The present study is based on 10-year follow-up survey of community elderly residents. The purpose of the present study is to observe changes of activities of daily living (ADL) with advancing age and to clarify physical, sociological, and psychological factors contributing to ADL changes. Subjects were 422 elderly residents living at home in Koganei City, a suburb of Tokyo. They participated in a comprehensive health survey undertaken in 1976 when they were aged 69 to 71 years. They were followed up in 1986, 10 years later . Out of the 422 elderly, 250 responded to the follow-up survey (the respondents) . One hundred and two subjects died during 10 years, and further 70 subjects did not responded because of moving out, admission to hospitals or institutions, or refusals. The results obtained are as follows: 1) Level of ADL at age 69-71 (initial survey) was likely to be lower in the deceased during 10 years than in the respondents. 2) Level of each category of ADL, i.e., walking, eating, toileting, bathing, and dressing more or less declined during 10 years, and the most remarkable decline was found in walking. 3) Bedridden status was observed in 3.7% of males and 2.1% of females at age 79-81 (follow-up survey), although all subjects were independent of ADL at initial survey. When those suffering from stroke or bone and joints diseases during the period of observation were excluded from analysis, bedridden status was 2.3% for males and 0.8% for females. 4) Decline of ADL was slightly more marked in males than in females, but it was not significant. 5) Contribution of initial factors to ADL changes due to other causes than stroke or bone and joints disease during 10 years. (1) Concerning physical factors, history of hypertension and ECG abnormalities in males, and overweight in females significantly contributed to the decline of ADL. (2) Among psychological factors, bad memory as measured by the Benton Visual Retention Test in males, and anxiety for health in females lowered ADL level. (3) For both sexes, social activity level had significantly inverse contribution to ADL decline in a graded fashion.
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