Purpose: To consider whether family doctors and health check doctors can screen early stages of mild cognitive impairment (MCI) and Alzheimer's Disease (AD) more easily. Method: We held the Urakami's simple screening test for dementia in 610 subjects, who underwent a health check at the Department of Health Promotion and Preventive Medicine in Osaka Rosai Hospital. We considered a score beyond 12 (full 15) as MCI. We investigated the relationship between MCI and age, sex, lifestyle-related diseases such as hypertension, hyperlipidemia and diabetes. We calculated an odds ratio using multivariate logistic regression analysis. Results: Our study demonstrated a high frequency of MCI in elderly people (over 70-years-old) compared to subjects who were not yet 69-years-old. Our data showed a high frequency of MCI in men compared to women. In reference to the relationship between lifestyle-related diseases and MCI, only diabetes contributed as a risk factor for MCI. From the results of the multivariate logistic regression analysis, men, over 70-years-old, diabetes displayed an independent risk factor for subsequent development of dementia (odds ratio 1.9-2.1). Conclusion: Our data showed that the Urakami's simple screening test for dementia is a very useful tool for dementia prevention.
A new software tool for the health guidance and management of Metabolic Syndrome (MS) patients was developed by us. The usability of this tool was verified on several patients. The method behind the tool relies on the application of Self-Organizing Maps (SOM) with which clusters are formed, following a “similarity” principle. Four components (obesity, diabetes, hyperlipidemia, hypertension), which make up the MS diagnosis, are used as dimensions of a space in which the individual cases are related to each other by their relative positions on a spherical surface that, in turn, is displayed as a planar map on a computer screen. This planar map is visualized as a color map, called ”Component Map“. A change over time in the physical relationship between the 4 components is observed as a trace in the ”Score Map“: a trend is given a score in the range from 0 to 100 corresponding to the degree of illness of the patient diagnosed with MS. The mutual understanding and trust between the patient and the health advisor, in taking steps to improve the living habits of the former, can be made more effective by using the ”Estimate Map“ as a guidance. With this map, the change can be visualized in terms of each one of the 4 components, and used for documenting and scheduling purposes. After reviewing the within-individual changes over 10 years, observed in 38 patients diagnosed with MS, which came in for their medical checkups, we found that the physiological change of the individual patient is important. The score value, which shows the degree of severity of MS, when contrasted with MS Diagnosis Standard, was validated. We can distinguish with our method a normal area, with a score equal or less than 20, which compared well to non MS cases of Japan MS Diagnosis Standard. Also, when comparing the scores obtained with our method, for the case of a group of 57 male patients, with the health guidance of “Specific Screening Program”, 64.9 % showed an improvement, 15.8 % remained unchanged, 19.3 % showed an aggravation of their condition. All these numbers approximately agreed with the ratios based on a large national investigation. In this study, the usability of a new method in support of the health care management of MS patients effectively in Health Evaluation and Promotion was validated.
The purpose of this study was to investigate the effects of health promotion class on participation rate, scales of profile of mood state (POMS scales) and physical characteristics. Fifty six subjects, whose age ranged from 40 to 69 years, participated. They were divided into 2 groups: 30 participants who already had exercise habits (EH group) at the time of participation, and 26 other participants who had been sedentary (S group). The health promotion classes were held 90 min per class, once a month, and for 6 months. The primary intervention of the class was based on supportive personal interview which is based on psychiatric therapy. In addition, simple weight training and stretching were instructed for 30 min. The participation rates for EH group and S group were 78.3±21.1% and 84.0±18.5%, respectively. Body weight, body mass index, percentage of body fat, and waist in both group significantly decreased at the end of the class. The number of steps on average in S group significantly increased at the end of the class. In EH group, the fatigue score of POMS significantly decreased. On the other hand in group S, the scores of depression, anger and fatigue significantly decreased, while vigor increased. In conclusion, the health promotion class based on supportive personal interview was effective on changing physical characteristics and POMS scores.
HIV/AIDS continue increasing in Japan and we considered the correspondence to the HIV examinees. The subjects were five HIV examinees whom we were able to know in our health care center from 2005 to 2010. We evaluated their background and abnormal items. In addition, we evaluated HIV screening that we examined as an option. The cases were all men (two 30s, three 40s), and they were 1) already under treatment, 2) acute HIV infection, and 3) AIDS. Two cases under treatment did not talk about their HIV at the time of their first contact. One case of acute HIV infection and two cases of AIDS were discovered because the abnormality of the gastric cancer screening of direct fluororadiography or the chest X-ray check existed. The ratio of examinees who examined optional HIV screening was only 0.35% of the whole. The examinee with positive HIV screening was only one who was acute HIV infection, and he was recommended to examine HIV screening by the doctor. We should understand the behavior of the HIV examinees and make an effort to discover HIV/AIDS early.
Prevention of cardiovascular diseases through comprehensive health screening is possible if risk factor modification is made from young to middle age generation. For successful aging, prevention of heart failure and cognitive impairment in the elderly are particularly important. To preserve diastolic heart function by adequate blood pressure control and primary prevention of coronary heart disease through conventional risk factor modification are useful. However, such outcome appears decades later, and long-term life style modification is usually difficult. Evidence about effectiveness of precise screening procedures using modern technology such as ultrasound and long-term risk factor modification are lacking. Since Japan is a leading country in comprehensive health evaluation system, we need to construct reliable database concerning long-term outcomes using modern screening procedures. Improving prevention of cardiovascular diseases through reliable database could be a touchstone of our future health evaluation and promotion system.