BackgroundVision and hearing impairments among elders are common, and cognitive impairment is a concern. This study assessed the association of vision and hearing impairments with cognitive impairment and mortality among long-term care recipients.MethodsData of 1754 adults aged 65 or older were included in analysis from the Gujo City Long-Term Care Insurance Database in Japan for a mean follow-up period of 4.7 years. Trained and certified investigators assessed sensory impairments and cognitive impairment using a national assessment tool. Five-level scales were used to measure vision and hearing impairments. Cognitive performance was assessed on two dimensions, namely communication/cognition and problem behaviors. We performed logistic regression analysis to estimate odd ratios (ORs) and 95 % confidence intervals (CIs) for the association of vision and hearing impairments with cognitive impairment. Using Cox proportional hazard regression models, we obtained hazard ratios (HRs) for mortality.ResultsOf 1754 elders, 773 (44.0 %) had normal sensory function, 252 (14.4 %) vision impairment, 409 (23.3 %) hearing impairment, and 320 (18.2 %) dual sensory impairment. After adjusting for potential cofounders, ORs of cognitive impairment were 1.46 (95 % CI 1.07–1.98) in individuals with vision impairment, 1.47 (95 % CI 1.13–1.92) in those with hearing impairment, and 1.97 (95 % CI 1.46–2.65) in those with dual sensory impairment compared to individuals with normal sensory function. The adjusted HR of overall mortality was 1.29 (95 % CI 1.01–1.65) in individuals with dual sensory impairment and cognitive impairment relative to normal sensory and cognitive functions.ConclusionsCognitive impairment was most common in individuals with dual sensory impairment, and those with dual sensory impairment and cognitive impairment had increased mortality.
The purpose of this study was to investigate the association between mental health (posttraumatic stress disorder, depression, anxiety disorder, and burnout) and intention to resign, and influencing factors regarding nurses involved with COVID-19 patients in A Prefecture as subjects.The design is a cross-sectional questionnaire-based study. Methods are conducted between August 4 and October 26, 2020. Basic attributes (gender, age, years of experience, etc.) were examined. Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, Impact of Event Scale-Revised, Maslach Burnout Inventory, "intent to resign," were used to collect data from nurses working at hospitals treating patients with COVID-19 in Japan.As a result, between 20% and 30% of nurses involved with patients with COVID-19 are in a state of high mental distress. Regarding the associations between psychiatric symptoms and intention to resign, "I want to quit being a nurse" was affected by "cynicism" and "professional efficacy"; "I want to change hospitals/wards" was affected by "cynicism"; and "subthreshold depression," "anxiety disorder," and "burnout" affected "I want to continue working as a nurse." The increase in the number of patients with COVID-19 was a factor affecting mental health and intention to resign. When the number of patients increased, anxiety disorders and intention to resign also increased. Damage from harmful rumors increased the severity of every psychiatric symptom. To prepare for a pandemic such as COVID-19, it is necessary in normal times to construct psychological support systems and community systems to prevent damage from harmful rumors.
The aim of this study was to determine whether home modification was associated with subsequent progression of frailty and mortality in older adults. We conducted a prospective cohort study in 574 adults 65 and older who required a low or moderate level of care. Of these, 34% modified their homes-most frequently a corridor-and the most common type of modification was the installation of handrails. The mortality was significantly lower among older adults with home modifications than in those without home modifications at 2 years (adjusted hazard ratio [HR] = 0.52; 95% confidence interval [CI] [0.32, 0.87]), 3 years (HR = 0.57, 95% CI [0.54, 0.81]), and 4.7 years (HR = 0.65, 95% CI [0.65, 0.91]). These findings suggest that home modification may prevent the progression of frailty (i.e., need for low/moderate level of care increasing to the need for high level of care) in older adults.
The present study assessed the decision-making and communication capacities of older adults with dementia who required assistance and care and measured the subsequent changes in these capacities. Of 845 older adults who received long-term care between April 2003 and December 2004, about half of them without dementia were excluded and the remaining 448 were finally included in the analyses. These individuals were completed follow-up for assessment for two years. The data were obtained from the Long-Term Care Insurance Certification Committee for Eligibility in Gujo City. A total of 73.7% of people with dementia were somewhat capable of making decisions (32.4% were reported as being “always capable”; 41.3% were reported as being “sometimes capable”). A total of 93.7% were somewhat capable of communicating with others (78.3% were reported as being “always capable”; 15.4% were reported as being “sometimes capable”). The results indicate that older adults with dementia can participate in their own care decisions, even if they require assistance and support in their daily lives. The present study shows, however, that baseline decision-making capacity declined to about half what they were after one year and to about one-third of what they were after two years, suggesting that earlier efforts are needed to ensure that the preferences of individuals with dementia are reflected in their care.
The purpose of this study was to specify the most accurate, reliable and valid technique for a general sexual behavioral survey in Japan. This pilot study was conducted to assure a high response rate and to keep respondents' privacy confidential by using an anonymous questionnaire survey technique. The sample (360 potential respondents) was selected randomly from basic resident registers in two geographically different areas. From the registries, 90 residents, aged 20 to 49 years old, were randomly selected to represent each sex from each area. The subjects were randomly assigned to three groups each having a different procedure of requesting the completion of the survey and providing the questionnaires: (1) Postal Group, (2) Telephone Group, and (3) Face-to-face Group. The survey was carried out from October 1995 to February 1996. Effective response rates for the above mentioned three groups were 69.2%, 69.2% and 55.8%, respectively. It is difficult to determine the best method when only considering the effective response rates. However, judging from our effort and expense, the mail survey is the best possible procedure and would be a reasonable method for a national sexual behavior survey.
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