Eriko Fukutomi

Aim: The 25‐item Kihon Checklist (KCL) is the official self‐administered questionnaire tool to screen frail older adults, consisting of seven categories: physical strength, nutritional status, oral function, houseboundness, cognitive function, depression risk and a score of more than 9 out of 1–20 items. The aim of the present study was to evaluate the relationships between each category of the KCL and newly certified cases under the Long‐Term Care Insurance (LTCI) in Japan during 24 months.Method: The study population consisted of 883 community‐dwelling adults aged 65 years or older uncertified by LTCI completing a questionnaire, which included the KCL and scales of basic/advanced activities of daily living (ADL), quality of life (QOL), and depressive symptoms. The participants were categorized into the risk or non‐risk group depending on the official criteria of each KCL category. The outcome was the incidence of newly certified cases by LTCI during 24 months. The difference between the risk and non‐risk group was analyzed by Cox regression hazard models.Results: Scores in basic/advanced ADL and QOL were higher, and the score in the geriatric depression scale was lower in the non‐risk than the risk group in KCL criteria. In men, the incidence of newly certified cases was higher in the risk group of the physical strength category after adjusting for age and the other categories of the KCL.Conclusion: The physical strength category in men was the only significant predictor of the incidence of newly certified cases by LTCI. Further studies are required to improve the assessment item of cognitive function in KCL under LTCI. Geriatr Gerontol Int 2015; 15: 864–871.

Depression in older adults deteriorates quality of life and increases morbidity, mortality, and medical expenses. Medicine and social policy should work together to decrease this burden. Existing prevention studies are often based on time-consuming psychotherapies, which therefore are not feasible for a wide application at the community level. Postcard interventions have been shown to be effective for patients after hospitalization for major depression, drug overdose, or self-harm. This paper describes the protocol of a pragmatic, randomized controlled trial designed to examine the efficacy of a postcard intervention for depression among community-dwelling individuals aged 65 years or older.

Aim: To investigate which category in the “Kihon Checklist” developed by the Japanese Ministry of Health, Labor and Welfare can predict functional decline for community‐dwelling elderly people at a 2‐year follow up.Method: We compared comprehensive geriatric assessment (CGA) between “specified elderly individuals” at high risk of requiring long‐term care insurance (LTCI) and “uncertified elderly people” (neither certified under LTCI nor “specified”), and also compared CGA between the risk group and non‐risk group, in subcategories of the “Kihon Checklist”, such as physical strength, nutrition/oral function, overall low score on questions 1–20, houseboundness, cognitive function, and depression risk. The study population consisted of 527 elderly participants aged 75 years and older in a cross‐sectional study, and 382 in a longitudinal study. CGA was assessed for basic and higher functional activities of daily living (ADL), depressive symptoms, and quality of life (QOL). The Student's t‐test was used in the cross‐sectional study and ANOVA with repeated measures was used in the longitudinal analysis.Results: In the cross‐sectional study, the risk group had lower functions in all CGA items than the non‐risk group in all subcategories of the “Kihon Checklist.” In the longitudinal study, Tokyo Metropolitan Institute of Gerontology Index of Competence scores and its three subscales declined in the risk group both in physical and cognitive subcategories compared with the non‐risk group, whereas only one or two subscales of Tokyo Metropolitan Institute of Gerontology Index of Competence declined in “specified” and the other two subcategories of the Kihon ChecklistConclusion: In both cross‐sectional and longitudinal studies, the assessment of physical strength and cognitive function was more useful to detect frail elderly. Geriatr Gerontol Int 2013; 13: 654–662.