Long-Term Care for the Elderly is Determined by a Causal Link to Lifestyle, Three Health Factors Based on Socioeconomic Status

Author(s): Tanji Hoshi

Background: Factors influencing the amount of long-term care needed by the elderly, which are more common in women than men, include lifestyle habits, physical, mental, and social health, as well as frailty and decreased exercise frequency. However, the causal relationships, including socioeconomic status as a background factor, remain unclear. In this study, the level of long-term care needs was designated as the dependent variable. A follow-up survey was conducted, utilizing educational background and annual income as underlying factors, to analyze physical, mental, and social health, along with the relationship between preferred diet and lifestyle habits such as exercise to clarify the underlying structure. The treatment status of cerebrovascular accidents will also be examined by sex. Methods: In September 2001, a mail-in survey was carried out among 16,462 elderly residents in the suburbs of Tokyo using a self-administered questionnaire. The cohort study evaluated the long-term care needs after three years for 8,162 individuals confirmed to be alive. The analysis method employed to explore the causal structure of care requirements was covariance structure analysis. Results: The study found that women had a significantly greater need for nursing care compared to men in older age groups. The level of long-term care needed after three years was only slightly affected by lifestyle habits, such as how often they exercised. However, the levels of mental, physical, and social health influenced by lifestyle habits were closely linked. Additionally, positive lifestyle habits and three health factors were influenced by advantageous socioeconomic factors. In other words, lifestyle habits like diet helped maintain the three health factors, reduced the number of diseases needing treatment, and ultimately prevented the need for long-term care. There were no sex differences in the overall relationship of the structure. In this survey, we were able to explain 45% of the variance in the coefficient of determination regarding the long-term care needed after 3 years. Conclusion: The amount of long-term care needed after three years was minimally influenced by socioeconomic factors and lifestyle choices as a direct result. The three health indicators remained the most important factors in preventing diseases, including cerebrovascular accidents, within the framework of socioeconomic status as a structural basis. Future research is likely to focus on the index of perception and cognitive functions related to health and aging, and the causal relationships are expected to become clearer through randomized intervention studies.