Causal Effect Relationship between Mental, Physical, Social Health and Long-term Care Needs: A Cohort Study on Japanese Elderly

Introduction: WHO defines health as a state of mental, physical and social wellbeing. However, there have been limited detailed evidences that systematically assessed the chronological relationships between these three health aspects and long-term care (LTC) needs.
Method: Among the urban dwelling elderly aged 65 years and over, data were collected through self-reported questionnaire in 2001 and 2004 in Tokyo. Ultimately, 8,126 respondents were included in the analysis. Exploratory factor analysis and Structural Equation Model (SEM) method was adopted in the analysis.
Results: By using exploratory factor analysis, 3 factors, named ’mental health’,’ physical health’, ‘social health’ , were defined as latent variables, respectively. The SEM analysis indicated significant direct but negative correlations between ‘physical health 2001’ and ‘LTC needs 2004’. In contrast, ‘mental health 2001’ and ‘social health 2001’ had little direct effects on ‘LTC needs 2004’. Meanwhile, we also observed an indirect effect of ‘mental health 2001’ on ‘LTC needs 2004’ through ‘physical health 2001’.
Conclusions: This study illustrates that the LTC needs is mainly confirmed by physical health, followed by mental and social health. It suggests that maintenance of good physical health may be entirely crucial to decrease the LTC needs.