{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:09:49Z","timestamp":1777507789184,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,6,4]],"date-time":"2012-06-04T00:00:00Z","timestamp":1338768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:p><jats:bold>Aim:\u2003<\/jats:bold> The aim of this study was to show which dimensions of functions differ among community\u2010dwelling elderly participants in four different certification levels of the current long\u2010term care insurance system (LTCI) in a rural, depopulated and aging town in Japan, with special consideration for strengths and weaknesses of the LTCI.<\/jats:p><jats:p><jats:bold>Methods:\u2003<\/jats:bold> The study population consisted of 1077 community\u2010dwelling elderly participants aged 65\u2003years and older, with LTCI certification comprising 542 uncertified elderly <jats:italic>(Ippan\u2010Koureisya)<\/jats:italic>, 437 specified elderly (<jats:italic>Tokutei\u2010Koreisha<\/jats:italic>), 57 support\u2010level elderly (<jats:italic>Youshien\u2010Koureisha<\/jats:italic>) and 41 care\u2010level elderly (<jats:italic>Youkaigo\u2010Ninteisha<\/jats:italic>). Each participant was rated regarding their health status, with question topics including basic activities of daily living (ADL), the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG\u2010IC), the 15\u2010item Geriatric Depression Scale (GDS\u201015), 21\u2010item Fall Risk Index (FRI\u201021), the quantitative subjective quality of life (QOL), current medical situation, past medical histories and social backgrounds.<\/jats:p><jats:p><jats:bold>Results:\u2003<\/jats:bold> The scores in basic ADL, each item of the TMIG\u2010IC and five items of the quantitative subjective QOL were significantly lower, and the scores in GDS\u201015 and in FRI\u201021 were significantly higher according to certification level, in order of uncertified, specified, support\u2010level and care\u2010level elderly in a dose\u2013response manner. Exercise and drinking habits were significantly less common in support\u2010 or care\u2010level elderly than in specified or uncertified elderly. The prevalence of taking antihypertensive, antihyperlipidemia, antidepressant or sleeping medications was significantly higher in the support\u2010 or care\u2010level elderly than in uncertified or specified elderly people. Support\u2010 or care\u2010level elderly also had a significantly higher prevalence of past medical histories of stroke, bone fractures, osteoarthropathy, heart disease and cancer than uncertified or specified elderly people.<\/jats:p><jats:p><jats:bold>Conclusion:\u2003<\/jats:bold> Actual standardized quantitative and qualitative geriatric functions of the elderly among four categories in newly revised LTCI system were shown in a depopulated and aging town in Japan. Based on the actual situation of functions of the elderly, the strengths and weaknesses of the current LTCI system were reconsidered. Further research on the measures to prevent future dependency among the specified and support\u2010level elderly is required. <jats:bold>Geriatr Gerontol Int 2013; 13: 63\u201369<\/jats:bold>.<\/jats:p>","DOI":"10.1111\/j.1447-0594.2012.00859.x","type":"journal-article","created":{"date-parts":[[2012,6,4]],"date-time":"2012-06-04T19:23:54Z","timestamp":1338837834000},"page":"63-69","source":"Crossref","is-referenced-by-count":31,"title":["Comprehensive geriatric functional analysis of elderly populations in four categories of the long\u2010term care insurance system in a rural, depopulated and aging town in Japan"],"prefix":"10.1111","volume":"13","author":[{"given":"Wenling","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eriko","family":"Fukutomi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taizo","family":"Wada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuko","family":"Ishimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumi","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoriko","family":"Kasahara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryota","family":"Sakamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyohito","family":"Okumiya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kozo","family":"Matsubayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,6,4]]},"reference":[{"key":"e_1_2_7_2_2","unstructured":"National Institute of Population Social Security Research. 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