Day care service use is associated with lower mortality in community-dwelling frail older people

Masafumi Kuzuya, Yuichiro Masuda, Yoshihisa Hirakawa, Mitsunaga Iwata, Hiromi Enoki, Jun Hasegawa, Akihisa Iguchi

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

OBJECTIVES: To clarify the association between day care service use and 21-month mortality in community-dwelling frail older people. DESIGN: Prospective cohort study (the Nagoya Longitudinal Study for Frail Elderly). SETTING: Community-based. PARTICIPANTS: One thousand six hundred seventy-three community-dwelling older people (540 men, 1,133 women). MEASUREMENTS: Data included the clients' demographic characteristics; depression as assessed using the short version of the Geriatric Depression Scale; a rating for basic activities of daily living (ADLs); comorbidity; number of prescribed medications and physician-diagnosed chronic diseases; use of home-care services, including day care, visiting nurse, and home-help services; and number of regular medical checkups. Survival analysis of 21-month mortality was conducted using Kaplan-Meier curves and multivariate Cox proportional hazards models. RESULTS: Of the 1,673 participants, 726 were day care service users at baseline, and 268 (94 day care service users, 174 nonusers) died during the 21-month follow-up. Multivariate Cox regression models adjusting for potential confounders showed that day care service use was associated with reduction in mortality. Subgroup analysis demonstrated that day care service use was associated with less risk of mortality in subjects who were female; were in the youngest age group (65-74); had higher ADL scores, lower comorbidity, depression, no dementia; and used a visiting nurse service. Participants using day care service two and three times or more a week had 63% or 44% lower relative hazard ratios, respectively, than participants not using the service. CONCLUSION: Among community-dwelling frail older people, day care service use two or more times per week was associated with 44% to 63% lower 21-month mortality.

Original languageEnglish
Pages (from-to)1364-1371
Number of pages8
JournalJournal of the American Geriatrics Society
Volume54
Issue number9
DOIs
Publication statusPublished - 01-09-2006

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Independent Living
Mortality
Community Health Nurses
Depression
Activities of Daily Living
Proportional Hazards Models
Comorbidity
Frail Elderly
Survival Analysis
Home Care Services
Geriatrics
Longitudinal Studies
Dementia
Chronic Disease
Cohort Studies
Age Groups
Demography
Prospective Studies
Physicians

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology

Cite this

Kuzuya, Masafumi ; Masuda, Yuichiro ; Hirakawa, Yoshihisa ; Iwata, Mitsunaga ; Enoki, Hiromi ; Hasegawa, Jun ; Iguchi, Akihisa. / Day care service use is associated with lower mortality in community-dwelling frail older people. In: Journal of the American Geriatrics Society. 2006 ; Vol. 54, No. 9. pp. 1364-1371.
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Day care service use is associated with lower mortality in community-dwelling frail older people. / Kuzuya, Masafumi; Masuda, Yuichiro; Hirakawa, Yoshihisa; Iwata, Mitsunaga; Enoki, Hiromi; Hasegawa, Jun; Iguchi, Akihisa.

In: Journal of the American Geriatrics Society, Vol. 54, No. 9, 01.09.2006, p. 1364-1371.

Research output: Contribution to journalArticle

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AU - Masuda, Yuichiro

AU - Hirakawa, Yoshihisa

AU - Iwata, Mitsunaga

AU - Enoki, Hiromi

AU - Hasegawa, Jun

AU - Iguchi, Akihisa

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N2 - OBJECTIVES: To clarify the association between day care service use and 21-month mortality in community-dwelling frail older people. DESIGN: Prospective cohort study (the Nagoya Longitudinal Study for Frail Elderly). SETTING: Community-based. PARTICIPANTS: One thousand six hundred seventy-three community-dwelling older people (540 men, 1,133 women). MEASUREMENTS: Data included the clients' demographic characteristics; depression as assessed using the short version of the Geriatric Depression Scale; a rating for basic activities of daily living (ADLs); comorbidity; number of prescribed medications and physician-diagnosed chronic diseases; use of home-care services, including day care, visiting nurse, and home-help services; and number of regular medical checkups. Survival analysis of 21-month mortality was conducted using Kaplan-Meier curves and multivariate Cox proportional hazards models. RESULTS: Of the 1,673 participants, 726 were day care service users at baseline, and 268 (94 day care service users, 174 nonusers) died during the 21-month follow-up. Multivariate Cox regression models adjusting for potential confounders showed that day care service use was associated with reduction in mortality. Subgroup analysis demonstrated that day care service use was associated with less risk of mortality in subjects who were female; were in the youngest age group (65-74); had higher ADL scores, lower comorbidity, depression, no dementia; and used a visiting nurse service. Participants using day care service two and three times or more a week had 63% or 44% lower relative hazard ratios, respectively, than participants not using the service. CONCLUSION: Among community-dwelling frail older people, day care service use two or more times per week was associated with 44% to 63% lower 21-month mortality.

AB - OBJECTIVES: To clarify the association between day care service use and 21-month mortality in community-dwelling frail older people. DESIGN: Prospective cohort study (the Nagoya Longitudinal Study for Frail Elderly). SETTING: Community-based. PARTICIPANTS: One thousand six hundred seventy-three community-dwelling older people (540 men, 1,133 women). MEASUREMENTS: Data included the clients' demographic characteristics; depression as assessed using the short version of the Geriatric Depression Scale; a rating for basic activities of daily living (ADLs); comorbidity; number of prescribed medications and physician-diagnosed chronic diseases; use of home-care services, including day care, visiting nurse, and home-help services; and number of regular medical checkups. Survival analysis of 21-month mortality was conducted using Kaplan-Meier curves and multivariate Cox proportional hazards models. RESULTS: Of the 1,673 participants, 726 were day care service users at baseline, and 268 (94 day care service users, 174 nonusers) died during the 21-month follow-up. Multivariate Cox regression models adjusting for potential confounders showed that day care service use was associated with reduction in mortality. Subgroup analysis demonstrated that day care service use was associated with less risk of mortality in subjects who were female; were in the youngest age group (65-74); had higher ADL scores, lower comorbidity, depression, no dementia; and used a visiting nurse service. Participants using day care service two and three times or more a week had 63% or 44% lower relative hazard ratios, respectively, than participants not using the service. CONCLUSION: Among community-dwelling frail older people, day care service use two or more times per week was associated with 44% to 63% lower 21-month mortality.

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