Both conventional indices of cognitive function and frailty predict levels of care required in a long-term care insurance program for memory clinic patients in Japan.
OBJECTIVE
To delineate relationships among cognitive function, frailty and level of care required in the Japanese long-term care insurance program (LTCIP) in outpatient memory clinic patients.


METHODS
This was a cross-sectional study carried out at an outpatient memory clinic. Participants were 201 cognitively impaired patients. Cognitive function was measured by the Mini-Mental State Examination (MMSE). Frailty was measured by Timed Up & Go (TUG) and grip strength. Waist circumference, body mass index, living arrangement and level of care required in the LTCIP (rank 1 minor disability to rank 7 severe disability) were also assessed.


RESULTS
Mean age, MMSE score, TUG score and grip strength were 78.8 ± 6.9 years, 19.6 ± 6.1, 14.6 ± 6.7 s and 16.9 ± 7.5 kg, respectively. A total of 70 patients (34.8%) had not applied for the certification, at least in part because of their younger age and existence of family caregivers. LTCIP rank was correlated both with MMSE score (β: -0.49, P = 0.001), grip strength (β: -0.27, P = 0.005) and living alone (β: -0.18, P = 0.03), but not with TUG score (β: 0.14, P = 0.105).


CONCLUSIONS
In outpatients of a memory clinic, care ranks, which define the upper limit of monthly benefit in the Japanese LTCIP, were influenced by age, cognitive function, frailty and living arrangements. Understanding the relationship among these parameters would be useful in predicting the needs of cognitively impaired patients and important when comparing the possible services provided by long-term care systems for them worldwide.
Departments of Geriatric Medicine, Graduate School of Medicine, Kyoto University, Faculty of Social Studies, Doshisha University, Kyoto, Japan. takechi@kuhp.kyoto-u.ac.jp
Hajime
H
Takechi
Yuriko
Y
Sugihara
Atsuko
A
Kokuryu
Maiko
M
Nishida
Hiroko
H
Yamada
Hidenori
H
Arai
Yoshiyuki
Y
Hamakawa
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis* / Q000628:therapy*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D018737:Hand Strength; D006801:Humans; D007353:Insurance, Long-Term Care; D007564:Japan; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000628:therapy*; D011237:Predictive Value of Tests