title: Effects of preventive health services on survival of the elderly living in a community in Osaka, Japan.
abstract: OBJECTIVE
  To examine the relationships between the use of preventive health services--such as health checks, basic health examination/cancer screening, and daily preventive health practices--and survival of elderly people living in the community.
  
  
  METHODS
  A cohort of elderly people aged 65 years and over living in Settsu City, Osaka was followed for 38 months. Data on the history of health management, disability scores, and psychosocial conditions were collected in October 1992 by interview during home visits.
  
  
  METHODS
  Of the 1491 people randomly selected from the computerised sex-age register at enrollment, 1473 were contacted and responses were obtained from 1405 (95.4%). They constituted the study cohort. Follow up was completed for 1325 (94.3%) (154 decreased and 1171 alive).
  
  
  RESULTS
  From the analysis using the Kaplan-Meier method and the log-rank test, female sex, younger age group (65-74 years), use of health checks, use of basic health examination and/or cancer screening, use of daily preventive health practices, less disability, taking part in social activity, and finding life worth living were univariately statistically significantly related to survival. The estimated survival rates were highest in those with regular health checks or daily preventive health practices before 59 years of age or both basic health examination and cancer screening. From the Cox proportional hazards model, use of health checks and use of daily preventive health practices remained as statistically significant factors associated with survival, controlling for other factors such as sex, age group, medical treatment, disability scores, and psycho-social conditions, and these hazard ratios (not used v starting at 59 years) were 0.41 (95% CI, 0.25, 0.66) and 0.52 (95% CI, 0.30, 0.88), respectively.
  
  
  CONCLUSIONS
  Health management efforts such as health checks and daily preventive health practices may increase survival in the elderly.
authors.affiliation: Department of Public Health, Osaka University Medical School, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Nakanishi
authors.forename: K
authors.initials: K
authors.lastname: Tatara
authors.forename: T
authors.initials: T
authors.lastname: Tatatorige
authors.forename: S
authors.initials: S
authors.lastname: Murakami
authors.forename: F
authors.initials: F
authors.lastname: Shinsho
mesh_terms: D000368:Aged / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007564:Japan; D008297:Male; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011788:Quality of Life; D012944:Social Support; D016019:Survival Analysis; D015996:Survival Rate