Self-Management Group Exercise Extends Healthy Life Expectancy in Frail Community-Dwelling Older Adults

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.

Physical activity and mortality in older patients with a pacemaker

“…Increased activity levels of older adults reduce the incidence of disability. 20 However, further study is required to investigate whether an increase in physical activity for such patients improves prognoses.…”

Comparing the differences in three measures of healthy life expectancy, effects of mortality, and proportions of unhealthy people according to prefectures in Japan: An Ecological study

“…Moreover, the three measures of HLE were not distinguished and tended to be treated as a single indicator. [9][10][11][12] It has also been reported that while LE and HLE are consistently linearly extended in both sexes, the percentage of unhealthy periods in LE has also increased; 13 therefore, the extension of HLE is strongly influenced by the extension of LE. In policymaking, it is important to clarify the relationships between length of HLE, mortality, and the proportion of unhealthy people.…”

Comparing the differences in three measures of healthy life expectancy among prefectures in Japan.

“…Moreover, the three measures of HLE were not distinguished and were treated as single indicators. [9][10][11][12] LE-SH and DFLE-AL can only be calculated every three years because the basic data for calculations are extracted from a triennial survey conducted by the Japanese government. Though Life Expectancy (LE) and HLE are consistently linearly extended in both sexes, the percentage of unhealthy periods in LE also increased.…”