Introduction: Existing evidence on the effectiveness of interventions for frailty is limited, and it is not known if long-term care insurance services affect changes in the level of care. This study aimed to investigate the relationship between the type of long-term care services used and changes in care level among Japanese individuals ≥65 years old described in a nationwide administrative database in Japan who were unstable when first certified for a care level.
Methods: This was a retrospective cohort study using certification of needed support data and long-term care insurance claim data stored in the Long-term Care Insurance Comprehensive Database by the Ministry of Health, Labour, and Welfare. We identified elderly people aged ≥65 years who were first certified as needing care level 1 because of their unstable condition between April 2016 and March 2017. We then evaluated which types of long-term care services improved care level.
Results: In total, 15,981 elderly people were included in this study. There were apparent differences between the nonimproving and improving groups in sex (women: 48% vs. 63%, respectively) and cognitive, mental, or behavioral disorders (33% vs. 20%, respectively). Multivariate analysis showed significant correlations between cognitive, mental, or behavioral disorders and worsening of the needed care level (OR=0.49; 95% CI=0.45-0.54; p < 0.001). There was also a significant correlation between using day service for rehabilitation after first certification and improvement of care level (OR=1.27; 95% CI=1.13-1.42; p < 0.001).
Conclusions: Our study findings suggested that including rehabilitation in elderly individual's care plans improved their condition. Our results also suggested that the presence of cognitive, mental, or behavioral disorders could interfere with improvement.
Introduction: Globally, the inappropriate use of antimicrobials has led to the spread of drug-resistant bacteria, which show strong resistance to first-line antimicrobials. In Japan, a high proportion of broad-spectrum antimicrobials, which are effective against many types of bacteria, are used; their use is believed to be related to the increase in the number of multidrug-resistant bacteria.
Methods: Using the Diagnosis Procedure Combination (DPC) data provided by the Ministry of Health, Labour and Welfare, this study calculated the total number of hospitalizations and the average number of days of antimicrobial use per hospitalization according to prefecture, procedure, antimicrobial component, and diabetes status.
Results: In FY27 and FY28, the total number of antimicrobials (by type) used in hospitalizations for laparoscopic cholecystectomy, open cholecystectomy, and breast malignancy surgery was 62,319, 21,296, and 42,313, respectively. Moreover, cefazolin, the only recommended Grade A-1 antimicrobial, was used in 15,914, 4,375, and 28,155 patients for laparoscopic cholecystectomy, open cholecystectomy, and breast malignancy surgery, respectively, whereas meropenem was used in 1,719, 2,161, and<10 patients, respectively.
Conclusion: Overall, the use of prophylactic antimicrobials in the perioperative period was generally in line with the recommended guidelines. However, differences in their use by region and procedure were noticeable. Future research considering the factors behind the differences in antimicrobial drug selection and using the DPC data compiled by the Ministry of Health, Labour and Welfare to monitor antimicrobial drug use is warranted.
Objectives: This pilot cross-sectional study aimed to investigate the characteristics of community-dwelling older adults, focusing on the components of social frailty.
Methods: The participants comprised 74 older adults (age 75.8±6.7 years, 60 women, 81.1%) who were recruited from local senior centers and through local newspaper advertisements in Ibaraki City. Social frailty was assessed using the five components of Makizako et al.: living alone, going out less frequently, rarely visiting friends, feeling unhelpful to friends or family, and not talking with someone every day. Physical frailty and physical functions, such as grip strength and walking speed, were assessed. The participants were divided into 2 groups: the social frail group and the non-socially frailty group. Next, we compared the two groups based on their answers on each component of social frailty.
Results: The prevalence of social frailty was 33.8%. The participants with social frailty were significantly older, had a higher prevalence of physical frailty, and had lower grip strength than those with non-social frailty. Participants living alone and those who did not feel helpful toward friends or family were also older and had a lower range of physical functions than those who did not live alone.
Conclusions: As the components of social frailty have different characteristics, it may be necessary to focus on the components to support community-dwelling older adults with social frailty.
This study examines the relationship between resilience (as measured by Hirano's Bidimensional Resilience Scale) and socio-demographic characteristics among 3,779 Japanese adults. From the results of the robust, multivariate, multiple regression analysis, we observed a significant positive correlation between: a) specific socio-demographic characteristics (sex, age, education level, and household income) and innate and acquired resilience; b) specific socio-demographic characteristics (squared term of age, employment status, and the number of children) and innate factors, which suggests that influence of socio-demographic characteristics changes resilience factors. Based on these findings, we recommend that future studies use the socio-demographic characteristics as confounding factors of resilience.
The purpose of this study was to examine the effect of an intervention using Taktil care that brings positive emotions. The subjects were 46 elderly people who live in a nursing home or use day service in S prefecture. Taktil care was performed three times for approximately 15 minutes for each hand. The effect was measured with Mini Mental State Examination (MMSE) and Japanese short version of Geriatric Depression Scale 1 week before the intervention (control period) and three times after the intervention. In addition, for stress analysis, autonomic nervous system activity, autonomic nervous system balance, physical stress, mental stress, stress resistance, fatigue, cardiac stability, and stress score were measured with Well up's Max Pulse. The Face Scale (FS) and salivary amylase activity were also measured before and after the intervention. The results showed that the MMSE score and the mean FS score have significantly improved after the intervention compared to the control period (P <0.01). The autonomic nervous system activity, mental stress, stress resistance, and cardiac stability have also significantly improved after the intervention compared to the control period. Comparing the salivary amylase activity levels before and after the intervention, 70% of the subjects showed a significant decrease. This study suggested the effectiveness of Taktil for bringing positive emotions and reducing stress in the elderly with dementia.