[Chronological evaluation of physical, psychological and social health of urban elderly dwellers over 6 years and assessment of causal inter-relationships].

Objectives: The purpose of this study is to make a chronological evaluation over 6 years of physical, psychological and social health of urban elderly dwellers.

Methods: A questionnaire survey was conducted with all urban elderly dwellers of 65 years old or more in A City in September, 2001. Answers were obtained from 13,195 people (response rate of 80.2%) in the first survey. Then 3 year and 6 year follow-up surveys of 2,375 members were performed in September 2004 and 2007. Causal relationships were analyzed using a Structural Equation Model based on the Cross-Lagged Effects Variation Model.

Results: According to this research, a chronological six year trend in ADL (Activities of Daily Living) was found for "physical factor" (" " means latent variable) as an observed variable, with a shifted from 91.0% to 82.9%. A trend for self-rated health with healthy as an observed variable of "psychological factor" was similarly apparent, shifting from 85.4% to 77.0%. "Social factor" conducted on the follow-up survey in 2007 was significantly affected by the "psychological factor" investigated in 2001 and "physical factor" in the follow-up survey in 2004, indirectly based on the Cross-Lagged Effects Variation Model. "Social factor" totals of 25% for men and 19% for women were explained by this model with high validity levels (NFI = 0.935, IFI = 0.950, RMSEA = 0.036).

Conclusion: It was suggested that social health was affected by psychological health directly and physical health indirectly during six years follow-up of urban elderly dwellers. Future research is needed to encompass other generations and also to improve the external validity of the results.