Cohort study of advance care planning in the end of life -from the view point of comprehensive geriatric assessment-

• Project/Area Number: 24590607
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Medical sociology
• Research Institution: Kyoto University
• Principal Investigator: Wada Taizo 京都大学, 東南アジア研究所, 連携准教授 (90378646)
• Co-Investigator(Kenkyū-buntansha): MATSUBAYASHI KOZO 京都大学, 東南アジア研究所, 教授 (70190494) ; OKUMIYA KIYOHITO 京都大学, 東南アジア研究所, 連携准教授 (20253346)
• Project Period (FY): 2012-04-01 – 2016-03-31
• Project Status: Completed (Fiscal Year 2015)
• Budget Amount: ¥5,330,000 (Direct Cost: ¥4,100,000、Indirect Cost: ¥1,230,000); Fiscal Year 2014: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2013: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2012: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
• Keywords: 事前指示書 / 終末期ケア / Advance Care Plannning / 総合機能評価 / 胃瘻 / 地域在住高齢者 / 事前ケア計画 / リビングウィル / VAS / SF-8 / QOL / 主観的健康感 / Advance Care Planning / 終末期医療 / 認知症 / 老年医学 / リビング・ウイル / 経管栄養

Outline of Final Research Achievements

Annual comprehensive geriatric assessment have been introduced in community-dwelling elderly aged over 65. Many of the participants completed advanced directives in rural area (15.7%; N=820) and in nursing home (60.3%; N=239), respectively.
In case, the participants cannot take meals orally, as for the preferred method, 42.5% of the participants chose drip infusion through peripheral vein , whereas other artificial feeding methods were chosen much less frequently (intravenous hyperalimentation, 5.1%; percutaneous endoscopicgastrostomy, 4.7%; nasal feeding tube, 4.3%); 50.3% chose none of the four methods, responding that they prefer oral intake until the end. It has been recommended that advance care planning be considered during a comprehensive geriatric assessment. To respect the best interest of individuals with dementia, advance care planning should be started early on.

Research Products

• [Journal Article] J-Curve Association Between Glucose Intolerance and Hemoglobin and Ferritin Levels at High Altitude. (2016)
  • Author(s): Okumiya K, Sakamoto R, et al.
  • Journal Title: Journal of the American Geriatrics Society Volume: 64 Issue: 1 Pages: 207-210
  • DOI: 10.1111/jgs.13915
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Postcard intervention for depression in community-dwelling older adults: A randomised controlled trial. (2015)
  • Author(s): Imai H, Furukawa TA, Okumiya K, Wada T, Fukutomi E, Sakamoto R, Fujisawa M, Ishimoto Y, Kimura Y, Chen WL, Tanaka M, Matsubayashi K.
  • Journal Title: Psychiatry Res. Volume: 229(1-2) Issue: 1-2 Pages: 545-50
  • DOI: 10.1016/j.psychres.2015.05.054
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Oxidized low density lipoprotein among the elderly in Qinghai-Tibetan plateau. (2015)
  • Author(s): Sakamoto R, et al.
  • Journal Title: Wilderness & Environmental Medicine Volume: 26 Issue: 3 Pages: 343-349
  • DOI: 10.1016/j.wem.2015.03.025
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Association between dental status and food diversity among older Japanese. (2015)
  • Author(s): Iwasaki M, Kimura Y, Yoshihara A, Ogawa H, Yamaga T, Takiguchi T, Wada T, Sakamoto R, Ishimoto Y, Fukutomi E, Chen W, Imai H, Fujisawa M, Okumiya K, ManzMC, Miyazaki H, Matsubayashi K.
  • Journal Title: Community Dent Health. Volume: 32 Pages: 104-110
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Social cohesion and health in old age: a study in southern Taiwan. (2015)
  • Author(s): Chen W, Okumiya K, Wada T, Sakamoto R, Imai H, Ishimoto Y, Kimura Y, Fukutomi E, Fujisawa M, Shih HI, Chang CM, Matsubayashi K.
  • Journal Title: Int Psychogeriatr. Volume: 27(11) Issue: 11 Pages: 1903-11
  • DOI: 10.1017/s1041610214002907
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Buddhist Social Networks and Health in Old Age:A Study in Central Thailand. (2015)
  • Author(s): Sasiwongsaroj K, Wada T, Okumiya K, Imai H, Ishimoto Y, Sakamoto R, Fujisawa M, Kimura Y, Chen WL, Fukutomi E, Matsubayashi K
  • Journal Title: Geriatr Gerontolo Int. Volume: in press Issue: 11 Pages: 1210-8
  • DOI: 10.1111/ggi.12421
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Depression and subjective economy among elderly people in Asian communities: Japan, Taiwan, and Korea. (2015)
  • Author(s): Imai H, Chen WL, Fukutomi E, Okumiya K, Wada T, Sakamoto R, Fujisawa M, Ishimoto Y, Kimura Y, Chang CM, Matsubayashi K.
  • Journal Title: Arch Gerontol Geriatr. Volume: 60(2) Issue: 2 Pages: 322-7
  • DOI: 10.1016/j.archger.2014.11.003
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] The effect of early diagnosis and lifestyle modification on functional activities in the community-dwelling elderly with glucose intolerance in 5-year longitudinal study (2015)
  • Author(s): Okumiya K, Sakamoto R, Fujisawa M, Wada T, Chen WL, Imai H, Ishimoto Y, Kimura Y, Fututomi E, Sasiwongsaroj K, Kato E, Tanaka M, Hirosaki M, Kasahara Y, Nakatsuka M, Ishine M, Yamamoto N, Otsuka K, Matsubayashi K
  • Journal Title: J Am Geriatr Soc Volume: 63(1) Issue: 1 Pages: 190-192
  • DOI: 10.1111/jgs.13225
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Effect of early diagnosis and lifestyle modification on depressive symptoms in community-dwelling elderly adults with glucose intolerance: 5-year longitudinal study. (2015)
  • Author(s): Okumiya K, Fujisawa M, Sakamoto R, Wada T, Chen WL, Imai H, Ishimoto Y, Kimura Y, Fukutomi E, Sasiwongsaroj K, Kato E, Tanaka M, Hirosaki M, Kasahara Y, Nakatsuka M, Nose M, Ishine M, Yamamoto N, Otsuka K, Matsubayashi K.
  • Journal Title: J Am Geriatr Soc Volume: inpress Issue: 2 Pages: 393-5
  • DOI: 10.1111/jgs.13269
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Preferred feeding methods for dysphagia due to end-stage dementia in community-dwelling elderly people in Japan. (2014)
  • Author(s): Wada T, Imai H, Fukutomi E, Chen WL, Okumiya K, Ishimoto Y, Kimura Y, Sakamoto R, Fujisawa M,Matsubayashi K.
  • Journal Title: J Am Geriatr Soc. Volume: 62(9) Issue: 9 Pages: 1810-1
  • DOI: 10.1111/jgs.13009
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Amyotrophic Lateral Sclerosis and Parkinsonism in Papua, Indonesia: 2001-2012 Survey Results (2014)
  • Author(s): Okumiya K, Wada T, Fujisawa M, Ishine M, Garcia Del Saz, Hirata Y, Kuzuhara S, Kokubo Y, Seguchi H, Sakamoto R, Manuba I, WatofaP, Rantetampang AL, Matsubayashi K
  • Journal Title: BMJ Open 2014 Volume: 4(4) Issue: 4 Pages: e004353-e004353
  • DOI: 10.1136/bmjopen-2013-004353
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Ipsative imputation for a 15-item Geriatric Depression Scale in community-dwelling elderly people. (2014)
  • Author(s): Imai H, Furukawa TA, Kasahara Y, Ishimoto Y, Kimura Y, Fukutomi E, Chen WL, Tanaka M, Sakamoto R, Wada T, Fujisawa M, Okumiya K, Matsubayashi K.
  • Journal Title: Psychogeriatrics Volume: 14(3) Issue: 3 Pages: 182-7
  • DOI: 10.1111/psyg.12060
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Factor structures of a Japanese version of the Geriatric Depression Scale and its correlation with the qualitv of life and functional ability. (2014)
  • Author(s): Imai H, Yamanaka G, Ishimoto Y , KimuraY, Fukutomi E.
  • Journal Title: Psychiatry Research Volume: 215 Issue: 2 Pages: 460-5
  • DOI: 10.1016/j.psychres.2013.12.015
  • Peer Reviewed
• [Journal Article] The postcard intervention against depression among community-dwelling older adults : study protocol for a randomized contr oiled trial. (2013)
  • Author(s): Imai H, Furukawa TA, Oku miya K, Wada T, Fukutomi E
  • Journal Title: Trials Volume: 9 Issue: 1 Pages: 202-202
  • DOI: 10.1186/1745-6215-14-202
  • Peer Reviewed
• [Journal Article] Relationship between depression and blood pressure in community-dwelling oldest-old adults in Japan. (2013)
  • Author(s): Imai H, Okumiya K, Wada T, Fujisawa M, Sakamoto R, Ishimoto Y, Kimura Y, Fukutomi E, Chen WL, Tanaka M, Matsubayashi K.
  • Journal Title: J Am Geriatr Soc. Volume: 61(12) Issue: 12 Pages: 2241-2
  • DOI: 10.1111/jgs.12576
  • Peer Reviewed
• [Journal Article] 生活機能の加齢性変化 (2013)
  • Author(s): 和田泰三
  • Journal Title: 日本臨床 Volume: 71(10) Pages: 1727-32
• [Journal Article] Long-term care prevention in Japan. (2013)
  • Author(s): Fukutomi E et al.
  • Journal Title: Lancet Volume: 381 Issue: 9861 Pages: 116-116
  • DOI: 10.1016/s0140-6736(13)60049-5
  • Peer Reviewed
• [Journal Article] Evaluation of chewing ability and its relationship with activities of daily living, depression, cognitive status and food intake in the community-dwelling elderly. (2013)
  • Author(s): Kimura Y, Ogawa H, Yoshihara A, Yamaga T, Takiguchi T, Wada T, Sakamoto R, Ishimoto Y, Fukutomi E, Chen W, Fujisowa M, Okumiya K, Otsuka K, Miyazaki H, Matsubayashi K.
  • Journal Title: Geriatr Gerontol Int Volume: 13(3) Issue: 3 Pages: 718-25
  • DOI: 10.1111/ggi.12006
  • Peer Reviewed
• [Journal Article] Importance of cognitive assessment as part of the "Kihon Checklist" developed by the Japanese Ministry of Health, Labor and Welfare for prediction of frailty at a 2-year follow up. (2013)
  • Author(s): Fukutomi E, Okumiya K, Wada T, Sakamoto R, Ishimoto Y, Kimura Y, Kasahara Y, et al.
  • Journal Title: Geriatrics and Gerontology international Volume: 13 Issue: 3 Pages: 654-662
  • DOI: 10.1111/j.1447-0594.2012.00959.x
  • Peer Reviewed
• [Journal Article] Positive affect as a predictor of lower risk of functional decline in communiry-dwelling elderly in Japan. (2012)
  • Author(s): Hirosaki M, Ishimoto Y, Kasahara Y, et al.
  • Journal Title: Geriatr Gerontolo Int Volume: 13(4) Issue: 4 Pages: 1051-8
  • DOI: 10.1111/ggi.12008
  • Peer Reviewed
• [Journal Article] Eating alone among community-dwelling Japanese elderly: association with depression and food diversity. (2012)
  • Author(s): Kimura Y et al.
  • Journal Title: J Nutr Health Aging Volume: 16(8) Issue: 8 Pages: 728-731
  • DOI: 10.1007/s12603-012-0067-3
  • Peer Reviewed
• [Journal Article] J-curve association between economic status and diabetes independent of functional disability in Japanese elderly. (2012)
  • Author(s): Okumiya K, Sakamoto R, Kimura Y, Ishimoto Y, Fukutomi E, Kasahara Y, et al.
  • Journal Title: Geriatr Gerontol Int Volume: 12(4) Issue: 4 Pages: 755-6
  • DOI: 10.1111/j.1447-0594.2012.00854.x
  • Peer Reviewed
• [Journal Article] Correlation of systolic blood pressure with age and body mass index in native Papuan populations (2012)
  • Author(s): Fujisawa M, Okumiya K
  • Journal Title: Hypertens Res. Volume: 35(9) Issue: 9 Pages: 959-60
  • DOI: 10.1038/hr.2012.106
  • Peer Reviewed
• [Journal Article] Activities of daily living rather than depressive symptoms increase the risk of mortality in Japanese community-dwelling elderly people : a 4-year longitudinal survey. (2012)
  • Author(s): Imai H, Wada T, Sakamoto R, Kasahara Y, et al.
  • Journal Title: J Am Geriatr Soc. Volume: 60(6) Issue: 6 Pages: 1191-93
  • DOI: 10.1111/j.1532-5415.2012.03981.x
  • Peer Reviewed
• [Presentation] How to appreciate the patients preference？----From the view point of advance care planning--- (2015)
  • Author(s): Wada T
  • Organizer: Korea Geriatric Society
  • Place of Presentation: ソウル・韓国
  • Year and Date: 2015-11-28
  • Int'l Joint Research / Invited
• [Presentation] 多職種連携により在宅看取りが可能であった独居高齢がん患者の一例 (2015)
  • Author(s): 和田泰三
  • Organizer: 第26回日本老年医学会近畿地方会
  • Place of Presentation: 京都
  • Year and Date: 2015-11-14
• [Presentation] Visual Analogue Scaleで測定したQOLとSF-8 の関連 (2015)
  • Author(s): 和田泰三
  • Organizer: 第57回日本老年医学会学術集会
  • Place of Presentation: 横浜
  • Year and Date: 2015-06-12
• [Presentation] その人らしい最期を迎えるため我々ができること ～アドバンス・ケア・プランニングについて～ (2015)
  • Author(s): 和田泰三
  • Organizer: 京都府地域医療支援センター（KMCC）京都大学ブランチ 地域医療セミナー
  • Place of Presentation: 京都
  • Year and Date: 2015-02-27
  • Invited
• [Presentation] 本邦における終末期医療のあり方 (2015)
  • Author(s): 和田泰三
  • Organizer: 国際高等研究所「老いを考える」第４回研究会
  • Place of Presentation: 京都
  • Year and Date: 2015-01-23 – 2015-01-24
  • Invited
• [Presentation] 有料老人ホーム入居高齢者における社会的ネットワークと抑うつ・主観的健康感との関連 (2014)
  • Author(s): 和田泰三
  • Organizer: 第25回日本老年医学会 近畿地方会
  • Place of Presentation: 和歌山
  • Year and Date: 2014-10-11
• [Presentation] 地域在住者における転倒スコアの有用性（FRI-21・FRI-5） (2014)
  • Author(s): 和田泰三
  • Organizer: 第56回日本老年医学会学術集会
  • Place of Presentation: 福岡
  • Year and Date: 2014-06-12 – 2014-06-14
  • Invited
• [Presentation] 農村部地域在住高齢者における事前ケア計画の試み (2013)
  • Author(s): 和田泰三 他9名
  • Organizer: 第55回 日本老年医学会学術集会
  • Place of Presentation: 大阪
• [Presentation] 有料老人ホームにおける リヴィング・ウィルの試みとその限界 (2012)
  • Author(s): 和田泰三 他
  • Organizer: 第54回日本老年医学会学術集会
  • Place of Presentation: 東京国際フォーラム（東京）
• [Presentation] 抑うつスクリーニングと Advance Care Planningの適応可能性 (2012)
  • Author(s): 和田泰三
  • Organizer: 第54回日本老年医学会学術集会
  • Place of Presentation: 東京国際フォーラム（東京）
• [Presentation] リビング・ウィルから事前ケア計画（Advance Care Planning)へ
  • Author(s): 和田泰三
  • Organizer: 第24回日本老年医学会近畿地方会 市民公開講座
  • Place of Presentation: 京都
  • Invited
• [Book] 老化生物学 老いと寿命のメカニズム （ 第7章 ヒトの寿命） (2015)
  • Author(s): 和田泰三 （編・近藤祥司）
  • Total Pages: 408
  • Publisher: メディカルサイエンス・インターナショナル
• [Book] 続・生老病死のエコロジー (2013)
  • Author(s): 和田泰三
  • Total Pages: 344
  • Publisher: 昭和堂
• [Book] 健康長寿学大事典―QOLからEBMまで I 総説 １５ 高齢者の総合機能評価 (2012)
  • Author(s): 和田泰三
  • Total Pages: 825
  • Publisher: 西村書店
• [Book] 高齢者の転倒予防ガイドライン I転倒リスク評価（転倒予測）/地域 Timed”Up&Go"testと転倒スコア（FRI-21) (2012)
  • Author(s): 石本恭子・和田泰三・松林公蔵
  • Total Pages: 165
  • Publisher: メジカルビュー社