Comprehensive health education combining hot spa bathing and lifestyle education in middle-aged and elderly women: one-year follow-up on randomized controlled trial of three- and six-month interventions.

BACKGROUND: This study attempted to clarify the duration of effects of 3- and 6-month comprehensive health education programs based on hot spa bathing, lifestyle education and physical exercise for women at 1-year follow-up. METHODS: We examined middle-aged and elderly women who were randomly divided into two groups and followed up them for one year. Spa programmers instructed subjects for one hour in lifestyle education and physical exercise and for one hour in a half bath (salt spring, temperature at 41.5 degrees C) once a week. The program for the 3-month group (n=19) was repeated in the 6-month group (n=14). The evaluation items were body mass index, PWC75%HRmax (by a bicycle ergometer as aerobic capacity), blood profiles (total cholesterol, HDL cholesterol, arteriosclerotic index, uric acid, and hemoglobin A1c), profile of mood states, self-rating depression scale, subjective happiness, pains in the knee and back, and active modification of lifestyle. RESULTS: There were significant interactions between groups and response over time to aerobic capacity, hemoglobin A1c, back pain, vigor, fatigue and self-rating depression (respectively, p<0.05). Duration of effects was longer for the 6-month intervention than for the 3-month intervention. CONCLUSIONS: Beneficial effects of 6-month intervention on hemoglobin A1c, aerobic capacity, pains in the back, vigor, fatigue and depression remained significant at the 1-year follow-up. Duration of effects was longer in the 6-month intervention than in the 3-month intervention.

[Scale for assessing interests of Japanese elderly people in their daily life].

OBJECTIVE: Programs to support independent living for elderly people are generally designed taking into account physical and psychological conditions. The interests of individuals are diverse even when the physical conditions are the same. Interests in daily life are important factors for adequate planning of the programs for independent living. The purpose of this study was to examine an evaluation structure of interests of Japanese elderly people in their daily life. METHODS: Focus group interviews were conducted to collect items for interests in daily life by several researchers targeting activity groups of elderly people. Eighteen items were extracted from a total of 50 following the principles: (1) Items with similar meanings are brought together; (2) Items which might have big differences in meaning depending on the subject were excluded; and (3) Items which were double barreled were excluded. The questionnaire 18 items were designed to give a 4-point Likart scale for answers from "very important" to "not important at all". The survey was conducted in 20 municipalities all over Japan in 2000. From residents aged 65 years and over, 6,094 individuals were selected randomly as the study population. RESULTS: Of 5,565 participants, 4,527 individuals answered all 18 items. "To have a good time with the family" was the favorite answer (54.8%), rated as "very important". Four factors (eigenvalue > 1) were extracted by applying principal component analysis: "to live with good communication", "to achieve one's purpose", "to live socially", and "to live comfortably". "To live with good communication" showed the highest score and "To live socially" showed the lowest score. CONCLUSION: With this scale, we could precisely determine the diversity of interests of Japanese elderly people in their daily life. We suggest that this scale might be useful not only to analyze the interests of individuals, but also to plan programs in terms of quality of life or independent living in late life.

[Factors associated with self-rated health for non-institutionalized aged persons].

OBJECTIVE: To determine factors affecting self-rated health among the non-institutionalized elderly in Japan. METHODS: In 20 municipalities in Japan, 6,094 persons aged 65 years and older who were not institutionalized were selected at random. A questionnaire survey was conducted from September through November 2000. The distribution of self-rated health was rated in terms of dependent variables, with odds ratios and their 95% confidence intervals calculated using unconditional logistic models. RESULTS: Of the study population, 5,565 persons (91.8%) responded to the survey. Of the respondents, 64.4% answered that they were healthy, while 28.8% were not. The necessity for periodical visit to hospitals and clinics, and lowering of the activity of daily living greatly lowered self-rated health. Compared with those who were 85 years of age or older, a high health status was observed among those aged between 75 and 84 years, but not those aged 65 to 74 years. Those who tried to have exercise periodically, who had a vice-leadership role in a group, who joined social activities, who lived what they considered a worthwhile life, and who had positive positive activities in daily life, had high levels of self-rated health. Joining social activities for passive reasons elevated the health as well as joining for active reasons such as "because it is fun." CONCLUSION: Even if the reason is passive, joining social activities may elevate the self-rated health levels of elderly people.