Publications by authors named "Erika Kobayashi"

51 Publications

Retirement and Social Activities in Japan: Does Age Moderate the Association?

Res Aging 2021 Apr 13:1640275211005185. Epub 2021 Apr 13.

School of Public Health, 1259University of Michigan, Ann Arbor, MI, USA.

Although retirement age is increasing in aging societies, its impact on individuals and communities is unclear. This study examined how age moderates the linkage between transition into retirement and participation in productive and non-productive social activities after retirement, using a nationwide longitudinal survey with a probability sample of Japanese aged 60 and over ( = 3,493). Multinomial logistic regression analyses were performed to predict changes in volunteering and hobbies/learning during 3-5 years of follow-up and their participation level at the follow-up. The significant interactions between change in work status (remained working as reference, full/partial retirement, remained not-working) and age at baseline showed that fully retired persons were more likely to increase these activities than remained workers only when they retired by their early seventies. Thus it is important to encourage engagement in social activities before retirement and remove psychological and environmental barriers that hinder starting new activities at old age.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/01640275211005185DOI Listing
April 2021

Short-, medium-, and long-term weight changes and all-cause mortality in old age: Findings from the National Survey of the Japanese Elderly.

J Gerontol A Biol Sci Med Sci 2021 Feb 24. Epub 2021 Feb 24.

Tokyo Metropolitan Institute of Gerontology, Sakae-cho, Itabashi-ku, Tokyo, Japan.

Background: Recent studies, predominantly in Western populations, suggest that both weight loss and weight gain are associated with an increased mortality risk in old age. However, evidence of this association in older Asian populations remains sparse. This study aimed to examine the association between weight change and all-cause mortality in a nationally representative sample of community-dwelling older Japanese people.

Methods: Data were obtained from the National Survey of the Japanese Elderly, which included 4,869 adults aged ≥60 years. Participants were followed for up to 30 years. We considered three indicators of weight change according to the follow-up interval: short-term (3 years), medium-term (6-7 years), and long-term (12-13 years). Weight change was classified as loss ≥5%, loss 2.5-4.9%, stable (±2.4%), gain 2.5-4.9%, and gain ≥5%. Cox proportional hazards models were used to calculate the relative mortality risk of each weight change category.

Results: Weight loss ≥5% for all intervals was associated with higher mortality than stable weight and the effects were largely similar across all three intervals (hazard ratio [95% confidence interval]: 1.36 [1.22-1.51] for short-term, 1.36 [1.22-1.51] for medium-term, and 1.31 [1.11-1.54] for long-term). A similar pattern of results was observed among the young-old and old-old, and among men and women. The effect of weight loss on higher mortality was greater among those with a lower body mass index at baseline.

Conclusions: These findings could inform clinical and public health approaches to body-weight management aimed at improving the health and survival of older adults, particularly in Asian populations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/gerona/glab052DOI Listing
February 2021

Two Cases of Cranial Nerve Metastasis Treated with Radiotherapy and Chemotherapy in Patients with Lung Adenocarcinoma.

Case Rep Oncol 2020 Sep-Dec;13(3):1495-1500. Epub 2020 Dec 17.

Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

The incidence of central nervous system metastasis is known to be high among patients with lung cancer. The frequency of brain metastasis and carcinomatous meningitis during the entire clinical course of non-small cell lung cancer is reported to be about 40% and 5%, respectively. In contrast, the incidence of cranial nerve metastasis is extremely rare, and detailed reports of its clinical course remain limited. Herein, we report 2 patients diagnosed with cranial nerve metastasis of lung adenocarcinoma and treated with radiotherapy and systemic chemotherapy. Both patients had cranial nerve symptoms, and brain magnetic resonance imaging showed cranial nerve enhancement. However, no evidence of carcinomatous meningitis was noted on magnetic resonance imaging and cerebrospinal fluid cytology. Based on these observations, these patients were diagnosed with cranial nerve metastasis of lung adenocarcinoma. Radiotherapy and chemotherapy were performed in both cases. In both cases, neurological symptoms had not worsened and imaging findings did not indicate any deteriorations. Therefore, radiotherapy and systemic chemotherapy should be considered when treating cranial nerve metastasis of lung adenocarcinoma. Early therapeutic intervention may lead to attenuation of the cranial nerve dysfunction resulting from cranial nerve metastasis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000510306DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7841724PMC
December 2020

Decomposition of gender differences in cognitive functioning: National Survey of the Japanese elderly.

BMC Geriatr 2021 Jan 10;21(1):38. Epub 2021 Jan 10.

Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan.

Background: It is well known that females generally live longer than males, but women tend to suffer from more illnesses and limitations than men do, also for dementia. However, limited empirical evidence is available why this 'male-female health-survival paradox' is observed. This study aimed to investigate factors which account for gender differences in health, particularly cognitive functioning and decline among older adults.

Methods: Data were retrieved from the National Survey of the Japanese Elderly, which is a longitudinal survey of a nationwide representative sample of Japanese adults aged 60 or over. Gender differences in cognitive functioning and decline in three-year follow-ups were decomposed using Blinder-Oaxaca decomposition analysis, regarding demographic, socioeconomic, and health-related factors into the 'explained' component, by differences in individual attributes listed above, and the 'unexplained' component.

Results: Empirical analyses showed that women's lower cognitive functioning was partly explained by the endowment effect. Moreover, a shorter duration of formal education and a larger proportion with their longest occupation being domestic worker accounted for steeper cognitive decline and more prevalent mild cognitive impairment in women than in men.

Conclusion: This empirical study suggested that gender differences in cognitive functioning and decline account for different individual attributes of social determinants among men and women. Particularly, men seem to be more engaged in activities which accumulate intellectual experiences through education and occupation, as suggested by the cognitive reserve hypothesis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12877-020-01990-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7798327PMC
January 2021

Social Isolation and Cognitive Functioning: A Quasi-Experimental Approach.

J Gerontol B Psychol Sci Soc Sci 2020 Dec 26. Epub 2020 Dec 26.

Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.

Objectives: This study aimed to assess the relationship between social isolation and cognitive functioning.

Methods: Data were retrieved from the National Survey of the Japanese Elderly, a nationally representative sample of Japanese adults, aged 60 years or older. We estimated a social isolation index to incorporate variables, such as social interactions, social engagement, and social support, with perceived social isolation, for a comprehensive measurement. The association of social isolation with cognitive functioning was assessed using a panel data fixed-effects model, controlling for age, socioeconomic status, health-related variables, and time-invariant heterogeneity. Moreover, we conducted analyses using the System Generalised Method of Moments (GMM) to address the dynamic relationship of cognitive functioning and potential endogeneity.

Results: For both men and women, the association between social isolation and cognitive functioning was significant, particularly among those aged 75 or older, as a 1% increase in social isolation was associated with decreased cognitive functioning (24% decrease for men, and 20% decrease for women). However, this association was not confirmed by the System GMM, after addressing endogeneity.

Discussion: Our findings potentially suggest that the association between social relationship and cognitive functioning reported in previous studies was biased, due to endogeneity. Although we did not observe causal impacts, this does not necessarily mean that social isolation does not have a negative impact on health, as both positive and negative consequences of social relationships may exist. Further research is needed to reveal the causal relationship, as well as the detailed mechanisms of health effects of social relationships.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/geronb/gbaa226DOI Listing
December 2020

Influence of co-existing social isolation and homebound status on medical care utilization and expenditure among older adults in Japan.

Arch Gerontol Geriatr 2021 Mar-Apr;93:104286. Epub 2020 Oct 22.

Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi, Tokyo, Japan. Electronic address:

Objective: To examine whether co-existing social isolation and homebound status influence medical care utilization and expenditure in older adults.

Methods: Postal surveys on social isolation and homebound status were performed on older adults aged ≥65 years residing in a Japanese suburban city. Information on medical care utilization and expenditure was obtained from insurance claims data. These outcomes were examined over a three-year period (December 2008 to November 2011) for all participants (Analysis I, n = 1386) and during the last year of life for mortality cases (Analysis II, n = 107). A two-part model was used to analyze the influence of social isolation and homebound status on medical care utilization (first model: logistic regression model) and its related expenditure (second model: generalized linear model).

Results: Almost 12 % of participants were both socially isolated and homebound. Analysis I showed that these participants were significantly less likely to use outpatient and home medical care than participants with neither characteristic (odds ratio: 0.536, 95 % confidence interval: 0.303-0.948). However, Analysis II showed that participants with both characteristics had significantly higher daily outpatient and home medical expenditure in the year before death than participants with neither characteristic (risk ratio: 2.155, 95 % confidence interval: 1.338-3.470).

Discussion: Older adults who are both socially isolated and homebound are less likely to regularly utilize medical care, which may eventually lead to serious health problems that require more intensive treatment. Measures are needed to encourage the appropriate use of medical care in these individuals to effectively manage any existing conditions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.archger.2020.104286DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7578670PMC
February 2021

Concomitant emphysema might increase the false-negative rate of urinary antigen tests in patients with pneumococcal pneumonia: results from a retrospective study.

Eur J Clin Microbiol Infect Dis 2021 Apr 4;40(4):871-877. Epub 2020 Nov 4.

Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.

The urinary antigen test (UAT) is a rapid diagnostic method for pneumococcal pneumonia, but the high false-negative rate of 30% may affect its reliability. To maximize the utility of UAT, it is necessary to investigate the patient factors affecting UAT results. However, there is no report elucidating the association between its utility and pre-existing lung abnormalities. We retrospectively reviewed 388 patients with pneumococcal pneumonia confirmed by blood and/or sputum culture tests. Finally, 94 of 388 patients who had the results of UAT and computed tomography scans were enrolled to evaluate the association between the utility of UAT and patient factors including pulmonary emphysema and fibrosis. The overall positive rate of UAT was 69.1%. The positive rates of UAT in the patients with emphysema were significantly lower than those in individuals without emphysema (33.3% and 77.6%, p < 0.001). Univariate logistic regression analysis showed that the presence of emphysema was associated with a low positive rate (odds ratio 6.944, 95% confidence interval 2.268-21.231). Multivariate logistic analysis showed that the presence of emphysema and lower levels of serum blood urea nitrogen (BUN) were significantly and independently associated with a low positive rate. The combination of emphysema and BUN can potentially stratify the positive rate of UAT in patients with pneumococcal pneumonia. Patients with pneumococcal pneumonia and emphysema have a lower positive rate of UAT. Additionally, the combination of emphysema and serum BUN value may be useful to evaluate the reliability of the negative results of pneumococcal UAT.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10096-020-04095-0DOI Listing
April 2021

National prevalence of frailty in the older Japanese population: Findings from a nationally representative survey.

Arch Gerontol Geriatr 2020 Aug 9;91:104220. Epub 2020 Aug 9.

Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan.

Background: Japan has the largest aging population in the world, thus, a focus on frailty is important in clinical geriatric practice. Using a nationally representative sample, this study provided national estimates of the prevalence of frailty among community-dwelling older Japanese people. We also examined variations in the prevalence by sociodemographic characteristics, health conditions, and geographical regions.

Methods: Data came from the National Survey of the Japanese Elderly in 2012. The data were collected using a home visit and face-to-face interviews with trained interviewers. The sample consisted of 2206 adults aged ≥65 years. We used the widely accepted definition of physical frailty phenotype and calculated weighted estimates of the prevalence of frailty.

Results: Overall estimated prevalence was 8.7 % (7.5 %-9.9 %) for frail, 40.8 % (38.7 %-42.9 %) for prefrail, and 50.5 % (48.4 %-52.6 %) for robust. Frailty was more prevalent in older groups, women, and those with lower socioeconomic status, which was measured by education and household income. Frail people tended to have worse health. We also observed a regional variation: frailty prevalence tended to be higher in eastern than western Japan.

Conclusions: This study provides important evidence on the prevalence of frailty in older Japanese people and found substantial disparities by sociodemographic characteristics, health conditions, and geographical regions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.archger.2020.104220DOI Listing
August 2020

[School students' greeting behavior and its association with their community attachment and helping behavior].

Nihon Koshu Eisei Zasshi 2020 ;67(7):452-460

Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.

Objectives Many local governments and elementary and junior high schools in Japan have conducted a "greeting campaign". This has been done in order to activate communication among local residents, and to instill public spirit and sociability in students' minds. However, few studies have explored the significance of greeting campaigns. The present study investigates greeting in neighborhoods and its relationship with students' spontaneous greeting behavior. The study also seeks to understand the quantity of greeting in daily life and its association with a student's community attachment and helping behavior.Methods A self-completion questionnaire survey was conducted with 1,346 students studying in the fourth and higher grades at elementary schools, and 1,357 students in the first and second grade at junior high schools. There were 2,692 valid respondents. We performed the following analyses using the data of elementary school students and junior high school students separately. A partial correlation analysis was conducted wherein gender and grade were introduced as control variables. This analysis tested the correlation between the frequency of being greeted by surrounding people and the frequency of greeting by students, of their own accord. A path analysis that tested the relationship between students' greeting behavior, their attachment to residential areas, and helping behavior was also conducted.Results The results of the partial correlation analysis revealed that there was a positive correlation between the frequency of being greeted by surrounding people and the frequency of greeting by students, of their own accord, regardless of gender and grade. Moreover, the results of the path analysis revealed that the frequency of being greeted was positively associated with community attachment and that the frequency of students' spontaneous greeting behavior was positively associated not only with community attachment but also with helping behavior. The goodness of model fit was high for both the data of elementary school students as well as the data of junior high school students.Conclusion We found that exchanging greetings with surrounding people in daily life enhanced students' attachment to the community. In particular, we showed that students' spontaneous greeting behavior led to their helping behavior, which supports the significance of recommending greeting at home, school, or in the local community. Since there was a correlation between the frequency of being greeted and the frequency of greeting willingly, we consider that actions of surrounding adults become important to help students acquire spontaneous greeting behavior.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11236/jph.67.7_452DOI Listing
September 2020

Working for only financial reasons attenuates the health effects of working beyond retirement age: A 2-year longitudinal study.

Geriatr Gerontol Int 2020 Aug 3;20(8):745-751. Epub 2020 Jul 3.

Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi, Japan.

Aim: The health benefits of paid employment in late life are understood, but they might vary according to work motives. We examined the health effects of employment among older adults, focusing on motivation.

Methods: We carried out a 2-year longitudinal survey from 2013 (baseline) to 2015 (follow up). Among 7608 older adults, the analysis included 1069 who completed both surveys and were employed at baseline. Work motives were assessed using a questionnaire. Participants were assigned to groups based on their responses: (i) financial reasons; (ii) motivation other than financial reasons; and (iii) both financial and non-financial reasons. Self-rated health, mental health and higher-level functional capacity were evaluated as health outcomes.

Results: There were group differences in baseline demographic variables and health status; those with financial reasons had lower socioeconomic status and worse mental health. Multivariable logistic regression analysis showed that compared with older workers with non-financial reasons, those with financial reasons were more likely to decline in self-rated health (OR 1.42; 95% CI 1.00-2.03) and higher-level functional capacity (OR 1.55; 95% CI 1.16-2.07), which was independent of potential covariates, including socioeconomic status. However, no differences were evident between those with only non-financial reasons and those having both financial and non-financial reasons.

Conclusions: We found that the participants who worked only for financial rewards had reduced health benefits through working in old age. A prolonged working life among older workers can contribute to maintaining health and can be enhanced by non-financial reasons, such as finding meaning in life and social contact. Geriatr Gerontol Int 2020; 20: 745-751.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ggi.13941DOI Listing
August 2020

Socioeconomic Differences in Trajectories of Functional Capacity Among Older Japanese: A 25-Year Longitudinal Study.

J Am Med Dir Assoc 2020 06 18;21(6):734-739.e1. Epub 2020 Apr 18.

Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan.

Objectives: There is limited research on long-term changes in functional capacity among older Japanese, who differ significantly from their counterparts in Western, developed nations. This study aimed to identify distinct trajectories of functional capacity over a 25-year period and to explore socioeconomic differences in trajectory-group membership probabilities, using a national sample of older Japanese.

Design: Longitudinal panel study with 8 observation points from 1987 to 2012.

Setting And Participants: The data came from the National Survey of the Japanese Elderly, which consisted of 6193 samples of community-dwelling Japanese aged 60 years and older at baseline.

Methods: Functional capacity measure included basic and instrumental activities of daily living. Group-based mixture models were used for data analysis.

Results: Among participants aged 60 to 74 years at baseline, 4 trajectories were identified: minimal disability (80.3%), late-onset disability (11.6%), early-onset disability (6.2%), and moderate disability (1.9%). Those aged ≥75 years at baseline experienced higher levels of disability but somewhat parallel trajectories, including minimal disability (73.3%), early-onset disability (11.2%), moderate disability (11.3%), and severe and worsening disability (4.2%). Lower socioeconomic status, including education and household income, was associated with a higher risk of experiencing trajectories of poorer functional capacity among those aged 60 to 74 years, but no such association existed among those aged ≥75 years.

Conclusions And Implications: We found that approximately 70% to 80% of older Japanese maintained healthy functional capacity over time. Although we could not follow those who dropped out during the observation period, this study provided useful evidence that socioeconomic disparities in functional health converge with age. Our findings inform the design of health policies and interventions aiming to maintain functional health among older adults with diverse socioeconomic backgrounds. In particular, public policies aiming to reduce socioeconomic disparities should be emphasized to promote healthy aging.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jamda.2020.02.012DOI Listing
June 2020

Factors relating to social isolation in urban Japanese older people: A 2-year prospective cohort study.

Arch Gerontol Geriatr 2020 Jan - Feb;86:103936. Epub 2019 Sep 18.

Research Team for Social Participation and Health Promotion, Japan.

Purpose: We analyzed the data from a 2-year prospective-cohort survey to identify factors relating to new incidences of social isolation and recovery from social isolation in community-dwelling older people.

Materials And Methods: We conducted a longitudinal study (2013-2015) involving 2657 older residents of Iriarai, Japan. A chi-square test, an independent t-test, and logistic regression analysis with imputed data were conducted to examine categorical data, continuous variables, and factors relating to social isolation, respectively.

Principal Results: The results suggested that the factors that predicted future social isolation included being a man, being older, living with others, having a decline in mental health, having a lower frequency of going out, and not participating in community groups. On the other hand, being younger, having a higher level of mental health, having a higher frequency of going out, and participating in community groups were identified as factors that predicted participants' recovery from social isolation.

Major Conclusions: Some demographic, mental, and social factors could relate to new incidences of social isolation and recovery from social isolation in community-dwelling older people. As aging is an irreversible phenomenon, and there is a limit to preventing all disorders, either building a safety net or introducing exchange programs to prevent social isolation are important interventions for older people.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.archger.2019.103936DOI Listing
July 2020

Association of physical performance and self-rated health with multimorbidity among older adults: Results from a nationwide survey in Japan.

Arch Gerontol Geriatr 2019 Sep - Oct;84:103904. Epub 2019 Jun 26.

School of Public Health, University of Michigan, 1415 Washington Heights, M3007 SPH II, Ann Arbor, MI 48109-2029, USA.

Objectives: To examine the association of physical performance measures and self-rated health with multimorbidity among older Japanese adults aged ≥60 years using cross-sectional data from a nationwide longitudinal survey.

Methods: Using respondents' self-reported data from the 2012 National Survey of the Japanese Elderly, we analyzed multimorbidity involving nine major chronic diseases (heart disease, arthralgia, hypertension, diabetes, stroke, cataract, cancer, respiratory disease, and low back pain). Respondents who reported having two or more of these diseases were identified as having multimorbidity. Multivariate logistic regression analysis was used to examine if physical performance (grip strength and walking speed) and self-rated health were independently associated with multimorbidity after adjusting for potential confounders (e.g., demographic, physiological, and lifestyle-related variables).

Results: The responses of 2525 participants who responded to the survey by themselves (i.e., without proxies) were analyzed (response rate: 57.9%). Among the chronic diseases examined, hypertension had the highest prevalence (44.1%), followed by low back pain (25.7%) and cataract (24.7%). Approximately 44.4% of the respondents had multimorbidity. The regression analysis revealed that multimorbidity was significantly associated with both poor grip strength (P = 0.006) and self-rated health (P < 0.001), but not with walking speed (P = 0.479).

Conclusions: Multimorbidity is prevalent in older Japanese adults, and poor grip strength and self-rated health were independently and significantly associated with multimorbidity. Health assessments that include these indicators may provide insight into the health status patterns of older adults with multimorbidity and inform the development of health management strategies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.archger.2019.103904DOI Listing
March 2020

Is unwilling volunteering protective for functional decline? The interactive effects of volunteer willingness and engagement on health in a 3-year longitudinal study of Japanese older adults.

Geriatr Gerontol Int 2019 Jul 16;19(7):673-678. Epub 2019 Apr 16.

Institute for Gerontology, J. F. Oberlin University, Tokyo, Japan.

Aim: The present study explored the interactive effects of willingness to volunteer and actual volunteer engagement on the maintenance of functional health among older Japanese adults, using data from a 3-year longitudinal study.

Methods: We used data from the 3-year longitudinal Tokyo Metropolitan Institute of Gerontology Longitudinal Interdisciplinary Study on Aging (1997). We examined 676 older adults aged >65 years from the rural Nangai District who were independent in their basic activities of daily living (BADL). A follow-up study was carried out in 2000. We categorized participants into four groups: "willing volunteers," "unwilling volunteers," "willing non-volunteers" and "unwilling non-volunteers." Logistic regression analyses were carried out to evaluate the interactive effects of willingness to volunteer and actual engagement in volunteering at baseline on BADL decline over a 3-year period.

Results: During the follow-up period, 6.6% of willing volunteers, 17.4% of unwilling volunteers, 16.3% of willing non-volunteers and 21.0% of unwilling non-volunteers experienced a decline in BADL. Unwilling volunteers (odds ratio [OR] 2.88, 95% confidence interval [CI] 1.29-6.43) and both non-volunteer groups (willing: OR 2.70, 95% CI 1.28-5.72; unwilling: OR 2.48, 95% CI 1.32-4.64) had significantly higher odds of BADL decline than did willing volunteers. When unwilling non-volunteer was set as the reference, the OR of unwilling volunteers became 1.16 (95% CI 0.55-2.49), suggesting that unwilling volunteers had a similar odds of BADL decline as non-volunteers.

Conclusion: Volunteer activity is effective for preventing BADL decline only for those who willingly engage. Geriatr Gerontol Int 2019; 19: 673-678.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ggi.13667DOI Listing
July 2019

[The influence of types of living alone on 2-year health changes according to elderly adults' marital status: Based on the Comprehensive Regional Studies for Preventing Isolation of the Elderly Who Live in Metropolitan Area (CAPITAL Study)].

Nihon Koshu Eisei Zasshi 2019 ;66(3):129-137

Tokyo Metropolitan Institute of Gerontology.

Objectives The aim of this research is to classify elderly adults who live alone by their marital status type and to clarify how those types affect their higher-level functional capacity and mental health with a 2-year follow-up survey.Methods This research is based on the results from a survey in 2013. The base-line scores were from 757 participants who completed a survey by mail, carried out in B area of A ward, Tokyo, within the jurisdiction of community general support centers, with people who were not at nursing care levels 4 or 5 and who were not residents of welfare facilities. This study analyzed data for 517 of 527 participants, who answered all questions in the 2015 survey and indicated their marital status. This research categorized the respondents into 4 types of marital status: separation, divorce, bereavement, and unmarried groups. This study adopted the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) as the index of higher-level functional capacity, and the WHO-Five Well-Being Index (WHO-5-J) as the mental health index. In the analysis of the causes of 2-year variations in TMIG-IC total scores and WHO-5-J scores, the dependent variable was each variation. This study used an analysis of covariance in which the fixed factors were types of living alone, sex, annual income, and having children who lived separately in the 2013 survey, and the covariance comprised the base-line scores for the dependent variables, age, and chronic diseases in the 2013 survey.Results With regards to the variation in TMIG-IC total scores, main effects of the types of living alone were observed. The adjusted variation of covariance decreased most in the separation group (-0.95). For the variation in WHO-5-J scores, main effects of the types of living alone were indicated. In the divorce group, the adjusted variation of covariance was significantly higher than for the unmarried group (2.33 vs. -0.55).Conclusion The results revealed that the types of marital status: separated, divorced, bereaved, and unmarried, affect changes in the higher-level functional capacity and mental health status of elderly adults living alone, 2 years later. Thus, although previously regarded as a single category, types of marital status should be considered in the analysis of elderly adults who live alone.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11236/jph.66.3_129DOI Listing
April 2019

[The relationship between intra- and inter-generational exchange and mental health among young and older adults].

Nihon Koshu Eisei Zasshi 2018 ;65(12):719-729

Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.

Objective The purpose of this study was to examine the relationship between intra- and inter-generational exchange and mental health among young adults aged 25-49 years and older adults aged 65-84 years.Methods In 2016, a community-based, cross-sectional survey was conducted. A total of 3,334 young adults (valid response rate: 24.6%), and 3,116 older adults (valid response rate: 46.0%) completed the survey and were included in the analysis. Their mental health was evaluated using the World Health Organization-Five Well-Being Index (WHO-5), and those who scored under 13 or scored less than one on any item were considered to have poor mental health. To evaluate the intra- or inter-generational exchange, participants were asked about their frequency of interaction with people aged 20-49 years or aged ≥70, excluding family and co-workers. Young adults who interacted with people aged 20-49 years or older adults who interacted with people ≥70 were classified as "having intra-generational exchange," while young adults who interacted with people ≥70 years or older adults who interacted with people aged 20-49 years were classified as "having intergenerational exchange." Therefore, individuals who interacted with both generations were classified as "having multi-generational exchange," and those who did not interact with any generation were categorized as "no exchange." We conducted a logistic regression analysis that included mental health as a dependent variable, intra- and inter-generational exchange as independent variables, and gender, age, educational attainment, marital status, living situation, subjective economic status, social participation, employment, self-rated health, and Instrumental Activity of Daily Living as covariates.Results Of the 3,334 young adults, 61.5% were mentally healthy, 51.3% had intra-generational exchange, 21.9% had inter-generational exchange, 16.5% had multi-generational exchange, and 42.7% did not have any exchange. Of the 3,116 older adults, 65.8% were mentally healthy, 67.9% had intra-generational exchange, 34.3% had inter-generational exchange, 29.9% had multi-generational exchange, and 21.1% did not have any exchange. A logistic regression analysis revealed that "having intra-generational exchange" and "having intergenerational exchange" were significantly related to better mental health in both young adults (intra-generational; Odds ratios (OR) 1.19, 95% confidence intervals (CI) 1.10-1.30: inter-generational; OR 1.13, 95% CI 1.03-1.25) and older adults (intra-generational; OR 1.15, 95% CI 1.02-1.29: inter-generational; OR 1.46, 95% CI 1.30-1.65). Therefore, "having multi-generational exchange" was more strongly related to better mental health compared with "only having intra-generational exchange."Conclusion Among young and older adults, intra- and inter-generational exchange were related to better mental health, and multi-generational exchange showed the strongest relationship with better mental health.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11236/jph.65.12_719DOI Listing
January 2019

[Community Child-Rearing Support Scale: Applicability across generations and differences in the supportive behaviors among generations].

Nihon Koshu Eisei Zasshi 2018 ;65(7):321-333

Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.

Objectives Using the Community Child-Rearing Support Scale (CCRSS), which was developed for older adults, we examined 1) the reliability and validity of the scale for multiple generations, as well as the generational differences in the 2) degree and content of supportive behaviors for child rearing and 3) correlates of the behavior, in conjunction with gender differences.Methods A mail survey was conducted with residents aged 25-84 years who were randomly selected from two cities in Tokyo and the surrounding areas, and responses were obtained from 8918 residents (response rate: 33%). The respondents were grouped as follows: old-aged (65-84 years), middle-aged (50-64 years), and young-aged (25-49 years). We performed the following analyses by age group and gender: 1) Cronbach's reliability coefficient and a confirmatory factor analysis of the CCRSS, 2) analysis of variance of the total CCRSS scores and scores of the three subscales ("children's security and sound growth," "instrumental support to parents," and "emotional support to parents"), and 3) a multiple regression analysis of the total scores in which various individual characteristics were introduced as explanatory variables.Results The reliability coefficient was over 0.85 for each age group, and the factor analysis showed good model fitness. Compared to the middle- and young-aged groups, the old-aged group was more likely to provide support for "children's security and sound growth," and equally (for women) or more likely (for men) to provide "emotional support to parents," thereby resulting in the highest total score among the three generations. The mean score of "instrumental support to parents," such as taking care of a child, was the highest for young women, although the score was low overall. Having a child or grandchild under 13 years old and stronger generativity were positively associated with child-rearing support for all age groups; however, the degree of associations varied across the groups. While having a child was strongly associated with support among the young-aged group, the association between support and generativity was stronger for older groups. Moreover, participation in neighborhood associations or volunteer groups and high school or lower education were associated with more support among all age groups, whereas living in rental apartments was associated with less support among the young-aged group.Conclusion Our findings suggest that the CCRSS can be used for multiple generations and that old people play an important role in child rearing in the community. We found both differences and similarities between generations with respect to the correlates of child-rearing support.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11236/jph.65.7_321DOI Listing
November 2018

Co-existence of social isolation and homebound status increase the risk of all-cause mortality.

Int Psychogeriatr 2019 05 19;31(5):703-711. Epub 2018 Jul 19.

Research Team for Social Participation and Community Health,Tokyo Metropolitan Institute of Gerontology,Tokyo,Japan.

ABSTRACTBackground:Social isolation and homebound statuses are possible risk factors for increased mortality among older adults. However, no study has addressed the impact of accumulation of these two factors on mortality. The aim of this study was to examine whether such accumulation increased the risk of all-cause mortality.

Methods: The analyzed sample was drawn from a mail survey of 1,023 older adults without instrumental activities of daily living disability. Participants were classified into four groups according to the frequency of both face-to-face and non-face-to-face interactions with others (social isolation and non-social isolation) and the frequency of going outdoors (homebound and non-homebound). Social isolation and homebound statuses were defined as having a social interaction less than once a week and going outdoors either every few days or less, respectively. All-cause mortality information during a six-year follow-up was obtained.

Results: In total, 78 (7.6%) participants were both socially isolated and homebound. During the follow-up period, 65 participants died, with an overall mortality rate of 10.6 per 1000 person-years. Cox proportional hazards regression analyses demonstrated that older adults who were socially isolated and homebound showed a significantly higher risk of subsequent all-cause mortality compared with healthy adults who were neither socially isolated nor homebound, independent of potential covariates (aHR, 2.19; 95% CI: 1.04-4.63).

Conclusion: Our results suggest that the co-existence of social isolation and homebound statuses may synergistically increase risk of mortality. Both active and socially integrated lifestyle in later life might play a major role in maintaining a healthy status.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S1041610218001047DOI Listing
May 2019

Factors that promote new or continuous participation in social group activity among Japanese community-dwelling older adults: A 2-year longitudinal study.

Geriatr Gerontol Int 2018 Aug 12;18(8):1259-1266. Epub 2018 Jul 12.

Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.

Aim: Identifying factors that influence participation in social group activities in older adults might be helpful in promoting social participation in this population. We examined factors related to new or continuous participation in social group activities according to group type.

Methods: We carried out a community-based, longitudinal study with a 2-year follow-up period. Of 7608 older adults aged ≥65 years, 3380 completed the follow-up survey and were included in the analysis. We examined private group (hobbies, sports and volunteering; PrG) and public group (neighborhood associations and senior citizen clubs; PuG) activity.

Results: For PrG, 39.6% of the participants were engaged at baseline, 25.5% initiated participation and 9.5% withdrew during the study period. For PuG, 20.8% of the participants were engaged at baseline, 10.8% initiated participation and 31.5% withdrew during the study period. Logistic regression analysis showed mental health, self-rated health, employment, relationships with neighbors, subjective economic status, educational attainment and participation in PuG were related to new participation in PrG. Mental health, employment and relationships with neighbors were significantly related to continuous participation. For PuG, mental health, sex and relationships with neighbors were significantly related to new participation, whereas sex, relationships with neighbors and educational attainment were related to continuous participation.

Conclusions: The rate of new and continuous participation in PrG was higher than that in PuG, and different related factors were identified as existing between social group types. Geriatr Gerontol Int 2018; 18: 1259-1266.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ggi.13457DOI Listing
August 2018

Age and gender differences in the association between body mass index and all-cause mortality among older Japanese.

Ethn Health 2020 08 4;25(6):874-887. Epub 2018 May 4.

Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.

Increasing evidence suggests a reverse J-shaped association between body mass index (BMI) and all-cause mortality among the older population. However, findings from non-Western societies including Japan are still sparse. Furthermore, little evidence regarding variation by age and gender in the BMI-mortality relationship in old age exists. This study aimed to examine age and gender variations in the relationship between BMI and all-cause mortality among older Japanese. Data came from a national representative sample of community-dwelling Japanese aged 60 years and older at baseline ( = 4,869). Participants were followed for up to 25 years. We categorized BMI into seven categories: < 18.5, 18.5-19.9, 20.0-21.4, 21.5-22.9, 23.0-24.9, 25.0-26.9, and ≥ 27.0. Cox proportional hazards models were used to assess the relative mortality risk associated with BMI categories. Lower BMI (< 18.5 and 18.5-19.9) was associated with higher mortality, compared to the mid-normal weight category (BMI: 21.5-22.9), after adjusting for covariates. In contrast, high-normal weight (BMI: 23.0-24.9) and overweight (BMI: 25.0-26.9 and ≥ 27.0) were not associated with mortality. Relative to old-old (aged ≥ 75 years), the higher mortality risk associated with lower BMI (< 20) appeared to be more prominent among young-old (aged 60-74 years). A moderately increased mortality risk associated with low BMI (18.5-19.9) was identified among men but not among women. Among older Japanese, low BMI (< 20.0) was associated with higher mortality, while high BMI (≥ 27.0) was not. The increased mortality risk associated with low BMI is more apparent among young-old and men. These age and gender differences need to be considered in assessing healthy body weight in old age.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/13557858.2018.1469737DOI Listing
August 2020

Population Aging and Health Trajectories at Older Ages.

J Gerontol B Psychol Sci Soc Sci 2017 10;72(6):1111-1112

Department of Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Japan.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/geronb/gbx088DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6790515PMC
October 2017

For how many days and what types of group activities should older Japanese adults be involved in to maintain health? A 4-year longitudinal study.

PLoS One 2017 14;12(9):e0183829. Epub 2017 Sep 14.

Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Tokyo, Japan.

Objective: Studies have suggested that frequent participation in social groups contributes to the well-being of older people. The primary aim of this study was to identify the number of days older adults should participate in the activities of social groups to maintain their health for 4 years. This study also aimed to examine whether the effective frequency differs by the type of social group activity.

Method: We examined a prospective cohort of 1,320 community-dwelling older adults over 65 years of age, who responded to both a baseline and a follow-up mail survey, in a suburban city of Tokyo, Japan. The dependent variable was the change in functional competence during 4 years. Logistic regression analyses were conducted to examine the effects of participation in the activities of the 5 most common social groups among older Japanese on maintaining functional competence.

Results: Nine hundred and ninety-four participants (76.5%) maintained their functional competence for 4 years. The results of the logistic regression analyses showed that participating in alumni groups less than once a month and being an inactive member were associated with higher odds of maintaining functional competence, after controlling for socioeconomic, demographic and baseline health status. Additionally, the odds of maintaining functional competence for 4 years increased upon participating in volunteer groups once a month or more. These results were also confirmed using logistic regression analysis, even after adjustment for the effects of participation in other social groups.

Discussion: The results indicated the effectiveness of volunteer activities that fulfill a social role in maintaining health. Therefore, older adults should be encouraged to participate in activities of volunteer groups at least once a month. Additionally, older adults can obtain positive health outcomes through less frequent participation in alumni groups, compared with the activities of volunteer groups.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0183829PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598946PMC
October 2017

Population Aging and Health Trajectories at Older Ages.

J Gerontol B Psychol Sci Soc Sci 2019 09;74(7):1245-1255

Department of Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Japan.

Objective: This study examines relationships between municipal age structure and two types of self-rated health: general (SRH) and comparison with similar-aged peers (C-SRH).

Methods: Using a national sample of almost 5,000 Japanese older adults over two decades, we employ hierarchical growth curve models to estimate health trajectories. For municipal age structure, we consider both the relative prevalence of elderly adults in the local population and the pace of aging over time.

Results: Living in the oldest municipalities was generally associated with worse health, particularly between the ages of 70 and 80 years. For SRH, the speed of municipal population aging was also independently associated with worse health. For C-SRH, worse health in older areas was partially explained by less favorable economic conditions in those municipalities. Results also suggest that higher levels of employment and social integration among older adults living in the oldest municipalities operate in the opposite direction. That is, these attributes partially "protect" individuals from other factors that contribute to worse health.

Discussion: Relative differences in municipal age structure and the pace of population aging are largely unexplored and potentially important correlates of older adult health. This line of research is increasingly salient in a world with substantial and growing regional variation in population aging.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/geronb/gbx071DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6748743PMC
September 2019

Changes in health behaviors and the trajectory of body mass index among older Japanese: A 19-year longitudinal study.

Geriatr Gerontol Int 2017 Nov 9;17(11):2008-2016. Epub 2017 Mar 9.

Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.

Aim: Although the modification of lifestyle factors might facilitate weight control, the effects of health behaviors on the trajectory of bodyweight among older adults have been understudied. We examined the effect of changes in smoking, alcohol use and physical activity on the long-term trajectory of body mass index (BMI) among older Japanese adults.

Methods: Data came from a national sample of 4869 Japanese adults aged 60 years and older at baseline, with up to seven repeated observations over a period of 19 years (1987-2006). Hierarchical linear modeling was used to analyze the intrapersonal and interpersonal differences in BMI trajectory.

Results: The average BMI among older Japanese adults was 22.3 at baseline, and decreased with an accelerating rate over time. Smoking was significantly associated with lower BMI over time, whereas smoking cessation was associated with higher BMI. Drinking and physical activity were not associated with BMI. We found significant interactions between age and smoking status, and between sex and physical activity, on BMI trajectory: the association between smoking and lower BMI was stronger in younger participants compared with older participants. The association between physical activity and higher BMI was more pronounced among men compared with women.

Conclusion: The present findings yield important new information regarding the complex dynamics underlying the linkage between lifestyles factors and BMI trajectory among older Japanese, and suggest that there might be cross-cultural differences in these linkages. Geriatr Gerontol Int 2017; 17: 2008-2016.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ggi.13008DOI Listing
November 2017

Older Adults Looking for a Job through Employment Support System in Tokyo.

PLoS One 2016 21;11(7):e0159713. Epub 2016 Jul 21.

Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.

Purpose Of The Study: This study aims to clarify the job seeking process of the elderly people through the local employment support facility known as the Active Senior Employment Support Center (ASESC)"AKUTIBU SINIA SHUGYO SIEN SENTAA" in the Tokyo metropolitan area, and evaluate the performance as a complement to the national support systems.

Methods: We conducted 6 waves of longitudinal mail surveys over 38 weeks to 235 older job seekers (146 males and 89 females, average age 63.7, SD 5.6), who visited two ASESCs for the first time, to clarify their living situation, health condition, and changes in their job seeking process.

Results: These older job seekers tended to be at a relatively low education level and on low income, as well as tended to seek jobs for earning living expenses rather than for well-being. Half of them found employment in 35.0 days; however, 23.8% couldn't find any job in 38 weeks, especially those who were younger and with higher education.

Implications: ASESCs are functioning to assist older job seekers who are mainly seeking jobs for earning living expenses, which can be attained in a short time span and enable them to earn some money. These facilities are expected to be consulting services, not only for employment support but also for general living, because it is important to maintain contact with people who are at risk of social isolation, serious financial difficulty, or suicide. We consider it very helpful to encourage and re-activate these mismatched people, by supporting them to engage in highly contributional services to our society and the next generation, such as providing child-care support or daily life support, the demands for which are rapidly increasing due to recent governmental policies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159713PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4956197PMC
July 2017

[Development of the community child-rearing support scale: Measuring supportive behavior among older adults].

Nihon Koshu Eisei Zasshi 2016 ;63(3):101-12

Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology.

Objectives: Isolation and anxiety among child-rearing mothers in Japan are a current social problem. Involving diverse people in the community is recognized as an important factor in successful child rearing. This study aimed to develop a scale to measure supportive behavior for child rearing among older adults in the community and examine its reliability and validity.

Methods: Items were selected to measure supportive behaviors for child rearing in the community in accordance with constructs introduced via literature reviews and a preliminary investigation. Participants were asked to evaluate the frequency of each behavior on a four-point scale in a mail-based survey. Of a random sample of 1,500 individuals aged 60-69, living in the Tokyo metropolitan area, 813 (54%) responded. Construct validity and reliability of the scale were examined by a confirmatory factor analysis and Cronbach's reliability coefficient. The validity was also examined by clarifying whether the assumed positive associations between the scale and the following variables were observed: frequency of contact with community residents; the generativity scale, which measured concern for the next generation; and experience of child rearing measured by number of own children and level of support for grandchildren. Pearson's correlation and multiple regression analyses were performed for the analysis of the results.

Results: The literature review and preliminary investigation revealed three constructs of supportive behaviors: "children's security and sound growth," "instrumental support to parents," and "emotional support to parents." A second-order factor analysis that modeled "child-rearing support in the community" as a higher-order factor above these three factors showed a good model fit when one item was deleted. The reliability coefficient was high enough (alpha=0.87) with the remaining seven items. As expected, the total score positively and significantly correlated with the frequency of contact with residents, especially with the younger generation, including children and their parents; generativity score; number of children; and care for grandchildren. Multiple regression analyses revealed that the measured child-rearing support in the community was largely explained by the frequency of contact with the younger generation. However, being female, taking care of grandchildren, and a higher generativity correlated with a higher child-rearing support score even after controlling for the frequency of contact.

Conclusion: Reliability and validity of the community child-rearing support scale, consisting of seven items, were confirmed. Further studies are required to show applicability of the scale to diverse communities and age groups, and investigate the effects of the measured supportive behaviors on the child-rearing generation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11236/jph.63.3_101DOI Listing
October 2016

Multiple impacts of an intergenerational program in Japan: Evidence from the Research on Productivity through Intergenerational Sympathy Project.

Geriatr Gerontol Int 2016 Mar;16 Suppl 1:98-109

Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.

Compelling evidence supporting the benefits of social engagement in older adults has been increasingly discussed. However, knowledge regarding an intergenerational program is limited. Herein, we provide a targeted review of intergenerational programs by focusing on our novel interventional program, Research on Productivity through Intergenerational Sympathy. The Research on Productivity through Intergenerational Sympathy program is an intergenerational picture-book reading program launched in 2004. Participants were involved a 3-month intensive weekly training seminar comprising classes about book selection, reading techniques and basic knowledge of children's school life. Subsequently, they participated in group activities that involved playing a hand game, and reading picture books to children at kindergartens, elementary schools and public childcare centers, once every 1-2 weeks. The Research on Productivity through Intergenerational Sympathy program has shown improvement of physical and psychological functioning of older adults and healthy upbringing of children. Similarly, Experience Corps - designed to train and place volunteers in participating elementary schools for an academic year during which time they assist teachers - also showed positive effects for older adults' health status and the psychological/academic success of young children in the USA. Health promotion efforts for older adults must support social policy for the creation of meaningful service programs for older adults on a large social scale. As such, an intergenerational program based on the concept of social capital, defined as "features of social organization, such as trust, norms and networks, that can improve the efficacy of society by facilitating coordinated actions," is an effective and sustainable program for health promotion among older adults.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ggi.12770DOI Listing
March 2016

Synergistic or independent impacts of low frequency of going outside the home and social isolation on functional decline: A 4-year prospective study of urban Japanese older adults.

Geriatr Gerontol Int 2017 Mar 22;17(3):500-508. Epub 2016 Jan 22.

Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.

Aim: Decreased frequency of going outside the home and being socially isolated are regarded as predictors of poor health. The object of the present study was to clarify whether these factors have synergistic or independent impacts on future functional decline.

Methods: We examined a prospective cohort of 2427 community-dwelling persons, aged ≥65 years, who responded to the baseline mail survey in Wako City, in 2008. Participants were asked about the frequency of going outside the home, social isolation status (having contact less than once a week with anyone outside household), functional capacity (Tokyo Metropolitan Institute of Gerontology-Index of Competence), age, sex, annual income, self-rated health, depressive mood and mobility.

Results: Of 1575 persons (72.1%) who completely responded to the follow-up survey (T2) in 2012, we defined the groups as follows: group 1, not isolated and going outside the home every day (n = 897); group 2, not isolated and going outside the home less than every day (n = 311); group 3, isolated and going outside the home every day (n = 224); and group 4, isolated and going outside the home less than every day (n = 143). Multiple logistic regression analyses showed that the variables identifying group 3 for men and group 2 for women with reference to group 1 were predictors of subsequent functional decline even after adjustment for confounders (odds ratios 2.01, 1.63; 95% CI 1.20-3.38, 1.03-2.56, respectively).

Conclusion: Social isolation regardless of going outside the home every day for men and going outside the home less than every day regardless of being not socially isolated for women might predict functional decline. Geriatr Gerontol Int 2017; 17: 500-508.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/ggi.12731DOI Listing
March 2017

Associations between social networks and life satisfaction among older Japanese: Does birth cohort make a difference?

Psychol Aging 2015 Dec 2;30(4):952-66. Epub 2015 Nov 2.

Institute of Gerontology.

Japanese older people experienced drastic changes in family structure and values after World War II at different life stages by birth cohorts. We examined how linkages between different types of social ties and life satisfaction (LS) vary across cohorts, in conjunction with age and survey year differences. Data from face-to-face interviews conducted in 1987, 1999, and 2012 with a nationally representative sample of older Japanese (N = 4,917) were analyzed. The participants were members of 4 birth cohorts (C1: 1901-1912, C2: 1913-1924, C3: 1925-1936, C4: 1937-1949), categorized into 6 groups based on cohort and age at time of measurement (young-old [YO]: 63-74; old-old [OO]: 75-86): C1OO, C2YO, C2OO, C3YO, C3OO, and C4YO. Effects of social networks on LS among the 6 groups were compared simultaneously and separately by gender using the Amos software. There were significant cohort variations in the linkages between family network and LS. The positive association between being married and LS was stronger for later cohorts (C3, C4) among men, whereas that of co-residence with a child and LS was stronger for the earlier cohorts (C1, C2) among women. Moreover, the positive association between meeting with nonfamily members and LS increased from 1987 to 2012 among women, indicating a period effect over a cohort effect. The effects of being married and participation in community groups on LS also changed with age. Our results suggest that linkages between social relations and LS should be interpreted within the context of individual and social changes over time.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1037/pag0000053DOI Listing
December 2015

Trajectories of Body Mass Index and Their Associations With Mortality Among Older Japanese: Do They Differ From Those of Western Populations?

Am J Epidemiol 2015 Oct 12;182(7):597-605. Epub 2015 Sep 12.

Few studies have focused on the relationship between the trajectories of long-term changes in body mass index (BMI; weight (kg)/height (m)(2)) and all-cause mortality in old age, particularly in non-Western populations. We evaluated this association by applying group-based mixture models to data derived from the National Survey of the Japanese Elderly, which included 4,869 adults aged 60 or more years, with up to 7 repeated observations between 1987 and 2006. Four distinct BMI trajectories were identified: "low-normal weight, decreasing" (baseline BMI = 18.7; 23.8% of sample); "mid-normal weight, decreasing" (baseline BMI = 21.9; 44.6% of sample); "high-normal weight, decreasing" (baseline BMI = 24.8; 26.5% of sample); and "overweight, stable" (baseline BMI = 28.7; 5.2% of sample). Survival analysis with an average follow-up of 13.8 years showed that trajectories of higher BMI were associated with lower mortality. In particular, relative to those with a mid-normal weight, decreasing BMI trajectory, those with an overweight, stable BMI trajectory had the lowest mortality, and those with a low-normal, decreasing BMI trajectory had the highest mortality. In sharp contrast with prior observations from Western populations, BMI changes lie primarily within the normal-weight range, and virtually no older Japanese are obese. The association between BMI trajectories and mortality varies according to the distribution of BMI within the population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/aje/kwv107DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692978PMC
October 2015