Abstract The purpose of this study was to explore the correlates of participation in adult day care programs and the quality of life (QOL) of ambulatory frail elderly in Japan. The study was conducted through questionnaires administered to 95 elderly participants at two adult day care centers in a prefecture in Japan. Participation in adult day care had positive correlations with QOL for female participants. However, for male elderly subjects, there was no significant correlation between participation and QOL. Results imply the need for additional research on factors influencing negative self-esteem in the male elderly, including an identification of the mechanisms by which their self-esteem was affected. The reliability of the Graham Global Well-Being Scale was supported for the first time in a domestic study in Japan.