Predicting emerging care-need with simple functional indicators: Findings from a national cohort study in Taiwan

Abstract

Aim: To evaluate the predictive abilities of single items and their combinations in the instrumental activities of daily living and Nagi scales to predict emerging care-need of older adults. Methods: We analyzed the 1999 (baseline) and 2003 (end-point) datasets of the Taiwan Longitudinal Study on Aging. After excluding the proxy respondents, incomplete data or those who had care-need at baseline, 2521 of the 2890 participants (aged ≥65 years at baseline) were included in data analysis. Care-need was defined as a person receiving formal or informal care, or having any activities of daily living dependency. The predictive abilities of the items in instrumental activities of daily living or Nagi scale, singly or in combination to predict emerging care-need during the subsequent 4 years were evaluated by the improvement in values of Nagelkerke R2, Akaike information criterion and Bayesian information criterion in logistic regression models. Results: The single item “doing heavy housework” showed the best predictive abilities among all others. When combined this item with “walking 200 m,” the two-item indicator significantly improved the predictive abilities. However, no three-item combined indicator improved the predictive abilities. Conclusions: The two-item indicator that combines “doing heavy housework” and “walking 200 m” from the instrumental activities of daily living and Nagi scales showed superior ability to predict emerging care-need of older Taiwanese. The indicator could serve as the foundation for developing a scale to predict emerging care-need of older adults. Geriatr Gerontol Int 2017; 17: 375–381.