• Open Access

Underweight/overweight and the risk of long-term care: Follow-up study using data of the Japanese long-term care insurance system

Authors

  • Akiko Honda,

    1. Division of Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
    2. Niigata Prefectural Government, Niigata, Japan
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  • Naohito Tanabe,

    Corresponding author
    1. Division of Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
    • Correspondence: Professor Naohito Tanabe MD PhD, Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, 471 Ebigase, Higashi-ku, Niigata 950-8680, Japan. Email: tanabena@gmail.com

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  • Nao Seki,

    1. School of Health Sciences, Faculty of Medicine, Niigata University, Niigata, Japan
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  • Yoshiko Ogawa,

    1. Division of Public Health, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
    2. Niigata Prefectural Government, Niigata, Japan
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  • Hiroshi Suzuki

    1. Division of Public Health, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Abstract

Aim

Both being underweight and overweight can lead to reduced activity of daily living, which subsequently can require long-term care. The aim of the present study was to clarify the association between underweight/overweight and the subsequent risk of long-term care introduction.

Methods

We tracked the data of long-term care insurance for 1580 men and women aged ≥65 years who had participated in the official population-based health check-up program in 2001 in Tsunan town and Sekikawa village, Japan. The health check-up data and medical expenditure data for the fiscal year 2001 were used as baseline data. Participants were classified into underweight (body mass index (BMI) <18.5 kg/m2), normal range (BMI = 18.5 to <25.0 kg/m2) and overweight (BMI ≥25.0 kg/m2); the normal range was used as a reference category in Cox proportional hazards models.

Results

During the average 5.8 years of follow up, 156 participants were identified to start using long-term care services. Among the young-old elderly (65–74 years-of-age), underweight was significantly associated with the risk of long-term care introduction (multivariable-adjusted HR 4.26, 95% CI 1.69–10.72), whereas overweight was not (multivariable-adjusted HR 1.45, 95% CI 0.69–3.06). Neither underweight nor overweight were significantly associated with long-term care introduction among the old-old elderly (≥75 years-of-age).

Conclusions

Underweight could be a good predictor of long-term care introduction in the young-old elderly. We should pay attention to underweight in the elderly, as it might be a manifestation of some physical or mental problems related to future long-term care introduction. Geriatr Gerontol Int 2014; 14: 328–335.

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