This study evaluated the relation between physical fitness and survival. This prospective cohort study included 74–88-year-old women who were living at home and who reported no disability in activities of daily living. Subjects completed physical fitness tests assessing walking ability, muscular strength, flexibility, agility, and balance. They were administered a follow-up interview 14 years later. Of 63 older women, 58 died during that 14-year period. Among the 16 physical fitness measurements, significant association with survival time was found for 11 measurements using Cox proportional hazards model (Adjusted for age, BMI, and TMIG index of competence score). Among them, maximum walking time was an indicative main physical fitness factor for predicting the survival of elderly women. The hazard ratio per 1 s of 10m maximum walking time was 1.93 (95% Confidential Interval [CI], 1.54–2.41). Among muscular strength, flexibility, agility, and balance, the most influential physical fitness element to survival was agility (nerve reaction time). Therefore, the functional decline of the nervous system is expected to affect survival strongly. When 10 m maximal walking speed is 8.5 s or more, the median survival time of elderly women is 6.75 years (95%CI, 6.25–7.67), but if the time is less than 8.5 s it is 11.58 years (95%CI, 10.25–13.08, p<0.0001; log-rank test). The ability to move rapidly is identified as the main physical fitness factor associated with survival.

Objective: In the treatment of patients with schizophrenia, pro re nata (PRN) drugs are commonly prescribed for medical indications such as agitation, acute psychiatric symptoms, insomnia, and anxiety. However, high-quality evidence supporting the use of PRN medications is lacking, and these drugs are administered on the basis of clinical experience and habits. Therefore, the actual use of psychotropic PRN drugs and its influence on the patients’ outcomes need to be investigated. Methods: This study included 205 patients who underwent inpatient treatment for schizophrenia. We investigated the prescription of psychotropic drugs before admission and at discharge, as well as the dosing frequency of PRN drugs during hospitalization. We also examined the influence of psychotropic PRN drug use on hospitalization days, antipsychotic polypharmacy, and readmission rates. Results: Patients who used psychotropic PRN drugs during hospitalization had significantly longer hospitalization days (p = 7.5 × 10−4 ) and significantly higher rates of antipsychotic polypharmacy (p = 2.4 × 10−4 ) at discharge than those who did not use psychotropic PRN drugs. Moreover, a higher number of psychotropic PRN drugs used per day was associated with higher readmission rates within 3 months of discharge (p = 4.4 × 10−3 ). Conclusion Psychotropic PRN drug use is associated with prolonged hospitalization, antipsychotic polypharmacy, and increased readmission rates in inpatients with schizophrenia. Therefore, psychiatric symptoms should be stabilized with regularly prescribed medications without the extensive use of psychotropic PRN drugs. Moreover, a system for monitoring and reexamining PRN drug use needs to be established.