A multidisciplinary intervention care program to prevent adverse health outcomes for the dependent community-dwelling elderly : a cluster randomized controlled trial.

• Project/Area Number: 21659127
• Research Category: Grant-in-Aid for Challenging Exploratory Research
• Allocation Type: Single-year Grants
• Research Field: Medical sociology
• Research Institution: Nagoya University
• Principal Investigator: KUZUYA Masafumi 名古屋大学, 大学院・医学系研究科, 教授 (10283441)
• Co-Investigator(Renkei-kenkyūsha): SUZUKI Yusuke 名古屋大学, 大学院・医学系研究科, 講師 (90378167) ; HIRAKAWA Yoshihisa 名古屋大学, 医学部附属病院, 助教 (00378168)
• Project Period (FY): 2009 – 2011
• Project Status: Completed (Fiscal Year 2011)
• Budget Amount: ¥3,570,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥270,000); Fiscal Year 2011: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2010: ¥1,000,000 (Direct Cost: ¥1,000,000); Fiscal Year 2009: ¥1,400,000 (Direct Cost: ¥1,400,000)
• Keywords: 要介護高齢者 / 介護保険 / ケアマネジャ / ケアプラン / 複合介入 / ランダム化比較試験 / 主介護医者 / 老年症候群 / ケアマネジャー

Research Abstract

To determine whether multiple interventions to enhance the quality of care management program for community-dwelling dependent elderly who have at least one of the risks of following 5 domains(falls, aspiration pneumonia, malnutrition, medication management, caregiver burden) through care manager provide better health outcomes during 2-year follow-up. There were no differences in mortality, hospitalization and institutionalization rates between control and intervention groups(hazard ration(HR), 95% confidence interval(CI); 0. 99 : 0. 76-1. 29, 1. 08 : 0. 90-1. 28, 0. 98 : 0. 69-1. 38, respectively after adjusting for confounders).

Research Products

• [Journal Article] Day-care service use is a risk factor for long-term care placement in community-dwelling dependent elderly (2012)
  • Author(s): Kuzuya M, Izawa S, Enoki H, Hasegawa J
  • Journal Title: Geriatr Gerontol Int Volume: (In press)
  • NAID: 10031148000
  • Peer Reviewed
• [Journal Article] Physical and functional factors in activities of daily living that predict falls in community-dwelling older women (2011)
  • Author(s): Aoyama M, Suzuki Y, Onishi J, Kuzuya M.
  • Journal Title: Geriatr Gerontol Int Volume: 11 Pages: 348-357
  • NAID: 10031147975
  • Peer Reviewed
• [Journal Article] Association between the caregiver's burden and physical activity in community-dwelling caregivers of dementia patients (2011)
  • Author(s): Hirano A, Suzuki Y, Kuzuya M, Onishi J, Hasegawa J, Ban N, Umegaki H.
  • Journal Title: Arch Gerontol Geriatr Volume: 52 Pages: 295-298
  • Peer Reviewed
• [Journal Article] Impact of informal care levels on discontinuation of living at home in community-dwelling dependent elderly using various community-based services (2011)
  • Author(s): Kuzuya M, Hasegawa J, Hirakawa Y, Enoki H, Izawa S, Hirose T, Iguchi A.
  • Journal Title: Arch Gerontol Geriatr Volume: 52 Pages: 127-132
  • Peer Reviewed
• [Journal Article] Impact of caregiver burden on adverse health outcomes in community-dwelling dependent oldercare recipients (2011)
  • Author(s): Kuzuya M, Enoki H, Hasegawa J, Izawa S, Hirakawa Y, Shimokata H, Iguchi A
  • Journal Title: Am J Geriatr Psychiatry Volume: 19 Pages: 382-391
  • Peer Reviewed
• [Journal Article] 鬱の程度は、在宅療養要介護高齢者の死亡、入院の原因となるか (2011)
  • Author(s): 広瀬貴久, 長谷川潤, 井澤幸子, 榎裕美, 葛谷雅文
  • Journal Title: 日本老年医学会雑誌 Volume: 48 Pages: 163-169
  • Peer Reviewed
• [Journal Article] 要介護高齢者の経口摂取困難の実態ならびに要因に関する研究 (2011)
  • Author(s): 葛谷雅文、榎裕美、井澤幸子、広瀬貴久、長谷川潤
  • Journal Title: 静脈経腸栄養 Volume: 26 Pages: 1265-1270
  • NAID: 130004487251
  • Peer Reviewed
• [Journal Article] Working group on guidelines for medical treatment and its safety in the elderly. Survey on geriatricians' experiences of adverse drug reactions caused by potentially inappropriate medications : commission report of the Japan Geriatrics Society (2011)
  • Author(s): Akishita M, Arai H, Arai H, Inamatsu T, Kuzuya M, Suzuki Y, Teramoto S, Mizukami K, Morimoto S, Toba K
  • Journal Title: Geriatr Gerontol Int Volume: 11 Pages: 3-7
  • Peer Reviewed
• [Journal Article] Impact of caregiver burden on adverse health outcomes in community-dwelling dependent older care recipients (2011)
  • Author(s): Kuzuya M, Enoki H, Hasegawa J, Izawa S, Hirakawa Y, Shimokata H, Iguchi A
  • Journal Title: Am J Geriatr Psychiatry Volume: 19 Pages: 382-91
  • Peer Reviewed
• [Journal Article] Impact of informal care levels on discontinuation of living at home in community-dwelling dependent elderly using various community-based services (2011)
  • Author(s): Kuzuya M, Hasegawa J, Hirakawa Y, Enoki H, Izawa S, Hirose T, Iguchi A
  • Journal Title: Arch Gerontol Geriatr Volume: 52 Pages: 127-32
  • Peer Reviewed
• [Journal Article] Inhibition of mineralocorticoid receptor is a renoprotective effect of the 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor pitavastatin. (2011)
  • Author(s): Cheng XW, Kuzuya M, et. al.
  • Journal Title: J Hypertens Volume: 印刷中(未定)
  • Peer Reviewed
• [Journal Article] Influence of regular exercise on subjective sense of burden and physical symptoms in community-dwelling caregivers of dementia patients : A randomized controlled trial. (2011)
  • Author(s): Hirano A, Suzuki Y, Kuzuya M, et. al.
  • Journal Title: Arch Gerontol Geriatr Volume: 印刷中(未定)
  • Peer Reviewed
• [Journal Article] Survey on geriatricians' experiences of adverse drug reactions caused by potentially inappropriate medications : commission report of the Japan Gerlatrics Society. (2011)
  • Author(s): Akishita M, Arai H, et. al.
  • Journal Title: Geriatr Gerontol Int. Volume: 11 Pages: 3-7
  • Peer Reviewed
• [Journal Article] Impact of caregiver burden on adverse health outcomes in community-dwelling dependent older care recipients. (2011)
  • Author(s): Kuzuya M, Enoki H, et. al.
  • Journal Title: American Journal of Geriatric Psychiatry Volume: 印刷中(未定)
  • Peer Reviewed
• [Journal Article] Factors associated with nonadherence to medication of community-dwelling disabled elderly in Japan (2010)
  • Author(s): Kuzuya M, Enoki H, Izawa S, Hasegawa J, Yusuke S, Iguchi A.
  • Journal Title: J Am Geriatr Soc Volume: 58 Pages: 1007-1009
  • Peer Reviewed
• [Journal Article] Factors influencing death at home in terminally ill cancer patients (2010)
  • Author(s): Nakamura S, Kuzuya M, Funaki Y, Matsui W, Ishiguro N.
  • Journal Title: Geriatr Gerontol Int Volume: 10 Pages: 154-160
  • NAID: 10027272103
  • Peer Reviewed
• [Journal Article] Depressive symptoms of informal caregivers are associated with those of community-dwelling dependent care recipients (2010)
  • Author(s): Izawa S, Hasegawa J, Enoki H, Iguch A, Kuzuya M.
  • Journal Title: Int Psychogeriatr Volume: 22 Pages: 1310-1317
  • Peer Reviewed
• [Journal Article] 在宅療養要介護高齢者の介護環境ならびに生命予後、入院、介護施設入所リスクの性差 (2010)
  • Author(s): 葛谷雅文、長谷川潤、榎裕美、井澤幸子、平川仁尚、広瀬貴久、井口昭久
  • Journal Title: 日本老年医学会誌 Volume: 47 Pages: 461-467
  • NAID: 10027914181
  • Peer Reviewed
• [Journal Article] The longitudinal change in anthropometric measurements and the association with physical function decline in Japanese community-dwelling frail elderly (2010)
  • Author(s): Izawa S, Enoki H, Hirakawa Y, Iwata M, Hasegawa J, Iguchi A, Kuzuya M
  • Journal Title: Br J Nutr Volume: 103 Pages: 289-294
  • Peer Reviewed
• [Journal Article] Urinary incontinence and behavioral symptoms are independent risk factors for recurrent and injurious falls, respectively, among residents in long-term care facilities (2010)
  • Author(s): Hasegawa J, Kuzuya M, Iguchi A.
  • Journal Title: Arch Gerontol Geriatr Volume: 50 Pages: 77-81
  • Peer Reviewed
• [Journal Article] Matrix Metalloproteinase-2 (MMP-2) Regulates the Expression of Tissue Inhibitor of MMP-2 (TIMP-2). (2010)
  • Author(s): Kimura K, Cheng XW, et. al.
  • Journal Title: Clin Exp Pharmacol Physiol. Volume: 37 Pages: 1096-1101
  • Peer Reviewed
• [Journal Article] Exercise training stimulates ischemia-induced neovascularization via phosphatidylin ositol 3-kinase/Akt-dependent hypoxia-induced factor-1 alpha reactivation in mice of advanced age. (2010)
  • Author(s): Cheng XW, Kuzuya M, et. al.
  • Journal Title: Circulation Volume: 122 Pages: 707-716
  • Peer Reviewed
• [Journal Article] Depressive symptoms of informal caregivers are associated with those of community-dwelling dependent care recipients. (2010)
  • Author(s): Izawa S, Hasegawa J, et. al.
  • Journal Title: Int Psychogeriatr. Volume: 22 Pages: 1310-1317
  • Peer Reviewed
• [Journal Article] AT1 Blockade Attenuates Atherosclerotic Plaque Destabiliization Accompanied by the Suppression of Cathepsin S Activity in ApoE-Deficient Mice. (2010)
  • Author(s): Sasaki T, Kuzuya M, et. al.
  • Journal Title: Atherosclerosis Volume: 210 Pages: 430-437
  • Peer Reviewed
• [Journal Article] Ca2+channel blocker benidipine promotes coronaly angiogenesis and reduces both left ventricular diastolic stiffness and mortality in hypertensive rats. (2010)
  • Author(s): Nishizawa T, Cheng XW, et. al.
  • Journal Title: J Hypertens Volume: 28 Pages: 1515-1526
  • Peer Reviewed
• [Journal Article] Factors associated with nonadherence to medication of community-dwelling disabled elderly in Japan. (2010)
  • Author(s): Kuzuya M, et al.
  • Journal Title: J Am Geriatr Soc (In press)
  • Peer Reviewed
• [Journal Article] The longitudinal change in anthropometric measurements and the association with physical function decline in Japanese community-dwelling frail elderly. (2010)
  • Author(s): Izawa S, Kuzuya M, et al.
  • Journal Title: Br J Nutr 103 Pages: 289-94
  • Peer Reviewed
• [Journal Article] Urinary incontinence and behavioral symptoms are independent risk factors for recurrent and injurious falls, respectively, among residents in long-term care facilities. (2010)
  • Author(s): Hasegawa J, Kuzuya M, et al.
  • Journal Title: Arch Gerontol Geriatr. 50 Pages: 77-81
  • Peer Reviewed
• [Journal Article] Opinion survey of nursing or caring staff at long-term care facilities about end-of-life care provision and staff education (2009)
  • Author(s): Hirakawa, Y ; Kuzuya, M ; Uemura, K.
  • Journal Title: Arch Gerontol Geriatr Volume: 49 Pages: 43-48
  • Peer Reviewed
• [Journal Article] Opinion survey of nursing or caring staff at long-term care facilities about end-of-life care provision and staff education. (2009)
  • Author(s): Hirakawa, Y ; Kuzuya, M, et al.
  • Journal Title: Arch Gerontol Geriatr. 49 Pages: 43-8
  • Peer Reviewed
• [Journal Article] Increased caregiver burden associated with hearing impairment but not vision impairment in disabled community-dwelling older people in Japsn. (2009)
  • Author(s): Kuzuya M, et al.
  • Journal Title: J Am Geriatr Soc 57 Pages: 357-8
  • Peer Reviewed
• [Presentation] 要介護高齢者の栄養状態と老年症候群の集積施設入所高齢者と在宅高齢者 (2011)
  • Author(s): 広瀬貴久,長谷川潤,井澤幸子,榎裕美,葛谷雅文
  • Organizer: 第53回日本老年医学会学術集会
  • Place of Presentation: 東京
  • Year and Date: 2011-06-17
• [Presentation] 通所サービス使用と介護施設入所との関連 (2011)
  • Author(s): 葛谷雅文,広瀬貴久,長谷川潤,榎裕美,井澤幸子
  • Organizer: 第53回日本老年医学会学術集会
  • Place of Presentation: 東京
  • Year and Date: 2011-06-17
• [Presentation] 要介護高齢者の食事形態と介護負担感との関連について (2011)
  • Author(s): 榎裕美,長谷川潤,井澤幸子,広瀬貴久,井口昭久,葛谷雅文
  • Organizer: 第53回日本老年医学会学術集会
  • Place of Presentation: 東京
  • Year and Date: 2011-06-15
• [Presentation] 高齢者の栄養管理 (2010)
  • Author(s): 葛谷雅文
  • Organizer: 第4回日本静脈経腸栄養学会東海支部学術会議
  • Place of Presentation: 名古屋
  • Year and Date: 2010-07-24
• [Presentation] 高齢者低栄養の評価とその対策 (2010)
  • Author(s): 葛谷雅文
  • Organizer: 第52回日本老年医学会学術集会
  • Place of Presentation: 神戸国際会議場
  • Year and Date: 2010-06-26
• [Presentation] 要介護高齢者の在宅療養の継続に対する家族介護レベルの影響 (2010)
  • Author(s): 長谷川潤,平川仁尚,榎裕美,井澤幸子,広瀬貴久,井口昭久,葛谷雅文
  • Organizer: 第52回日本老年医学会学術集会
  • Place of Presentation: 神戸
  • Year and Date: 2010-06-25
• [Presentation] 在宅要介護高齢者の服薬アドヒアランス低下とその要因 (2010)
  • Author(s): 葛谷雅文,榎裕美,井澤幸子,長谷川潤,鈴木裕介,井口昭久
  • Organizer: 第52回日本老年医学会学術集会
  • Place of Presentation: 神戸
  • Year and Date: 2010-06-25
• [Presentation] サルコペニアの疫学、診断 (2010)
  • Author(s): 葛谷雅文
  • Organizer: 第52回日本老年医学会学術集会
  • Place of Presentation: 神戸国際会議場
  • Year and Date: 2010-06-25
• [Presentation] 鬱の程度は、在宅療養要介護高齢者の死亡、入院の原因となるか (2010)
  • Author(s): 葛谷雅文,榎裕美,井澤幸子,長谷川潤,鈴木裕介,井口昭久,葛谷雅文
  • Organizer: 第52回日本老年医学会学術集会
  • Place of Presentation: 神戸
  • Year and Date: 2010-06-24
• [Presentation] 在宅要介護高齢者のうつと介護者のうつの関連について (2010)
  • Author(s): 井澤幸子,長谷川潤,榎裕美,井口昭久,葛谷雅文
  • Organizer: 第52回日本老年医学会学術集会
  • Place of Presentation: 神戸
  • Year and Date: 2010-06-24
• [Presentation] Meet the Expert嚥下困難 (2010)
  • Author(s): 葛谷雅文
  • Organizer: 第52回日本老年医学会学術集会
  • Place of Presentation: 神戸国際会議場
  • Year and Date: 2010-06-24
• [Presentation] 介護負担感と要介護者の健康との関係 (2009)
  • Author(s): 葛谷雅文,平川仁尚,榎裕美,井澤幸子,長谷川潤,広瀬貴久,井口昭久
  • Organizer: 第51回日本老年医学会学術集会
  • Place of Presentation: 横浜
  • Year and Date: 2009-06-20
• [Presentation] 在宅要介護高齢者のInstrumental ADL低下の要因についての検討 (2009)
  • Author(s): 井澤幸子,榎裕美,平川仁尚,長谷川潤,井口昭久,葛谷雅文
  • Organizer: 第51回日本老年医学会学術集会
  • Place of Presentation: 横浜
  • Year and Date: 2009-06-20
• [Presentation] 介護負担感と要介護者の健康との関係 (2009)
  • Author(s): 葛谷雅文
  • Organizer: 日本老年医学会
  • Place of Presentation: 横浜
  • Year and Date: 2009-06-20
• [Presentation] 在宅療養要介護高齢者の死亡場所ならびに死因についての検討 (2009)
  • Author(s): 長谷川潤,平川仁尚,井澤幸子,榎裕美,井口昭久,葛谷雅文
  • Organizer: 第51回日本老年医学会学術集会
  • Place of Presentation: 横浜
  • Year and Date: 2009-06-19
• [Book] 新老年学(第3版) (2010)
  • Author(s): 葛谷雅文
  • Total Pages: 12
  • Publisher: 東京大学出版
• [Book] 栄養塾症例で学ぶクリニカルパール (2010)
  • Author(s): 葛谷雅文
  • Total Pages: 6
  • Publisher: 医学書院
• [Book] 高齢者の生活機能の総合的評価 (2010)
  • Author(s): 葛谷雅文
  • Total Pages: 5
  • Publisher: 新興医学出版
• [Book] 経腸栄養 (2010)
  • Author(s): 葛谷雅文
  • Total Pages: 4
  • Publisher: 医歯薬出版
• [Book] 栄養アセスメント (2010)
  • Author(s): 葛谷雅文
  • Total Pages: 5
  • Publisher: 医歯薬出版