[Differences in risk of requiring care between screening using queries with and without definitions when determining...

Objectives　This study elucidates the differences in risk for a functional decline in general housebound screening using queries with and without definitions.Methods　This study involved 10,802 community-dwelling older people who lived in four municipalities in Aichi Prefecture. The participants were asked about their frequency of going out in general and for five specific purposes: shopping, hospital visitation, strolling, leisure, and work. A person was defined as being "generally housebound" if he/she answered "less than once per week." However, a query with the definition of "going out" was used in only one of the four municipalities. Furthermore, we defined a person who goes out once a week, for any of the purposes, as "by-purpose non-housebound." If the response to the general and purpose-specific queries were inconsistent, we regarded it as an "inconsistent answer." Additionally, we compared the occurrence rate and hazard ratio for the onset of long-term care insurance certification of general housebound screening using queries with and without definition. We also calculated the occurrence rate and related risk factors for inconsistent answers.Results　The occurrence rate of general housebound screening using query with and without definition was 2.8% and 11.7%, respectively. Additionally, the hazard ratio for the onset of long-term care insurance certification of general housebound screening using the query with definition was 1.56 times more than that of general housebound screening using query without definition. The rate of inconsistent answers in by-purpose non-housebound using query with and without definition was 2.2% and 10.2%, respectively. However, sex, age, living with spouse and child(ren), years of schooling, self-rated health, depression, habitation in islands, and indicating definition of "going out" were related to inconsistent answers. The prevalence ratio of inconsistent answers in respondents using query with definition was significantly lower than among respondents using query without definition (PR=0.29).Conclusion　Query with definition reduced the occurrence rate of general housebound and increased the hazard ratio for the onset of long-term care insurance certification. Therefore, a definition should be added to queries asking for the frequency of going out to screen for housebound.