Impact of informal care levels on discontinuation of living at home in community-dwelling dependent elderly using various community-based services.

The aim of the study was to examine the effect of informal care levels on overall discontinuation of living at home, all-cause death, hospital admission, and long-term care placement for community-dwelling older people using various community-based services during a 3-year period. Prospective cohort study of 1582 community-dwelling disabled elderly and paired informal caregivers was conducted. Baseline data included the recipients and caregivers' demographic characteristics, comorbidities, informal care levels (sufficient, moderate, and insufficient care), which were evaluated by trained visiting nurses, and the level of formal community-based service use. Among 1582 participants, 97 died at home, 692 were admitted to hospitals, 318 died during their hospital stay, and 117 were institutionalized in long-term care facilities during 3 years of follow-up. A multivariate Cox hazard model demonstrated that when compared with a sufficient informal care level, an insufficient informal care level was associated with overall discontinuation of living at home, all-cause mortality, hospitalization, and institutionalization during 3 years of follow-up (hazard ratio: 1.65, 95% confidence interval: 1.15-2.36; 1.98, 1.17-3.34; 1.56, 1.04-2.35; 2.93, 1.25-6.86, respectively). The results suggested that informal caregiving is an important factor in the prevention of overall discontinuation of living at home in a population of disabled older people.

Kuzuya M ，Hasegawa J ，Hirakawa Y ，Enoki H ，Izawa S ，Hirose T ，Iguchi A ... -  《-》

Association between unmet needs for medication support and all-cause hospitalization in community-dwelling disabled elderly people.

Kuzuya M ，Hirakawa Y ，Suzuki Y ，Iwata M ，Enoki H ，Hasegawa J ，Iguchi A ... -  《-》

Day-care service use is a risk factor for long-term care placement in community-dwelling dependent elderly.

To identify predictors of long-term care placement and to examine the effect of day-care service use on long-term care placement over a 36-month follow-up period among community-dwelling dependent elderly. This study was a prospective cohort analysis of 1739 community-dwelling elderly and 1442 caregivers registered in the Nagoya Longitudinal Study for Frail Elderly. Data included the clients' demographic characteristics, basic activities of daily living, comorbidities, and use of home care services, including the day-care, visiting nurse, and home-help services, as well as caregivers' demographic characteristics and care burden. Analysis of long-term care placement over 36 month was conducted using Kaplan-Meier curves and multivariate Cox proportional hazards models. Among the 1739 participants, 217 were institutionalized at long-term care facilities during the 36-month follow-up. Multivariate Cox regression models, adjusted for potential confounders, showed that day-care service use was significantly associated with an elevated risk for long-term care placement within the 36-month follow-up period. Participants using a day-care service two or more times/week had significantly higher relative hazard ratios than participants not using such a service. The results highlight the need for effective measures to reduce the long-term care placement of day-care service users. Policy makers and practitioners must consider implementing multidimensional support programs to reduce the caregivers' willingness to consider long-term care placement.

Kuzuya M ，Izawa S ，Enoki H ，Hasegawa J ... -  《-》

Quality of private personal care for elderly people in Italy living at home with disabilities: risk of nursing home placement at a 1-year follow-up.

Bilotta C ，Nicolini P ，Vergani C 《-》

Day care service use is associated with lower mortality in community-dwelling frail older people.

Kuzuya M ，Masuda Y ，Hirakawa Y ，Iwata M ，Enoki H ，Hasegawa J ，Iguchi A ... -  《JOURNAL OF THE AMERICAN GERIATRICS SOCIETY》