| アブストラクト | AIM: This study aimed to assess the validity of the criteria for determination of the daily life independence level of older adults with dementia (CDED) in the diagnosis procedure combination (DPC) database, compared with the dementia assessment sheet for community-based integrated care system (DASC-21), to promote the use of CDED in DPC data for clinical and policy research on in-patients. METHODS: A validation study was conducted using a DPC database and medical records. Data from patients aged >/= 65 years hospitalized at Tokyo Metropolitan Geriatric Hospital and the Institute of Gerontology were extracted. The CDED scores range across five levels of dementia severity, and their validity was confirmed using the DASC-21 as a reference standard. The association between both scales was assessed using descriptive statistics and a generalized linear model. RESULTS: Data from 9401 patients were analyzed. As CDED scores increased, age, Charlson Comorbidity Index, and frailty risk increased, while activities of daily living scores decreased. Additionally, higher CDED scores were associated with higher mean DASC-21 scores, indicating worsening cognitive and functional status. A generalized linear regression model with a Gaussian link function showed that DASC-21 scores significantly increased with higher CDED scores (CDED 1: 1.19, CDED 2: 1.48, CDED 3: 1.64, CDED 4: 1.84, and CDED M: 1.80; p < 0.001). CONCLUSIONS: The CDED reliably assessed dementia severity and showed a strong association with the DASC-21, reflecting dementia progression. It is useful for patient assessment and policy research on dementia. |
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