Serum total cholesterol levels and eligibility for long-term care insurance A prospective cohort study of the Tsurugaya Project

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  • HOSHI Rena
    Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine
  • TOMATA Yasutake
    Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine
  • KAKIZAKI Masako
    Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine
  • TSUBOYA Toru
    Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine
  • NAGAI Masato
    Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine
  • WATANABE Ikue
    Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine
  • HOZAWA Atsushi
    Department of Public Health, Yamagata University Graduate School of Medical Science Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
  • TSUJI Ichiro
    Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine

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Other Title
  • 血清総コレステロール値と要介護認定リスクに関する前向きコホート研究 鶴ヶ谷プロジェクト
  • ケッセイ ソウ コレステロールチ ト ヨウカイゴニンテイ リスク ニ カンスル マエムキ コホート ケンキュウ : ツルガタニ プロジェクト

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Abstract

Objectives The purpose of this study was to examine the relationship between serum total cholesterol levels and certification eligibility for long-term care insurance in elderly Japanese individuals.<br/>Methods The Tsurugaya Project was a comprehensive geriatric assessment conducted for community-dwelling elderly individuals aged ≥70 years in the Tsurugaya area, Sendai, Japan. Of the 2,925 inhabitants, 958 subjects participated in the Tsurugaya Project. For this analysis, we used 827 subjects who gave informed consent and were not qualified for long-term care insurance at the time of the baseline survey. Subjects were followed up for 6 years. We classified the subjects into 4 quintiles and used the fourth quintile (212–230 mg/dL) as a reference for statistical analysis. We used Cox proportional hazards model to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of certification eligibility for long-term care insurance according to total cholesterol levels in serum.<br/>Results During 6 years of follow-up, a total of 214 subjects were qualified for long-term care insurance certification. The lowest serum total cholesterol level (<177 mg/dL) was significantly associated with increased eligibility for long-term care insurance certification. Compared with the fourth quintile, multivariate HRs (95%CIs) of long-term care insurance certification were 1.91 (1.23–2.98), 1.36 (0.85–2.18), 0.99 (0.62–1.56), 1.38 (0.88–2.17), for <177 mg/dL, 177–194 mg/dL, 195–211 mg/dL, and ≤231 mg/dL, respectively. Moreover, the association was statistically significant even after excluding subjects with a history of liver disease or cancer, an abnormality in the liver function test, or high levels of high-sensitivity C-reactive protein.<br/>Conclusion Low serum total cholesterol levels were significantly associated with increased eligibility for long-term care insurance certification even after adjusting for a variety of confounding factors.

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