Factors associated with the level of disability in elderly adults based on the Japanese long-term care insurance system

Abstract

Aim: The aim of this study was to identify factors associated with the level of disability in elderly adults based on the Japanese long-term care insurance system. Methods: The participants included 3,198 frail elderly subjects (mean age: 82.0±6.45). The slightly disabled group, with a support level in the long-term care insurance system, comprised 1,129 elderly adults, and the moderately disabled group, with a care level of 1 or 2 in the long-term care insurance system, comprised 2,208 elderly adults who received day-care services. The following parameters were evaluated: grip strength, chair stand test 5-times (CST), one-leg standing with eyes open (OLS), timed "up & go" (TUG), walking speed, the mental status questionnaire (MSQ) score and functional independence measures (FIM). The participants were categorized into two groups based on the 13 motor subscales of the FIM (FIM-M): the activity of daily living (ADL) independent group, who scored 6 points or higher on all ADL measurements, and the ADL care need group, who scored 5 points or under on at least one item in all ADL measurements. A multiple logistic regression analysis was used to examine the relationships between the long-term care insurance level and the potential correlates. Results: The multiple logistic regression model indicated that gender, grip strength and the MSQ and FIM-M scores were significantly associated with the long-term care insurance level (p<0.05). The FIM-M score exhibited a particularly strong correlation with the type of long-term care required (odds ratio: 2.47, 95% confidence interval: 1.89-3.24). Conclusions: The Japanese long-term care insurance level is associated with physical performance, the cognitive function and the ability to perform ADL's. These results suggest that comprehensive assessments are useful for understanding the impact of the long-term care insurance level in elderly adults.