Hayato Uchida

Predictors of Improvement or Decline in Instrumental Activities of Daily Living among Community-Dwelling Older Japanese

Background: To explore predictors of functional improvement or decline in instrumental activities of daily living (IADL) among community-dwelling older people. Methods: Of all the residents (≧65 years, n = 1,673) living in Yoita town, Niigata prefecture, Japan, in 2000, 1,544 subjects who participated in the baseline interview survey (T1) were followed up until 2002 (T2). A wide range of variables obtained in T1 was entered into the model predicting functional improvement or decline in IADL. Results: Among 1,274 individuals who participated in both T1 and T2, 105 subjects showed improvement, 194 decline, and the remaining 975 showed stability in IADL. Multiple logistic regression analyses indicated that good self-rated health and cognitive function (MMSE ≧24) at T1 were good predictors of both improvement and protection against decline in IADL. Independence in basic activities of daily living predicted improvement in IADL. Advanced age and poor walking ability predicted decline in IADL. Conclusions: Good self-rated health and cognitive function predicted both improvement and protection against decline in IADL. Thus, intervention programs aiming at maintaining both good self-rated health and cognitive function should be able to improve IADL.

REPRINTS: Effects of an Intergenerational Health Promotion Program for Older Adults in Japan

We launched a new intervention study called REPRINTS in which senior volunteers engaged in reading picture books to children. Sixty-nine volunteers and 72 participants in a control group, all aged 60 years and over, living in three urban locations, participated in a baseline health checkup in June 2004. After completion of a three-month training seminar, volunteers visited public elementary schools and kindergartens in groups of 6 to 10 for an 18 month period. They were assessed again by a follow-up health checkup in March 2006. At the follow-up, social network scores (frequency of contact with grandchildren and others around the neighborhood) and self-rated health improved or was maintained at a significantly higher rate for the 37 individuals volunteering most intensively as compared to those who did not volunteer or volunteered minimally. In conclusion, through intensively being engaged in the intergenerational volunteer programs during 21 months, self-rated health and social networks were more likely to improve or be maintained among senior volunteers than controls.

Age-related self-overestimation of step-over ability in healthy older adults and its relationship to fall risk

BackgroundOlder adults could not safely step over an obstacle unless they correctly estimated their physical ability to be capable of a successful step over action. Thus, incorrect estimation (overestimation) of ability to step over an obstacle could result in severe accident such as falls in older adults. We investigated whether older adults tended to overestimate step-over ability compared with young adults and whether such overestimation in stepping over obstacles was associated with falls.MethodsThree groups of adults, young-old (age, 60–74 years; n, 343), old-old (age, >74 years; n, 151), and young (age, 18–35 years; n, 71), performed our original step-over test (SOT). In the SOT, participants observed a horizontal bar at a 7-m distance and estimated the maximum height (EH) that they could step over. After estimation, they performed real SOT trials to measure the actual maximum height (AH). We also identified participants who had experienced falls in the 1 year period before the study.ResultsThirty-nine young-old adults (11.4%) and 49 old-old adults (32.5%) failed to step over the bar at EH (overestimation), whereas all young adults succeeded (underestimation). There was a significant negative correlation between actual performance (AH) and self-estimation error (difference between EH and AH) in the older adults, indicating that older adults with lower AH (SOT ability) tended to overestimate actual ability (EH > AH) and vice versa. Furthermore, the percentage of participants who overestimated SOT ability in the fallers (28%) was almost double larger than that in the non-fallers (16%), with the fallers showing significantly lower SOT ability than the non-fallers.ConclusionsOlder adults appear unaware of age-related physical decline and tended to overestimate step-over ability. Both age-related decline in step-over ability, and more importantly, overestimation or decreased underestimation of this ability may raise potential risk of falls.

Intellectual activity and likelihood of subsequently improving or maintaining instrumental activities of daily living functioning in community‐dwelling older Japanese: a longitudinal study

To test the a priori hypothesis that increase or maintenance of the level of cognitive activity would be independently associated with a subsequent beneficial impact (i.e. improvement or maintenance) on instrumental activity of daily living (IADL) functioning.

The effect of intergenerational programs on the mental health of elderly adults

Objectives: The aim of this study was to clarify the effect of an intergenerational program on elderly persons’ symptoms of depressive mood and in improving their sense of coherence, which is an element for successful coping with stressors. Method: We evaluated an intervention research project (Research of Productivity by Intergenerational Sympathy [REPRINTS]), in which volunteers >65 years old read picture books to children in a school setting. The intervention group (REPRINTS) was recruited through intensive weekly training seminars for three months. The no-contact control group members were also recreated to participate in health checks and surveys for data collection purposes. Eventually, 26 participants in the intervention group and 54 in the control group were included for data analysis. Results: The age or gender was not significantly different between the intervention and control groups. A two-way repeated-measures ANOVA shows a time × group significant interaction effects. Analyses of the simple main effects showed that sense of meaningfulness significantly increased for members of the intervention group at all terms, with no changes in the control group over time. Multiple mediation analysis revealed that participation in the intergenerational program was associated with a sense of manageability which was also significantly related to depressive mood. Conclusion: Intergenerational programs could serve as key health promoters among elderly people by decreasing the risk of social isolation and loneliness due to the greater sense of meaningfulness. However, given our limited sample size, generalizability was restricted and studies with larger cohorts are required to further validate our findings.

Effects of the Change in Working Status on the Health of Older People in Japan.

Background Working at old ages is regarded as a good way to keep one’s health according to the idea of productive aging. However, there is not enough evidence yet whether retirement is good or bad, or the kind of effects it has on the health of older adults aged 65 and over. We examined it by using a recent data of Wako city, a suburb area near Tokyo in Japan. Methods One thousand seven hundred sixty-eight participants answered to 3 waves of survey questionnaires: 2008, 2010, and 2012, successively. We considered 3 indicators of health; self-rated health, mental health (GDS15) and HLFC (Higher-Level Functional Capacity: TMIG-IC). In cross-sectional analysis, we compared these 3 indicators by three groups: full-time worker, part-time worker, and non-worker. In longitudinal analysis, we compared these three indicators by two groups: subjects who successively worked in 2008, 2010, 2012, and subjects who worked in 2008 but retired before 2010. We used one-way and two way repeated measures ANCOVA for these analyses, respectively. Results It was significantly clear that retirement worsened both mental health and HLFC in people aged 65 years and over; especially, mental health worsened rapidly and HLFC gradually. However, these indicators didn’t worsen in subjects who changed from full-time jobs to part-time jobs. Quitting from part-time jobs deteriorated mental health gradually and HLFC moderately compared to full-time jobs. Conclusion The results support the activity theory that older adults who quit from full-time jobs deteriorated both mental health and HLFC, though at different speeds. If they make a transit to part-time jobs, the deterioration would be moderate. It shows that working is an effective way of social participation for older people aged 65 years and over in Japan.

Preventive effects of an intergenerational program on age‐related hippocampal atrophy in older adults: The REPRINTS study

A growing body of literature indicates that social engagements, such as intergenerational programs, are effective strategies to improve a range of cognitive abilities. The present study examined whether the intergenerational program—REPRINTS—prevents age‐related hippocampal atrophy.

Relation between the IADL and Physical Fitness Tests Focusing on Uncertainty of Answering Questionnaire in Elderly Women

This paper examines the uncertainty of answering questionnaire in elderly women. We derive a membership function demonstrating a robustness of the knee-raising test and height related to decreased instrumental activities of daily living (lADL) for the uncertainty of answering questiormaire. This result could be maintained if the number of movement were within range from -10 to +5 persons.

Rough Set Based Knowledge Discovery of Interface for the Internet Usage among Japanese Elderly Women

The world currently faces the new wave of industrial civilization, that is regarded as the changes caused by the Revolution of Information Technology (IT). This study is conducted to clarify how a mobile phone (MP) and the Internet through personal computer (IPC) have been actually used. We also examine what kind of interface (input device) is preferred by the elderly, by using a questionnaire regarding the IT equipment. This study adopts not only the ?2 test but also the rough set analysis. As a result of the rough set analysis and ?2 test, those who were interested in a MP preferred, Japanese kana syllabary (JKS) the most. The rough set analysis also discovered the facts that those interested in the keyboard had a preference for the IPC and also that those interested in the JKS and the speech preferred a MP. We can conclude that the complementary use of the rough set analysis and ?2 test bring more powerful knowledge discovery.