Graduate School of Urban Environmental Science, Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji, Tokyo, 192-0397, Japan.
Environ Health Prev Med. 2013 Jan;18(1):33-9. doi: 10.1007/s12199-012-0287-5. Epub 2012 Jul 3.
The aim of this chronological study was to elucidate the effects of socio-economic status (SES) and physical health on the long-term care (LTC) needs of a Japanese elderly population and to explore their causal relationships.
A self-administered questionnaire was distributed to all residents aged 65 years and older of Tama City, Tokyo, in September 2001. A total of 13,195 completed questionnaires were returned, giving a response rate of 80.2 %. A follow-up study was done using the same questionnaire in 2004. Ultimately, 7,905 respondents were included in our analysis. Data analysis was performed using correlation analysis and structural equation modeling (SEM). For SEM, we used one observed variable (LTC needs in 2004) and three latent variables (SES in 2001 and physical health in both 2001 and 2004).
The data were well fit by the models, with a NFI of 0.980, CFI of 0.982, and RMSEA of 0.032. LTC needs were well explained by the three latent variables (R (2) = 0.70 and 0.66 for elderly men and women, respectively). Among all variables, physical health in 2004 was the strongest determinant of LTC needs, followed by physical health in 2001, and SES in 2001. Gender differences in the structural relationships were minor.
Our results indicate that good physical health directly contributes to reducing LTC needs among Japanese elderly. In addition, efforts to increase income and educational levels may help to decrease LTC needs by indirectly improving physical health.
本纵向研究旨在阐明社会经济地位（SES）和身体健康对日本老年人群长期护理（LTC）需求的影响，并探讨它们之间的因果关系。
2001 年 9 月，向东京多摩市所有 65 岁及以上的居民发放了一份自填式问卷。共收回 13195 份完整问卷，应答率为 80.2%。2004 年采用相同问卷进行了随访研究。最终，有 7905 名受访者纳入我们的分析。采用相关分析和结构方程模型（SEM）进行数据分析。对于 SEM，我们使用了一个观测变量（2004 年的 LTC 需求）和三个潜在变量（2001 年的 SES 和 2001 年和 2004 年的身体健康）。
模型数据拟合良好，NFI 为 0.980，CFI 为 0.982，RMSEA 为 0.032。三个潜在变量很好地解释了 LTC 需求（男性和女性的 R²分别为 0.70 和 0.66）。在所有变量中，2004 年的身体健康是 LTC 需求的最强决定因素，其次是 2001 年的身体健康和 2001 年的 SES。性别对结构关系的影响较小。
我们的研究结果表明，良好的身体健康直接有助于减少日本老年人对 LTC 的需求。此外，增加收入和教育水平的努力可能通过间接改善身体健康来帮助减少 LTC 需求。
