Purpose This study was conducted to examine the relationship between physical activity level (PAL) and physical, mental and social factors in community-dwelling elderly people.
Methods The subjects comprised 428 residents aged 70 or over living in Kusatsu-machi, Gunma, who took part in an interview and tests of physical fitness as part of the “NIKKORI-KENKOSODANJIGYO”. Data for 330 out of the 428 residents were adopted for this study. The PAL was evaluated with a questionnaire developed by Naito et al. (2003). Subjects were interviewed on physical, mental and social functioning including the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence and cognitive function (Mini Mental State Examination: MMSE). Physical fitness tests included assessment of handgrip strength, usual and maximal walking speed, and one-leg standing balance with eyes open.
Results Correlations between PAL and the TMIG Index of Competence, physical (e.g. physical fitness), mental (e.g. depression) and social (e.g. roles at home) factors, and smoking status were significant by ANCOVA adjusted for age and sex. Analysis using a general linear model indicated that smoking status, usual walking speed, depression, roles at home, frequency of going outdoors and visual impairment all together explained 13.5% of the PAL variance.
Conclusion The findings indicate that PAL in the community-dwelling elderly aged 70 years or over is associated with physical, mental and social factors.

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Objectives This study was designed to clarify the relation between social interaction and seven-year-mortality in a group of elderly people.
Methods The participants were all 65 years or older living in farming communities near major urban centers in Japan (n=801). The contents of the questionnaire covered social interaction (using an “Index of Social Interaction” consisting of 18 items), health status, physical function, activities of daily living (ADL), age and gender.
Results A total of 139 subjects died within the seven year period after the baseline survey: 1) baseline age and physical function were related to the seven-year mortality; 2) greater social interaction was positively related to reduced mortality; 3) multiple logistic regression analysis adjusted for baseline age, gender, physical function, health status, and ADL indicated that greater social interaction was related to reduced mortality.
Discussion These findings highlight the importance of social interaction in successful aging.

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Purpose To examine factors associated with participation in a community based comprehensive health check to screen frail elderly before they become in need of long-term care.
Methods All residents aged 70 years and over living in Kusatsu, Gumma prefecture were surveyed for their sociodemographics, and physical, mental and social functioning through in-person interview in the years 2001 and 2003. In the following years—in 2002 and 2004, respectively—mass screenings were conducted to detect early signs of need for care among the elderly. Using the baseline interview information as explanatory variables, we performed multiple logistic regression analysis in order to examine the social determinants of participation in the mass-screening.
Results For the first mass-screening, having high blood pressure and poor subjective health decreased the likelihood of attending the screening by 34% and 65% respectively. In contrast, one point increases in IADL, mobility and social-role score increased the probability of attendance by 27%, 26% and 26% respectively. After the screening was re-conducted, the factors influencing attendance appeared to have changed. With a third mass-screening, while the IADL and mobility score still had significant effects, elderly having excellent subjective health were less likely to go by some 48%. It was also found that not having visual impairment had a significantly positive effect on attendance.
Conclusion If local government conducts community-based mass screening aiming to screen the frail elderly in need of care, it is likely that there are high risk elderly among the non-participants. It is very important to follow up those non-participants using an attendance roll and provide appropriate advice. It is also worth discussing mass screening that focuses more on health promotion than on “screening” itself.

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Objective We have launched a new intervention study, called “Research of Productivity by Intergenerational Sympathy (REPRINTS)” in which senior volunteers engage in reading picture books to children. The “REPRINTS” program consistently involves social roles and intellectual activity, two higher-level functional capacities. This study reported findings and problems experienced through “REPRINTS” during the first year, ascertained potential effectiveness of social activity, and proposed methods for continued activity.
Methods Basic concepts of “REPRINTS”program include “contribution to society”, “life-long learning”, and “group activity.” Sixty seven volunteers and 74 controls, all aged 60 years and over living in three areas, ie., Chuo-ku, central Tokyo, Kawasaki city, suburb of Tokyo and Nagahama city, a local city, participated in a baseline health check-up in June, 2004. After completion of 3-month training seminars (once a week, 2 hr per session), volunteers visited public elementary schools and kindergartens in groups of 6-10 persons for 6 months. They were assessed again by follow-up health check-up in March, 2005.
Results At baseline, the proportion of those who had no grand children (41.8% vs. 20.3%, P=0.006), average school years (13.4±2.5 vs. 12.3±2.5 years, P=0.008), having any experience of volunteer activities (79.1% vs. 52.7%, P=0.001), and an usual walking speed (86.7±12.3 vs. 81.3±12.9 m/min, P=0.012) were significantly higher in volunteers than in controls. There was no significant difference in other baseline characteristics between the two groups. At follow-up, social network scores for 56 volunteers were significantly improved: frequency of contact with grandchildren and others around neighborhood and size of circles of friends and acquaintances were increased, as compared to controls. Social support scores for the volunteers significantly decreased in the receiving aspect, while increased in the giving aspect. In addition, consciousness of loving community and self-rated health were significantly enhanced and hand-grip strength showed significantly less decline in volunteers than in controls.
Conclusions Through engaging in the intergenerational and intellectual volunteer programs for 9 months, subjective health, social support and network, consciousness of loving community and some aspects of physical performance were significantly promoted in senior volunteers. Coordination of existing administrative services enabled us to establish this “REPRINTS” health promotion program for community-dwelling older adults.

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[in Japanese]

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