Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH)
Online ISSN : 2187-8986
Print ISSN : 0546-1766
ISSN-L : 0546-1766
Volume 64, Issue 5
Displaying 1-5 of 5 articles from this issue
Original article
  • Kumi WATANABE, Emiko TANAKA, Bailiang WU, Zyunko KOBAYASHI, Yukiko MOC ...
    2017 Volume 64 Issue 5 Pages 235-245
    Published: 2017
    Released on J-STAGE: June 14, 2017
    JOURNAL FREE ACCESS

    Objectives Recently, social isolation has been reported to be a critical problem among Japanese elderly persons. However, few studies have compared social interaction in the past and the present or investigated its predictive factors. This study aimed to clarify the transitional changes in social interaction over 20 years and explore the factors related to social interaction focusing on the use of community resources.

    Methods The participants were community-dwelling elderly persons aged 65 years and over. A survey was conducted 8 times from 1994 to 2014 in the suburban area of Tobishima, Japan. The Index of Social Interaction Scale was used and each subscale and the total score were calculated. Subsequently, the 2014 scores were compared with the 1994 scores using the Wilcoxon rank sum test. Logistic regression analysis was conducted to clarify the factors related to social interaction, focusing on the association between the use of community resources (local elderly management center, health care center, health promotion facility, library) in 2011 and social interaction 3 years later. Age, gender, disease, and mobility were also entered into the model as control variables.

    Results Comparing social interaction in 1994 and 2014, total scores were found to have significantly increased in all age groups. Independence scores significantly increased in the overall group and in females aged 75-84. Curiosity scores also increased in both males and females. These results show that social interaction has increased over 2 decades. In addition, the use of local elderly management and health care centers, and health promotion facilities was associated with total social interaction scores 3 years later.

    Conclusion The current study clarified changes in social interaction, both comprehensively and for each of its aspects, among community-dwelling elderly adults. Increasing social isolation has been reported in recent years; however, the current study showed that social interaction, including social curiosity and independence, has increased over 20 years. The effect of preventive intervention in local elderly management centers, health care centers, and health promotion facilities may be one of the causes for this increase.

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  • Taishi TSUJI, Daisuke TAKAGI, Naoki KONDO, Katsunori KONDO
    2017 Volume 64 Issue 5 Pages 246-257
    Published: 2017
    Released on J-STAGE: June 14, 2017
    JOURNAL FREE ACCESS

    Objectives This study aimed to develop risk assessment scales for predicting the incidence of Needed Support/Long-Term Care certification, by aggregating data from the Kihon Checklist, medical assessments, and long-term care insurance certification during a follow-up period (a maximum of 4 years and 2 months) conducted in a municipality.

    Methods This retrospective cohort study included 72,127 older adults aged 65 years or older living in K City (an ordinance-designated city) who responded to the Kihon Checklist in 2011. We linked their medical assessment data (examined/unexamined, blood pressure, and five blood biochemical items) from 2011 and information on the incidence of long-term care insurance certification from 2011 to 2015 to the Kihon Checklist data (the 12 essential items and seven optional items from the Needs Survey). We constructed four Cox proportional hazards models as follows: 1) age, sex, and the Needs Survey's 12 essential items; 2) model 1 plus seven optional items; 3) model 2 plus examined/unexamined at medical assessment; and 4) model 3 plus blood pressure and five blood biochemical items, as independent variables. Recent requirement for Support/Long-Term Care certification was included as an outcome with stepwise forward selection. We assigned scores for each item based on the non-standardized regression coefficients obtained (B) and the sum of those scores was used to establish the risk assessment scales for predicting Needed Support/Long-Term Care certification from each model. A receiver operating characteristic (ROC) analysis was conducted to estimate the sensitivity and specificity in order to compare predictive validity of the scales.

    Results During the follow-up period, 11,039 (15.3%) individuals required a new incidence of a Needed Support/Needed Long-Term Care certification. A risk assessment scale of 0-55 was established based on age, sex, and the 10 essential items from the Needs Survey's. The incidence of certification were 3.2%, 14.7%, 31.6%, 56.7%, and 75.0% at scores of 10, 20, 30, 40, and 50, respectively. The area under the ROC curve (AUC) was 0.783, and the sensitivity and the specificity were 0.705 and 0.731, respectively (cut-off: 21/22). These values remained almost unchanged despite the addition of optional and medical assessment items (AUC: 0.786-0.787, sensitivity: 0.721-0.730, and specificity: 0.710-0.717).

    Conclusion Although the medical assessment data was not aggregated, the scale developed from the Kihon Checklist's 10 items (included in the Needs Survey's essential items) is useful for predicting the incidence of Needed Support/Long-Term Care certification. The scale, which evaluates the risk of needed support/long-term care at individual and community levels, was developed using the existing Kihon Checklist data or the Needs Survey's data collected subsequently by municipalities.

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  • Hiromi TSUTATANI, Mika FUNAMOTO, Daisuke SUGIYAMA, Kazuyo KUWABARA, Na ...
    2017 Volume 64 Issue 5 Pages 258-269
    Published: 2017
    Released on J-STAGE: June 14, 2017
    JOURNAL FREE ACCESS

    Objective From April 2008, specific health checkups have been implemented to prevent metabolic syndrome (MetS) and related cardiovascular diseases based on assurance of medical care for the elderly in Japan. In its “Standard Health Checkup and Counseling Guidance Program,” 22 standard question items are recommended to assess health conditions of Japanese citizens. However, there are few community-based studies to clarify the relationship between question items and new onset of high risk conditions for cardiovascular diseases such as MetS. Accordingly, we performed a 5-year follow-up study of community dwellers who participated in health checkups of National Health Insurance beneficiaries in Habikino City, Osaka.

    Method Lifestyle factors assessed by standard question items in 2008 were defined as exposures at baseline survey. In the analysis of MetS, we followed-up 4,720 participants without MetS; and in the analysis of hypertension, we followed-up 3,326 participants without hypertension until the end of March in 2013. New-onset MetS or hypertension during follow-up were defined as outcomes. Cox proportional hazard model was used to evaluate the relationship between lifestyle factors and the incidence of MetS or hypertension after adjustment for age and waist circumference.

    Results The median follow-up period for incidence of MetS was 3.1 years for men and 3.6 years for women. We observed 570 new cases of MetS during follow-up. For men, “taking dinner within 2 hours before going to sleep” and “body weight increase by 10 kg or greater from 20 years old” were significantly associated with MetS (hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.09-1.88 and HR, 1.33; 95% CI, 1.19-1.75, respectively). Occasional consumption of alcohol in men was negatively associated with MetS. For women, “increase or decrease of body weight by 3 kg or greater within 1 year” and “body weight increase by 10 kg or greater from age of 20” were significantly associated with MetS (HR, 1.83; 95% CI, 1.40-2.40 and HR, 2.02; 95% CI, 1.52-2.68, respectively). Daily alcohol consumption from 1 to less than 2 gou (about 23 to 45 g of ethanol) in women was positively associated with MetS (HR, 2.64; 95% CI, 1.51-4.64). We observed 1,045 new cases of hypertension; however, except for daily alcohol consumption for men, no lifestyle factors were associated with incidence of hypertension.

    Conclusion Most standard question items of specific health checkups did not predict new-onset MetS or hypertension, at least within 5 years. Thus, development of more predictive question items is warranted.

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