Non‐participation in health checkup and Kihon Checklist predicts loss of certification‐free survival in community‐dwelling older adults

Aim Despite efforts toward health promotion and preventive care for older adults, including health checkups and postal Kihon Checklist survey, one fifth of community‐dwelling older adults do not participate in them. The aim of the present study was to examine the relationship between this non‐participation and the end of certification‐free survival in older adults. Methods In a cohort of 4120 older adults with no prior history of Long‐Term Care Insurance certification, the associations of non‐participation with risk of later death without certification and support/care‐need certification for 72 months were evaluated using Cox proportional hazards analysis. Results Of them, 4022 (mean age 72.7 years, 54.7% women) were followed up (97.6%). At baseline, 1072 received health checkups, 2085 replied to the Kihon Checklist alone and 865 did not participate. During 72 months, 310 deaths without certification and 701 certifications occurred. After adjustment, non‐participating individuals had significantly higher hazard ratios for death up to 72 months and for certification up to 36 months, compared with the other two groups. The Kruskal–Wallis test showed associations of increasing incidence of certification due to stroke in pre‐old (aged 65–74 years) men for 72 months, and due to arthralgia/fracture and dementia in old (aged ≥75 years) women for 24 months, with non‐participation in health promotions. Certified non‐participating individuals incurred higher estimated Long‐Term Care Insurance expenditure per person for 72 months, especially in pre‐old men and old women. Conclusions Health promotion by health checkup and even Kihon Checklist survey increases certification‐free survival in older residents, and decreases Long‐Term Care Insurance expenditure. Geriatr Gerontol Int 2019; 19: 1206–1214.