Evidence map›Paper›PMID 29165172›Full record

ArticleEnvironmental health and preventive medicine2017

Cross-sectional association between medical expenses and intellectual activity in community-dwelling older adults.

Kimiko Tomioka, Norio Kurumatani, Hiroshi Hosoi

Abstract read
In one paragraph

Article in Environmental health and preventive medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Kimiko TomiokaNara Prefectural Health Research Center, Nara Medical University, Shijo-cho 840, Kashihara city, Nara, 634-8521, Japan. tkimiko@naramed-u.ac.jp.ORCID http://orcid.org/0000-0002-9471-6987
Norio KurumataniNara Prefectural Health Research Center, Nara Medical University, Shijo-cho 840, Kashihara city, Nara, 634-8521, Japan.
Hiroshi HosoiNara Prefectural Health Research Center, Nara Medical University, Shijo-cho 840, Kashihara city, Nara, 634-8521, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLittle is known concerning the lifestyle habits and health conditions in community-dwelling elderly who do not get medical care. We investigated the cross-sectional association between medical expenses (ME) and intellectual activity (IA) in community-dwelling older Japanese.

methodsSelf-administered questionnaires were mailed to all residents born between 1945 and 1949 and covered by A City's medical insurance system (n = 19,354). Independent variables including health behaviors, oral health, social capital, neighborhood environment, and physical and mental functioning were included in the questionnaires. Medical fee receipts were used to evaluate ME for fiscal 2014, and respondents were classified into no, low, medium, and high ME groups. Higher-level functional capacity was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence, which is comprised of three subscales: instrumental activities of daily living, IA, and social role. Poisson regression models were used to examine the association of ME with IA, with the low ME group as reference.

resultsQuestionnaires were returned by 12,747 individuals (response rate 65.9%). The no ME group had the lowest response rate, the worst lifestyle behaviors, and the lowest social capital, but no problems with neighborhood environment. Higher-level functional capacity, especially IA, was reduced in both the high ME and no ME groups. After adjustments for age, gender, health insurance, accessibility to public facilities in their residential area, family size, body mass index, and physical and mental functioning, the prevalence ratio (PR) for impaired IA lost its significance in the high ME group (PR 0.97, 95% confidence interval 0.90-1.05), but remained significant in the no ME group (1.19, 1.08-1.31). After additional adjustments for health behaviors (i.e., health checks, smoking, fitness, and dietary variety), the PR of the no ME group was attenuated towards the null (1.08, 0.98-1.20).

conclusionsCommunity-dwelling elderly who did not seek medical treatment were indifferent to health surveys and health-promoting behaviors, and undesirable health behaviors were a possible determinant of their impaired IA. Further longitudinal research is needed to confirm the causal associations.

Indexed as

Health BehaviorHealth StatusAgedCognitive DysfunctionCross-Sectional StudiesFemaleGeriatric AssessmentHealth ExpendituresHumansIndependent LivingLife StyleMaleOral HealthResidence CharacteristicsSocial CapitalTokyoCommunity-dwelling elderlyHealth behaviorsHigher-level functional capacityIntellectual activityMedical expenses

Identifiers

PMID29165172
PMCPMC5664812

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.