Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
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Original Articles
  • Wonchul Choi, Katsuyoshi Mizukami
    2020 Volume 57 Issue 4 Pages 441-449
    Published: October 25, 2020
    Released: December 01, 2020

    Aim: The purpose of this study was to clarify the effect of sonic wave vibration (SWV) on mood, the autonomic-nervous system, brain function and cognitive function in elderly people.

    Methods: We randomly assigned 24 late-stage elderly people (M 88.0±5.0 yrs) into a SWV group and a control group. The SWV group conducted 10 minutes of SWV per day, 5 days a week for 8 consecutive weeks. For evaluation purposes, we analyzed the moods with TDMS, heart rate variability (HRV), resting energy expenditure (REE), and brain activation during the Stroop test using near-infrared spectroscopy (NIRS).

    Results: The stability level and pleasure level of mood increased significantly immediately after SWV. Simultaneously, the levels of the parasympathetic nervous system index of HRV significantly increased while the levels of the sympathetic nervous system index significantly decreased. REE also significantly increased. These results suggest that SWV has a relaxation effect as well as increasing the energy expenditure for elderly people. After intervention, Stroop B's execution time significantly decreased suggesting an improvement in the processing speed. The NIRS revealed that SWV may therefore activate the frontal lobe function.

    Conclusions: These results suggest that SWV may have a positive effect on mood, the autonomic nervous system, cognitive function and brain functions, and thus such treatment may be useful for elderly people.

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  • Setsuko Ueno, Yoshiki Takao, Yosuke Wakutani
    2020 Volume 57 Issue 4 Pages 450-457
    Published: October 25, 2020
    Released: December 01, 2020

    Due to the rapid increase in traffic accidents caused by the old populations of ages 65-74 and more than 75 in Japan, the renewal of driver's licenses has become more difficult following the revision of traffic laws in March 2017. As part of the driver's license clinic at Kurashiki Heisei Hospital, the present study investigated the status of voluntary license surrender in Okayama Prefecture of Japan. From March 2017 to December 2019, the number of voluntary surrenders increased from 5,434 to 10,284 cases, or at a rate of 0.42% to 0.80%, among license holders, with the old-old accounting for 68%-77% of voluntary surrenders. The major reasons for surrender were a decline in physical ability (25%-38%), a decline in driving needs (28%-60%), and family's suggestion (14%-17%). The increase in voluntary license surrender over these 3 years was common across all municipalities within Okayama Prefecture, but the surrender rate was closely correlated with the aged-society rate for both old populations of ages 65-74 and more than 75 (r = −0.5508, **p = 0.002 and r = −0.3086, p = 0.110, respectively). The driver's license clinic at Kurashiki Heisei Hospital received 110 visits during the 3-year period, in which MCI (mild cognitive impairment) accounted for 67% of voluntary surrenders (21.8%). The present study suggests that the increase in the rate of voluntary license surrender during the 3-year period was closely related to the aged-society rate in Okayama Prefecture, and that a driver's license clinic provides a detailed dementia status among license holders who have voluntarily surrendered their license.

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  • Georg von Fingerhut, Akihiro Araki, Noriko Okamoto, Toshifumi Takao, K ...
    2020 Volume 57 Issue 4 Pages 458-466
    Published: October 25, 2020
    Released: December 01, 2020

    Aim: Alcohol consumption is high in the colder regions of Russia, and it is related to poor sleep quality, mental and physical health problems. Little known on the actual situation, and no appropriate amount of drinking has been shown as a health guidance. The purpose of this study is to examine the relationship between alcohol consumption (in pure alcohol) and sleep among older people living in the Russian Siberian region, and the factors related to alcohol consumption.

    Methods: A self-reported questionnaire survey was administered to 422 elderly over the age of 60 living in Novosibirsk, the central city of Siberia. Question items were basic attributes, health status, drinking habits, Short Form-8 Health Survey, Geriatric Depression Scale, and Pittsburgh Sleep Quality Index. For drinking elderly, daily amount of alcohol converted in pure alcohol was calculated, and logistic regression analysis among the two groups was compared based on the median value (32 g).

    Results: The valid responses from the survey was 416 (98.9%). Of these, 293 with drinking habits were subjected to logistic regression analysis using pure alcohol (≥32 g/day) as the dependent variable. Significant relationships were found with gender (OR=0.586; 95%CI: 0.345-0.995), years of education (OR=1.538; 95%CI: 1.239-1.910), insomnia (OR=2.442; 95%CI: 1.185-5.032), alcohol intake, due to better sleep (OR=4.120; 95%CI: 1.044-16.258), effects of drinking, arousal during the night (OR=2.586; 95%CI: 1.317-5.077), effects of drinking, from family (OR=26.938; 95%CI: 3.368-215.431).

    Conclusions: Among the elderly people in colder regions of Russia, high alcohol consumption reduces sleep quality, suggesting the need for appropriate standards for pure alcohol and health education.

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  • Tsuyoshi Okamura, Mika Sugiyama, Ayako Edahiro, Fumiko Miyamae, Yukiko ...
    2020 Volume 57 Issue 4 Pages 467-474
    Published: October 25, 2020
    Released: December 01, 2020

    Aim: To clarify the conditions under which dignity is maintained by reviewing the decision-supporting process for a case.

    Methods: We conducted both a longitudinal epidemiological survey and action research in parallel in a large housing complex district in Tokyo, Japan, using the community-based participatory research framework. Through collaboration with community professionals, we supported an isolated elderly man who refused medical intervention for three years until his death. After his passing, we re-examined all of his records, conducted in-depth interviews with the community professionals, and held a conference to review the process of managing this individual.

    Results: Concerning support for the decision-making, three conclusions were obtained from the data: 1) a decision is not always stated explicitly; 2) a decision should be supported by the team, because mind sometimes changes; and 3) supporting decision-making is a process in itself. For the maintenance of dignity in the medical setting, the following were kept in mind: medical context is not all that is important; supporters should wait for the right moment to intervene, and support should be provided to help the patient keep in touch with other people and the community.

    Conclusions: While precisely defining dignity can be difficult, we explored the conditions under which dignity could be maintained by reviewing the decision-supporting process for a single case. Geriatricians may encounter difficult and complex cases such as this in the clinical setting, but guidelines cannot cover such diverse cases.

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  • Yujiro Kose, Masahiro Ikenaga, Yosuke Yamada, Noriko Takeda, Kazuhiro ...
    2020 Volume 57 Issue 4 Pages 475-483
    Published: October 25, 2020
    Released: December 01, 2020

    Aim: This study investigated whether driving-related anxiety was independently associated with physical parameters and physical function in community-dwelling older people.

    Methods: Participants were 523 community-dwelling older drivers (353 men and 170 women). Participants self-reported driving-related anxiety when driving in familiar environments, and completed physical assessments: visual impairment, auditory impairment, cerebrovascular disease (CVD), hand grip strength, knee extension strength, timed up and go (TUG), chair stand, one leg standing with open eyes, functional reach, vertical jump, preferred gait speed and maximal gait speed. Participants were divided into a driving-related anxiety group (72.8±5.1 years; 21 men, seven women) and a no-anxiety (non-anxiety) group (70.7±4.7 years; 325 men, 163 women). We examined physical performance differences between the anxiety and non-anxiety groups using analysis of covariance, and investigated the relationship between anxiety, physical function and performance using logistic regression analysis (forward stepwise selection).

    Results: The driving-related anxiety group was significantly older, with higher rates of visual impairment, auditory impairment, and CVD than the non-anxiety group. The anxiety group exhibited independently poorer TUG and maximal gait speed (P<0.05 for both). Logistic regression analysis revealed significant relationships between anxiety and visual impairment (odds ratio [OR]: 5.6, 95% confidence interval [CI]: 2.5-12.6), auditory impairment (OR: 3.0, 95% CI: 1.3-7.0), TUG (OR: 1.46, 95% CI: 1.1-1.9) and CVD (OR: 3.1, 95% CI: 1.0-9.4) (P<0.05 for all).

    Conclusions: Driving-related anxiety was significantly associated with worse physical performance, visual impairment, auditory impairment, and CVD in community-dwelling older drivers.

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