scholarly journals Association between multimorbidity patterns and disability among older people covered by long-term care insurance in Shanghai, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zijing Wang ◽  
Wenjia Peng ◽  
Mengying Li ◽  
Xinghui Li ◽  
Tingting Yang ◽  
...  
Keyword(s):  
Older People ◽  
Functional Disability ◽  
Long Term Care ◽  
Strong Association ◽  
Binary Logistic Regression ◽  
Term Care ◽  
Logistic Regression Models ◽  
Disease Pattern ◽  
Long Term Care Insurance

Abstract Background Functional disability and multimorbidity are common among older people. However, little is known about the relationship between functional disability and different multimorbidity combinations. We aimed to identify multimorbidity patterns and explore the associations between these patterns and functional disability. Methods We investigated a multi-stage random sample of 1871 participants aged ≥60 years and covered by long-term care insurance in Shanghai, China. Multimorbidity was defined as the simultaneous presence of two or more chronic diseases in an individual. Participants completed scales to assess basic and instrumental activities of daily living (BADL and IADL, respectively). Multimorbidity patterns were identified via exploratory factor analysis. Binary logistic regression models were used to determine adjusted associations between functional disability and number and patterns of multimorbidity. Results Multimorbidity was present in 74.3% of participants. The prevalence of BADL disability was 50.7% and that of IADL disability was 90.7%. There was a strong association between multimorbidity and disability. We identified three multimorbidity patterns: musculoskeletal, cardio-metabolic, and mental-degenerative diseases. The cardio-metabolic disease pattern was associated with both BADL (OR 1.28, 95%CI 1.16–1.41) and IADL (OR 1.41, 95%CI 1.19–1.68) disability. The mental-degenerative disease pattern was associated with BADL disability (OR 1.55, 95%CI 1.40–1.72). Conclusions Multimorbidity and functional disability are highly prevalent among older people covered by long-term care insurance in Shanghai, and distinct multimorbidity patterns are differentially associated with functional disability. Appropriate long-term healthcare and prevention strategies for older people may help reduce multimorbidity, maintain functional ability, and improve health-related quality of life.

Functional disability with systematic trends and uncertainty: a comparison between China and the US

2021 ◽  
pp. 1-30
Author(s):  
Yu Fu ◽  
Michael Sherris ◽  
Mengyi Xu
Keyword(s):  
Systematic Uncertainty ◽  
Functional Disability ◽  
Long Term Care ◽  
The Elderly ◽  
Aged Care ◽  
Term Care ◽  
Healthy Longevity ◽  
The Us ◽  
Long Term Care Insurance

Abstract China and the US are two contrasting countries in terms of functional disability and long-term care. China is experiencing declining family support for long-term care and developing private long-term care insurance. The US has a more developed public aged care system and private long-term care insurance market than China. Changes in the demand for long-term care are driven by the levels, trends and uncertainty in mortality and functional disability. To understand the future potential demand for long-term care, we compare mortality and functional disability experiences in China and the US, using a multi-state latent factor intensity model with time trends and systematic uncertainty in transition rates. We estimate the model with the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and the US Health and Retirement Study (HRS) data. The estimation results show that if trends continue, both countries will experience longevity improvement with morbidity compression and a declining proportion of the older population with functional disability. Although the elderly Chinese have a shorter estimated life expectancy, they are expected to spend a smaller proportion of their future lifetime functionally disabled than the elderly Americans. Systematic uncertainty is shown to be significant in future trends in disability rates and our model estimates higher uncertainty in trends for the Chinese elderly, especially for urban residents.

scholarly journals Evaluation of the South Korean national long-term care insurance-funded cognitive function training programme for older people with mild dementia

2019 ◽  
Vol 48 (5) ◽  
pp. 636-642 ◽  
Author(s):  
Yeong Jun Ju ◽  
Chung Mo Nam ◽  
Sang Gyu Lee ◽  
Sohee Park ◽  
Myung-Il Hahm ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Older People ◽  
Long Term Care ◽  
Training Programme ◽  
Control Groups ◽  
Term Care ◽  
Mild Dementia ◽  
Long Term Care Insurance ◽  
And Control

Abstract Objectives despite the extensive literature on the effectiveness of cognitive training, its effectiveness has not been demonstrated within a population-based long-term care system. To provide cognitive training services to older people with mild dementia, Korea introduced a special dementia rating, as a long-term care grades, in the national long-term care insurance in July 2014. These services are only offered to those with the special dementia rating. This study evaluated the national long-term care insurance-funded cognitive function training programme for older people with mild dementia. Methods data were derived from the Korean National Health Insurance Elderly Cohort database between 2008 and 2015. We compared changes in function between the intervention (n = 352) and control (n = 1952) groups before (2014) and after (2015) introduction of the cognitive function training programme. Difference-in-differences analysis was performed, to compare changes in each score between the intervention and control groups before and after introduction of the cognitive function training programme. Results introduction of the cognitive function training programme was associated with significantly less cognitive function decline in the intervention group than in the control groups (β = –3.39; standard errors [SE] = 1.14; P = 0.003). A subgroup analysis revealed that this effect increased in subjects in the youngest group, low income bracket, who had a primary caregiver, who were supported in multiple activities of daily living by the primary caregiver, or who were not living alone. Conclusions introduction of the cognitive function training programme was associated with positive effects on cognitive function.

scholarly journals Exploring the relationship between depression and different multimorbidity patterns among older people covered by long-term care insurance in Shanghai, China

2021 ◽  
Author(s):  
Cancan Li ◽  
Wenjia Peng ◽  
Mengying Li ◽  
Xinghui Li ◽  
Tingting Yang ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Older People ◽  
Long Term Care ◽  
Depression Scale ◽  
Degenerative Disease ◽  
Cross Sectional ◽  
Term Care ◽  
Long Term Care Insurance ◽  
The Relationship

Abstract Background: Depression is common in patients with multimorbidity, but little is known about the relationship between depression and multimorbidity. The purpose of our research was to investigate multimorbidity patterns and their association with depression in a sample of older people covered by long-term care insurance in Shanghai, China.Method: This was a population-based cross-sectional study, and participants included older people covered by long-term care insurance in Shanghai. We collected information on chronic conditions using a self-reported medical history, and we used the 30-item Geriatric Depression Scale to evaluate depressive symptoms. Patterns of multimorbidity were identified with exploratory factor analysis, using oblimin rotation. Logistic regression was used to estimate the relationship between multimorbidity patterns and depressive symptoms.Results: Hypertension, cardiovascular disease, cerebrovascular disease (CVD), and cataract showed strong associations with depression when co-occurring with other conditions. Three patterns of multimorbidity were identified: a musculoskeletal pattern, cardiometabolic pattern, and degenerative disease pattern. Among these, the cardiometabolic (adjusted odds ratio [AOR] 1.223; 95% confidence interval [CI] 1.102, 1.357) and degenerative disease (AOR 1.185; 95% CI 1.071, 1.311) patterns were associated with a higher risk of depressive symptoms.Conclusion: Two of three multimorbidity patterns were found to be associated with depression. Physical and psychological dimensions require greater attention in the care of older adults who are covered by long-term care insurance.

scholarly journals The Effects of Old Age Care Services and Long-Term Care Insurance: Evidence From Korea

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 85-85
Author(s):  
Hoolda Kim ◽  
Sophie Mitra
Keyword(s):  
Older People ◽  
Old Age ◽  
Long Term Care ◽  
Public Assistance ◽  
Financial Burden ◽  
Term Care ◽  
Assistance Programs ◽  
Care Services ◽  
Long Term Care Insurance

Abstract Along with a rapidly aging population globally, the need for homecare is on the rise. Such care can be a heavy financial burden on older people and their households. To address this issue, the Korean government initiated two programs: care services for low-income individuals and voluntary long-term care insurance for people age 65+. Although it has been a decade since the implementation of the programs, there is limited evidence on how they affect the economic lives of older people, with and without disabilities. We use the 2008-2018 Korean Longitudinal Study of Aging (KLoSa) that provides detailed information about healthcare and homecare utilization and out of pocket costs for people aged 45 or older. We investigate the economic effects of old age public assistance programs using multivariate linear regression models and a dynamic panel model. The preliminary results indicate that older people with disabilities are more likely to utilize homecare services but do not experience any significant extra costs associated with homecare, implying that old age public assistance programs mitigate the financial burden of homecare for older people.

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