Investigation of Factors Associated with the Long-term Care and Cognitive Decline in Community Dwelling Older People

概要

Background: Investigating factors associated with receiving LTC and cognitive decline is important for decreasing LTC burden. The aims of this study were to investigate the factors associated with LTC and cognitive decline in community-dwelling older people.

Methods: The methodology in this study was divided into two sections. The first study was to investigate the factors associated with LTC. The participants were 1098 community-dwelling older people. The endpoint was receiving LTC after the baseline survey. The main independent variables were grip strength and walking speed. We calculated the hazard ratio of receiving LTC using the Cox proportional hazard model. Whereas the second study was to investigate the factors associated with cognitive decline. The participants were 1333 community-dwelling older people. The MoCA-J was declined of > 2 points was defined as cognitive decline. Multiple logistic regression analysis was used to investigate the association between risk factors and cognitive decline during a 3-year follow­up.

Results: The result of the first study, the physical function revealed that only slow walking speed was significantly correlated with LTC. Additional factors significantly correlated with LTC were lower MoCA-J score, advanced age, and female sex. In the second study found that history of stroke, advanced age, and greater MoCA-J score at the baseline were important risk factors, while the presence of dyslipidemia and a higher educational level were protective factors significantly correlated with cognitive decline.

Conclusion: Decreasing LTC burden, we must be focused on the prevention of slow walking speed and cognitive decline, especially in females with advanced age. Moreover, prevention of cognitive decline by paying more attention to the risk factors included a history of stroke, maintaining cognitive stability function in early life of older people are useful to reduce cost of LTC and enhance older people’s quality of life.