2019 年 68 巻 5 号 p. 303-312
Prevention of functional disabilities leading to long-term care and support needs in older population is one of the most urgent social issues facing Japan today. Frailty has been recognized as a pre-stage of functional disabilities leading to long-term care and support needs, and so, it is often treated as a target in their preventive interventions. Furthermore, because reductions of daily physical activities and physical fitness are considered as part of the major causes of physical frailty, their improvements have been also explored in community-based measures to prevent long-term care and support needs. This review paper aimed to summarize present findings regarding associations of frailty, physical activity, and physical fitness with incident long-term care and support needs in community-dwelling older Japanese adults. Through the review of literature, most of the previous prospective cohort studies showed that community-dwelling older Japanese adults who are free from frailty or maintain good physical activities and physical fitness have a reduced risk for the incidence of long-term care and support needs. These findings support an expectation that prevention of frailty and/or improvements of daily physical activities and physical fitness can be effective strategies to prevent older people from undergoing long-term care and support needs. It should be, however, understood that the associations found in the previous studies are not causal. Future prospective cohort studies defining exposure variables based on multipoint observations, as well as well-designed interventional studies are needed to validate the expectation.