Agricultural activities reduce the risk of requiring long-term care among older Japanese

Abstract Introduction Controlling the risks that lead to requiring long-term care for the older adults is a crucial medical and socio-economic issue. This study investigated the impact of agricultural activities (AAs) on the risk of requiring long-term care. Methods A 5-year follow-up was conducted on 1,009 healthy individuals aged 65-80 years (mean age 72 years; 44% men) living in a rural area (Wakayama, Japan). Requiring long-term care was assessed as requiring support or nursing care (RSNC) according to the Japanese criteria. Health status including frailty and metabolic syndrome were also assessed using Japanese criteria. Work status and lifestyle habits were assessed using self-administered questionnaires. The main outcome was the probability of RSNC. COX proportional hazards regressions were performed, stratified by occupation (agricultural worker or other) or frequency of AAs (none, less than or >150 days/year), adjusted for sex, age, frailty, metabolic syndrome and household as possible confounding factors. Results Approximately 35% of the participants were in agriculture, forestry, and fisheries as occupation, and 78% engaged in AAs. A total of 85 participants RSNC and 39 deaths were observed during the follow-up. The cumulative survival probability did not differ according to occupation or frequency of AAs, whereas the probability of RSNC was significantly lower in participants engaged in AAs (hazard ratio 0.37 [95% CI 0.22, 0.62]; <150 days/year, 0.29 [95% CI 0.17, 0.50]; >150 days/year). Participants engaged in AAs were significantly more likely to engage in low- and vigorous-intensity physical activity, and to participate in industry and community organizations and relating events. Conclusions These findings suggest that AAs may promote a physically and socially active lifestyle, independent of frailty or metabolic syndrome, and reduce the risk of RSNC. Key messages • Prevention of long-term care is important in the older population. • A lifestyle associated with agricultural activities may contribute to healthy aging.