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Introduction: Rural older farmers experience poorer health status compared to older workers in other industries, due to both the physically demanding nature of farming and the aging of the agricultural population. In particular, the decline in physical function among older farmers negatively affects not only their ability to perform agricultural tasks but also their health-related quality of life (HRQoL), indicating the need for health programs aimed at physical function recovery. This study aimed to develop and implement an intervention program designed to improve physical function among older farmers residing in rural areas.

Methods: A quasi-experimental design was employed involving 154 older farmers living in rural villages (pre- and post-intervention). The intervention program included a set of 10 exercises targeting the prevention and management of musculoskeletal disorders related to farming activities, consisting of flexibility and resistance exercises (e.g., thigh muscle strengthening, upper extremity flexibility, lumbar extension exercises). Additionally, the program incorporated nutrition counseling tailored for older adults and protein supplementation through the provision of protein drinks to enhance protein intake. The intervention was conducted over six months from March to September 2024. Evaluation was performed one month after the completion of the program. Physical function was assessed using the criteria proposed by the Asian Working Group for Sarcopenia (AWGS), including gait speed, five-times sit-to-stand test, and handgrip strength. HRQoL was evaluated using the Sarcopenia & Quality of Life (SarQOL) questionnaire.

Results: The mean age of the participants was 76.8 years, and the majority were female (89.0%). Significant improvements were observed in gait speed, muscle strength (five-times sit-to-stand test), and handgrip strength after the program. The proportion of participants classified as having low gait speed decreased by 47.4% (from 88.3% to 40.9%, p<0.001), and those with reduced performance in the sit-to-stand test decreased by 44.2% (from 55.2 to 11.0%, p<0.001). Although the proportion with reduced handgrip strength decreased by 1.9% (from 37.0% to 35.1%, p=0.06), the change was not statistically significant. Regarding HRQoL, significant improvements were observed in several domains: physical and mental health (from 52.6 to 59.2, p<0.001), locomotion (from 53.1 to 58.7, p<0.001), body composition (from 54.9 to 58.4, p=0.03), functionality (from 65.8 to 71.0, p<0.001), activities of daily living (from 55.5 to 61.4, p<0.001), leisure activities (from 47.7 to 66.8, p<0.001), and fears (from 78.5 to 81.9, p=0.04). The total SarQOL score significantly improved from 57.8 to 63.9 (p<0.001).

Conclusion: The exercise and nutrition program tailored to older farmers in rural areas effectively improved physical function and health-related quality of life. Notably, substantial improvement was observed in leisure activities, suggesting that such programs may contribute not only to physical health but also to enhancing leisure and cultural participation among older adults living in culturally underprivileged rural areas.