Assessing long-term care risk in older individuals with possible cognitive decline: A large population-based study using the Kihon Checklist

Abstract

Aim: The present population-based study investigated the predictive ability of the Kihon Checklist (a self-reported frailty questionnaire) and the cognitive domain therein for incident long-term care need certification. This is the first large population-based study to investigate an association between the Kihon Checklist and the outcome measure, long-term care need certification. Methods: The study population consisted of community-dwelling citizens aged >65 years who responded to the Kihon Checklist in Kobe City. The Kihon Checklist is a simple 26-item questionnaire to identify frail citizens, including three items (Q18-20) on subjective cognitive function (the cognitive domain). Results: A total of 182 099 citizens were included for statistical analysis. The overall incidence of long-term care need certification was 1.6%, 3.5% and 5.4% at 1, 2 and 3 years. Associations were found between the Kihon Checklist questions and long-term care need certification. Furthermore, each unfavorable answer on the cognitive domain was associated with the risk for long-term care need (HR 1.493 for Q18, 1.285 for Q19, 1.321 for Q20, all P < 0.0001), independent of age, sex and other items on the Kihon Checklist. Also, after 3 years, as the number of unfavorable answers to the cognitive domain increased from 0 to 1, 2 and 3, the incidence of long-term care need certification progressively increased from 3.5% to 6.4%, 12.6% and 29.6%. Conclusions: The Kihon Checklist, especially the cognitive domain therein, appears to be predictive of long-term care need in community-dwelling citizens, suggesting the potential utility of the questionnaire for early detection of high-risk individuals. Geriatr Gerontol Int 2019; 19: 598–603.