[A longitudinal study on health status and factors relating to it in elderly residents of a community].

The purpose of the present study is to clarify the relationship of physical, sociological and psychological factors to health status, the decline in activities of daily living (ADL) and death, in community elderly residents, by analysis of participation or non-participation in a comprehensive health survey. Subjects were 737 elderly residents (306 males, 431 females) aged 70-75 years living at home in Fujishimamachi, a rural town of Yamagata prefecture. A baseline comprehensive health survey including door-to-door survey for non-respondents to the comprehensive survey, was performed in 1986, and repeated at follow-up five years later. The results obtained are as follows: 1) In both sexes, survival rate was highest in the respondents to the comprehensive health survey and lowest in non-respondents to either surveys. Causes of death, place of death, the bedridden period prior to death and ADL before bedridden status were different among those three groups. 2) Factors predisposing to ADL decline (all subjects had competent normal ADL at the baseline survey) were low self-rated health, low score of the Index of Competence developed by Tokyo Metropolitan Institute of Gerontology (the TMIG Index of Competence), inactivity in daily life especially in household affairs and social activities. The predicting factors of death were almost similar to those of ADL decline mentioned above. The relationship of the factors to health status was stronger in those who had to be surveyed door-to-door compared to respondents to the comprehensive health survey, and in women than in men. 3) Blood pressure, ECG findings, retinal findings, hand grip, memory as measured by the Benton Visual Retention Test showed no relationship to either ADL decline or mortality. 4) The present study shows that subjective health and functional capacity are useful to predict the outcome of community elderly residents. Further, life styles and health behavior have a significant effect on outcome prediction.