs increases. RESULTS: The cumulative survival rates before care needs increased over the 4.5-year observation period were 17.6% in the dementia group and 31.9% in the non-dementia group. After adjusting for age, sex, care needs level, and status of living alone, the risk of care needs increases was found to be 1.5 times higher in the dementia group. Living alone was not a significant risk factor of care needs increases, but people with dementia who lived alone had a higher risk of care needs increases than those without dementia. CONCLUSION: Dementia, older age, the female sex, and lower care needs levels were associated with a higher risk of care needs increases over the study period. Among these variables, dementia had the strongest impact on care needs increases, especially in persons who lived alone. BioMed Central 2017-08-15 /pmc/articles/PMC5559793/ /pubmed/28814271 http://dx.doi.org/10.1186/s12877-017-0555-8 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Lin, Huei-Ru
Otsubo, Tetsuya
Imanaka, Yuichi
Survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in Japan
title Survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in Japan
title_full Survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in Japan
title_fullStr Survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in Japan
title_full_unstemmed Survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in Japan
title_short Survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in Japan
title_sort survival analysis of increases in care needs associated with dementia and living alone among older long-term care service users in japan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5559793/
https://www.ncbi.nlm.nih.gov/pubmed/28814271
http://dx.doi.org/10.1186/s12877-017-0555-8
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