Aim: The maintenance and improvement of self-rated health is important for prolonging healthy life expectancy in a well-aged society. In the present study, we examined the effectiveness of beauty care on self-rated health among community-dwelling older people through a quasi- randomized controlled trial by propensity score matching (PSM). Method: One hundred twelve community-dwelling older people who were recruited from the local community, participated in a beauty care program that consisted of two training sessions per month for 3 months and daily enforcement of facial skin care (intervention group). Seven hundred fifty-nine participants who received a comprehensive geriatric assessment were treated as a control group. Sex, age, BMI, lifestyle habits, hand grip strength, walking speed, skeletal muscle mass, bone density, medical history and life function (Kihon Checklist) were matched by the PSM method. We compared the subjects' self-rated health, depressive mood status (self-rating depression scale: SDS), and the frequency of going outdoors in the intervention and control groups before and after intervention. Results: The improvements of SDS were significantly greater in the intervention group than in the control group. The self-rated health and the frequency of going outdoors were maintained in the intervention group but were significantly decreased in the control group. Conclusion: We conclude that beauty care is effective for maintaining and improving the self-rated health and depression status of community-dwelling older people and that it may help prolong healthy life expectancy.
Objective: This study aimed to elucidate the urination status among elderly people with incontinence who require at-home nursing care as well as the status of their family caregivers, and to identify the factors related to their urination methods. Methods: In the present study, questionnaires were distributed to 101 elderly subjects (n=101) and their caregivers. Results: The most prevalent urination method was the collaboration of toilet and adult diapers (69, 68.8%).There was a significantly larger number of patients who used a toilet <4 times and who had a "moderate" amount of incontinence and patients who used toilet 4-8 times and had a "slight" amount of incontinence (p<0.05). We performed a multivariate logistic regression analysis using the stepwise method. We used 8 items from the responses of the elderly subjects and their caregivers that were identified as being independently associated with the urination method using the chi-squared test (or Fisher's exact probability test), with the urination method as the dependent variable. Among elderly people, the ability to use a toilet properly (p=0.004) and independent mobility (p=0.028) strongly influenced their use of a toilet for urination. Among caregivers, the influencing factor was not thinking that they have to use the toilet even though they are unable to urinate (p=0.027). Conclusion: The use of a toilet for urination by elderly people was influenced by their physical functions and by the caregivers' attitudes toward excretion-related nursing care. When providing urination assistance, it is important for caregivers to maintain the physical functions of the elderly by providing support when necessary. It is also important to assess the bladder function by, methods such, as measuring the amount of residual urine and cooperate with a physician.
Aim: We herein investigated the clinical features of elderly patients with newly developed type 1 diabetes with respect to onset age, frequency of islet-associated antibodies, and other clinical markers. Methods: One hundred and ninety-nine patients aged 65 and older with new-onset diabetes, who were admitted to our hospital between July 2000 and June 2013, were classified into 4 types of diabetes. In addition, 85 patients with newly diagnosed type 1A diabetes among all age ranges admitted during the same period were divided into two groups: a younger group (less than 65 years, n=71) and an elderly group (65 years and older, n=14). Clinical features including mode of onset, frequency of islet-associated antibodies, and serum C-peptide (CPR) levels were compared between these groups. The elderly group was further divided into two age groups (less than 75 years, n=7; 75 years and older, n=7), and the frequency of autoantibodies was compared. Results: The patients (n=199) were classified into type 1 (n=16, 8%), type 2 (n=155, 78%), pancreatic (n=22, 11%), and other type (n=6, 3%) diabetes. Between the younger and elderly groups with type 1 diabetes, no significant difference in the CPR levels, frequency of autoantibodies, or other clinical features were observed. Positivity for IA-2 antibody was higher in the younger group (53.5%) than in the elderly group (35.7%), however, it was also considerably high (57.1%) in the oldest age group (75 years and older). Conclusions: Type 1 diabetes may develop in the elderly, and an IA-2 antibody test may be useful for diagnosing type 1 diabetes in older patients.
Aim: Subacute myelo-optico-neuropathy (SMON) is a known adverse effect of clioquinol use; however, clioquinol dissolves beta-amyloid aggregation in Alzheimer's disease (AD). Therefore, we investigated the prevalence of dementia in SMON patients and whether past clioquinol use affected the current incidence of AD. Methods: We included 647 SMON patients (195 men, 452 women; mean age 77.9 years) who had undergone medical checkups including the mini-mental state examination (MMSE) in 2012. Of them, 105 patients scored ≤23 on the MMSE assessment. The presence/absence of dementia and disease backgrounds were obtained by a questionnaire. Then, using the medical checkup database, the correlation between the degree of severity when signs of SMON were at their worst and the concurrent presence or absence of AD at present was analyzed. Results: In patients ≥65 years of age, the estimated prevalence of dementia was approximately 10.9% (95% confidence interval: 7.9%-13.8%). The concurrent presence of AD at present was not correlated with the past degree of SMON severity when the SMON signs were at their worst. Conclusions: The 10.9% prevalence of dementia in SMON patients was lower than a previously reported 15% prevalence found in the general population. According to these results, we cannot draw a definitive conclusion regarding the preventive effect of clioquinol on AD. Additionally, the lack of association between the onset of AD and past severity of SMON precludes definitive conclusions on the relationship between concurrent presence of AD and past clioquinol use.
An 85-year-old man with severe aortic stenosis (transaortic peak velocity 4.4 m/s, mean gradient 46 mmHg and valve area 0.71 cm2) was admitted to our hospital due to mild exertional dyspnea (NYHA class II). He had received low-dose prednisolone (5 mg/day) plus tacrolimus hydrate (1.5 mg/day) for rheumatic arthritis and interstitial pneumonia. Although aortic valve replacement was indicated, he was considered at high risk to undergo open heart surgery because of reduced pulmonary function (FEV1.0%, 77.2%) and long-term treatment with immunosuppressive drugs. After a multidisciplinary heart team conference, the decision was made to perform transfemoral transcatheter aortic valve implantation (TAVI) using a SAPIEN XT 26 mm valve. TAVI was completed in 105 minutes without any complications. After the procedure, his symptom was improved and his activity of daily life was maintained, and he was ambulatory the next day. Aortic stenosis by degenerative calcification is becoming increasingly common as the Japanese population ages. TAVI has been used to treat patients with concomitant diseases and at high risk of open heart surgery. We herein report a case with rheumatic arthritis and interstitial pneumonia that underwent successful TAVI.