Effects on mortality of getting the basic health examination under the Health Services for the Elderly Act and modification of the effects by health status among elderly persons in a rural community.

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This longitudinal study examines the effect on mortality of regular use of the basic health examination under the Health Services for the Elderly Act and heterogeneity of the effect according to levels of physical and mental health status among community dwelling elderly persons. Of persons aged 65 and older who lived in Otsuki town, Kochi prefecture, and completed a questionnaire survey about health in February 1991, 1,470 survivors on the anniversary of the baseline survey were followed by the end of March 1996. Regularity of getting the examination was determined by the history of use of the examination in 1990 and 1991. Mortality reduction associated with annual use of the examination was observed in both the 65-74 and the 75 and older age groups and the benefit got smaller with advancing in age. In the 75 and older age group, the benefit from annual use of the examination was restricted to persons having no impairment in physical activities of daily living and those having favorable mental health. Biennial use of the examination was associated with the same amount of mortality reduction as annual use among persons having chronic conditions under treatment in the 65-74 age group. Regular use of the basic health examination at old ages is effective and the effectiveness varies by age range and level of functional health status.