Elderly Health Check-Up and Functional Disability or Death in Adults 75 to 84 Years: A Target Trial Emulation.

Authors

Ryohei Yamamoto, Hajime Yamazaki, Hiroaki Nakagawa, Akihiro Ozaka, Sho Sasaki, Sayaka Shimizu, Sugihiro Hamaguchi, Shunichi Fukuhara

Published in

Journal of the American Medical Directors Association. Volume 27. Issue 11. Pages 106473. Sep 03, 2026. Epub Sep 03, 2026.

Abstract

To estimate the effect of initial Elderly Health Check-up (EHC) attendance on the 5-year risk of functional disability or death in community-dwelling older adults in a setting where preventing entry into long-term care (LTC) is a primary health-policy goal.
Sequential target trial emulation using a population-based cohort.
Community-dwelling adults aged 75 to 84 years without functional disability and without recent EHC participation, drawn from the Sukagawa Study, a population-based cohort in Sukagawa City, a rural municipality with an aging population in Fukushima Prefecture, Japan, between April 2018 and March 2021.
We compared initial EHC attendance within a 3-month grace period with nonattendance. The primary outcome was a composite of incident functional disability (LTC certification at care-need level ≥3) or death over 5 years; secondary outcomes were each component, with death treated as dependent censoring for disability. Five-year risks were estimated by inverse probability-weighted pooled logistic regression with 95% CIs.
The cohort included 21,484 person-trials from 3096 unique individuals (1001 EHCs, 20,483 non-EHCs). The 5-year composite risk was 20.6% (EHC) vs 26.7% (non-EHC): risk difference, -6.1 percentage points (pp; 95% CI, -11.6 to 0.9); risk ratio, 0.77 (95% CI, 0.57-1.03). Corresponding risk differences were -3.7 pps (95% CI, -10.4 to 3.9) for all-cause mortality and -5.4 pps (95% CI, -12.9 to 0.1) for functional disability alone.
The evidence is uncertain about the effect of initial EHC participation on the 5-year risk of functional disability or death; the point estimate is compatible with a modest benefit, but the 95% CI included the null. These findings neither support expansion nor justify discontinuation of the EHC program for preventing entry into LTC, and call for replication in additional cohorts before policy changes are considered.

PMID:
42691802
Bibliographic data and abstract were imported from PubMed on 04 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.