{"id":"https://openalex.org/W7220649082","doi":"https://doi.org/10.3389/fpubh.2026.1950765","title":"Higher-level functional capacity and incident long-term care insurance certification: a competing risks analysis","display_name":"Higher-level functional capacity and incident long-term care insurance certification: a competing risks analysis","publication_year":2026,"publication_date":"2026-10-06","ids":{"openalex":"https://openalex.org/W7220649082","doi":"https://doi.org/10.3389/fpubh.2026.1950765","pmid":"https://pubmed.ncbi.nlm.nih.gov/42903110","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13680145"},"language":"en","primary_location":{"id":"doi:10.3389/fpubh.2026.1950765","doi":"https://doi.org/10.3389/fpubh.2026.1950765","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2026.1950765","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1950765/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1950765/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5122799578","display_name":"Meiling Qian","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I146399215","display_name":"University of Tsukuba","ror":"https://ror.org/02956yf07","country_code":"JP","type":"education","lineage":["https://openalex.org/I146399215"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Meiling Qian","raw_affiliation_strings":["Graduate School of Comprehensive Human Sciences, University of Tsukuba"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Graduate School of Comprehensive Human Sciences, University of Tsukuba","institution_ids":["https://openalex.org/I146399215"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5049549369","display_name":"Jinrui Zhang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I146399215","display_name":"University of Tsukuba","ror":"https://ror.org/02956yf07","country_code":"JP","type":"education","lineage":["https://openalex.org/I146399215"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Jinrui Zhang","raw_affiliation_strings":["Graduate School of Comprehensive Human Sciences, University of Tsukuba"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Graduate School of Comprehensive Human Sciences, University of Tsukuba","institution_ids":["https://openalex.org/I146399215"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5006300451","display_name":"Shuanghong Li","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I146399215","display_name":"University of Tsukuba","ror":"https://ror.org/02956yf07","country_code":"JP","type":"education","lineage":["https://openalex.org/I146399215"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Shuanghong Li","raw_affiliation_strings":["Graduate School of Comprehensive Human Sciences, University of Tsukuba"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Graduate School of Comprehensive Human Sciences, University of Tsukuba","institution_ids":["https://openalex.org/I146399215"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5116686623","display_name":"Maiko Shigeeda","orcid":"https://orcid.org/0009-0007-5627-8705","observed_orcids":["https://orcid.org/0009-0007-5627-8705"]},"institutions":[{"id":"https://openalex.org/I146399215","display_name":"University of Tsukuba","ror":"https://ror.org/02956yf07","country_code":"JP","type":"education","lineage":["https://openalex.org/I146399215"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Maiko Shigeeda","raw_affiliation_strings":["Graduate School of Comprehensive Human Sciences, University of Tsukuba"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Graduate School of Comprehensive Human Sciences, University of Tsukuba","institution_ids":["https://openalex.org/I146399215"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5126276599","display_name":"Haotian Gao","orcid":"https://orcid.org/0009-0006-5270-3017","observed_orcids":["https://orcid.org/0009-0006-5270-3017"]},"institutions":[{"id":"https://openalex.org/I146399215","display_name":"University of Tsukuba","ror":"https://ror.org/02956yf07","country_code":"JP","type":"education","lineage":["https://openalex.org/I146399215"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Haotian Gao","raw_affiliation_strings":["Graduate School of Comprehensive Human Sciences, University of Tsukuba"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Graduate School of Comprehensive Human Sciences, University of Tsukuba","institution_ids":["https://openalex.org/I146399215"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5122770929","display_name":"Ruifeng Zhao","orcid":"https://orcid.org/0009-0003-1568-0387","observed_orcids":["https://orcid.org/0009-0003-1568-0387"]},"institutions":[{"id":"https://openalex.org/I146399215","display_name":"University of Tsukuba","ror":"https://ror.org/02956yf07","country_code":"JP","type":"education","lineage":["https://openalex.org/I146399215"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Ruifeng Zhao","raw_affiliation_strings":["Graduate School of Comprehensive Human Sciences, University of Tsukuba"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Graduate School of Comprehensive Human Sciences, University of Tsukuba","institution_ids":["https://openalex.org/I146399215"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5121008615","display_name":"Mengxuan Wang","orcid":"https://orcid.org/0009-0000-1301-9868","observed_orcids":["https://orcid.org/0009-0000-1301-9868"]},"institutions":[{"id":"https://openalex.org/I146399215","display_name":"University of Tsukuba","ror":"https://ror.org/02956yf07","country_code":"JP","type":"education","lineage":["https://openalex.org/I146399215"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Mengxuan Wang","raw_affiliation_strings":["Graduate School of Comprehensive Human Sciences, University of Tsukuba"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Graduate School of Comprehensive Human Sciences, University of Tsukuba","institution_ids":["https://openalex.org/I146399215"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5062052620","display_name":"Dandan Jiao","orcid":"https://orcid.org/0000-0002-0295-0953","observed_orcids":["https://orcid.org/0000-0002-0295-0953"]},"institutions":[{"id":"https://openalex.org/I167383011","display_name":"Henan University of Science and Technology","ror":"https://ror.org/05d80kz58","country_code":"CN","type":"education","lineage":["https://openalex.org/I167383011"]},{"id":"https://openalex.org/I4210134906","display_name":"First Affiliated Hospital of Henan University of Science and Technology","ror":"https://ror.org/035zbbv42","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210134906"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Dandan Jiao","raw_affiliation_strings":["Department of Nursing, The First Affiliated Hospital and College of Clinical Medicine, Henan University of Science and Technology"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Nursing, The First Affiliated Hospital and College of Clinical Medicine, Henan University of Science and Technology","institution_ids":["https://openalex.org/I167383011","https://openalex.org/I4210134906"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5060777962","display_name":"Yuko Sawada","orcid":"https://orcid.org/0000-0003-2784-5321","observed_orcids":["https://orcid.org/0000-0003-2784-5321"]},"institutions":[{"id":"https://openalex.org/I164555798","display_name":"Morinomiya University of Medical Sciences","ror":"https://ror.org/05sjznd72","country_code":"JP","type":"education","lineage":["https://openalex.org/I164555798"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Yuko Sawada","raw_affiliation_strings":["Department of Physical Therapy, Morinomiya University of Medical Sciences"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Physical Therapy, Morinomiya University of Medical Sciences","institution_ids":["https://openalex.org/I164555798"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5048340030","display_name":"Akihiro Kakuda","orcid":"https://orcid.org/0009-0001-4648-8908","observed_orcids":["https://orcid.org/0009-0001-4648-8908"]},"institutions":[{"id":"https://openalex.org/I164555798","display_name":"Morinomiya University of Medical Sciences","ror":"https://ror.org/05sjznd72","country_code":"JP","type":"education","lineage":["https://openalex.org/I164555798"]}],"countries":["JP"],"is_corresponding":false,"raw_author_name":"Akihiro Kakuda","raw_affiliation_strings":["Department of Physical Therapy, Morinomiya University of Medical Sciences"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Physical Therapy, Morinomiya University of Medical Sciences","institution_ids":["https://openalex.org/I164555798"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5157663512","display_name":"Hiroshi Kinoshita","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Hiroshi Kinoshita","raw_affiliation_strings":["Department of Public Welfare"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Public Welfare","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5038419978","display_name":"Rika Okumura","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Rika Okumura","raw_affiliation_strings":["Department of Public Welfare"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Public Welfare","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5111371150","display_name":"Yuriko Kawasaki","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Yuriko Kawasaki","raw_affiliation_strings":["Department of Public Welfare"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Public Welfare","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5070026093","display_name":"Tokie Anme","orcid":"https://orcid.org/0000-0002-3361-7715","observed_orcids":["https://orcid.org/0000-0002-3361-7715"]},"institutions":[{"id":"https://openalex.org/I146399215","display_name":"University of Tsukuba","ror":"https://ror.org/02956yf07","country_code":"JP","type":"education","lineage":["https://openalex.org/I146399215"]}],"countries":["JP"],"is_corresponding":true,"raw_author_name":"Tokie Anme","raw_affiliation_strings":["Faculty of Medicine, University of Tsukuba"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Faculty of Medicine, University of Tsukuba","institution_ids":["https://openalex.org/I146399215"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5070026093"],"corresponding_institution_ids":["https://openalex.org/I146399215"],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.76072055,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"14","issue":null,"first_page":"1950765","last_page":"1950765"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12811","display_name":"Aging, Health, and Disability","score":0.8901000022888184,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12811","display_name":"Aging, Health, and Disability","score":0.8901000022888184,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11376","display_name":"Geriatric Care and Nursing Homes","score":0.05590000003576279,"subfield":{"id":"https://openalex.org/subfields/2717","display_name":"Geriatrics and Gerontology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11011","display_name":"Frailty in Older Adults","score":0.041999999433755875,"subfield":{"id":"https://openalex.org/subfields/2717","display_name":"Geriatrics and Gerontology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/older-adults","display_name":"older adults","score":0.7919999957084656},{"id":"https://openalex.org/keywords/social-roles","display_name":"social roles","score":0.7160000205039978},{"id":"https://openalex.org/keywords/intellectual-activity","display_name":"intellectual activity","score":0.9959999918937683},{"id":"https://openalex.org/keywords/functional-vulnerability","display_name":"functional vulnerability","score":0.6380000114440918},{"id":"https://openalex.org/keywords/competing-risks","display_name":"competing risks","score":0.5130000114440918},{"id":"https://openalex.org/keywords/death","display_name":"death","score":0.48100000619888306},{"id":"https://openalex.org/keywords/community-dwelling-elderly","display_name":"community-dwelling older adults","score":0.7229999899864197},{"id":"https://openalex.org/keywords/age-standardization","display_name":"age adjustment","score":0.5830000042915344}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.6718000173568726},{"id":"https://openalex.org/C74909509","wikidata":"https://www.wikidata.org/wiki/Q10387","display_name":"Gerontology","level":1,"score":0.5602999925613403},{"id":"https://openalex.org/C88879693","wikidata":"https://www.wikidata.org/wiki/Q217690","display_name":"Cumulative incidence","level":3,"score":0.47110000252723694},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.4341999888420105},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.4284999966621399},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.42750000953674316},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.4226999878883362},{"id":"https://openalex.org/C79544238","wikidata":"https://www.wikidata.org/wiki/Q423243","display_name":"Activities of daily living","level":2,"score":0.39730000495910645},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.3756999969482422},{"id":"https://openalex.org/C46304622","wikidata":"https://www.wikidata.org/wiki/Q374814","display_name":"Certification","level":2,"score":0.3431999981403351},{"id":"https://openalex.org/C147077947","wikidata":"https://www.wikidata.org/wiki/Q1515895","display_name":"Socioeconomic status","level":3,"score":0.32510000467300415},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.30390000343322754},{"id":"https://openalex.org/C2780233487","wikidata":"https://www.wikidata.org/wiki/Q6672123","display_name":"Long-term care","level":2,"score":0.3012999892234802},{"id":"https://openalex.org/C2778087770","wikidata":"https://www.wikidata.org/wiki/Q2297111","display_name":"Social support","level":2,"score":0.2976999878883362},{"id":"https://openalex.org/C2776534028","wikidata":"https://www.wikidata.org/wiki/Q1141363","display_name":"Medicaid","level":3,"score":0.29499998688697815},{"id":"https://openalex.org/C2781058065","wikidata":"https://www.wikidata.org/wiki/Q1674580","display_name":"Long-term care insurance","level":3,"score":0.2865000069141388},{"id":"https://openalex.org/C2779668873","wikidata":"https://www.wikidata.org/wiki/Q6693756","display_name":"Lower risk","level":3,"score":0.26969999074935913},{"id":"https://openalex.org/C54183767","wikidata":"https://www.wikidata.org/wiki/Q10384","display_name":"Geriatrics","level":2,"score":0.2678000032901764},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.2639999985694885},{"id":"https://openalex.org/C100521375","wikidata":"https://www.wikidata.org/wiki/Q2015382","display_name":"Competence (human resources)","level":2,"score":0.2538999915122986}],"mesh":[{"descriptor_ui":"D000099093","descriptor_name":"Aging in Place","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000203","descriptor_name":"Activities of Daily Living","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D000368","descriptor_name":"Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000369","descriptor_name":"Aged, 80 and over","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002568","descriptor_name":"Certification","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007353","descriptor_name":"Insurance, Long-Term Care","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D007564","descriptor_name":"Japan","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011446","descriptor_name":"Prospective Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015577","descriptor_name":"Geriatric Assessment","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D018570","descriptor_name":"Risk Assessment","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057187","descriptor_name":"Independent Living","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false}],"locations_count":4,"locations":[{"id":"doi:10.3389/fpubh.2026.1950765","doi":"https://doi.org/10.3389/fpubh.2026.1950765","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2026.1950765","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1950765/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13680145","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13680145/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13680145/pdf/fpubh-14-1950765.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Front Public Health","raw_type":"Text"},{"id":"pmid:42903110","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42903110","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in public health","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:6fdb4e5caafe4b0391877562a0993741","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/6fdb4e5caafe4b0391877562a0993741","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Public Health, Vol 14 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/fpubh.2026.1950765","doi":"https://doi.org/10.3389/fpubh.2026.1950765","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fpubh.2026.1950765","pdf_url":"https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1950765/pdf","source":{"id":"https://openalex.org/S2595931848","display_name":"Frontiers in Public Health","issn_l":"2296-2565","issn":["2296-2565"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["anvur-scientific","cwts-core","doaj","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Public Health","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320334764","display_name":"Japan Society for the Promotion of Science","ror":"https://ror.org/00hhkn466"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7220649082.pdf","grobid_xml":"https://content.openalex.org/works/W7220649082.grobid-xml"},"referenced_works_count":38,"referenced_works":["https://openalex.org/W1975505813","https://openalex.org/W1990115406","https://openalex.org/W1990172327","https://openalex.org/W2021859534","https://openalex.org/W2038981426","https://openalex.org/W2054802062","https://openalex.org/W2071458891","https://openalex.org/W2104800754","https://openalex.org/W2113414191","https://openalex.org/W2125323720","https://openalex.org/W2128529067","https://openalex.org/W2138922470","https://openalex.org/W2142141410","https://openalex.org/W2145622148","https://openalex.org/W2172213127","https://openalex.org/W2264767503","https://openalex.org/W2395116472","https://openalex.org/W2485776049","https://openalex.org/W2754160328","https://openalex.org/W2794448948","https://openalex.org/W2802235172","https://openalex.org/W2972069866","https://openalex.org/W2981024537","https://openalex.org/W2985821085","https://openalex.org/W3080607234","https://openalex.org/W3088306309","https://openalex.org/W3102895566","https://openalex.org/W3150916209","https://openalex.org/W3173528543","https://openalex.org/W3180017411","https://openalex.org/W3180869031","https://openalex.org/W3203938245","https://openalex.org/W4213163979","https://openalex.org/W4318925032","https://openalex.org/W4379743884","https://openalex.org/W4399901615","https://openalex.org/W4400746750","https://openalex.org/W4412026605"],"related_works":["https://openalex.org/W3198662049","https://openalex.org/W1580275543","https://openalex.org/W3180017411","https://openalex.org/W3102895566","https://openalex.org/W4402191208","https://openalex.org/W2138922470","https://openalex.org/W3191717889","https://openalex.org/W7033284273","https://openalex.org/W6902058762","https://openalex.org/W2071458891"],"abstract_inverted_index":{"Background":[0],"Higher-level":[1],"functional":[2,7],"capacity":[3],"(HLFC)":[4],"may":[5],"capture":[6],"vulnerability":[8],"beyond":[9],"basic":[10],"activities":[11],"of":[12,21,62,85,88,189,251,276,297,319],"daily":[13],"living":[14,147],"in":[15,58,301],"older":[16,55],"adults.":[17],"However,":[18],"the":[19,59,63,81,92,96,174,225,235,246,252,259,277,302,317,320],"association":[20,308,323],"baseline":[22,79,282],"HLFC":[23,74,179,283],"with":[24,129,184,211,272,291],"subsequent":[25,294],"incident":[26,165,190,298],"long-term":[27],"care":[28],"insurance":[29],"(LTCI)":[30],"certification":[31,116,132,167,192,300],"remains":[32],"unclear":[33],"when":[34],"death":[35,130],"is":[36],"considered":[37],"a":[38,135,185,212,292],"competing":[39,136],"event.":[40,137],"Methods":[41],"This":[42],"prospective":[43],"cohort":[44],"study":[45],"included":[46,143,234],"688":[47,160],"community-dwelling":[48],"Japanese":[49],"adults":[50],"aged":[51],"65":[52],"years":[53],"or":[54,121],"who":[56],"participated":[57],"2017":[60],"wave":[61],"Community":[64],"Empowerment":[65],"and":[66,70,95,105,155,168,230,241,248,285],"Care":[67],"for":[68,100,111],"Well-being":[69],"Healthy":[71],"Longevity":[72],"Study.":[73],"was":[75,123,182,208,309],"assessed":[76],"once":[77],"at":[78,117],"using":[80,125],"Tokyo":[82],"Metropolitan":[83],"Institute":[84],"Gerontology":[86],"Index":[87],"Competence":[89],"(TMIG-IC),":[90],"including":[91],"total":[93,180,284],"score":[94,181,207],"formal":[97],"subdomain":[98],"scores":[99,288],"Instrumental":[101,228],"Self-Maintenance,":[102],"Intellectual":[103,231],"Activity,":[104],"Social":[106,205,286,321],"Role.":[107],"Participants":[108],"were":[109,289],"followed":[110],"8":[112],"years.":[113],"Incident":[114],"LTCI":[115,166,191,299],"Support":[118],"Level":[119],"1":[120],"higher":[122,178],"analyzed":[124],"Fine\u2013Gray":[126,141],"competing-risk":[127],"regression,":[128],"before":[131,171],"treated":[133],"as":[134],"The":[138,306],"fully":[139,175],"adjusted":[140,176],"model":[142],"age":[144,270,314],"group,":[145],"sex,":[146],"arrangement,":[148],"physical":[149],"activity,":[150],"smoking":[151],"status,":[152],"alcohol":[153],"consumption,":[154],"disease":[156],"status.":[157],"Results":[158],"Among":[159],"complete-case":[161,253],"participants,":[162],"145":[163],"developed":[164],"79":[169],"died":[170],"certification.":[172],"In":[173],"model,":[177],"associated":[183,210,290],"lower":[186,213,293],"cumulative":[187,214,295],"incidence":[188,215,296],"(sHR":[193],"per":[194],"1-point":[195],"increase,":[196],"0.941;":[197],"95%":[198,218],"CI,":[199,219],"0.891\u20130.994;":[200],"p":[201,221],"=":[202,222],"0.029).":[203],"Higher":[204,281],"Role":[206,287,322],"also":[209,266,324],"(sHR,":[216],"0.803;":[217],"0.702\u20130.918;":[220],"0.001),":[223],"whereas":[224],"continuous":[226],"per-point":[227],"Self-Maintenance":[229],"Activity":[232],"estimates":[233],"null":[236],"after":[237],"full":[238],"adjustment.":[239],"Multiple-imputation":[240],"lagged-event":[242],"analyses":[243],"generally":[244],"retained":[245],"direction":[247],"broad":[249],"magnitude":[250,318],"estimates.":[254],"Exposure-by-log(time)":[255],"diagnostics":[256],"indicated":[257],"that":[258],"Fine-Gray":[260],"associations":[261],"varied":[262,267],"over":[263],"follow-up.":[264],"Estimates":[265],"under":[268,312],"alternative":[269,313],"specifications,":[271],"particularly":[273],"marked":[274],"attenuation":[275],"total-score":[278,307],"association.":[279],"Conclusion":[280],"prespecified":[303],"age-group-adjusted":[304],"analysis.":[305],"substantially":[310],"attenuated":[311],"adjustments,":[315],"while":[316],"varied.":[325]},"counts_by_year":[],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2026-10-07T00:00:00"}