WHO Center for Health Development (WHO Kobe Centre)
A simple question related to cognitive function can estimate the risk of needing long-term care
Kobe City Basic Checklist Analysis Results
A research team led by Visiting Professor Yoji Nagai of the Kobe University Graduate School of Medicine, Department of Translational Science, has conducted several studies since 2017, targeting about 80,000 Kobe citizens in their 70s. Using the questionnaire “Basic Checklist”, we clarified that the risk of becoming certified as requiring long-term care can be estimated by asking three questions related to cognitive function. The results of this research were published in Health Research Policy and Systems on November 29, 2022. ■ Background
Dementia is increasing rapidly worldwide. The number of dementia patients in Japan was about 4.6 million in 2012, but it is reported that it will increase to more than 6.75 million in 2025 and more than 8 million in 2040 (Health, Labor and Welfare Science Research, 2014). (Source: Research on Future Estimates of the Elderly Population with Dementia in Japan, a special subsidy project). Kobe University and the WHO Center for Health Development (WHO Kobe Center) aim to build a “Kobe model” for early detection and early intervention of dementia based on data created with great cooperation from Kobe City Hall. In collaboration with research institutes, the Medical Innovation Promotion Center (TRI) of the Kobe Biomedical Innovation Promotion Organization and Kobe Gakuin University, we have been conducting joint research “Kobe Project for Reducing the Social Burden of Dementia”. rice field. Four research projects were carried out in this project, and this press release introduces the main results of one of the research projects, following the completion of the paper presentation (first author: Shinsuke Kojima (TRI)). To do. This study is a retrospective survey of previous studies that integrated the basic checklist and long-term care certification data stored at Kobe City Hall, and estimated that the higher the number of unfavorable answers, the higher the risk of long-term care certification. It is a study that prospectively demonstrates the The results of other shared research will be introduced sequentially through the WHO Kobe Center website (https://extranet.who.int/kobe_centre/ja).
■ Research methods and results
In this study, a 25-item questionnaire regarding the degree of independence in daily life mailed by the city of Kobe to 77,877 elderly people aged 70 and over living in Kobe who were not certified as requiring long-term care in 2015. I used a basic checklist. We compared the answers to the questions on the basic checklist with data collected from 2015 to 2019 for certification of long-term care need, and investigated the relationship with the occurrence of certification for long-term care need. In addition, as in the previous research, three questions related to cognitive function in the basic checklist, “Do you feel forgetful, such as always asking the same thing from people around you?” (Preferred answer: No) , “Do you look up phone numbers and make calls yourself?” We also paid attention to the results.
Of the 77,877 citizens who received the questionnaire, 50,154 responded (response rate: 64.4%). First, 4 years after the baseline checklist survey, the cumulative incidence of certified long-term care needs was higher among those who did not respond than among those who responded (12.5% vs. 8.4%) (Fig. 1).
Figure 1: Those who did not complete the basic checklist sent to them had a higher risk of certification for long-term care than those who did.
[Image 1
In addition, among the respondents, the more unfavorable answers they gave to the three questions, the higher the incidence of certification for long-term care need (respondents with 0, 1, 2, or 3 unfavorable answers were , 5.0%, 8.4%, 15.7%, and 30.2%, respectively, after 4 years) (Figure 2). Similarly, even when limited to certification of long-term care need with cognitive decline, the more unfavorable responses, the higher the incidence of certification of long-term care need (responses with 0, 1, 2, or 3 unfavorable responses). 3.4%, 6.5%, 13.7%, 27.9%).
Figure 2: To the three questions in the basic checklist for cognitive function, unfavorable responses suggesting cognitive decline are associated with the occurrence of long-term care need certification over time, and the number of unfavorable responses increases and the need for long-term care needs increases. There was a high risk of nursing certification.
[Image 2
■ Considerations and Future Prospects
Based on this research, we were able to estimate that those who did not complete the basic checklist by mail were at high risk of being certified as requiring long-term care. In addition, simple questions about cognitive function enabled us to estimate the risk of
certification for long-term care, especially certification for long-term care with cognitive decline. These observations point to the possibility of finding ways to reduce the social burden of dementia by targeting measures to populations presumed to be at high risk. On December 14, 2016, the Basic Act on Promotion of Utilization of Public and Private Sector Data was promulgated and enforced, promoting the proper and effective utilization of highly accurate data held by Kobe City and other government agencies. . In addition, on April 1, 2022, the Japanese Federation of Medical Sciences issued the “Declaration of the Medical Society for Overcoming Frailty and Locomotive Syndrome”, and related academic societies announced their respective policies for overcoming frailty and locomotive syndrome. However, the movement toward overcoming the super-aging society, which is an important national issue, is gaining momentum. This research periodically analyzes highly accurate data held by administrative agencies, reflects the analysis results in administrative measures, and repeats the cycle of demonstrating that the prognosis has improved after a certain period of time. We believe that this is an important research that can be positioned within a “learning health system” that reduces the number of people requiring support and long-term care and extends healthy life expectancy. The above concept can be applied to all policies and all prefectures and municipalities, and we believe that this research has shown concrete examples of research methods that use valuable data on residents to return results to residents. . In addition, this study aims to develop a specific approach to dementia countermeasures that can be implemented at low cost not only in Japan but also in other countries, especially in Asian countries where the aging rate will rise and the society will become a full-fledged super-aging society. I can suggest one.
[Research team]
lead investigator
Yoji Nagai Visiting Professor, Department of Translational Science, Graduate School of Medicine, Kobe University
Research team (organization name in alphabetical order)
Kobe Biomedical Innovation Promotion Organization Medical Innovation Promotion Center
Team Leader Shinsuke Kojima
Kobe Biomedical Innovation Promotion Organization Medical Innovation Promotion Center
Senior Researcher Takashi Kikuchi
Kobe Gakuin University Faculty of Comprehensive Rehabilitation Assistant Professor Hiroyuki Kajita
Kobe Gakuin University Faculty of Comprehensive Rehabilitation Assistant Professor Tomi Ozaki
Kobe University Hospital Clinical Research Promotion Center Specially Appointed Lecturer Yasumasa Kakei
Kobe University Graduate School of Health Sciences Department of Rehabilitation Science Professor Hisatomo Kowa
Taiji Yamamoto, Professor, Health Administration Center, Kobe University Masanori Fukushima, Representative Director, LHS Research Institute, Professor Emeritus, Kyoto University
Ryoma Kayano, Medical Officer, WHO Center for Health Development [Published paper]
Kojima, S., Kikuchi, T., Kakei, Y. et al. Implication of using cognitive function-related simple questions to stratify the risk of long-term care need: population-based prospective study in Kobe, Japan. Health Res Policy Sys 20 (Suppl 1), 120 (2022).
https://doi.org/10.1186/s12961-022-00920-4
Details about this release:
https://prtimes.jp/main/html/rd/p/000000001.000112635.html