Predictive Factors for Hospitalized and Institutionalized Care-giving of the Aged Patients with Diabetes Mellitus in Japan
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概要
- 論文の詳細を見る
To identify predictive factors for hospitalized and institutionalized care-giving among agroup of aged patients with diabetes mellitus in Japan, retrospective chart review wasperformed in 288 diabetic subjects aged 65 years or older. Independent variables, based onthe chart review, were age, sex, diagnosis, diabetic control and complications.Comprehensive geriatric assessment was performed to obtain information on the functionalcapacity and demographic variables, including physical and mental function, andsocioeconomic status. 131 diabetic patients were considered as frail elderly and characterizedfor their higher age, longer duration of diabetes, higher frequency of insulin use, lowercognitive function, and lower QOL, in comparison with those of non-frail patients. Allnon-frail diabetic patients were independently treated at their homes, while 38 subjects out of131 frail diabetic patients were hospitalized or institutionalized. Apparent clinical features ofhospitalized/institutionalized patients were higher age, higher serum creatinine, and higherprevalence of stroke episodes, advanced cognitive decline and absence of key caregiver inthe family members, in comparison with those of in-home frail diabetic patients. Thepredicted probabilities from the multivariate logistic regression analysis in predictinghospitalized and institutionalized care-giving were as follows: Log p/(1 - p) = -19.801x1 -54.269x2 + 721.405; where x1 = cognitive function (score), x2 = social support (score).Receiver operating characteristic curve analysis revealed a satisfactory discrimination forhospitalized and institutionalized care-giving in frail diabetic elderly with 92.9% ofsensitivity and 91.4% of specificity, when the cutoff point of the model was set at 0.992. Weconcluded that cognitive decline and low social support are the predictive for hospital andinstitutional care-giving, and that demographic and mental information as well as diagnosticdata should be analyzed to predict the hospitalization/institutionalization among frail diabeticelderly.
- 神戸大学の論文
- 2010-00-00
著者
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Sakurai Takashi
Department Of Astronomy The University Of Tokyo
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Endo Hidetoshi
Department Of Comprehensive Geriatric Medicine National Center For Geriatrics And Gerontology
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Yokono Koichi
Department Of General Internal Medicine Kobe University Graduate School Of Medicine
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Kuranaga Masako
Department Of Internal And Geriatric Medicine Kobe University Graduate School Of Medicine
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Yokono Koichi
Department of General Medicine, Kobe University Graduate School of Medicine
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Matsuzawa Toshioki
Department of General Medicine, Kobe University Graduate School of Medicine
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Kuranaga Masako
Department of General Medicine, Kobe University Graduate School of Medicine
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Sakurai Takashi
Department of General Medicine, Kobe University Graduate School of Medicine
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Endo Hidetoshi
Department of Chemistry, Faculty of Science and Technology, Sophia University
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SAKURAI Takashi
Department of Aerospace Engineering, Tokyo Metropolitan University
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