Sachiko Yamazaki

Excess mortality among relocated institutionalized elderly after the Fukushima nuclear disaster

Immediately after the accident at the Fukushima Daiichi nuclear power plant following the Great East Japan Earthquake on 11 March 2011, the Japanese Government ordered all residents within 20 km of the plant to evacuate. Among the evacuees were 1770 institutionalized elderly at 34 community facilities in the evacuation zone, including: specialist nursing homes; general nursing homes; geriatric health service facilities; and group homes. The Government arranged transportation, and transfers started on 12 March, moving the elderly to hospitals, municipal gymnasiums and public schools. They could not take any personal belongings (even clothes and blankets) because of limited space, and many were transferred several times to different locations over a few months. Some institutions in other prefectures rejected evacuees from the radiation zone due to fears that they could transmit radiation to others. Evacuees were required to present certificates of being ‘radiation free’ to the shelters, and if not presented, they were refused entrance. Previous studies outside Japan have reported that the relocation of elderly inpatients increases their mortality risk by two to four times. This is the first report of data on excess mortality among relocated institutionalized elderly after the nuclear disaster in Fukushima prefecture.

Prediction of functional disability by depressive state among community-dwelling elderly in Japan: a prospective cohort study.

Aim:  We carried out a prospective cohort study to evaluate the risk factors of functional disability by depressive state.

Prevalence of Social Isolation in Community-Dwelling Elderly by Differences in Household Composition and Related Factors: From a Social Network Perspective in Urban Japan

Objective: The aim of this study was to measure the prevalence of social isolation in community-dwelling elderly and related factors based on household composition differences. Method: We used the six-item Lubben Social Network Scale to measure social isolation in 2,000 individuals. Multiple logistic regression analysis was performed to examine factors related to social isolation with household composition after adjusting for gender and age. Results: The prevalence of social isolation was 31.0% for elderly living alone and 24.1% for those living with family. For both, poor mental health and lack of social support from nonfamily members were associated with social isolation risk. For elderly living with family, low intellectual activities and poor health practice were associated with social isolation risk. Discussion: This study showed high prevalence of social isolation. For prevention, promoting mental health and encouraging them to make friends may be important. For elderly living with family, promoting intellectual activities and good health practice is recommended.

Community‐based exercise program reduces chronic knee pain in elderly Japanese women at high risk of requiring long‐term care: A non‐randomized controlled trial

Aim:  To estimate the prevalence of low back pain and/or knee pain among the elderly at high risk of requiring long‐term care, and to determine the effectiveness of a community‐based exercise program provided in accordance with the Motor Function Improvement Program for improving low back and/or knee pain.

Barriers and motivators to blood donation among university students in Japan: development of a measurement tool

Despite growing demand for transfusion, the number of voluntary young blood donors has steadily decreased over recent years in Japan. This study aimed to develop an easy‐to‐use survey tool to assess barriers and motivators to blood donation among Japanese university students.

The Prevalence of Social Engagement in the Disabled Elderly and Related Factors

The purpose of this study is to explore the prevalence and related factors of social engagement in the disabled elderly. Participants were 86 elderly ranging from 65 to 84 years of age with disability dwelling in Fukushima City, Fukushima Prefecture, Japan. Among them, socially engaged elderly were 23 people (26.7% of the participants). Seventeen of the 23 socially engaged elderly were mildly disabled (32.7% of the mild disability group). Four were moderately disabled (20.0% of the moderate disability group), and 2 were severely disabled elderly (14.3% of the severe disability group). Factors related to social engagement in the disabled elderly were examined using multiple logistic regression analysis. Results showed that self-rated health and psychological independence were significantly associated with social engagement in the disabled elderly. This result did not change even after adjusting for disability status level. These findings suggest that support in psychological aspects, such as self-rated health and psychological independence, may promote social engagement in the disabled elderly.

Rice-farming care for the elderly people with cognitive impairment in Japan: a case series: Rice-farming care for the elderly people with cognitive impairment

unmet need for a new instrument, which could aid the diagnosis of Acreemagnosia and quantify its severity. Such tool should incorporate informant-based, selfreport and performance-based measures that would complement each other. It should be based on sound psychometric techniques (e.g. item response theory analysis) and should incorporate unidimensional items that measure specific constructs as well as items that measure more than one construct, referred to as complex. It should consider prior knowledge, proficiency or interest in finances. Finally, the ideal instrument assessing financial competence will have to be culturally valid.

Depression in older adults: Do close family members recognize it?

Depression in older adults places them at significant risk of functional disability regarding activities of daily living. Early detection of depression is therefore important to prevent a decline in functional ability and progression to severe depression. However, the clinical manifestations of depression in older adults tend to be different compared with other age groups. Sleep disturbances, fatigue, psychomotor retardation, loss of interest in living and hopelessness about the future might be more prevalent in late-life depression than in depression in young and middle-aged adults. These symptoms are different from the conventionally described affective symptoms of sadness and depressed feelings. Hence, the older adults themselves are often unable to recognize that they have depression. Consequently, the ability of close family members to recognize depression, even when not reported by the older adults themselves, is important. However, the extent of this competence has not been adequately studied. The present study aimed at examining close family members’ recognition of depression in older adults. Participants included individuals aged 70 years and older who had not been certified under the long-term care insurance (n = 1234), and their family members. The family member was selected by the older adult based on perceived proximity, and was often a person in close contact and living with them. To assess depression in older adults, we used the Center for Epidemiologic Studies Depression scale, a 20-item selfreported measure of the frequency and severity of depressive symptoms experienced in the previous week, with scores ranging from 0–60. We used a cutoff value of ≥16 to operationally define depression. Those with scores of 16–20 were classified as having mild depression, 21–25 as moderate depression and ≥26 as severe depression. The family member’s recognition of depression in the older adult was assessed by the question “Over the past 2 weeks, has he/she (older adult) appeared depressed?” The choices of answers were as follows: (i) no, he/she has not; (ii) yes, he/she appears a little depressed; (iii) yes, he/she appears quite depressed; and (iv) I don’t know. The depression status as per family members’ assessment was categorized as “not having depression” in case of response (i) and “having depression” in case of responses (ii) and (iii). Responses from 1085 older adults and 673 family members were obtained; however, just 663 responses that were obtained from both the older adults and their family members were analyzed. The older adults (257 men and 406 women) had a mean age of 79.0 ± 5.8 years. Among the family members, the mean age was 59.5 ± 21.5 years, and 378 were women. The majority were children (431), followed by spouses (197) and others (35). In nearly half the participant pairs (49.5%), both the older adult and the family recognized “depression” (Table 1). The non-recognition of depression by family members was highest when the person had only mild depression (64.1%). However, even moderate and severe depression went unnoticed by more than 30% of the family members. More than one-fifth (22.6%) of family members responded with “I don’t know” even in cases of severe depression. A previous study that used a single item for assessment of depression reported good agreement between self-evaluated and family-evaluated elderly depression. However, the present study shows that nearly 50% of the close family members failed to recognize depression that was detected using a self-answered multi-item depression rating scale. It is remarkable that in addition to the huge proportion that did not notice mild depression, many family members were unable to identify even moderate or severe depression, which is easier to recognize objectively. These discrepancies in recognition would interfere with early detection, management and provision of support in elderly depression. Further studies are required to develop strategies to educate family members to enable them to accurately detect or suspect elderly depression even in its milder forms and initial stages. Accepted for publication 22 December 2015.