The association of health management with the health of elderly people.

To assess the effect of health management on the health of a community-based sample of people aged 65 years and over, a cross-sectional survey was carried out of 1491 people aged 65 years and over (22.3%) randomly drawn from the computerized age-sex register in Settsu City, Osaka. A total of 1473 people were contacted and complete responses were obtained from 1383 of these (a response rate of 93.9%). The proportion of the sample who had been receiving regular health checks or had been taking care of their health decreased with a decline in Activities of Daily Living (ADL). This trend was more pronounced among the younger subjects aged 65-74 years. For disability, those who had been receiving regular health checks had lower overall severity scores in both the 65-74 years and 75 years and over age groups. There were no significant differences in the severity scores for those practising health maintenance (watching diet and exercise) in both age groups, but those practising health maintenance tended to have less disability. The percentage of those who were socially active and thought life worth living also decreased with the decline in ADL for both age groups. These psycho-social factors were also associated with a lower overall severity score. A multiple linear regression analysis showed that health checks, social activity and the presence of aspects of life subjectively evaluated as making it worth living (Ikigai) were shown to have statistically significant negative associations with disability when other factors were controlled for.