Effect of Daily Living Activities on the Need for Long-Term Care in Older Adults

Background: Japan has become a super-aged society, resulting in an increased number of insurance certifications for long-term care needs. This study aimed to identify the effects of daily living activities on changes in certification among older persons with support needs classified by cognitive function. Methods: The sample, sourced from the 2014 and 2016 Japanese long-term care insurance certification surveys, consisted of 6,219 individuals with support needs. Logistic regression analysis was performed to identify activities of daily living (ADL) associated with certification changes. Separate logistic regressions were performed to predict certification changes based on participants' cognitive functioning. Results: Regarding levels of cognitive functioning, ADL associated with certification change among the highest functioning individuals were bathing, nail trimming, mobility, managing money, and decision-making ability. At the next level of functioning, the activities included bathing, toilet hygiene (urinary), taking prescribed medications, managing money, decision-making ability, and preparing meals. At the lowest level of functioning, only managing money was associated with a certification change. Conclusion: ADL affecting certification change varies with the level of cognitive functioning. Thus, managing money was considered to be the most important activity as it influences change in certification in all cognitive categories. When occupational therapists create interventions for older persons with support needs, they should use IADL abilities such as managing money, which requires complex cognitive functions, from an early stage. This may lead to the reduction of the need for care in older persons with support needs.