Objective The “Kihon Checklist” (a frailty checklist), consisting of 25 items, is used for screening frail elderly, based on the Japanese long-term care insurance system. However, few reports have investigated predictive ability of incident long-term care insurance certification in the Kihon Checklist. The purpose of this study was to investigate inter-relationships and accuracy as a screening test of individual items and criteria in the Kihon Checklist for incident long-term care insurance certification.
Methods In December 2006, we distributed a questionnaire including the Kihon Checklist to individuals older than 65 years living in Ohsaki City, Japan. Among the valid respondents, we followed those who gave informed consent to follow-up, had more than 1 item of response on the Kihon Checklist, and were not qualified for long-term care insurance certification at the baseline. We further excluded individuals who died or moved away in the one year follow-up, analyzing 14,636 elderly. The age- and sex-adjusted odds ratio (OR) and 95% confidence interval (95%CI) for newly incident long-term care insurance certification were estimated by logistic regression analysis. Independent variables were each of the items and criteria in the Kihon Checklist used for screening of “frail elderly”. In addition, we estimated the sensitivity and specificity, and conducted receiver operating characteristic (ROC) analysis for each criteria domain.
Results 5,560 (38.0%) matched the criteria of “frail elderly”. During the one year of follow-up, 483 (3.3%) required newly incident long-term care insurance certification. All of the items in the Kihon Checklist were significantly associated with incident long-term care insurance certification (range of ORs: 1.45–4.67). In addition, all of the criteria also significantly predicted the risk of incident long-term care insurance certification (range of OR: 1.93–6.54). The OR (95%CI) for “frail elderly” was 3.80 (3.02–4.78). Among the various domains, “20 items other than five related to prevention and support for depression” had the largest area under the ROC curve.
Conclusion All items and criteria used for screening frail elderly in the Kihon Checklist are useful for predicting the risk of incident long-term care insurance certification during a one-year period. However, the strength of the relation and accuracy for screening test were variable among items or domains, and criteria values could be improved.

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[in Japanese]

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Objective Square-Stepping Exercise (SSE), composed of movements similar to walking, involves varied movements in multiple directions and is performed on a thin mat (100×250 cm) that is partitioned into 40 squares (25 cm each). We introduced SSE to a group of older adults for three months as a supervised intervention. After this intervention period, the participants continued SSE without supervision for four years. The current study was conducted to determine why the participants independently continued SSE.
Methods Among 52 older adults who attended the SSE intervention, 40 continued SSE (continued group) and 12 discontinued (discontinued group). Seven in the continued group were excluded from analyses because of low attendance rates. Each of the remainder (n=33) was independently interviewed and asked why he/she had continued SSE. The average interview time for the continued group was 12 minutes. Twelve in the discontinued group were investigated for exercise habits by postal questionnaire.
Results The participants in the continued group noted two to six reasons for continuation of SSE. After analyzing data inductively, the answers were categorized as follows: (1) friends and social communication; (2) equitable management of group activity; (3) expectation of health from exercise; (4) simple-easy exercise; and (5) family support for exercise. The participants in the discontinued group reported that 89% of them continually did walking, muscular strength exercise, and calisthenics.
Conclusion We found that reasons why adoption of SSE as an intervention program for older adults enhance their exercise adherence in the long term.

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Objective This research was conducted to determine the prevalence of recognition of child maltreatment among mothers with children aged 12 or under, and to identify associated factors in order to prevent child maltreatment.
Methods The subjects of this study were 3,000 women extracted by systematic random sampling of mothers of 6,790 children who had had four-month health check-ups in Nishinomiya city. The response rate was 57.5%. After excluding mothers with children aged 13 years and over, the study sample included 1,471 mothers with children aged 12 or under. A questionnaire survey was conducted by mail. Recognition of child maltreatment by mothers was assessed with a question that asked the mother if she was sometimes aware that she had potentially abused her child, and, if yes, what kind of acts had she performed.
Results There were 333 mothers (22.6%) who answered “yes” to the question “Are you sometimes aware that you have potentially abused your child?” These mothers reported emotional or physical aggression toward their children. Results of logistic regression showed that recognition of child maltreatment was associated with existence of a child whom the mother felt difficulty in cherishing, number of children, maternal poor health, higher scores of STAI trait anxiety and disabled children. Mothers reported difficulties in child-rearing for more than one child as the main reason behind existence of a child whom the mother felt difficulty in cherishing.
Conclusion These findings suggested that mothers with more than one child need more support in order to prevent child maltreatment.

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[in Japanese]

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