Takahashi Keisuke, Ideo Katsumasa, Uragami Masaru, Fukuma Yuko, Koga Takehiro, Yoshiura Kazuhiro, Boku Shuken, Kajitani Naoto, Takebayashi Minoru, Miyamoto Takeshi
Department of Orthopedic Surgery, Faculty of Life Sciences, Kumamoto University, 1-1- Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan.
Department of Physical Medicine and Rehabilitation, Kumamoto University Hospital, Kumamoto, Japan.
J Bone Miner Metab. 2025 May 28. doi: 10.1007/s00774-025-01606-x.
The increase in the older population is a serious concern in developed countries, and how to maintain independence of these individuals is now an urgent issue. Various factors are known to put older people at risk for needing long-term care, but it is not clear to what extent each factor is associated with that need.
In a cohort of 1577 community-dwelling older persons, we excluded 40 persons whose long-term care insurance certification was unknown and then divided the remaining 1537 into two groups: dependent group (134 persons) certified as requiring assistance or long-term care, and an independent group (1403 persons). We extracted 7 factors and created a scoring system from these factors based on regression coefficients.
Among 92 factors initially evaluated, 7 were significantly associated with the need for assistance or long-term care, namely walking speed, age, grip strength, mobility (EQ5D), ability to use public transportation by oneself (IADL), ability to perform usual activities (EQ5D), and serum albumin levels. Based on these 7, we constructed a scoring system and calculated a cutoff value of 8 points with an area under curve as high as 0.949.
We determined the cutoff value for dependency risk to be 8, but no single factor scored 8 or higher, suggesting that a combination of these factors promotes the need for nursing care in older people.
在发达国家，老年人口的增加是一个严重问题，如何维持这些人的独立性如今已成为紧迫问题。已知多种因素会使老年人面临需要长期护理的风险，但尚不清楚每个因素与这种需求的关联程度。
在一个由1577名居住在社区的老年人组成的队列中，我们排除了40名长期护理保险认证情况不明的人，然后将其余1537人分为两组：被认证为需要协助或长期护理的依赖组（134人）和独立组（1403人）。我们提取了7个因素，并根据回归系数从这些因素创建了一个评分系统。
在最初评估的92个因素中，有7个与需要协助或长期护理显著相关，即步行速度、年龄、握力、活动能力（EQ5D）、独自使用公共交通工具的能力（IADL）、进行日常活动的能力（EQ5D）以及血清白蛋白水平。基于这7个因素，我们构建了一个评分系统，并计算出截断值为8分，曲线下面积高达0.949。
我们确定依赖风险的截断值为8，但没有单一因素得分达到或超过8分，这表明这些因素的组合促使老年人产生护理需求。
