title: Main medical conditions of elderly Japanese in urban areas requiring long-term care: improving the focus of preventive care.
abstract: OBJECTIVE
  To improve preventive care administration, this paper epidemiologically categorized causative illnesses of frail Japanese elderly living in urban areas by age and sex.
  
  
  METHODS
  Data from Japanese long-term care insurance (LTCI) documentation was used to categorize the patterns of disease incidence consisting of the main medical conditions and comorbid diseases among frail elders aged above 65 years (male: 193; female: 360) from the central area of Osaka prefecture. Logistic regression analysis was used to determine the diseases requiring intensive care: care level 3+. The fracture patients' ADL and cognitive functions were examined using the Cognitive Performance Scale (CPS).
  
  
  RESULTS
  In the patterns of disease incidence, 43% of the men had lifestyle-related diseases, while 53% of the women had musculoskeletal disorders. The main medical conditions associated with care level 3+ in men were dementia (odds ratio, 5.4), cerebrovascular disease (CVD; 3.9), renal failure (8.9), and fracture and fracture sequelae (4.7); and in women, femoral fracture (42.7), CVD (8), vertebral fracture (6.2), dementia (4.4), and neoplasms (4.1). Further, 46% of the female patients with femoral fractures had dementia.
  
  
  CONCLUSIONS
  Preventive measures should focus on lifestyle-related diseases, preventing dementia by early detection, treatment of hypertension and diabetes through medication, physical exercise and nutrition, and cancer screenings for both sexes, along with musculoskeletal disorders prevention for women. Since femoral fractures render patients (especially those over 80 years) bedridden with cognitive dysfunctions, fall prevention is essential.
authors.affiliation: Department of Health Promotion Science, Division of Health Sciences, Osaka University Graduate School of Medicine, Japan. kaonishi@pearl.ocn.ne.jp
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Onishi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008134:Long-Term Care; D008297:Male; D011315:Preventive Medicine; D011787:Quality of Health Care; D014505:Urban Population