Lifestyle-related diseases among the elderly have been brought to light by many investigaters. However, it remains unclear whether age-related frailty in the basic activities of daily living (ADLs) affects mortality independently of lifestyle. To clarify the relationship of lifestyle and frailty to elderly mortality, we conducted a three-year prospective study on 66 elderly people with reduced vital functions newly certified as requiring nursing care (frail elderly) and 72 elderly people living on their own (independent elderly) in Unnan City, Shimane Prefecture. The mortality rate for the frail elderly tended to be higher than for the independent elderly. However, this difference was not statistically significant. Gender was the only factor related to mortality in the frail elderly, who had advanced frailty. Furthermore, mortality rates were significantly higher for men than women. No relationship was observed between lifestyle and frailty. In the independent elderly, smoking and unstable gait, respectively, were significantly related to mortality. The present findings indicate that lifestyle and frailty are independently related to elderly mortality.

  A long-term care insurance law was enacted in 2000 for the purpose of socializing elderly care. Since then, the Japanese government has come to shoulder an unexpected financial burden because of a large increase in the number of the slightly frail elderly. Based on the need of frail elderly individuals, five care levels were established by the insurance law. Predictive factors for changes of the care level of such individuals are not yet clear. We conducted an analysis of the relationship between changes of care levels of frail elderly people residing in Izumo City, Shimane, and such factors as gender, age, activity of daily life (ADL) and care services utilization, in a cohort study of 1,965 certified elderly individuals in 2000, and of 2,547 such individuals in 2002. We arbitrarily set the care levels into three categories:maintenance/improvement, deterioration, and death; we then tracked the care levels of each cohort over a two-year period. At the end of 2-year tracking, 39.9% of the 2000 cohort were in the maintenance/improvement level, 37.7% in deterioration and 22.4% had died; for the 2002 cohort, the results were 51.8%, 25.8% and 22.5%, respectively. The elderly in all care levels in the 2002 cohort, especially those with the higher ADL (support necessary and care level 1), improved their ADL but showed no significant differences in death rate, compared with the 2000 cohort. The certification method of care level for long-term care did not substantially change between 2000 and 2004. The improvement of care level change in the 2002 cohort was not related to either level of care or dementia, or to utilization rates of services at home. Therefore, the attitude of the users of services and the quality of home care may have contributed to the improvement of care levels from 2000 to 2002.

　　This study aimed at clarifying the effects of intervention with the composite Dementia Prevention Program. Subjects were 46 elderly people who had participated in the program. The study method included intervention trials to test the effects on the changes in BMI, physical function, and cognitive function of the program participants before and after the trial. Those aged 75 and up (old-old participants) had significantly stronger grip strength before the intervention than those below the age of 75 (young-old participants), but there was no difference in cognitive and physical functions between old-old and young-old participants. The average number of steps taken in the young-old group had significantly increased from approximately 4,000 steps before intervention to approximately 7,000 steps after intervention. When it comes to physical functions, the time taken for the 5-m walking exercise was significantly shortened from 3.8±0.8s to 3.5±0.5s in the young-old subjects; a change from 3.5±0.8s to 3.7±1.0s was observed for TUG in the young-old subjects and from 4.1±1.0s to 3.6±1.0s in old-old subjects. As regards cognitive function, episodic memory of the young-old subjects improved significantly, from 47.9±7.5 points before intervention to 56.5±8.8 points after intervention. The improvement in the old-old subjects was gradual. Episodic memory was improved without bearing on the changes shown in the 5-m walking tests (β＝-0.751, p＝0.020). The physical functions and episodic memory in cognitive function had both improved. This study suggested early intervention could increase the dementia prevention effect.