Preventive care strategies based on disease prevalence among Japanese urban elderly: focus on disease prevention in mildly frail elders with long-term care insurance.

Aim: To investigate the relationship between prevalent diseases and medical conditions in frail elderly in Japan who require lighter levels of care in order to improve preventive care strategies.

Methods: Data from Japanese long-term care insurance (LTCI) documentation was used to investigate the relationship between the prevalence of diseases and medical conditions among 553 frail elderly people (193 men and 360 women) over 65 years old in a central area of Osaka prefecture. Logistic regression analysis was used to determine the associations among related diseases and main medical conditions in the lightest levels of care required.

Results: With age, the prevalence of hypertension, heart disease, dementia, and fractures increased, whereas neoplasms, cerebrovascular disease, and diabetes mellitus decreased. Neoplasms and circulatory disease were significantly more common in men, and musculoskeletal disease and injury were more common in women among main medical conditions requiring light care. Diseases significantly associated with the lightest level of care were hyperlipidemia (odds ratio 3.0), osteoporosis without fracture (1.9), and gonarthrosis (1.7) in women.

Conclusions: Efforts to control musculoskeletal diseases and lifestyle diseases are essential preventive care strategies, especially in the preliminary stages of care under LTCI. Previously proven measures such as the cancer screening, intensive blood pressure control, continuous nutritional management, and thorough diabetes treatment beginning in middle age can help to prevent fractures, cancer, cerebrovascular disease, and dementia, all of which severely erode quality of life.