A scoring system and seven factors associated with certification for Japanese long-term care insurance in older...

The increase in the older population is a serious concern in developed countries, and how to maintain independence of these individuals is now an urgent issue. Various factors are known to put older people at risk for needing long-term care, but it is not clear to what extent each factor is associated with that need.

In a cohort of 1577 community-dwelling older persons, we excluded 40 persons whose long-term care insurance certification was unknown and then divided the remaining 1537 into two groups: dependent group (134 persons) certified as requiring assistance or long-term care, and an independent group (1403 persons). We extracted 7 factors and created a scoring system from these factors based on regression coefficients.

Among 92 factors initially evaluated, 7 were significantly associated with the need for assistance or long-term care, namely walking speed, age, grip strength, mobility (EQ5D), ability to use public transportation by oneself (IADL), ability to perform usual activities (EQ5D), and serum albumin levels. Based on these 7, we constructed a scoring system and calculated a cutoff value of 8 points with an area under curve as high as 0.949.

We determined the cutoff value for dependency risk to be 8, but no single factor scored 8 or higher, suggesting that a combination of these factors promotes the need for nursing care in older people.