手段的日常生活活動低下者割合の市町村間格差は存在するのか─JAGESプロジェクト─

Are there inter-municipality differences in the ratio of individuals with limited activities of daily living?: The JAGES Project

要旨：地域づくりによる介護予防戦略の開発に向け，地域在住高齢者のIADL低下者割合などの市町村間格差とその関連要因を検討した．日本老年学的評価研究データを用い，88,370名（53市区町村）を対象に，老研式活動能力指標IADL 5項目いずれかの非自立者割合と関連要因の地域相関分析を行った．前期高齢者のIADL低下者割合は市区町村間で7.9〜23.2％の差があり，関連しうる心理社会的指標など多指標でも2〜17倍の差があった．特に女性でスポーツや趣味の会への参加者割合が高い市町村はIADL低下者割合が低いという負の関連を認めた．今後多面的な検証は必要だが，作業療法が重視する趣味や集団活動を促す地域づくりが，介護予防に寄与すると考えられた．

　We investigated inter-municipal differences in the ratio of community-dwelling older adults with limited instrumental activities of daily living (IADL) and relevant factors with the aim of forming a strategy for preventing the need for long-term care through community development. We used the Japan Gerontological Evaluation Study (JAGES) data for 88,370 individuals in 53 municipalities to perform a regional correlation analysis on the ratio of non-independence in any of the 5 IADL items of a gerontology index of competence and relevant factors. The ratio of under-75 older adults with limited IADL ranged from 7.9-23.2% among municipalities, and a 2-17 times difference was seen in many indices including potentially relevant psychosocial indicators. Of particular note, municipalities with a higher participation rate in sports, and interest groups by women had a lower proportion of women with limited IADL, showing a negative relationship. Although multi-faceted studies are needed, these findings suggest that hobbies that are the focus of occupational therapy and community development to promote group activities may help prevent the need for long-term care.