Frequency of cardiac arrhythmias and age-related changes were studied in a general hospital. Standard electrocardiogram were recorded from 5079 consecutive patients (2546 men and 2533 women) aged from 15 to 93 at Inada-Noborito Hospital in 1983. The “major” abnormal impulse formation and conduction disturbance were as follows: left axis deviation (LAD) 8.3%, ventricular premature complex (VPC) 3.4%, supraventricular premature complex (SVPC) 3.2%, I°AV block 2.7%, atrial fibrillation (AF) 2.5%. The abnormalities that were found with significantly increased frequency in the aged ere LAD, VPC, SVPC, AF and complete right bundle branch block (RBBB). However, there was no significant increase in frequency with age were I°AV block, incomplete RBBB, sinus tachycardia and sinus bradycardia. The males showed a significantly higher frequency of I°AV block and sinus bradycardia than in females. The patients were classified into following three groups by age, group I (below 49, 1542 cases), group II (50 to 69, 2236 cases), group III (over 70, 1291 cases). The frequency of abnormal impulse formation in group III were as follows: (1) LAD 14.5%, (2) SVPC 8.2%, (3) VPC 6.1%, (4) AF 4.7%, (5) complete RBBB 4.0%, (6) sinus tachycardia 3.9%. In group III, SVPC was 9, 8 times higher than in group I and 3.3 times higher than in Group II. VPC was 2.7 times and 2.0 times, AF was 8.1 times and 1.9 times, complete RBBB was 4.1 times and 1.9 times respectively. The recognition that age-related changes in frequency of arrhythmias might reflect not only age-related increase in cardiac disorders but nonspecific cardiac changes.

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The changing patterns of blood chemical constituents related to menopause were studied by inquiring both inter-and intraindividual variations in the general population sample of Hisayama residents. At the cross-sectional screenings in both 1973-74 and 1978, the distribution of blood chemical constituents for the whole population was firstly examined in order to determine the normal-mean value of the polulation. Applying Hoffmann's method of renouncement to the whole distribution of each blood chemical constituent, those with values of more or less than the range of mean±2.2 SD were excluded. After that 566 females aged 40 to 54 years old were recruited from the remaining population at 1973-74. Then, the study subjects were divided into menopausal and non-menopausal groups. The mean values of alkaline phosphatase (ALP), leucine aminopeptidase (LAP), serum total cholesterol (CHOL), serum uric acid (SUA), blood urea nitrogen (BUN), sodium (Na), and calcium (Ca) were significantly higher in the menopausal group than in the non-menopausal one at a whole range of age. Similar changes were found in each age group of 40 to 44, 45 to 49, and 50 to 54 years old, although a statistical significance could not necessarily be obtained between the menopausal and non-menopausal group. In 1978, 472 females were re-examined of which seven blood chemical constituents mentioned above were available. Of 472 subjects, menstruation continued in 166 (premenopausal group), and discontinued in 131 (menopausal group). remaining 175 females were already menopausal at 1973-74 (postmenopausal group). Within each group, the mean values for seven blood chemical constituents studied in 1973-74 were compared to those in 1978. Simultaneously, a change of difference in each value of blood chemical constituents for study-subjects during five-year interval was corrected by the difference between two values which had previously been determined as a normal mean of the whole population at 1973-74 or at 1978, respectively. All seven constituents increased in menopausal group, while only ALP increased but the other six remained unchaged in pre-menopausal groups. Increases in blood chemical constituents except BUN were significantly greater in the menopausal group than those in the other groups. These evidences strongly suggest that increases in ALP, LAP, CHOL, Ca, SUA and Na are closely related to menopause.

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A prospective study was carried out to elucidate the relationship between blood chemical constituents and occurrence of cerebral infarction in Hisayama residents aged 40 and over. Twenty four blood chemical constituents were measured at the cross-sectional survey in 1973-74. In addition, the following informations were also obtained at that time: anthropometries, blood pressure, physical findings, electrocardiographic findings, habits of cigarette-smoking, alcohol consumption and others. One thousand and nine hundred eighty-two subjects (823 males and 1159 females) without previous cardiovascular diseases were entered into the follow-up from 1974 to 1981. During a 7-year period, 71 cerebral strokes newly occurred, of which cerebral infarction was found in 27 males and 24 females. Seventeen blood chemical constituents such as total bilirubin, glutamate pyruvate transaminase, serum protein, serum total cholesterol and so on were studied in relation to the incidence of cerebral infarction by multiple logistic regression model. The standardized regression coefficients of β-lipoprotein, blood urea nitrogen (BUN) and creatinine were estimated to be statistically significant in this model only for males. Mean values for β-lipoprotein, BUN and creatinine were compared between the males with and without cerebral infarction. β-lipoprotein was only significantly higher in the former than the latter. Those who had higher β-lipoprotein developed cerebral infarction more frequently. A multiple logistic regression analysis was performed to obtain the most powerful risk factor of cerebral infarction for males among these blood variables and additional ones as age, blood pressure, electrocardiographic findings etc. as a independant variable. Then, both age and mean blood pressure were considered to be important risk factors of cerebral infarction. β-lipoprotein was ranked in the third, but its standardized regression coefficient did not reach the significant level. An appraisal of lipid metabolism was discussed as a risk for cerebral infarction in the Japanese.

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In order to elucidate whether changes of blood chemistries could be an indicator of development of fatal diseases in aged persons, 18 blood chemical constituents were measured at two different occasions, 1973-74 and 1978, in 818 Hisayama residents aged 60 or over. They were followed for 3 years from 1978 to 1981. During this period, 57 of the study-subjects died of various diseases such as neoplasms, cardiovascular diseases and the others, and their causes of death were mostly verified by autopsy. Values of blood chemical constituents at the cross-sectional surveys and the difference of those between the two examinations were compared between the groups of death and survival. Comparing data between the two groups, age was adjusted because of the deceased persons being much more distributed in the old age. Of all 18 blood chemical constituents of the second determination, serum albumin and calcium (Ca) were significantly lower in female deceased than survived, while in male, blood urea nitrogen (BUN) and serum albumin were lowered in deceased subjects, even though age was adjusted between the two groups. On the other hand, glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), thymol turbidity test (TTT), alkaline phosphatase (ALP) and leucine aminopeptidase (LAP) were significantly higher in male deceased than survived group. Between the first and second determinations, albumin, uric acid (SUA), sodium (Na) and Ca were more decreased in male death group, and only albumin and Ca were more diminished in female one, than in either male or female survived group during 5 years. Although the intra-individual changes were greater in dead than survived subjects, such changes seemed unlikely to be related with the special causes of death. The changing patterns of blood chemical constituents were compared among the survived subjects and the deceased ones with and without previous surgical operation, cerebral stroke or bed-ridden state. However, there were no remarkable differences of variables among the groups. These findings suggest that in the aged humans the intra-individual changes in blood chemistries during a certain interval before death seem to be related to the state of nutrition or aging rather than cause of death or complications.

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A histopathological study was made on 512 cases of gastric cancer that were obtained surgically from aged patients (73 years old in the mean age) in Tokyo Metropolitan Geriatric Hospital. They were composed of 408 cases of differentiated-type (80%) and 104 cases of undifferentiated-type (20%). There were 75 cases of gastric cancer with multiple independent cancer lesions (hereafter referred to as multiple gastric cancer), in which 71 cases were histologically diagnosed as multiple gastric cancer composed of 2-5 cancer lesions of differentiatedtype only. The multiple gastric cancer of differentiatedtype was more common in men; the ratio of males to females was about 3 to 1 in the present study. The maximum incidence was around the age of 70. Regarding the depth of invasion of the lesion, 21 out of 71 cases were combination of intramucosal cancer only, 35 cases of intramucosal cancer and invasive cancer, and 15 cases of invasive cancer only. The maximum diameter of each lesion and its location within the stomach were assessed in 14 cases in which the distance between centers of two lesions ranged in 3.9cm and compared with those of 49 cases of single intramucosal gastric cancer in aged patients. The results has suggested that there is a great possibility that collision of multiple cancer lesions resulted in a single intramucosal gastric cancer over 3.1cm in the maximum diameter in aged patients. Autopsy examination was performed in 17 out of 71 cases which had undergone surgical resection of multiple gastric cancer of differentiated-type. In 4 out of 17 cases, the major cause of death was ascribed to malignant neoplasm occurred in organs other than the stomach, and 2 out of 4 cases had triple carcinomas; one, triple carcinomas in the stomach, liver and colon, and the other, those in the stomach, esophagus and colon.

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The stability in standing posture was studied in 148 healthy males ranging from 22 to 95 years of age. The subjects stood in the Romberg's posture on a force platform and performed following two tasks: 1) to stand as quietly as possible first with eyes open and then with eyes closed for 20sec, respectively. 2) to shift the center of foot pressure (CFP) voluntarily in the anteroposterior direction without bending the trunk and then maintain several different positions with eyes open for 10sec. The movements of the CFP were displayed on an X-Y recorder and their length (L-value) were calculated with the length analyzer (S-110, Patella). Relative distance from the most hind point of the heel to the center of the CFP traces were calculated using the foot length as 100%. The range between the center of the trace in the maximum anterior position and that in the maximum posterior position was defined as A-P%. In addition, duration of standing on a foot was measured on a floor first with eyes open and then with eyes closed. Mean A-P% markedly reduced while mean L-value during quiet standing slightly increased as a function of age. In approximately a half of the aged subjects who were more than 70 years old, L-value during quiet standing was much the same as younger subjects. Only small number of them had a great range of A-P% like younger subjects. L-value during standing along with shift of the CFP more markedly increased in the aged subjects. Duration of standing on a foot also decreased with an increase in age. There was a tendency for aged subjects who had relatively great A-P% to be capable of standing on a foot for longer duration. The results suggest that the postural adjustments in response to a shift of the CFP appear in the earlier stage of aging rather than the steadiness of the quiet standing. Duration of the subject's ability to stand on a foot appears to be a useful evaluation of the ability to make postural adjustments.

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