title: Chronic kidney disease (CKD) is an independent risk factor for long-term care insurance (LTCI) need certification among older Japanese adults: a two-year prospective cohort study.
abstract: CKD is associated with impairments in health status, physical function, and frailty. The aim of the current prospective cohort study was to determine whether CKD predicted new LTCI need certification among community-dwelling older Japanese adults. This was a prospective cohort study. We analyzed the cohort data from a prospective study, The Japan Multicenter Aging Cohort for Care Prevention (J-MACC). We followed 8063 elderly adults for 2 years, and we analyzed the relationship between CKD and LTCI need. The outcome studied was new certification for LTCI service need during a 2-year period. We measured serum creatinine (the estimated glomerular filtration rate; eGFR), serum albumin, frailty checklist scores, and body mass index. During the 2-year follow-up, 536 subjects (6.6%) were newly certified as needing LTCI services. We stratified the cohort according to eGFR quartile and performed multivariate analyses using an eGFR value of 71.4-83.6 ml/min/1.73 m(2) as a reference. We found that subjects with eGFR values <60.0 ml/min/1.73 m(2) had a significantly elevated risk of LTCI service need (adjusted hazard ratio: 1.44 [95% CI 1.12-1.86]). Our results indicate that CKD is independently associated with new LTCI service need certification and is an important marker of frailty in older adults.
authors.affiliation: Department of Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. yamada@hs.med.kyoto-u.ac.jp
authors.forename: Minoru
authors.initials: M
authors.lastname: Yamada
authors.forename: Hidenori
authors.initials: H
authors.lastname: Arai
authors.forename: Shu
authors.initials: S
authors.lastname: Nishiguchi
authors.forename: Yuu
authors.initials: Y
authors.lastname: Kajiwara
authors.forename: Kazuya
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Takuya
authors.initials: T
authors.lastname: Sonoda
authors.forename: Taiki
authors.initials: T
authors.lastname: Yukutake
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kayama
authors.forename: Takanori
authors.initials: T
authors.lastname: Tanigawa
authors.forename: Tomoki
authors.initials: T
authors.lastname: Aoyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D057189:Checklist; D003404:Creatinine / Q000097:blood; D004608:Eligibility Determination / Q000706:statistics & numerical data; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data; D015577:Geriatric Assessment; D005919:Glomerular Filtration Rate; D006801:Humans; D007353:Insurance, Long-Term Care / Q000706:statistics & numerical data*; D007564:Japan / Q000453:epidemiology; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000628:therapy*; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis
chemical_list: D012709:Serum Albumin; D003404:Creatinine
keywords: CKD; Japanese; LTCI; Older adults; Risk factor