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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
Author(s) -
Takechi Hajime,
Sugihara Yuriko,
Kokuryu Atsuko,
Nishida Maiko,
Yamada Hiroko,
Arai Hidenori,
Hamakawa Yoshiyuki
Publication year - 2012
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/j.1447-0594.2011.00828.x
Subject(s) - medicine , grip strength , cognition , long term care insurance , body mass index , waist , memory clinic , gerontology , outpatient clinic , physical therapy , mini–mental state examination , cognitive impairment , long term care , psychiatry
Aim: 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). Conclusion: 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. Geriatr Gerontol Int 2012; ••: ••–•• .