A mortality comparison of participants and non-participants in a comprehensive health examination among elderly people living in an urban Japanese community
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Background and aims: Recent studies have revealed that there are critical differences between participants and non-participants in health examinations. The aim of this study was to examine mortality differences between participants and non-participants in a comprehensive health examination for prevention of geriatric syndromes among community-dwelling elderly people, using a three-year prospective cohort study. Methods: The study population included 854 adults aged 70 to 84 at baseline. The following items were all studied: the status of participation in the comprehensive health examination as an independent variable, age, gender, number of years of education, living alone, presence of chronic diseases, experience of falls over one year, history of hospitalization over one year, self-rated health, body mass index, instrumental activities of daily living, and subjective well-being as covariates; and all-cause mortality during a three-year follow-up as a dependent variable. Results: In an adjusted Cox’s proportional hazard regression model, the mortality risk for participants in the comprehensive health examination was significantly lower than that of non-participants (Risk Ratio (for participants)=0.44, 95% confidence interval=0.24 to 0.78). Conclusions: The present study shows that there is a large mortality difference between participants and non-participants. Our findings suggest two possible interpretations: 1) There is a bias due to self-selection for participation in the trial, which was not eliminated by adjustment for the covariates in the statistical model; 2) There is an intervention effect associated with participation in the comprehensive health examination which reduces the mortality risk.
KeywordsAll-cause mortality comprehensive health examination for the elderly prevention of geriatric syndromes and long-term care dependence self-selection bias
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- 3.Reuben DB. Geriatric syndromes. In: Beck AC, ed. Geriatric Review Syllabus, 2nd Ed. New York: American Geriatrics Society, 1991: 117–231.Google Scholar
- 7.Suzuki T, Iwasa H, Yoshida H, et al. Comprehensive health examination (“Otasha-Kenshin”) for the prevention of geriatric syndromes and a bed-ridden state in the community elderly. 1. Differences in characteristics between participants and non-participants. Nippon Koshu Eisei Zasshi (Japanese Journal of Public Health) 2003; 50: 39–48.Google Scholar
- 8.Iwasa H, Suzuki T, Yoshida H, et al. Cognitive function as the factor determining higher-level competence in community-dwelling elderly: comprehensive health examination for the community elderly for the prevention of the geriatric syndrome and a bed-ridden state (“Otasha-kenshin”). Nippon Koshu Eisei Zasshi (Japanese Journal of Public Health) 2003; 50: 950–8.Google Scholar
- 10.Shinsho F, Fukuda H, Murakami S, Takatorige T, Nakanishi N, Tatara K. Analysis on the relationship between use of health check-ups and medical care by elderly patients. A study on urban cities with high health check-up rates. Nippon Koshu Eisei Zasshi (Japanese Journal of Public Health) 2001; 48: 314–23.Google Scholar
- 11.Nakahara T. Public health policies and strategies in Japan. In: Detels R, Holland WW, McEwen J, Omenn GS (Eds.), Oxford Textbook of Public Health, 3rd Edition. New York: Oxford University Press, 1997: 323–9.Google Scholar
- 22.Shimonaka Y, Nakazato K, Kawaai C, Sato S, Ishihara O, Gondo Y. The effect of life events on psychological well-being among Japanese middle-aged and elderly. In: Shibata H, Suzuki T, Shimonaka Y (Eds.), Facts research and intervention in geriatrics 1997. Longitudinal Interdisciplinary Study on Aging. Paris: Serdi Publisher, 1997: 137–46.Google Scholar
- 23.Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.Google Scholar
- 29.Saltvedt I, Saltnes T, Mo ES, Fayers P, Kaasa S, Sletvold O. Acute geriatric intervention increases the number of patients able to live at home. A prospective randomized study. Aging Clin Exp Res 2004; 16: 300–6.Google Scholar