Japan is reported to have the world’s highest per-capita drowning mortality among older adults, and most deaths occur in bathtubs, suggesting that Japan-specific bathing practices contribute to this occurrence. Because fatal bath-related accidents increase during the cold seasons and physiological studies simulating bathing have documented marked blood pressure fluctuations, prevention efforts have traditionally focused on preventing rapid blood pressure changes induced by indoor temperature gradients—the so-called “heat shock.” However, it has been reported that cases involving organic diseases, such as myocardial infarction or stroke, which may be triggered by blood pressure fluctuations, account for less than half of all fatal bath-related accidents. Furthermore, among individuals rescued after being unable to get out of the bathtub unaided, fewer than 10% were diagnosed as having an organic disease; in the remaining individuals, impaired consciousness, hyperthermia, and tachycardia improved after their rescue and removal from the hot environment. These findings suggest that hyperthermia due to heat exposure—i.e., heat illness—may play a larger role than blood pressure fluctuations alone, indicating the need to prioritize prevention strategies with heat illness in mind.

In this article, we re-examine the validity of the conventional heat-shock–centered framework and argue for new prevention strategies focused on preventing hyperthermia and heat illness during bathing. We specifically address two practical questions: how to avoid bathing-related hyperthermia that can lead to heat illness, and how to detect early situations in which hyperthermia causes impaired consciousness and prevents self-evacuation from the bathtub.

Falls among older adults are a growing public health concern and an increasingly important cause of long-term care needs. Evidence shows that exercise programs combining balance and resistance training can effectively reduce fall risk, yet participation in regular exercise remains limited among community-dwelling older adults in Japan. The Lively 100-Year-Old Exercise was developed in Kochi City in 2002 as a resident-led, community-based fall-prevention program. Despite its spread to many municipalities nationwide, regional disparities in implementation remain, and certain populations—particularly older men—are less likely to participate. To address these challenges, in this paper, implementation science frameworks are applied. The Consolidated Framework for Implementation Research was used to identify barriers and facilitators across five domains, namely, innovation, outer setting, inner setting, individual, and implementation process. Key strategies include strengthening social appeal, administrative support, interdepartmental collaboration, and resident leadership. Furthermore, the COM-B model was used to identify barriers and facilitators to individual participation in the Lively 100-Year-Old Exercise, classifying them into capability (understanding health benefits), motivation (enjoyment and sense of purpose), and opportunity (social support and accessible environments). In this paper, it is concluded that sustained dissemination of the Lively 100-Year-Old Exercise requires evidence-based implementation strategies, systematic evaluation of implementation outcomes, and close collaboration among researchers, local governments, and community stakeholders.

Habitual alcohol consumption is an established risk factor for hypertension. To prevent hypertension, daily alcohol consumption is generally recommended to be less than 20–30 ml in men and 10–20 ml in women. The association between alcohol consumption and hypertension is affected by various factors, including age, sex, body weight, genetic disposition, drinking patterns, smoking habits, and medication for hypertension. The difference in blood pressure between drinkers and nondrinkers tended to be more prominent in men than in women, in the elderly than in the young, in individuals with high alcohol exposure per body weight than in those with low alcohol exposure, in smokers than in nonsmokers, and in individuals not receiving medication for hypertension than in those receiving it. Regarding the effect of polymorphisms of alcohol-metabolizing enzymes on the association between alcohol consumption and blood pressure or hypertension, the findings of previous studies were inconsistent: the associations were reported to be stronger in individuals showing facial flushing after drinking (flushers) than in nonflushers in some studies, but not in others. It remains to be clarified whether the polymorphism of aldehyde dehydrogenase 2 is involved in determining the sensitivity of blood pressure to alcohol. Drinking with a meal may be effective in suppressing the increase in blood pressure induced by alcohol consumption. According to the evidence obtained from the previous studies, differences in the types of alcohol beverage may not affect the association between alcohol consumption and blood pressure, although the anti-oxidative action of wine is expected to lower blood pressure by increasing nitric oxide activity. In conclusion, the effects of the aforementioned confounders on the relationship between alcohol consumption and blood pressure should be taken into consideration when recommending the upper limit of individual alcohol consumption for the prevention and therapy for hypertension.

Background: Japanese workers face long working hours, mental stress, and caregiving responsibilities, contributing to physical and psychological symptoms (e.g., fatigue, depressive mood, and sleep disturbances). These symptoms adversely affect the quality of life (QOL) and work productivity. Nationwide studies on symptom–QOL–work productivity associations across various occupations remain scarce.

Objective: In this study, we quantitatively assessed the associations between self-reported symptoms, QOL, and work productivity loss using a large-scale person-reported outcomes database (PRO-DB).

Methods: In this cross-sectional analysis, we used data from the first PRO-DB survey (June 2024). Among 192,572 employed respondents, demographic data, 40 self-reported symptoms, QOL (EuroQol 5-Dimension 5-Level questionnaire), and work productivity loss [overall work impairment (OWI), Work Productivity and Activity Impairment questionnaire] were analyzed. Generalized linear regression models, adjusted for demographics, were used to assess the impact of symptoms on QOL and OWI. A weighted analysis was conducted to estimate workforce burden by weighting the effect sizes of symptoms on QOL and OWI by the number of respondents reporting each symptom.

Results: Consciousness disturbance (–0.207 QOL, 29.3 OWI) and hallucinations/delusions/auditory hallucinations (–0.192 QOL, 29.3 OWI) were strongly associated with lower QOL and increased OWI but had a limited population impact due to their low prevalence. In contrast, weighted analysis showed that easy fatigability (–0.0199 QOL, 4.79 OWI) and depressive mood (–0.0135 QOL, 2.44 OWI) had the greatest workforce-wide effects on QOL and productivity loss.

Conclusion: These findings highlight a dual burden of symptoms among Japanese workers. Effective interventions should address both rare severe symptoms and common mild symptoms to improve well-being and productivity.

Objectives: In this study, we aimed to clarify the association between social relationships and specific domains of cognitive function in older adults.

Methods: The participants were 1,409 community-dwelling individuals aged 65–95 years (mean age: 68.7 years) who had not received treatment for cognitive impairment. Their cognitive function was assessed using the Japanese version of the Mini-Mental State Examination (MMSE-J), which evaluates six domains: orientation, registration, attention, recall, language, and figure copying. Social relationships were measured using the Index of Social Interaction (ISI), which consists of 18 items across five subdomains: independence, social curiosity, interpersonal interaction, social participation, and sense of safety.

Results: Although MMSE-J domain scores were high, attention showed greater variability between individuals and declined earlier than other domains, whereas registration and figure copying remained relatively stable. Multivariate-adjusted logistic regression analyses revealed that reduced social curiosity was associated with lower scores across multiple cognitive domains. A lower score for independence in daily life was associated with lower scores in recall and language, and limited social participation was linked to lower scores in orientation and figure copying. Furthermore, age-related patterns were observed. Among individuals under 75 years, reduced social curiosity was associated with cognitive decline. In contrast, among those aged 75 years and over, cognitive decline was more strongly associated with a lack of safety, fewer interpersonal interactions, and limited social participation.

Conclusions: These findings suggest that the association between social relationships and cognitive function varies across cognitive domains and differs by age group, providing valuable information for developing support and preventive strategies for older adults.