Ikuta Kasumi, Noguchi-Watanabe Maiko, Aishima Miya, Anzai Tatsuhiko, Takahashi Kunihiko, Fukui Sakiko
Department of Home Health and Palliative Care Nursing, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo 113-8519, Japan.
Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, 2-3-10 Kandasurugadai, Chiyoda-Ku, Tokyo 101-0062, Japan.
Geriatrics (Basel). 2024 Sep 19;9(5):123. doi: 10.3390/geriatrics9050123.
Physical function trajectory (PFT) is associated with mortality and hospitalization risks. We aimed to identify and compare the PFTs of newly admitted high-functioning older adults during their first six months at long-term care (LTC) facilities. In this multicenter retrospective cohort study, we included newly admitted high-functioning older adults (Barthel index > 60) from 47 Japanese LTC facilities. The primary outcome was physical function changes after admission. Data were collected from the Long-Term Care Information System for Evidence (LIFE), which monitored LTC facility residents' function between 1 January 2021 and 31 January 2022. A group-based trajectory model and binomial logistic regression analyses were applied to identify and compare residents' PFTs. Among the 718 residents included, the average age was 85.69 years and 64.5% were female. PFTs were classified as maintenance (66.0%), improvement (9.5%), slight decline (16.6%), and large decline (7.9%). The improvement group had significantly fewer residents who expressed a lack of interest in daily activities (odds ratio (OR) 0.45; 95% confidence interval (CI) 0.21-0.97) compared to the maintenance group. The large decline group had significantly more residents with a low BMI at admission (OR 2.42; 95% CI 1.29-4.55) and residents who did not use dentures (OR 0.49; 95% CI 0.26-0.95), compared to the maintenance group. Considering future PFTs may aid the development of care plans and the provision of appropriate interventions. Moreover, utilizing existing data has the potential to maintain residents' physical independence and enhance the quality of care without burdening residents themselves or staff.
身体功能轨迹(PFT)与死亡率和住院风险相关。我们旨在识别并比较新入住的高功能老年人在长期护理(LTC)机构的前六个月中的PFT。在这项多中心回顾性队列研究中,我们纳入了来自47家日本LTC机构的新入住的高功能老年人(巴氏指数>60)。主要结局是入院后的身体功能变化。数据从长期护理证据信息系统(LIFE)收集,该系统在2021年1月1日至2022年1月31日期间监测LTC机构居民的功能。应用基于组的轨迹模型和二项逻辑回归分析来识别和比较居民的PFT。在纳入的718名居民中,平均年龄为85.69岁,64.5%为女性。PFT被分类为维持(66.0%)、改善(9.5%)、轻微下降(16.6%)和大幅下降(7.9%)。与维持组相比,改善组中对日常活动缺乏兴趣的居民明显更少(优势比(OR)0.45;95%置信区间(CI)0.21 - 0.97)。与维持组相比,大幅下降组入院时BMI较低的居民明显更多(OR 2.42;95% CI 1.29 - 4.55),且未使用假牙的居民也明显更多(OR 0.49;95% CI 0.26 - 0.95)。考虑未来的PFT可能有助于护理计划的制定和适当干预措施的提供。此外,利用现有数据有潜力维持居民的身体独立性并提高护理质量,而不会给居民自身或工作人员带来负担。