Long-term care-service use and increases in care-need level among home-based elderly people in a Japanese urban area

Abstract Background: Multimorbidity is common among older people and a major cause of reduced quality of life. The study aim was to investigate the relationship between multimorbidity and self-rated health and its mediators in home-based long-term care residents.Methods: Participants were 1067 home-based long-term care residents covered by long-term care insurance in Shanghai. Stratified sampling was used to select participants from six Shanghai districts. Data were collected using face-to-face interviews. Multimorbidity was defined as co-occurrence of ≥2 chronic diseases in the same person. The 30-item Geriatric Depression Scale was used to assess depressive symptoms. Structural equation modeling was used for data analysis.Results: The findings showed that 59.4% of participants had multimorbidity and 67.7% reported depressive symptoms. The mean self-rated health score was 1.97 (standard deviation [SD] = 0.861) and mean health service use frequency was 1.61 (SD = 3.406) per month. Compared with participants with no multimorbidity, those with multimorbidity were more likely to report low self-rated health (β = −0.141, p<0.001), more severe depressive symptoms (β = 0.100, p<0.001), and more health service use (β = 0.121, p<0.001). Low self-rated health may be caused by depression and health service use (β = −0.280, p<0.001). The effect of multimorbidity on self-rated health was significantly mediated by depression (β = −0.024, p<0.001) and health service use (β = −0.034, p<0.001).Conclusion: Multimorbidity is associated with self-rated health, and depression and health service use mediate this association. Prevention and proper management of multimorbidity and depression in long-term care residents may help to maintain and improve quality of life.

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Long-Term Care Service Use and Caregiver Burden, Depression, and Health: A Systematic Review and Meta-Analysis

Innovation in Aging ◽

10.1093/geroni/igab046.940 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 245-245

Author(s):

Cindy Ng ◽

Ringo Ho ◽

Wayne Chong

Keyword(s):

Health Status ◽

Caregiver Burden ◽

Service Use ◽

Long Term Care ◽

Care Service ◽

Meta Analysis ◽

Informal Caregivers ◽

Effect Sizes ◽

Term Care

Abstract This study examined whether long-term care service use (LTCSU) is associated with informal caregivers’ burden, depression, and health status. Eligible articles collected data directly from caregivers, written in English, and allowed for extraction or computation of effect sizes. MEDLINE, PsycINFO and ProQuest Dissertations & Theses Global databases were searched between September 2017 and January 2018. The risk of bias of individual studies was assessed regarding confounding, study power, and other biases. This unfunded study was registered with PROSPERO: CRD42018108827. Of the 419, 209 and 346 articles identified, 24, 14 and 15 articles that involved 12,530, 6,687 and 7,331 informal caregivers respectively, were eligible for analyses regarding the above associations. With unadjusted effect sizes, omnibus tests found statistically non-significant overall effect estimates in the association of LTCSU with caregiver burden, depression, and health status. Subgroup analyses, however, revealed that the above associations differed by service type, caregiver sex, and country, respectively.

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