We examined sex and age differences in health promotion behavior, participation in social activities, and perceived transportation problems of elderly people living in a small town far from the nearest train station. A questionnaire was sent to 567 men and women aged 60 years old and over living in a small town in Kanagawa prefecture. A total of 397 people responded. The questionnaire consisted of 42 questions concerning their health, daily activities (including their desire to participate in social activities), the frequency with which they went out, their attitude toward health promotion behavior, and their perceived transportation problems. They were also asked why they acted in ways that promote their health. The reliability of the data was examined with the coefficient κ and with Cronbach's alpha. Chisquared tests were used to examine sex and age differences. Women reported more health problems and more transportation problems, and said that they were less active in social activities than did men. Women become inactive in daily life with increasing age earlier than do men. Contrary to our hypothesis, women tended to have medical examinations more often than did men. More women under 75 years old than men answered that they acted in ways that promote their health because they did not want to give others trouble when they became ill, fewer women than men said that they wanted to enjoy their intended activities. These results seem to show that women lead less active social lives than do men and have less motivation for promoting their health because of a desire to lead an active life.
Although exercise electrocardiography (ECG) is a useful noninvasive screening test for coronary artery disease (CAD), one prerequisite for ECG screening is that patient be able to exercise enough to evoke myocardial ischemia. Thus, exercise ECG may not be suitable for, some elderly people with CAD who cannot exercise enough. We compared electron beam Computed Tomography (EBCT) with exercise ECG for detecting CAD in 196 patients (mean age, 58.4±12.5 [standard deviation]) who had undergone coronary angiography. Using the angiographic findings as the “gold standard”, we found that the sensitivity, specificity, positive predictive value, and negative predictive value were 88%, 77%, 89%, and 77%, respectively, for EBCT, and 66%, 72%, 83%, and 52%, respectively, for exercise ECG. Although the results were similar when the subjects were divided into different age groups, the negative predictive value for exercise ECG, among older patients was very low. These findings suggest that EBCT is superior to exercise ECG in detecting CAD in the elderly.
The effects of aging on the relationships between changes in body weight, serum lipid levels (total cholesterol, HDL-cholesterol, triglyceride, β-lipoprotein), and blood pressure (systolic pressure, diastolic pressure) were studied. The subjects were 17, 689 Japanese (aged 19 to 88 years) who had received annual examinations at health centers for two consecutive years. After the date were adjusted for sex, body mass index, and serum lipid levels at baseline, changes in serum lipid levels and blood pressure per kilogram change in body weight were estimated for 3 age groups (under 45, 45 to 64, and 65 or older). Positive relationship between changes in body weight and blood pressure were noted for all 3 age groups. Although total cholesterol, triglyceride, and β-lipoprotein levels all decreased with weight loss in the under-65 groups, total cholesterol in the 65-and-over group did not change significantly. The increases in total cholesterol, triglyceride, and β-lipoprotein levels were associated with weight gain in the under-65 groups, but not in the 65-and-over group. HDL-cholesterol levels in all age groups decreased significantly with weight gain. These results suggest that aging affects the relationship between changes in body weight and serum lipid levels but not that between changes in body weight and blood pressure.
Holter electrocardiography was used to study the circadian rhythm of heart rate in 50 centenarians living in Tokyo and in Aichi prefecture. As a control group, 50 healthy subjects aged under 65 years old underwent medical check-ups including Holter electrocardiography at Keio Health Consulting Center. Harmonic analysis was used to approximate the 24-h time-series data on the RR intervals to a summation of three cosine waves with 24-h, 12-h and 8-h periods. The power of each period was adjusted for the goodness of the curve-fit, and the powers of the centenarians were compared with those of the controls. Then all the subjects were classified by k-means cluster analysis into k groups based on the power of the period, and patterns of heart rate rhythms were then idenitified. The power of the 24-h period in centenarians (32.7±16.0%) was significantly lower than that in controls (45.8±17.8%). Although there were no signigicant differences in the powers of the 12-h and 8-h periods, the power of the 8-h period in centenarians (7.0±8.4%) was slightly higher than that in controls (4.2±3.3%). Advances or delays in acrophase (acrophasal shift) were more common in centenarians than in controls. Five patterns of heart rate rhythms were identified: 24-h period dominant (n=58). 24-h+12-h period (n=15), 12-h period dominant (n=7), 8-h period augmented (n=7), and low curve-fitting (n=13). Both the 8-h period augmented pattern and the low curvefitting pattern were more common in centenarians than in controls. Both the 24-h period dominant pattern and the 24-h+12-h period pattern were less common in centenarians than in controls. These data indicate that the circadian rhythm of heart rate changes with aging.