Abstract
Preventing frailty and its adverse health outcomes is crucial in countries with a large elderly population, such as Japan. Since the long-term care insurance (LTCI) system was launched, the number of certified older adults with LTCI service requirement has continued to increase. This is a serious problem, because the LTCI service requirement certification is equivalent to disability. The aim of this study was to evaluate the effect of a self-management group intervention on new LTCI service requirement certifications in community-dwelling older adults in Japan. We analyzed the cohort data from a prospective study. In this study, we recruited community-dwelling adults aged 65 years and older who were independent in a city in Kyoto prefecture in 2012. The subjects in the participation group (n = 1620) attended 60-min group training sessions once or twice every two weeks from December 2012 to December 2016. The exercise sessions consisted of mild-intensity aerobic exercise, mild strength training, flexibility and balance exercises, and cool-down activities. These exercise classes were facilitated by well-trained volunteer staff. The outcome measure was the number of new LTCI requirement certifications during a four-year follow-up period. During the four-year follow-up period, 247 subjects (15.2%) in the participation group and 334 (20.6%) in the control group were newly certified for LTCI service requirements. The hazard ratio for new LTCI service requirements in the participation group compared with the control group was 0.73 (95% CI = 0.62–0.86) in the four-year follow-up period. These results indicate the usefulness of self-management group exercise to reduce the incidence of disability in older adults. Thus, increasing self-management group activities in each community should be encouraged.
Highlights
Frailty is a risk factor for disability, hospitalization and mortality [1,2,3,4]
These results indicate the usefulness of self-management group exercise to reduce the incidence of disability in older adults
The exclusion criteria were older adults who had already been designated as being activities of daily living (ADL)-dependent and who were already eligible to receive the benefits of the long-term care insurance (LTCI) services
Summary
The prevalence of frailty is approximately 10% in the community-dwelling older population [2,4,5], and this high prevalence is a crucial social issue in countries with large elderly populations, such as Japan. In 2000, the Japanese government launched the long-term care insurance (LTCI) system. This system provides friendly services to older adults who are certified as requiring support or care according to their level of frailty or disabilities [6]. Since the LTCI system was launched, the number of certified disabled older adults has continued to increase in Japan. The increasingly disabled older population has led to increasing social security expenses, which is a major issue in Japan
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