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Having a high level hand-grip strength, good intellectual activities, and good social roles are strongly associated with remaining independence in IADL for the nondisabled Japanese persons aged > or = 65.

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Serum from a thrombocytopenic patient who was refractory to the transfusions of HLA-matched platelets contained a platelet-specific alloantibody, anti-Nak^a. Immunofluorescence analyses revealed that the Nak^a antigen defined by the serum was expressed exclusively on platelets and its distribution was different from P1^A1, Bak^a Yuk^a or Yuk^b. Analysis by Dr. von dem Borne’s group revealed the Nak^a was also different from Ko^a, Ko^b or Zw^b. Family studies showed that the Nak^a antigen was inherited as an autosomal codominant trait. Its antigen frequency in the Japanese population was over 97%. The results of the enzyme immunoassay using monoclonal antibodies for antigen immobilization showed that the Nak^a epitope did not appear to reside on GPIIb/IIIa or Ib. The transfusions of Nak^a-compatible platelets improved the patient’s thrombocytopenia.

Eight hundred and seven elderly persons aged 65-84 years who were randomly selected from the community were interviewed about falls. The rate of falls in the preceding year was 12.8% in men and 21.5% in women. The difference in the rate between the sexes was statistically significant. The rate in the older group was significantly higher than that in the younger group in both sexes, when they were divided into two major age categories. Multivariate logistic regression analysis showed that contact with a doctor within a month preceding the survey in both sexes, age, history of stroke, visual deficit in men, and urinary or bowel incontinence in women were significantly associated with increased risk of falling. The study reveals that falls tend to occur in physically frail elderly people in the community.

The relationship of serum albumin at baseline to mortality, and longitudinal changes of serum albumin were investigated in a 10-year longitudinal study of 421 (197 men, 224 women) community residents aged 69-71. The 10-year survival rate was the lowest in the first quartile of serum albumin at baseline, followed by the second quartile, and third and fourth quartiles (p less than 0.05). In both sexes, 10-year survival curves did not differ between the group with diseases or disabilities at baseline or over time and the group without them.

Objective:  To examine the longitudinal changes in higher‐level functional capacity in Japanese urban and rural community older populations. Design:  Population‐based cross‐sectional, and prospective cohort studies. Setting:  Koganei city in a suburb of Tokyo, and Nangai village, Akita Prefecture, Japan. Participants:  One thousand, five hundred and six older persons (793 in Koganei and 713 in Nangai) aged 65–83 years living at home. Main outcome measures:  Disability in Instrumental Self‐Maintenance (IADL), Intellectual Activity or Social Role, measured by the Tokyo Metropolitan Institute of Gerontology Index of Competence. Results:  At baseline, older men and women in the rural area, Nangai, had higher prevalence of disability in Intellectual Activity compared with respective counterparts in the urban area, Koganei. By contrast, disability in Social Role was more prevalent among elderly people in Koganei than in Nangai. In both areas older men and women had lowest prevalence of disability in IADL among three subscales. The six‐year longitudinal survey on older persons who had initially no disability in all three subscales demonstrated that in urban Koganei older persons were most likely to be disabled in Social Role with advancing age, followed in turn by Intellectual Activity and IADL. By contrast, elderly people in rural Nangai were most likely to be disabled in Intellectual Activity, followed by Social Role and instrumental ADL. The Cox‐proportional hazard model analysis for those who had no IADL disability at baseline revealed that the baseline level of Intellectual Activity or Social Role predicted significantly future onset of IADL disability in both areas even after controlling for sex, age, and chronic medical conditions. Conclusions:  In both urban and rural community older populations, disability in Social Role and Intellectual Activity preceded IADL disability, and predicted significantly the future onset of IADL disability.

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