[Disorders requiring nursing care and the period before recognized as needing nursing care (active life expectancy) in relation to nursing care insurance].
OBJECTIVE
To measure the state of health of the elderly population, active and dependent life expectancies were calculated based on the number of people needing nursing care. For this purpose, active life expectancy was defined as the period before nursing care was recognized by insurers as being required. Moreover, to cast light on disorders requiring nursing care, age-adjusted nursing time needed for different ailments per ten thousand elderly population was calculated.


METHODS
Subjects were those 65 years or over living in Taihaku-ku, Sendai City, recognized as needing nursing care by nursing care insurers. The period before being recognized as needing nursing care was calculated using the Sullivan method, and termed the active life expectancy. Dependent life expectancy = life expectancy - active life expectancy. The number of those needing nursing care caused by each disorder diagnosed by attending physicians, was also age-adjusted by the reference population and multiplied by the nursing time needed for each level of nursing, resulting in the age-adjusted nursing time needed per ten thousand elderly population.


RESULTS
Those recognized as needing nursing care were 7.5% (7.7% after age adjustment) of the male elderly population, and 12.5% of the female population (10.7% after age adjustment). For men, the active life expectancy was 16.1 years for the age of 65, 9.2 years for 75 and 4.4 years for 85, while the dependent one was 2.0-2.1 years for all ages. For women, the active life expectancy was 19.3 years for the age of 65, 11.1 years for 75 and 4.8 years for 85, while the dependent one was 4.6-5.3 years. The age-adjusted nursing time needed per ten thousand elderly population was 874 hours for men and 1,125 hours for women: of the time 51% was for men with cerebrovascular disease (40% for cerebral infarction), 11% for men with dementia; 37% for women with cerebrovascular disease (26% for cerebral infarction), 20% for women with skeletal diseases, 18% for women with dementia.


CONCLUSIONS
The active life expectancy for women is longer than for men, by 3.7 years for the age of 65, by 2.3 years for 75 and by 0.5 years for 85. The dependent life expectancy for women is also longer than for men, by 3.2 years for the ages of 65 and 75 and by 2.6 years for 85. Thus, nursing prevention is an urgent issue, especially for women. The disorders requiring particularly long age-adjusted nursing time are carebrovascular disease (particularly cerebral infarction), dementia and skeletal disorders (particularly among women).
Takeda
Shumpei
S
Canter for Public Health and Welfare, Taihaku-ku, Sendai.
D000367:Age Factors; D000368:Aged; D000544:Alzheimer Disease / Q000451:nursing; D001847:Bone Diseases / Q000451:nursing; D002561:Cerebrovascular Disorders / Q000451:nursing; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007355:Insurance, Nursing Services / Q000592:standards*; D007564:Japan; D008297:Male