[Purpose] The purpose of this study is to investigate whether lower Fall-related self-efficacy in the elderly would cause a decrease in their Instrumental Activities of Daily Life (IADLs) in one year, and whether the Fall-related self-efficacy in elderly people would decrease after falling. [Methods] The participants were 86 elderly cared for at day care centers, followed for one year. At baseline and at follow-up, the participants were asked how many times they had fallen down in the past year. We also evaluated their Fall-related self-efficacy using the Modified Falls Efficacy Scale (MFES) and evaluated IADLs using the Tokyo Metropolitan Institute of Gerontology (TMIG) Index, via an interview. First, the differences in the TMIG Index for one year were compared between the participants with lower MFES and the participants with higher MFES at baseline. Moreover, the differences in MFES for one year were compared between the participants who had fallen and those who hadn't fallen for one year by follow-up. [Results] 27 participants had fallen down at least once by the follow-up. The participants who had lower Fall-related self-efficacy didn't experience a significant decrease in their IADLs compared with participants who had higher Fall-related self-efficacy in one year. Moreover, the Fall-related self-efficacy in the participants who had fallen, didn't significantly decrease compared with that of the participants who hadn't fallen for one year. It may be necessary to adopt scales which evaluate the Fall-related self-efficacy depending on the degree of functional ability in participants.

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[Purpose] To clarify efficacy of the test for independent walking using our convalescent rehabilitation ward. [Subjects and methods] Subjects were 178 stroke patients who had hospitalized in our convalescent rehabilitation ward from December 2009 to May 2011. 64 patients (35 male, 29 female, average age 66.7±14.4) of those who were able to achieve independent walking by our original test protocol participated in this study. The test includes 8 specific items, which assume some situations of falls while walking. In order to obtain permission of walk alone in the ward, it is necessary to pass this test. Nurses perform assessment of each items for through 3 days, consecutively, then a Rehabilitation doctor allows the patients to walk alone. We used passing rate, days to pass the test and proportion of falls as index of efficacy. [Result] 56 patients (87.5%) achieved independent walking, 51.8% of these patients passed the test less than 4 days. Proportion of falls after independent walking was 19.6% (11 patients, 17 falls) including 1 patient (1.8%) who had femoral neck fracture. [Discussion] It is reported that falls in patients walk independently with cane or walker in convalescent rehabilitation ward was 15.6% by research among multi facilities, which is similar to our result. We concluded that our test for independent walking is efficient of its convenience and eliminates certain risk of falls in stroke patients after independent walking.

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According to vital statistics collected by the Japan Ministry of Heath, Labour, and Welfare in 1998, there were 31,755 suicides, with the number maintaining to 30,000 or more during twelve years. In order to improve suicide problems, there are lot of researches and practical type programs of suicide prevention in Japan, and implementation of mental health-supporting programs are planned from 2011 in Nagano Prefecture, Tomi city, too. The aim of this study is to reveal the epidemiologic features of mental health in Nagano Prefecture, Tomi city. A self administered anonymous questionnaire was sent to 700 citizens in tomi city in August, 2010 (response rate, 65.6%). The male was 29.9% in participants, and the female of 38.7% had the anxiety of the mental health, and the male and the female felt sleep dissatisfaction and the stress feeling in one's fifties, especially. In the comparison between the male group and the female group of the anxiety of mental health, the femal group was higher the male group (p<0.05). These results in this study reveal the epidemiologic feature of mental health (anxiety of the mental health, sleep satisfaction, stress feeling, coping) in Tomi city.

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