Frequency of Going Outdoors as a Good Predictors for Incident Disability of Physical Function as well as Disability Recovery in Community-Dwelling Older Adults in Rural Japan

Abstract

Older people go outdoors for various purposes, such as going shopping, taking a walk, visiting friends, and working in their garden or field. These activities are important for the maintenance of health and quality of life. With advancing age, there is a decline in the frequency of going outdoors. For example, in Japan more than 50% of older people aged 65-69 years go outside the house at least once a day, but among those aged 70-79 years and over 80 years, the respective percentages are less than 40% and 30%. 1 The clinico-epidemiologic relevance of the reduction in the frequency of going outdoors in community-dwelling older adults has not been well characterized. Getting outdoors requires a certain level of physical and mental Study PopulationThis was a two-year prospective study conducted in Yoita Town, a rural area in Niigata Prefecture, Japan. In 2000, the total population of this town was 7,493, and the proportion of older adults (i.e., 65 years and older) was 22.3%. A baseline survey was conducted in November 2000, in which all residents aged 65+ years (n=1,673) were invited to participate. Out of them, 1,544 (92.3%) persons responded to the survey. Among the 129 non-responders, 80 were institutionalized, 2 were relocated, 3 had died, and 44 refused to participate.A follow-up survey was conducted in October of 2002. Out of the initial 1,544 respondents, 1,283 (83.1%) participated again. Among the 261 non-participants, 57 were institutionalized, 12 persons were relocated, 81 persons had died, 88 refused to participate, and the remaining 23 persons did not participate for miscellaneous reasons.Trained personnel conducted standardized, face-to-face interviews with study subjects either at the community hall or in their homes, both at baseline and follow-up. The purpose of the study (collecting information on how to prevent disability among older people) was explained before interview, and all subjects participated voluntarily in accordance with a protocol approved by the Ethics Committee of Tokyo Metropolitan Institute of Gerontology. VariablesThe questionnaire comprised of sociodemographic, medical and physical function, cognitive, and psychosocial items. Sociodemographic variables included age, sex, education, principal occupation, and household structure. Medical and physical function variables included the basic activities of daily living (BADL), IADL, walking ability, visual and hearing ability, pain, chronic medical conditions, urinary incontinence, use of outpatient clinics, history of hospital admission, and frequency of going outdoors. Psychosocial variables included cognitive function, subjective health, contacts with intimate friends or relatives, participation in formal or informal community groups, and depressive mood state.In regard to the assessment of the frequency of going outdoors, subjects were asked the question, "How often do you usually go outside the house?" (Examples of going outdoors include going shopping, taking a walk, going to a hospital, or going out to work in your garden or f...

Self-reported hearing is associated with time spent out-of-home and withdrawal from leisure activities in older community-dwelling adults

“…Hence, spending time out-of-home provides more opportunities than merely staying at home for engagement in a variety of activities that help to maintain physical functioning and mental health. This is supported by previous studies which have found that, among older adults, homebound status predicts poorer future physical functioning [7][8][9] and poorer mental health [7] independently of baseline health.…”

“…Previous longitudinal studies have shown that being homebound may negatively affect older adults' mental health [7] and physical functioning [7][8][9], and increase the risk for death [7] independent of baseline health status.…”

Homebound status among middle-aged and older adults with disabilities in ADLs and its associations with clinical, functional, and environmental factors

“…Homebound status has been associated with loneliness, 1 depression, [1][2][3][4][5] comorbidity, 1,6 hospitalization, 4,7 and worse self-reported health status 1,8 ; moreover, it is a risk factor for mortality. 3,7,8 Previous research has estimated the prevalence of homebound status in the older population, 1,4,[8][9][10][11] using diverse definitions. 6 Several studies have defined being homebound as going out of the house once a week or less, with a prevalence ranging between 7.5% and 19% 1,4,9,11 ; the prevalence was below 5% when this frequency was less than once a week.…”

The Relation between the Maintenance of Physical Functions and Social Interaction among Community-dwelling Elderly People: A Six-year Follow-up Study

“…The promotion of a healthy, long-lasting life is an important concern in contemporary Japanese society [2][3][4] . The preservation of the physical functions of elderly people living in the community is crucial 5,6) .…”

“…In recent years, the continuous residence in a region by the elderly has become a focus of attention 2,3) . It is important to preserve the quality of life 4) .…”