Influence Factors of Mobility-Related Activities of Daily Living in Chronic Dialysis Patients Needing Long-Term Care: Analysis of Long-Term Care Eligibility Assessment Survey Data
- 1 School of Sciences Faculty of Medicine, Niigata University, Niigata, Japan
- 2 School of Sciences Faculty of Medicine, Niigata University, Niigata, Japan
- 3 School of Sciences Faculty of Medicine, Niigata University, Niigata, Japan
- 4 Division of Legal Medicine, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan
- 5 Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan
Abstract
Background: In the near future in Japan, chronic dialysis patients will likely face a situation where the aging and the lengthening of hemodialysis treatment periods will adversely affect the mobility-related activities of daily living (MR-ADL). The aim of this study was to investigate chronological change in MR-ADL among chronic dialysis patients in need of long-term care and the effect of admission to long-term care facilities on their MR-ADL. Methods: Data were analyzed from a long-term care eligibility assessment survey conducted in late March 2009 of 1000 individuals residing in Niigata City, Japan who were approved to receive long-term care. Then data from those individuals who had undergone the assessment survey ≥4 times over a period of ≥4 years were statistically evaluated. To reveal change in MR-ADL, this study performed a three-way analysis of variance with mean survey scores from assessment categories 2 - 5 containing questions related to MR-ADL as the independent variable and the number of eligibility assessment surveys (within-subjects factor), facility admission, and dialysis therapy (between-subjects factors) as dependent variables. Results: We observed the effect of facility admission in individuals aged >70 years for categories 2 - 5, and observed the effect of the number of assessment surveys taken only in women ≥80 years for categories 2 and 5. Regarding the effect of dialysis therapy, female dialysis patients aged ≥80 years and in need of long-term care scored significantly higher on survey items for transferring, grooming, toileting, eating, and instrumental activities of daily living, all of which are indicators of a moderate decline in ADL. Conclusions: Because dialysis is often initiated in women aged around 80 years, ADL in this group of individuals can be improved by the initiation and proper provision of dialysis.
- The Japanese Society for Dialysis Therapy (2011) Current Status of Dialysis Therapy as of December 31, 2011: Illustrations. http://docs.jsdt.or.jp/overview/
- Farrokhi, F. and Jassal, S.V. (2013) Routine Use of an Abbreviated 4-Item Scale to Assess Dependence in Essential Activities of Daily Living amongst Elderly Hemodialysis Patients: A Validation Study. International Urology and Nephrology, 45, 259-264. http://dx.doi.org/10.1007/s11255-012-0360-4
- Kurella Tamura, M., Covinsky, K.E., Chertow, G.M., Yaffe, K., Landefeld, C.S., et al. (2009) Functional Status of Elderly Adults before and after Initiation of Dialysis. The New England Journal of Medicine, 361, 1539-1547. http://dx.doi.org/10.1056/NEJMoa0904655
- Tsutsui, T. and Muramatsu, N. (2005) Care-Needs Certification in the Long-Term Care Insurance System of Japan. Journal of the American Geriatrics Society, 53, 522-527. http://dx.doi.org/10.1111/j.1532-5415.2005.53175.x
- Tomata, Y. (2012) Green Tea Consumption and the Risk of Incident Functional Disability in Elderly Japanese: The Ohsaki Cohort 2006 Study. The American Journal of Clinical Nutrition, 95, 732-739. http://dx.doi.org/10.3945/ajcn.111.023200
- Tsutsui, T. and Muramatsu, N. (2007) Japan’s Universal Long-Term Care System Reform of 2005: Containing Costs and Realizing a Vision. Journal of the American Geriatrics Society, 55, 1458-1463. http://dx.doi.org/10.1111/j.1532-5415.2007.01281.x
- Japan Medical Association Research Institute (2004) Assessment of the Efficacy of Long Term Care Services. Report No. 65. Part 2, Current Situation and the Efficacy of Care Management by Multiple Insurers, Japan Medical Association Research Institute, Tokyo, 65-130.
- The Japanese Society for Dialysis Therapy (2008) Current Status of Dialysis Therapy as of December 31, 2008: Illustrations. http://docs.jsdt.or.jp/overview/index2009.html
- Health and Welfare Statistical Association (2005) Part 4: Health Insurance and Long Term Care Insurance. Chapter 2, The Long Term Care Insurance System: 2, Overview of the Long Term Care Insurance System; 3, Benefit Procedure and Description, Extra Edition. Journal of Health and Welfare Statistics, 52, 219-221. (in Japanese)
- Thompson, M., Lee, E., Hinomizu, A. and Nakamura, Y. (2005) Development of an Exercise Program for the Improvement of QOL (and for Care Prevention) in the Elderly over 75 Years of Age. Sport Science Research, 2, 113-121. (in Japanese)