Effects of preventive long-term care on physical and psychological health status for the elderly: Evidence from a "Salon for the Elderly" in Abashiri City.

Objectives The study objectives were to clarify the characteristics of elderly persons participating in a preventive long-term care program (PLTC) organized by a local government, and to verify how the program would affect the health status of the elderly.Methods We made secondary use of individual-level micro-based longitudinal data from the "Health and Living Survey of Elderly Persons", conducted in Abashiri City of Hokkaido Prefecture in two consecutive years (2013 and 2014). The treatment group included subjects who joined the PLTC program, agreed to the survey, and responded to the survey in both 2013 and 2014. The control group included residents ≥65 years of age who were randomly chosen from a basic resident register, who had never participated in the PLTC program and had also responded to both periods of surveys. The sample size of the treatment group was 157 and that of the control group was 252. We applied a propensity-score (PS) matching method to verify the effects of PLTC programs on the health status of the elderly. The covariates were demographic and socio-economic characteristics in the baseline period (2013), such as sex, age, living arrangements, marital status, working status, monthly mean household expenditure, distance to the nearest PTLC program site (called "Fureaino-ie"), and health status such as self-rated health status, Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), Kessler 6 (K6), and outpatient status. The outcome was that the health status of elderly persons was the same as the above in 2014.Results From basic statistics in 2013, older women who live near to "Fureaino-ie" are more likely to join a PLTC program. The mean monthly expenditure of participants would be approximately 20,000 ¥, which tended to be lower than that of non-participants. However, for living arrangements and marital status, we did not observe statistical significance between treatment and control groups. Regarding health status in 2013, participants tended to be healthier than non-participants. PS matching results indicated that almost all the characteristics became balanced.Conclusion The PLTC program in Abashiri City would contribute to improved psychological health in the elderly. However, study observation periods are only 2 years, which might not be long enough to observe the effect of the program on physical health. Therefore, further study should be conducted for longer periods of follow-up and for intervention by specialists.