地域における介護予防のエビデンス

抄録

Although multiple disability prevention efforts and interventions for older adults have been implemented in the community, only a limited number of studies have verified whether these efforts have actually reduced the occurrence of disability or frailty. This paper reviewed evidence on the effects of community-based interventions for disability prevention on risks of disability and frailty at both the individual and population levels. Consequently, first, participation in exercise or nutrition programs based on high-risk strategies significantly reduced the risk of disability occurrence and suppressed medical and care costs for frail older adults, compared with nonparticipants. However, the participation rate for elderly populations in such programs was extremely low. Second, the creation of self-management programs based on population strategies, such as exercise groups or community salons, significantly reduced the participant’s risk for disability and frailty. The number of such “gathering places” and the participation rate in the elderly population progressively increased, suggesting it may contribute to disability prevention not only at the individual level, but also at the population level. However, previous studies have required long terms (4–5 years) to confirm significant reduction in an individual’s risk for disability and frailty. Finally, although previous studies that verified the effects of disability or frailty prevention at the population level have been extremely limited, one study demonstrated it is possible to reduce the rate of disability at the population level. Further studies are needed to verify the effects of various community-based disability prevention efforts on individual- and population-level disability and frailty for older adults.