The prevalence of "bedridden elderly" in Japan is at least three times higher than that of anyother industrialized country. To decrease likelihood of being bedridden, it is important to cultivate and maintain the willingness of older disabled patients for rehabilitation and to preserve functioning in activities of daily living (ADL). The purpose of this study was to identify the factors influencing the willingness of Japanese and American institutionalized elderly with disabilities regarding rehabilitation, with respect to physical, goal-attainment, psychological and cultural aspects. These results were compared to examine cultural differences which might explain higher prevalence of the bedridden elderly in Japan. The sample of this study consisted of 71 disabled older adults (45 in Japan and 26 in the U. S.), and the data were gathered using structured interviews to the subjects and administering questionnaires to the nurses. Thirty Japan subjects (66.7%) and 16 American subjects (61.5%) were identified as "willing for rehabilitation", whereas 15 Japanese (33.3%) and 10 Americans (38.5%) were "unwilling for rehabilitation". The data were compared between the "willing" and the "unwilling" in each country. This study revealed that factors found to influence willingness of older persons for rehabilitation included, in common, generalized endurance/stamina, presence of pain, presence of depression, presence of regressive behavior, and presence of dementia. Two more factors were included for Japanese elderly : functionally independence level in ADL and expectation of others help all the time, known as amae. Healthcare workers should use a multidimensional perspective of an individual's cultural factors as well as his/her physical and psychological factors in order to motivate him/her toward achieving his/her optimum level of functional ability.
Chronological age (CA) is an insufficiently sensitive measure of senescence because it cannot distinguish between individuals who share the same CA but differ in physiological and/or functional status. The purpose of this study was to develop an age index for assessing functional fitness applicable to older Japanese and Korean women. The subjects were 429 (176 Japanese and 253 Korean) women, aged 65 to 85 years. Seventeen items related to functional fitness were measured. In order to combine all of the variables into a single expression, the principal component analysis was applied to the 17×17 correlation matrix. The first principal component was significantly loaded with all variables, and explained 36.3% of the total variance . The first principal component score (FPCS) showed a siginificant correlation (r= - 0.582) with CA, and was used as an overall index of age-related changes in functional capacity. The individual FPCS were transformed to functional fitness age (FFA). The equation developed for est mation of functional fitness in older Japanese and Korean women was FFA = - 4.92FFS + 72.98, FFS =-0 .035X1 + 0.049X2 + 0.032X3 - 0.132X4 + 0.049X5 -1.84; where FFS = functional fitness score, X1 = walking around two cones in a figure 8, X2 = manipulating pegs in a pegboard, X3 = functional reach, X4= standing up from a supine position, X5= grip strength. Correlation coefficient between FFA and CA was 0.580 (P< 0.05). This index is thus judged valid for discrimination between older Japanese and Korean women who share the same CA but differ in functional status.
The purpose of this study is to propose an effective strategy for prevention and interventionof developmental problems in early adulthood by the Developmental Risk Screening (DRS) which has been originally developed by the authors. The subjects of this study were 267 pairs of young adult and his/her parent(s); these young adults were all who were born in 1972 in the area of one health center in Tokyo and received a third-month postnatal health examination and whose current addresses were grasped. They were divided into the follow-up group (N =149) and the non-follow-up group (N =118). Among the 267 subjects, 68 (25.5%) participated in the questionnaire survey for this study.The items of the DRS consist of seven developmental risk factors covering three, i.e. biological, psycho-social and domestic environmental, domains. The positive/negative dichotomization of the DRS screening was determined by the number of risk domains: 20 subjects (29.4%) who had two or three risk domains were classified as the developmentally questionable group and 48 (70.6%) who had one or no such domain were the non-developmentally questionable group. Taking into account the positive DRS and the level of subjective life satisfaction, four subjects (5.9%) were identified as the targets of the primary prevention and intervention. Discussion focuses on usefulness of the DRS for judgment of the needs for primary prevention and intervention among the early adulthood in a community.
During the past several decades, birth rate and death rate have remarkably declined in both developed and developing countries. As the result, the age structure of any countries have been rapidly changing, and it is difficult to grasp such changing patterns in the age structure by means of any demographic indices used so far (e.g. age dependency ratio and mean age). In 1980, Kazumasa Kobayashi applied the two-parameter logit model developed by William Brass to the analysis of the age structures for 12 Asian countries . He judged that this mathematical model provided more suitable outcomes than any other demographic methods did. Considering his early application of this model, Kobayashi's analysis was judged to have led to fairly good results. However, it is noted that the Brass model sometimes fails to fullyreflect the mortality patterns of childhood and old ages, implying that there is still room for improvement in the analysis of age structure by means of mathematical models . The four-parameter logit model developed by Douglas Ewbank and his colleagues was desigened to cope with the problems which were incorporated in the Brass model . The purpose of this paper is to ascertain the validity and applicability of the Ewbank model, while analyzing the data of age structure for the 12 Asian countries . This study concluded that this model is far more valid and applicable than the Brass model .