Public health approach to preventing frailty in the community and its effect on healthy aging in Japan

Abstract

Effective methods to prevent or delay the onset of frailty are urgently required in aging societies, such as Japan. As a public health approach, we carried out a 10-year community intervention for frailty prevention, and examined its impact on healthy aging among older adults. The target population was all residents aged 65 years or older in the town of Kusatsu, Gunma Prefecture, Japan. For community empowerment, we organized a community forum, and discussed how to address the frailty issue in the community. For primary prevention, we attempted to promote physical activity, nutrition and social participation by means of a health education program to motivate older residents. For secondary prevention, we added a comprehensive geriatric assessment to routine annual health check-ups, which helped older participants improve self-care ability of functional health. High-risk persons were screened and encouraged to participate in a frailty prevention class with a multicomponent program. The attendance rate at annual health check-ups has remained constant at 30-40% of the target population; however, over 80% of the population appeared at least once during the 10 year-period. For evaluation, we carried out biennial health monitoring surveys, and reviewed the records of the local Long-Term Care Insurance system. The functional health of older residents was significantly improved as a result of the interventions; the incidence rate of Long-Term Care Insurance system certification in the old-old population (age ≥75 years) was decreased by one second, and healthy life expectancy at age 70 years was extended by 1.2 years for women and 0.5 years for men. Such trends greatly contrasted with those in the reference area, and Japan as a whole. In summary, the present public health approach to frailty prevention appears to promote healthy aging among older adults. Geriatr Gerontol Int 2016; 16 (Suppl. 1): 87-97.

Is It Time to Begin a Public Campaign Concerning Frailty and Pre-frailty? A Review Article

“…The 10-year community-based intervention to prevent frailty in Kusatsu (Japan) effectively improved the functional status of older residents in this area (Shinkai et al, 2016). The project included physical, nutritional and social aspects and targeted enhancing human connections and encouraging participants to continue the group activities after the end of the project.…”

The role of Perioperative Surgical Home on health and longevity in society: importance of the surgical prehabilitation program

“…Frailty is an age-related syndrome characterized by decreased reserve and resistance to stressors and classified into physical, social and cognitive frailty, all of which increase the risk of adverse health outcomes, such as falls, disability, long-term care, and mortality [11,12]. The terms of frailty and locomotive syndrome are similar, but locomotive syndrome is specified as physical frailty with musculoskeletal disease without social or cognitive frailty ( Fig.…”

“…The median survival of people with a low risk profile (healthy lifestyle behaviors, participation in at least one leisure activity, and a rich or moderate social network) was 5.4 years longer than those with a high-risk profile. Shinkai et al [11] examined the impact of 10-year community intervention to promote physical activity, nutrition and social participation by means of a health education program on healthy aging among older adults aged ≥65 years, and demonstrated that such an approach was effective in preventing frailty and promoting healthy aging.…”

Challenges of population ageing: putting frailty as a cornerstone of health and social care systems

“…From the health promotion perspective, frailty may be prevented or its onset retarded by nutrition and physical activity [11][12][13]. The frailty phenotype may be detected in community screening using a simplified questionnaire without the need for measurements or administration by specialist healthcare personnel, incorporated as a part of general practice routine assessment, or part of the health and social needs assessment [14,15].…”