Fukutomi Eriko, Okumiya Kiyohito, Wada Taizo, Sakamoto Ryota, Ishimoto Yasuko, Kimura Yumi, Chen Wen-Ling, Imai Hissei, Kasahara Yoriko, Fujisawa Michiko, Otsuka Kuniaki, Matsubayashi Kozo
School of Public Health, Kyoto University, Kyoto, Japan.
Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
Geriatr Gerontol Int. 2015 Jul;15(7):864-71. doi: 10.1111/ggi.12360. Epub 2014 Oct 15.
The 25-item Kihon Checklist (KCL) is the official self-administered questionnaire tool to screen frail older adults, consisting of seven categories: physical strength, nutritional status, oral function, houseboundness, cognitive function, depression risk and a score of more than 9 out of 1-20 items. The aim of the present study was to evaluate the relationships between each category of the KCL and newly certified cases under the Long-Term Care Insurance (LTCI) in Japan during 24 months.
The study population consisted of 883 community-dwelling adults aged 65 years or older uncertified by LTCI completing a questionnaire, which included the KCL and scales of basic/advanced activities of daily living (ADL), quality of life (QOL), and depressive symptoms. The participants were categorized into the risk or non-risk group depending on the official criteria of each KCL category. The outcome was the incidence of newly certified cases by LTCI during 24 months. The difference between the risk and non-risk group was analyzed by Cox regression hazard models.
Scores in basic/advanced ADL and QOL were higher, and the score in the geriatric depression scale was lower in the non-risk than the risk group in KCL criteria. In men, the incidence of newly certified cases was higher in the risk group of the physical strength category after adjusting for age and the other categories of the KCL.
The physical strength category in men was the only significant predictor of the incidence of newly certified cases by LTCI. Further studies are required to improve the assessment item of cognitive function in KCL under LTCI.
25项基準检查表（KCL）是用于筛查衰弱老年人的官方自填式问卷调查工具，由七个类别组成：体力、营养状况、口腔功能、居家情况、认知功能、抑郁风险以及1 - 20项中得分超过9分的一项。本研究的目的是评估KCL的每个类别与日本长期护理保险（LTCI）在24个月内新认证病例之间的关系。
研究人群包括883名65岁及以上未通过LTCI认证的社区居住成年人，他们完成了一份问卷，其中包括KCL以及日常生活基本/高级活动（ADL）、生活质量（QOL）和抑郁症状量表。根据每个KCL类别的官方标准，将参与者分为风险组或非风险组。结果是LTCI在24个月内新认证病例的发生率。通过Cox回归风险模型分析风险组和非风险组之间的差异。
在KCL标准中，非风险组的基本/高级ADL和QOL得分较高，老年抑郁量表得分低于风险组。在男性中，在调整年龄和KCL的其他类别后，体力类别风险组中新认证病例的发生率较高。
男性的体力类别是LTCI新认证病例发生率的唯一显著预测因素。需要进一步研究以改进LTCI下KCL中认知功能的评估项目。
