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Complex Multimorbidity and Incidence of Long-Term Care Needs in Japan: A Prospective Cohort Study

Daisuke Kato1, Ichiro Kawachi2, Junko Saito3

  • 1Department of Family Medicine, Mie University Graduate School of Medicine, Tsu 514-8507, Japan.

International Journal of Environmental Research and Public Health
|October 13, 2021
PubMed

Insights

Complex multimorbidity (CMM) and multimorbidity (MM) are linked to increased long-term care (LTC) needs in older Japanese adults. This study highlights the importance of considering CMM and MM in LTC assessments.

Area of Science:

  • Gerontology
  • Public Health
  • Epidemiology

Background:

  • Multimorbidity (MM) describes the co-occurrence of multiple chronic conditions.
  • Complex multimorbidity (CMM) offers a more nuanced view of MM.
  • Understanding MM and CMM's impact on long-term care (LTC) is crucial for aging populations.

Purpose of the Study:

  • To quantify the association between MM and CMM with the incidence of long-term care (LTC) needs.
  • To analyze these associations in a cohort of functionally dependent older Japanese individuals.
  • To inform policy regarding MM in LTC needs assessment.

Main Methods:

  • Nationwide longitudinal cohort study of Japanese individuals aged over 65 years.
  • Inclusion of 38,889 functionally dependent participants at baseline.
  • Propensity score matching and inverse probability of treatment weights (IPTW) used for analysis.

Main Results:

  • Both MM (HR 1.07) and CMM (HR 1.10) were significantly associated with a higher rate of LTC insurance certification over six years.
  • A modest but statistically significant increase in LTC needs was observed for individuals with MM and CMM.
  • MM affected 52.0% and CMM affected 19.5% of the study cohort.

Conclusions:

  • MM and CMM are associated with an increased incidence of long-term care needs in older Japanese adults.
  • Findings support the integration of MM assessment into LTC insurance evaluations.
  • Current Japanese policy does not incorporate MM into LTC needs assessment, suggesting a gap for potential improvement.
Keywords:
complex multimorbiditylong-term care needsmultimorbidity

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