Asae Oura

Relationship of hobby activities with mortality and frailty among community-dwelling elderly adults: results of a follow-up study in Japan.

Background The proportion of Japanese adults aged 65 years or older is predicted to increase; thus, it is becoming more important to identify factors that influence health status among elderly adults in Japan. We conducted a follow-up study of community-dwelling elderly adults to assess the relationship of hobby activities with mortality and incident frailty. Methods We randomly selected 3583 individuals aged 65 to 84 years from the residential registries of 7 study areas in Hokkaido, Japan in August 2007. Among them, 1955 (54.6%) returned completed questionnaires with written informed consent by mail. The baseline assessment questionnaire comprised questions on current and past involvement in hobby activities, self-perceived health status, smoking and drinking habits, and body height and weight. Questions on hobby activities were from 4 categories: solitary physical, group physical, solitary cultural, and group cultural activities. We later conducted a follow-up survey of the participants to ascertain all-cause mortality and incident frailty. A Cox proportional hazards model was used for analysis of data from September 2007 to May 2010. Results After adjusting for potential confounders, the risk of incident frailty among respondents participating in solitary physical activities was significantly lower than in those who did not participate in such activities (hazard ratio = 0.57; 95% CI 0.33, 0.99). Furthermore, the risk of incident frailty among respondents taking part in group cultural activities was significantly lower than in those who did not participate in such activities (0.41; 0.19, 0.87). Conclusions These findings may be important for programs that seek to promote good health among elderly adults.

Factors related to institutionalization among the frail elderly with home-visiting nursing service in Japan.

A dramatic increase in the number of elderly people in Japan has led to a concurrent increase in the number of frail elderly in need of care. It is estimated that the number of frail elderly will reach 3.9 million by the year 2010. Family members are often both physically and mentally burdened with caring for the frail elderly. The present study was conducted to identify the risk factors for institutionalization among the frail elderly receiving in-home care in Japan.

Comparison of the Clinical Features of Japanese Patients with Primary Biliary Cirrhosis in 1999 and 2004: Utilization of Clinical Data When Patients Applied to Receive Public Financial Aid

BACKGROUND In Asia there are few reports considering time intervals in the examination of clinical features of primary biliary cirrhosis (PBC). Therefore, we tried to compare the characteristics of patients with PBC in two different years. METHODS In two fiscal years (1999 and 2004), 9,761 and 13,142 patients with symptomatic PBC were registered to receive public financial aid from the Ministry of Health, Labour and Welfare of Japan, respectively. For the present study, clinical data from 2,127 patients in 1999 and 6,423 ones in 2004 were available. We compared the data in the two different years, including sex, age, major symptoms, and laboratory data. RESULTS Male/female ratios were the same figure (0.13 for 1999 and 2004). The median age was significantly older in 2004 than in 1999 (59 years for 1999, 63 years for 2004, respectively, p<0.01). Jaundice and esophageal varices were found significantly less frequent in 2004 than in 1999 (p<0.01 for each item). Levels of total bilirubin, γ-glutamyl transpeptidase (γ-GTP), total cholesterol, and immunoglobulin M were significantly lower in 2004 than in 1999 (p< 0.02 for total bilirubin, and p<0.01 for other each item). The positive rate of antimitochondrial antibodies was significantly higher in 1999 than in 2004 (87.0% for 1999, 83.5% for 2004, respectively, p<0.01)). Complicated autoimmune diseases such as Sjögrens syndrome, rheumatoid arthritis, and chronic thyroiditis were found significantly more frequent in 2004 than in 1999 (p<0.01 for each item). CONCLUSIONS Among the patients with PBC in 2004, an increase in median age, and lower levels of laboratory data such as γ-GTP have been found compared to 1999. These results may show an accumulation of patients with better prognosis and the recent medical progress in controlling patients with PBC.

Depression among caregivers of the frail elderly in Japan before and after the introduction of the Public Long-Term Care Insurance System.

SummaryCross sectional studies were conducted in five towns in Japan before and after the introduction of the Long-term Care Insurance System (LTCIS), in order to evaluate the factors relating to depression among family caregivers for the frail elderly.Depressive caregivers were more likely to consult with their doctors, to be in poor health, to care for demented elderly with behavioral disturbances than the non-depressive caregivers both before and after the LTCIS. Before LTCIS, depressive caregivers were more likely to attend to the elderly for more than 16 hours per day than their counterparts. After the LTCIS, depressive caregivers were more likely to be a spouse, to care for a frail elderly male, and less likely to be able to go out without accompanying the elderly than their counterparts.Even after the introduction of LTCIS, half of the caregivers were depressive. It is suggested that a government agency should be created to support not only the frail elderly but also their caregivers.ZusammenfassungIn fünf japanischen Städten wurden „cross-sectional“ Studien durchgeführt, um die Faktoren betreffend Depressionen der Angehörigen von zu Hause gepflegten älteren Patienten vor und nach der Einführung des Langzeit-Pflegeversicherungssystems (the long term care insurance system; LTCIS) zu untersuchen. Depressive Familienangehörige konsultierten häufiger ihren Arzt, waren häufiger in schlechtem Gesundheitszustand und pflegten häufiger Pflegebedürftige mit Verhaltensstörungen als nicht-depressive Angehörige, dies sowohl vor als auch nach der Einführung des LTCIS. Vor der Einführung des LTCIS pflegten depressive Angehörige häufiger als ihre nicht-depressiven Konterparts ihre Patienten mehr als 16 Stunden täglich. Nach der Einführung des LTCIS gab es – vergleichen mit nicht-depressiven – mehr weibliche depressive Angehörige, mehr pflegebedürftige Männer, aber weniger, die das Haus alleine verlassen konnten, ohne von ihren pflegebedürftigen Partnern begleitet zu werden.Auch nach der Einführung des LTCIS waren mehr als die Hälfte der Angehörigen depressiv. Es wird die Einrichtung einer staatlichen Institution zur Unterstützung nicht nur Pflegebedürftiger, sondern auch deren Angehörigen empfohlen.

What is a common factor in different areas?: The case of depression among caregivers of the frail elderly in Sapporo and Kochi, Japan.

Aim:  Depression affecting caregivers is a risk factor for discontinuing at‐home care. The present cross‐sectional study was conducted to evaluate factors related to depression among family caregivers.

Association of Passive and Active Smoking with Elevated Blood Lead Levels Among Children and Adults Resided in a City of Japan

There were no previous reports assessing the effect of tobacco smoke on blood lead levels (BLLs) simultaneously in children and adults in Japan. We investigated the association of passive and active smoking with BLLs in children and adults among the general population in Hokkaido, Japan. One hundred seventy-seven persons (78 males, 99 females) participated in the survey in May, 2014. Age groups of subjects younger than 18 years (age group A) and subjects older than or equal to 18 years (age group B) were designated. The median value of the BLLs was used for us to divide into two groups, such as high and low BLL groups. Age and sex adjusted odds ratios (OR) and 95% confidence levels (CLs) were estimated with analysis of the logistic regression model. BLLs in age group B were significantly higher than age group A (p=0.023). In age group A, the proportion of subjects living with habitual smokers other than parents in the household was significantly higher in the high BLL group than in the low BLL group (p=0.019). In age group B, currently habitual smoking was significantly associated with increased risk being in the high BLL group (OR=3.17, 95% CL, 1.28-7.86). A duration of smoking longer than or equal to 20 years was significantly associated with increased risk of being in the high BLL group (OR=2.73, 95% CL, 1.07-6.94), BLL is higher in older persons than in younger persons. Active and passive smoking may be associated with high BLLs in adults and children, respectively.

Intervention Programme for Promoting Physical Activities in the Citizens of Sapporo City, Japan

In accordance with nutritional improvement, the environmental sanitation, and advance in medical technology after World War II, Japan has achieved almost the longest lifespan in the world. This change has two implications. Firstly, this has led to a drastic increase in elderly population in Japan. Secondly, a part of Japanese has faced the problem of over-nutrition due to e.g. an inappropriately increased intake of total energy and total fat, a more sedentary lifestyle or insufficient physical activity in association with use of various mechanic devices or transportation including a car in their life. Their lifestyles are not only associated with an increased risk of lifestyle-related morbidity, but also with increased medical expenditure. Some studies reported higher prevalences of obesity, glucose intolerance (Kawamori 2002), hypertension (Ueshima et al. 2000), and/or hyperlipidemia (Koba and Sasaki 2006) in recent years as compared to past. These lifestyles factors and morbidity are suggested as possible risk factors for a higher mortality related to cardiovascular diseases and certain types of cancer.