This study sought to investigate the association between preliminary advance care and decision making, and care planning and participation in community activities, among the rural and advanced aged community in Japan in efforts to enhance advance care planning when it is direly needed. Subjects were 920 people aged 40-74 years in rural areas identified by cluster sampling and who had consented to participate in the survey. The 15 survey items included sex, age, experiences of care for the elderly, degree of health anxiety, degree of participation in community activities, and self-measurement of home blood pressure. Univariate analysis and binary logistic regression analysis using a step-wise principle were used throughout the survey. Of the 920 participants, 23.8% and 25.0% had previously made decisions on care planning and advance care planning, respectively, which were mutually associated, although decision making on care planning did not necessarily presuppose advance care planning. Odds ratios were high for decision making on care planning, awareness of care planning, advance care planning, and conversations about medical checkups. Also, odds ratios were high for advance care planning on awareness of care planning, decision making on care planning, and high participation in community activities. The results suggest that to help participants “make a decision” or undertake “advance care planning”, it is important to have opportunities to participate in community activities and/or converse with another resident about medical checkups.