Purpose
Long-term elderly care of the elderly (Jap. “Ro-ro Kaigo”) is a serious problem in Japan. The purpose of this study is to reveal the current state of Ro-ro Kaigo and to evaluate the factors affecting the burden on elderly caregivers.
Method
Ninety-three households of elderly subjects participated in this study. We conducted semi-structured interviews concerning the life styles of caregivers, the burden on caregivers and the condition of elderly subjects requiring long-term care.
Results
Eighty percent or more of the caregivers were spouses, and about 40 percent of the households were not supported by family members living separately.
Moreover, the burden of care borne by the caregivers was correlated with "hours spent daily providing care", "ADL of elderly requiring long-term care" (p<0.001), "hours of sleep" (p<0.01), "subjective feeling of wellbeing", "support from family living separately", and "behavioral disorders of dementia" (p<0.05).
Conclusion
These data suggest that supporting "health promotion", "reduction of hours of caregiving", "reduction of amount of assistance with toilet activity of care recipients", and "securing enough hours of sleep" were important for maintaining home care in Ro-ro kaigo.

This study examined relationships between physical activity and sleep relative to leisure-time, household, and occupational physical activity in community-dwelling, older adults. From 3,000 randomly chosen community-dwelling, adults, aged 65-85 years, we recruited 509 eligible subjects (mean age 73.2 ± 5.1 years). We assessed nocturnal sleep duration, sleep onset latency and subjective sleep quality over the previous month through a questionnaire. Physical Activity Scale for the Elderly was used to assess leisure-time, household, and occupational physical activity. Items pertaining to sleep were expressed as dichotomous variables (good/poor), and each physical activity score was divided into two categories based on activity level. To investigate the relationship between sleep (dependent variable) and physical activity (independent variable), we used a logistic regression analysis, controlling for age, gender, living arrangement, depressive symptoms, and cognitive function. Prolonged sleep latency was significantly related to no participation in low intensity exercise (OR 2.14; 95% CI 1.42-3.21) and muscle strength exercise (OR 1.99; 95% CI 1.06-3.74). Our data suggest that not participating in low intensity exercise or muscle strength exercise may be associated with difficulty initiating sleep in older adults.

Purpose : The purpose of this study was to examine quantitative activity and determine characteristics using an activity meter in community-dwelling frail elderly people.
Methods : We monitored 25 community-dwelling elderly of support-requiring condition level1 and 2 by attaching activity monitoring evaluation system (A-MES) and measured physical activity (PA) over 24 hours as well as body information, care information, everyday life function.
We examined according to sex / care category using obtained results.
Results : Women's standing position time and walk time were significantly longer, and men's daytime lying position and sitting position time were significantly longer.
Also, in persons of support-required condition level 2 there was a significantly higher number of posture changes from sitting position to daytime lying position.
It was suggested that a quantitative evaluation of the PA could lead to discovery of activity decrease in home life in association with each PA item and low rank criteria of the functional independence measure (FIM).
Securing of enough walk time and shortening of the lying position time in the daytime tend to be important for self-care ability and maintenance of locomotiveness.
Conclusion : It was suggested that the evaluation of shortening the lying position time in the daytime and increasing the amount of position changes will supplement a decrease of the PA, which is related to preventing decrease in activity.

Introduction : In recent years, aging of the population and the low birth rate are progressing rapidly in China, resulting in an increase in the number of elderly individuals engaged in the long-term care of an elderly family member (Jap. “Ro-ro kaigo”). We conducted a cross-sectional study to evaluate the current Ro-ro kaigo situation and the factors related to the quality of life of the caregivers in two ethnic groups : Han Chinese and Korean Chinese.
Methods : Fifty-one Korean Chinese households and sixty-one Han Chinese households (≥60 years old) in Changchun or Yanji of Jilin Province, China, participated. The quality of life of the caregivers was measured using the SF-8 health survey questionnaire. We conducted a multiple regression analysis to investigate the factors related to the caregivers' quality of life.
Results : There was no significant difference in gender ratio and caregiver age between the two ethnic groups. In both groups, a spouse was often the cargiver. Factors related to the caregivers' quality of physical life were as follows. For the Korean Chinese : the caregivers' subjective feeling of health, and the number of the caregivers' diseases ; for the Han Chinese : the caregivers' subjective feeling of health, the care period, and the frequency of participation in community activities. Factors related to the caregivers' quality of the mental life were as follows. For the Korean Chinese : the frequency of consultation for nursing-care problems ; for the Han Chinese : the care-recipients' educational history, and having assistance on ceremonial occasions.
Conclusion : The results suggest that good health is important to maintain the quality of physical life of elderly caregivers in both ethnic groups. As factors related to the physical and mental summary scores differed by ethnicity, support for the caregivers that considers their ethnic background is necessary.

Introduction: The purpose of this study was to investigate the effects that a group exercise activity managed by elderly volunteers would have on the physical function of older women after they participated in a formal exercise program taught by fitness experts.

Methods: Subjects were 47 community-dwelling older women who had completed a 3-month exercise program led by expert instructors in Kasama City, Ibaraki. After completing this exercise program, 28 subjects continued to participate in a group exercise activity led by elderly volunteers for approximately 11 months. The remaining 19 subjects did not join the group activities after the formal program. In both the initial, expert-led exercise program and the subsequent, volunteer-led group activity, subjects mainly engaged in the square-stepping exercise, which is a novel exercise for improving lower extremity physical function. In order to assess participants' physical function, we conducted five physical performance tests at both the baseline and follow-up; the former is the last day of the exercise program and the latter is approximately a year after the baseline.

Results: Two-way ANOVA demonstrated a significant interaction in the timed up and go test (P=0.003). The performance of subjects who had participated in the volunteer-managed group activity improved between the baseline and follow-up tests (P=0.007).

Conclusion: Participating in a group exercise activity managed by elderly volunteers can improve mobility skills of older women who had previously completed a formal exercise program led by expert instructors.

Introduction: The present study was conducted to identify the influence of self-efficacy score and having an action plan on “stages of change” for exercise after one year.
Methods: Physical functions and psychological factors at baseline and after one year in 105 elderly individuals who participated in a preventive care program. The subjects were classified into four groups by using the stages of change scale for physical activity.
The cause related to impact on physical activity and action stage change (stage) after one year later with having or not having action plan for preventive care program in elderly at home in community as well as sense of self efficacy was investigated.
Results: Self-efficacy scored significantly higher in the usual activity group with continuity of stage activity both at baseline and one year later. The relative risk of having an action plan at baseline for exercise after one year was 2 . 90 (95% CI: 1.52-5.55). This value significantly influenced the maintenance of physical activity after one year.
Conclusion: The results of this study suggest that showing an action plan was effective in maintenance of physical activity.

Purpose: In this study, we performed a longitudinal examination of the occurrence of homeboundness among community-dwelling elderly individuals and changes in associated factors, including the sense of coherence (SOC).Methods: A questionnaire survey was conducted targeting community-dwelling elderly individuals to evaluate homebound status, a basic checklist (CL), and SOC. Among these individuals, frail elderly people who maintained a non-homebound state were extracted and a follow-up survey was carried out one year later. Those who maintained the non-homebound state one year later were classified into the maintenance group and those who became socially withdrawn were classified into the transition group. Factors predicting the homebound state one year later were examined using multiple logistic regression analysis. Furthermore, the changes in CL and SOC between the transition and maintenance groups were compared.Results: In the transition group, motor function, cognitive function, and sense of manageability on the initial survey were significantly lower than those in the maintenance group. Significant correlations were noted in the homebound transition group with lack of money management (OR: 3.04, 95% CI: 1.19-7.82) and a declined sense of manageability (OR: 0.82, 95% CI: 0.69-0.99). Depression and the sense of manageability had also significantly deteriorated one year later compared with those in the maintenance group.Conclusion: This study suggests that individuals who transition to a state of homeboundness have a slightly lower SOC than those who maintain their non-homebound status.