Aim: We compared gender differences in the sociodemographic characteristics of community-dwelling dependent elderly who use various community-based services under long-term care insurance programs, as well as in mortality, hospitalization, and institutionalization during a 3-year follow-up period.
Methods: We conducted a cross-sectional study using the baseline data of 1,875 care recipients from the Nagoya Longitudinal Study for Frail Elderly (NLS-FE), and a prospective study using their 3-year follow-up data. The data, which were collected at the patients' homes or from care-managing center records, included the clients' and caregivers' demographic characteristics, living arrangements, community-based services used, depression as assessed by the Geriatric Depression Scale (GDS-15), a rating for basic activities of daily living (ADL), and comorbidities. The data included, at 3-year follow-up, all-cause mortality, hospitalization, and institutionalization.
Results: Among 1,875 care recipients 66.3% were women. They had a higher rate of living alone (26.2% vs 14.6% in men), and a lower rate of receiving care by a spouse (22.1% vs. 73.6% of men). Although there were no differences in ADL levels or GDS-15 scores between genders, a higher Charlson comorbidity index, higher prevalence of cerebrovascular disease, chronic obstructive pulmonary disease (COPD), and cancer were observed in the male care recipients. Kaplan-Meier analysis demonstrated that during the 3-year follow-up, higher mortality, hospitalization, and lower institutionalization rates were observed in men.
Conclusion: We observed that two thirds of care recipients were women. Compared with male recipients, female recipients were more likely to live alone, and to be cared for by non-spouse caregivers. Lower mortality and hospitalization, but higher institutionalization, were observed in female recipients.