{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:41:23Z","timestamp":1793835683088,"version":"4.6.1"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Long-term care (LTC) prevention is a pressing concern in ageing societies. To understand the risk factors of LTC, it is vital to consider psychological and social factors in addition to physical factors. Owing to a lack of relevant data, we aimed to investigate the social, physical and psychological factors associated with LTC using large-scale, nationally representative data to identify a high-risk population for LTC in terms of multidimensional frailty.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We performed a cross-sectional study using anonymised data from the 2013 Comprehensive Survey of Living Conditions conducted by the Ministry of Health, Labour and Welfare of Japan. Among the 23,730 eligible people aged 65\u2009years or older and those who were not in hospitals or care facilities during the survey, 1718 stated that they had LTC certification. Univariate and multivariate logistic regression analyses were performed to determine the factors associated with LTC certification.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Factors positively associated with LTC certification in the multivariate analyses included older age, the interaction term between sex and age group at age 85\u201389\u2009years, limb movement difficulties, swollen\/heavy feet, incontinence, severe psychological distress (indicated by a Kessler Psychological Distress Scale [K6] score\u2009\u2265\u200913), regular hospital visits for dementia, stroke, Parkinson\u2019s disease, chronic obstructive pulmonary disease, fracture, rheumatoid arthritis, kidney disease, diabetes and osteoporosis. Factors negatively associated with LTC certification included the presence of a spouse, regular hospital visits for hypertension and consulting with friends or acquaintances about worries and stress.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In summary, we identified the physical, psychological and social factors associated with LTC certification using nationally representative data. Our findings highlight the importance of the establishment of multidimensional approaches for LTC prevention in older adults.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12877-021-02308-5","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T11:03:37Z","timestamp":1624273417000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Factors associated with long-term care certification in older adults: a cross-sectional study based on a nationally representative survey in Japan"],"prefix":"10.1186","volume":"21","author":[{"given":"Akira","family":"Momose","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoko","family":"Yamaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Okada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayo","family":"Ikeda-Kurakawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Namiki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhito","family":"Nannya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Kato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshimasa","family":"Yamauchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaomi","family":"Nangaku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kadowaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"2308_CR1","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1016\/S0140-6736(11)61176-8","volume":"378","author":"N Tamiya","year":"2011","unstructured":"Tamiya N, Noguchi H, Nishi A, Reich MR, Ikegami N, Hashimoto H, et al. Population ageing and wellbeing: lessons from Japan\u2019s long-term care insurance policy. Lancet. 2011;378:1183\u201392. https:\/\/doi.org\/10.1016\/S0140-6736(11)61176-8 PMID 21885099.","journal-title":"Lancet"},{"issue":"1","key":"2308_CR2","doi-asserted-by":"publisher","first-page":"67","DOI":"10.31662\/jmaj.2018-0015","volume":"2","author":"M Iwagami","year":"2019","unstructured":"Iwagami M, Tamiya N. The long-term care insurance system in Japan: past, present, and future. JMA J. 2019;2(1):67\u20139. https:\/\/doi.org\/10.31662\/jmaj.2018-0015.","journal-title":"JMA J"},{"key":"2308_CR3","unstructured":"Survey of long-term care benefit expenditures. Ministry of Health, Labour and Welfare. Available from: https:\/\/www.mhlw.go.jp\/toukei\/list\/45-1b.html. Accessed 27 Apr 2021.\u00a0"},{"issue":"1","key":"2308_CR4","doi-asserted-by":"publisher","first-page":"34","DOI":"10.20683\/jniph.68.1_34","volume":"68","author":"H Masui","year":"2019","unstructured":"Masui H, Otaga M, Moriyama Y, Matsushige T. Current issues in long-term care policy and research: toward the promotion of evidence-based policy. Hokeniryokagaku. 2019;68(1):34\u201344 https:\/\/doi.org\/10.20683\/jniph.68.1_34.","journal-title":"Hokeniryokagaku"},{"key":"2308_CR5","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1016\/S0140-6736(19)31786-6","volume":"394","author":"EO Hoogendijk","year":"2019","unstructured":"Hoogendijk EO, Afilalo J, Ensrud KE, Kowal P, Onder G, Fried LP. Frailty: implications for clinical practice and public health. Lancet. 2019;394:1365\u201375. https:\/\/doi.org\/10.1016\/S0140-6736(19)31786-6 PMID 31609228.","journal-title":"Lancet"},{"key":"2308_CR6","doi-asserted-by":"publisher","first-page":"2051","DOI":"10.1007\/s11136-012-0341-1","volume":"22","author":"RJ Gobbens","year":"2013","unstructured":"Gobbens RJ, Luijkx KG, van Assen MA. Explaining quality of life of older people in the Netherlands using a multidimensional assessment of frailty. Qual Life Res. 2013;22:2051\u201361. https:\/\/doi.org\/10.1007\/s11136-012-0341-1 PMID 23274572.","journal-title":"Qual Life Res"},{"key":"2308_CR7","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1186\/1471-2318-14-70","volume":"14","author":"D Koller","year":"2014","unstructured":"Koller D, Sch\u00f6n G, Sch\u00e4fer I, Glaeske G, van den Bussche H, Hansen H. Multimorbidity and long-term care dependency--a five-year follow-up. BMC Geriatr. 2014;14:70. https:\/\/doi.org\/10.1186\/1471-2318-14-70 PMID 24884813.","journal-title":"BMC Geriatr"},{"key":"2308_CR8","doi-asserted-by":"publisher","first-page":"270","DOI":"10.5582\/bst.2015.01059","volume":"9","author":"T Naruse","year":"2015","unstructured":"Naruse T, Sakai M, Matsumoto H, Nagata S. Diseases that precede disability among latter-stage elderly individuals in Japan. BioSci Trends. 2015;9:270\u20134. https:\/\/doi.org\/10.5582\/bst.2015.01059 PMID 26355228.","journal-title":"BioSci Trends"},{"key":"2308_CR9","doi-asserted-by":"publisher","first-page":"56","DOI":"10.37737\/ace.1.2_56","volume":"1","author":"M Iwagami","year":"2019","unstructured":"Iwagami M, Taniguchi Y, Jin X, Adomi M, Mori T, Hamada S, et al. Association between recorded medical diagnoses and incidence of long-term care needs certification: a case control study using linked medical and long-term care data in two Japanese cities. Annals Clin Epidemiol. 2019;1:56\u201368. https:\/\/doi.org\/10.37737\/ace.1.2_56.","journal-title":"Annals Clin Epidemiol"},{"key":"2308_CR10","unstructured":"Summary report of Comprehensive Survey of Living Conditions 2013. Ministry of Health, Labour and Welfare. Available from: https:\/\/www.mhlw.go.jp\/english\/database\/db-hss\/cslc-report2013.html.\u00a0Accessed 27 Apr 2021.\u00a0"},{"key":"2308_CR11","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/j.ypmed.2007.12.007","volume":"46","author":"N Kondo","year":"2008","unstructured":"Kondo N, Kazama M, Suzuki K, Yamagata Z. Impact of mental health on daily living activities of Japanese elderly. Prev Med. 2008;46:457\u201362. https:\/\/doi.org\/10.1016\/j.ypmed.2007.12.007 PMID 18258290.","journal-title":"Prev Med"},{"key":"2308_CR12","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1111\/ggi.12533","volume":"16","author":"T Monma","year":"2016","unstructured":"Monma T, Takeda F, Noguchi H, Tamiya N. Age and sex differences of risk factors of activity limitations in Japanese older adults. Geriatr Gerontol Int. 2016;16:670\u20138. https:\/\/doi.org\/10.1111\/ggi.12533 PMID 26044713.","journal-title":"Geriatr Gerontol Int"},{"key":"2308_CR13","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1192\/bjp.181.5.406","volume":"181","author":"S Paterniti","year":"2002","unstructured":"Paterniti S, Verdier-Taillefer MH, Dufouil C, Alp\u00e9rovitch A. Depressive symptoms and cognitive decline in elderly people. Longitudinal study. Br J Psychiatry. 2002;181:406\u201310. https:\/\/doi.org\/10.1192\/bjp.181.5.406 PMID 12411266.","journal-title":"Br J Psychiatry"},{"key":"2308_CR14","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1177\/0898264318822364","volume":"32","author":"S Schnitzer","year":"2020","unstructured":"Schnitzer S, Bl\u00fcher S, Teti A, Schaeffner E, Ebert N, Martus P, et al. Risk profiles for care dependency: cross-sectional findings of a population-based cohort study in Germany. J Aging Health. 2020;32:352\u201360. https:\/\/doi.org\/10.1177\/0898264318822364 PMID 30658538.","journal-title":"J Aging Health"},{"key":"2308_CR15","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1111\/ggi.13684","volume":"19","author":"WC Hsu","year":"2019","unstructured":"Hsu WC, Wang JY, Tsai AC. Predictors of developing a new need for long-term care of older adults aged \u226570 years: results from a population-based cohort study in Taiwan. Geriatr Gerontol Int. 2019;19:641\u20136. https:\/\/doi.org\/10.1111\/ggi.13684 PMID 31099138.","journal-title":"Geriatr Gerontol Int"},{"key":"2308_CR16","doi-asserted-by":"publisher","first-page":"e89213","DOI":"10.1371\/journal.pone.0089213","volume":"9","author":"CY Wu","year":"2014","unstructured":"Wu CY, Hu HY, Huang N, Fang YT, Chou YJ, Li CP. Determinants of long-term care services among the elderly: a population-based study in Taiwan. PLoS One. 2014;9:e89213. https:\/\/doi.org\/10.1371\/journal.pone.0089213 PMID 24586602.","journal-title":"PLoS One"},{"key":"2308_CR17","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1111\/j.1741-6612.2012.00601.x","volume":"32","author":"S Moriya","year":"2013","unstructured":"Moriya S, Murata A, Kimura S, Inoue N, Miura H. Predictors of eligibility for long-term care funding for older people in Japan. Australas J Ageing. 2013;32:79\u201385. https:\/\/doi.org\/10.1111\/j.1741-6612.2012.00601.x PMID 23773245.","journal-title":"Australas J Ageing"},{"key":"2308_CR18","unstructured":"Comprehensive Survey of Living Conditions. Ministry of Health, Labour and Welfare. Available from: https:\/\/www.mhlw.go.jp\/english\/database\/db-hss\/cslc.html.\u00a0Accessed 27 Apr 2021.\u00a0"},{"issue":"1","key":"2308_CR19","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1111\/j.1468-0009.2005.00428.x","volume":"51","author":"R Andersen","year":"1973","unstructured":"Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. Milbank Mem Fund Q Health Soc. 1973;51(1):95\u2013124. https:\/\/doi.org\/10.1111\/j.1468-0009.2005.00428.x PMID: 4198894.","journal-title":"Milbank Mem Fund Q Health Soc"},{"key":"2308_CR20","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1017\/s0033291702006074","volume":"32","author":"RC Kessler","year":"2002","unstructured":"Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32:959\u201376. https:\/\/doi.org\/10.1017\/s0033291702006074 PMID 12214795.","journal-title":"Psychol Med"},{"issue":"3","key":"2308_CR21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v045.i03","volume":"45","author":"S van Buuren","year":"2011","unstructured":"van Buuren S, Groothuis-Oudshoorn K. Mice: multivariate imputation by chained equations in R. J Stat Softw. 2011;45(3):1\u201367. https:\/\/doi.org\/10.18637\/jss.v045.i03.","journal-title":"J Stat Softw"},{"key":"2308_CR22","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/j.archger.2018.12.010","volume":"81","author":"E Kiyoshige","year":"2019","unstructured":"Kiyoshige E, Kabayama M, Gondo Y, Masui Y, Ryuno H, Sawayama Y, et al. Association between long-term care and chronic and lifestyle-related disease modified by social profiles in community-dwelling people aged 80 and 90; SONIC study. Arch Gerontol Geriatr. 2019;81:176\u201381. https:\/\/doi.org\/10.1016\/j.archger.2018.12.010 PMID 30597340.","journal-title":"Arch Gerontol Geriatr"},{"key":"2308_CR23","unstructured":"Results of the National Health and Nutrition Survey Japan; 2013. Available from: https:\/\/www.mhlw.go.jp\/bunya\/kenkou\/eiyou\/h25-houkoku.html.\u00a0Accessed 27 Apr 2021.\u00a0"},{"key":"2308_CR24","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1017\/S0033291713001384","volume":"44","author":"CR Gale","year":"2014","unstructured":"Gale CR, Cooper C, Deary IJ, Aihie SA. Psychological well-being and incident frailty in men and women: the English Longitudinal Study of Ageing. Psychol Med. 2014;44:697\u2013706. https:\/\/doi.org\/10.1017\/S0033291713001384 PMID 23822897.","journal-title":"Psychol Med"},{"key":"2308_CR25","doi-asserted-by":"publisher","first-page":"1346","DOI":"10.2105\/ajph.89.9.1346","volume":"89","author":"BW Penninx","year":"1999","unstructured":"Penninx BW, Leveille S, Ferrucci L, van Eijk JT, Guralnik JM. Exploring the effect of depression on physical disability: longitudinal evidence from the established populations for epidemiologic studies of the elderly. Am J Public Health. 1999;89:1346\u201352. https:\/\/doi.org\/10.2105\/ajph.89.9.1346 PMID 10474551.","journal-title":"Am J Public Health"},{"key":"2308_CR26","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1016\/s0277-9536(98)00370-0","volume":"48","author":"AE Stuck","year":"1999","unstructured":"Stuck AE, Walthert JM, Nikolaus T, B\u00fcla CJ, Hohmann C, Beck JC. Risk factors for functional status decline in community-living elderly people: a systematic literature review. Soc Sci Med. 1999;48:445\u201369. https:\/\/doi.org\/10.1016\/s0277-9536(98)00370-0 PMID 10075171.","journal-title":"Soc Sci Med"},{"key":"2308_CR27","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/j.annepidem.2008.09.006","volume":"18","author":"SE Ramsay","year":"2008","unstructured":"Ramsay SE, Whincup PH, Morris RW, Lennon LT, Wannamethee SG. Extent of social inequalities in disability in the elderly: results from a population-based study of British men. Ann Epidemiol. 2008;18:896\u2013903. https:\/\/doi.org\/10.1016\/j.annepidem.2008.09.006 PMID 19041588.","journal-title":"Ann Epidemiol"}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-021-02308-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-021-02308-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-021-02308-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T11:06:54Z","timestamp":1624273614000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgeriatr.biomedcentral.com\/articles\/10.1186\/s12877-021-02308-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,21]]},"references-count":27,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2308"],"URL":"https:\/\/doi.org\/10.1186\/s12877-021-02308-5","relation":{},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,21]]},"assertion":[{"value":"28 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Institutional Review Board of the University of Tokyo (2018030NI). As the data we obtained were anonymised, no consent was required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"This study was conducted at the Department of Prevention of Diabetes and Lifestyle-Related Diseases, which is engaged in a cooperative program between the University of Tokyo and Asahi Mutual Life Insurance Company, which is the funding organisation for the present study. AM, SY, AO, KIK, DN, HK and TK were members of the department when the study was conducted. AM, KIK and DN are employees of Asahi Mutual Life Insurance Company.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"374"}}