title: [Developing the checklist for at-risk elderly requiring assistance from comprehensive community care support center].
abstract: OBJECTIVE
  Area Comprehensive Support Centers play critical roles in identifying those elderly not currently using medical or long-term health care services, offering preventative measures against further health crises and possible isolated death. The purpose of this study was to develop an "At-Risk Elderly Checklist." This checklist can help in identifying those at-risk elderly, allowing people in communities to provide the Area Comprehensive Support Center with information about at-risk elderly.
  
  
  METHODS
  As a preliminary step, interviews were conducted with 29 professionals who work for 17 different Area Comprehensive Support Centers located in 4 municipalities around the Tokyo Metropolitan Area. We constructed 23 items based on the findings of this preliminary research and existing tools used in different areas. These items represented distinctive characteristics of elderly who need support from Area Comprehensive Support Centers in order to receive necessary medical and long-term care services. A self-report survey was conducted on 109 professionals of 20 Area Comprehensive Support Centers of Ota-ku, Tokyo in order to examine the content validity of the items.
  
  
  RESULTS
  Using factor analysis, we identified 5 factors consisting of 19 items. The first factor consisted of 5 items helping people to identify a serious health crisis from the appearance and condition of the elderly individual's home. The health crisis indicated by these items might require immediate hospitalization. The second factor consisted of 5 items that can help people notice symptoms of dementia through their communication with elderly. The third factor consisted of 4 items useful for assessing health deterioration of the elderly by observing various behaviors. The fourth factor consisted of 3 items that people can use to measure the progress of dementia, including issues with how the elderly dressed themselves. The fifth factor consisted of 2 items that can be used to understand signs of declining health or the progress of dementia by paying attention to the elderly individuals' body odor and personal appearance. From the original 19 items, 14 that were considered the most useful in detecting at-risk elderly were selected based on a frequency distribution. The content validity of 14 items was confirmed by 20 professionals from Area Comprehensive Support Centers in Outa-ku.
  
  
  CONCLUSIONS
  This checklist may be effective in the early detection of elderly at risk of serious health crises and isolated death due to not using necessary medical and long-term care services.
authors.affiliation: Research Teams for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Nonaka
authors.forename: Mariko
authors.initials: M
authors.lastname: Nishi
authors.forename: Erika
authors.initials: E
authors.lastname: Kobayashi
authors.forename: Tarou
authors.initials: T
authors.lastname: Fukaya
authors.forename: You
authors.initials: Y
authors.lastname: Murayama
authors.forename: Shouji
authors.initials: S
authors.lastname: Shinkai
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Fujiwara
mesh_terms: D000368:Aged; D057189:Checklist; D005163:Factor Analysis, Statistical; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006299:Health Services for the Aged; D006801:Humans; D007407:Interviews as Topic; D007564:Japan; D008134:Long-Term Care; D008297:Male