Table 1 Distribution of survey subjects by happiness, by age and sex CI indicates cofidence interval. and Background Factors in Community-Dwelling Older Persons Ryuichi Kawamoto1), Takaaki Doi1), Akihiro Yamada1), Masanobu Okayama2), Kouki Tsuruoka2), Motomi Satho3) and Eiji Kajii2) In order to maintain and improve mental health of elderly people living in the community, a cross sectional survey was conducted to elucidate their happiness and background factors. The subjects were elderly persons living in the community who were able to fill in the questionnaire themselves. The study employed the self-recording questionnaire forms used in Kahoku Longitudinal Aging Study by Matsubayashi et al. Happiness was assessed using a visual analogue scale. Out of 2,379 elderly persons who were able to fill in the questionnaire by themselves in 2,361 (99.2%) returned the questionnaire sheets. After removing inadequate responses, analysis was possible for 1,873 (78.7%) (860 men (average age 72.7 years) and 1,013 women (average age 72.8 years)). Among those with greater happiness, the ratio of those living with others (p= 0.0051) was high, as well as those with spouses (p=0.0240), without a history of hypertension (p=0.0096) and apoplexy (p=0.0039), not receiving medication regularly (p=0.0039), with regular habit of walking (p<0.001), or with work (p< 0.001). As for the relationship between happiness and various scores, the higher the happiness scale became, the scores for ADL, information-related function, functional and emotional support network, healthy condition, appetite condition, sleep condition, memory condition, family relationships, friendship, economic condition became significantly higner (p<0.001, respectively). On multiple regression analysis using the background factors for happiness as explanatory variables, factors such as functional support network (p<0.001), emotional support network (p=0.0254), healthy condition (p<0.001), good memory condition (p=0.0027), friendship (p<0.001), good economic condition (p<0.001) were significant independent contributing factors. As for the relation between SDS and happiness, the more serious the SDS score (higher score) became, the scores for the feeling of happiness became significantly smaller (p<0.001). For amelioration of the happiness of elderly persons living in the community, attempts should be made to improve the background factors clarified by the present study by efficiently utilizing health, medical and welfare services.
Plasma homocysteine (Hcy) concentration has been shown to be influenced by a mutation in the gene coding methylenetetrahydrofolate reductase (MTHFR). Although plasma Hcy is related to atherosclerotic disorders, conflicting results have been reported about the association between MTHFR gene polymorphism and sclerotic lesions of the common carotid arteries. The effect of agegene interaction on carotid arterial remodeling was investigated in elderly subjects with several risk factors for atherosclerosis. We evaluated sclerotic lesions of the common carotid arteries by ultrasonography in 326 patients (mean age Ϯ standard deviation, 73 Ϯ 12 years) and studied relations among the known risk factors for atherosclerosis, including MTHFR gene polymorphism and its interactions with age and sex. Of the 326 subjects studied, 136 had MTHFR genotype CC, 136 genotype CT, and 54 genotype TT. The three groups did not differ with respect to background factors such as age, history of cigarette smoking, blood pressure, lipids or uric acid, or in the incidence of atherosclerotic diseases. Spearman's rank correlation revealed a significant relationship between gender, age, Brinkman index, systolic blood pressure, triglycerides, HDL-cholesterol (HDL-C), uric acid, and MTHFR gene polymorphism. Multiple regression analysis using intimamedia complex thickness (IMT) as a criterion variable and risk factors, including MTHFR gene polymorphism as explanatory variables showed that MTHFR gene polymorphism (P ϭ 0.039) was a significant independent explanatory variable for IMT, along with gender (male) (P Ͻ 0.001), age (P Ͻ 0.001), systolic blood pressure (SBP) (P ϭ 0.047), total cholesterol (T-C) (P Ͻ 0.001), and HDL-C (P Ͻ 0.001). Furthermore, a general linear model analysis revealed that interaction between age and MTHFR gene polymorphism was significantly associated with IMT, independently of age, SBP, T-C, and HDL-C in male subjects. However, age-gene interaction was not observed in female subjects. The findings of the present study confirm an association between MTHFR gene polymorphism and common carotid atherosclerosis in the Japanese population and further support the role of risk factor-gene interaction in common carotid atherosclerosis.
Background: A comprehensive evaluation of the functions of community‐dwelling older persons was conducted in 1988. Three years after the 1988 study commenced, the relationship between these background factors and changes during the subsequent 3 years were examined. Methods: The study was a comprehensive evaluation of the daily functions of community‐dwelling elderly people, and encompassed age, gender, mode of living, marital status, financial status, family relationships, basic activities of daily living, visual and hearing impairment, a history of disease, self‐related feeling, social role, social support, habits and physical exercise and the relationship between independence and survival for 3 years after the basic study. The subjects were 2274 community‐dwelling elderly people who participated in the first survey in July 1998 and who were aged 65 years and over at that time. Unassisted questionnaire sheets were used for the first survey and changes since the first survey. Results: Thirty men and 60 women died during the 3 year period. Data were also gathered about the daily activity levels of 1709 persons (75.2%) with 1499 (87.7%) ranking J for independence and 210 persons (12.3%) ranking A to C for dependence. Age, gender, basic activities of daily living (BADL), history of falls, self‐related happiness, participation in community events and physical‐exercise habits were found to be explanatory variables for independence after three years; as were age, gender, and BADL for survival. Conclusion: The explanatory variables relating to independence and prognosis of life of the elderly obtained in this study will be important in future considerations of the issue of care‐taking and measures to enable it.
Background: Falls cause serious problems for the elderly. Sleep problems impair the control of postural balance and cause falls, and lack of sleep induces sleepiness, which in turn causes inattentiveness. The present study aims to clarify the relation between sleep disorders and falls among the community‐dwelling elderly and to determine whether or not sleep disorder is an independent risk factor for falls. Methods: Of 2274 community‐dwelling persons aged 65 and older who participated in the first study in July 1998, 1771 (77.9%) who responded to the questions concerning sleep disorders were the subjects in the present study. Results: There were 1521 persons (85.9%) who had not experienced any fall during the past year, 194 (11.0%) who had one or two falls, 27 (1.5%) had three to four falls and 29 (1.6%) had more than five falls. The relation between the history of falls and the sleep problems indicates that the odds ratio for the history of falls was significantly higher if the nocturnal sleep disorder was more intense (P < 0.001) and the sleep hours during the day were longer (P < 0.01). In order to determine the independent risk factors for falls, the general linear model analysis was conducted using the significantly different background. The nocturnal sleep problems (F = 4.05; P = 0.018), the daytime sleep (F = 4.17; P = 0.016) and nocturnal sleep problems and interaction between (*) daytime sleep (F = 2.54; P = 0.038) were significant independent explanatory variables as the age (F = 14.4; P < 0.001), difficulty in walking (F = 4.30; P = 0.038), history of stroke (F = 64.1; P < 0.001) and arthralgia (F = 5.31; P = 0.021). Conclusion: The data emphasize that the sleep disorder is closely related to falls.
A Study of Depressive State and Background Factors in Community-DwellingOlder Persons Ryuichi Kawamoto1)2), Takaaki Doi1), Akihiro Yamada1), Takashi Oguni1), Masanobu Okayama2), Kouki Tsuruoka2), Motomi Satho3) and Eiji Kajii2)In order to maintain and improve the mental health of elderly people living in the community, a cross-sectional survey was conducted to elucidate their depressive state and its background factors. Subjects were elderly persons living in the community who were able to fill in the questionnaire themselves. The study used the self recording questionnaire sheets used in the Kahoku Longitudinal Aging Study by Matsubayashi et al and the Zung Self-rating Depression Scale (SDS). Out of 2,379 elderly persons who were able to fill in the questionnaire by themselves in the community, 2,361 (99.2%) returned the questionnaire sheets. After removing inadequate responses, analysis was possible for 1,181 (49.6%) (542 males (average persons (61.9%); mild, 240 (20.3%); moderate, 181 (15.3%); and severe, 29 (2.5%). The average age became higher as the SDS became high, of being indicating the seriousness of the depressive state (p=0.0155), with the ratio women significantly higher (p=0.0077). Among those with severe SDS, the ratio of single persons was high (p<0.001) as well as those who were non-drinkers (p=0.0015), without regular habit of walking (p<0.001), or without work (p<0.001). The ratio of those receiving medication regularly was also significantly high (p=0.0022). As for the relation of SDS with various of the scores, the higher the SDS score became, the scores for ADL, information-related function, functional and emotional support network, family relationship, friendship, economic condition became significantly lower (p<0.001, respectively). In logistic regression analysis using the background factors for SDS as explanatory variables, factors such as being women (odds ratio, 1.73; 95% confidence interval, 1.10-2.72), ADL (0.80; 0.69-0.93), emotional support network (0.88; 0.81-0.96), friendship (0.98; 0.96-0.99) were significant independent contributing factors. As for the relation between SDS and subjective senses, the more serious the SDS score became, the scores for feelings of healthiness and satisfaction became significantly smaller (both p<0.001). For prevention and amelioration of the depressive state of elderly persons living in the community, attempts should be made to improve the background factors which were clarified by the present study by efficiently utilizing health, medical and welfare services and following the future course with a positive attitude.
Objective Chlamydia pneumoniae (C. pneumoniae) is an important pathogen for infections of the respiratory tract, and there are recently also a numberof reports suggesting its relation with atherosclerosis. This study was performed to clarify the relation between C. pneumoniae infection and sclerotic lesions of the commoncarotid arteries.Methods and Patients Weevaluated sclerotic lesions of commoncarotid arteries by ultrasonography in 147 in-patients (mean age, 70 years; 95% confidence interval, 68-72) in the internal medicine ward, and studied the relation of the known risk factors for atherosclerosis including C. pneumoniae infection. An ultrasonograph and 7.5 MHzlinear type B-modeprobe were used by a specialist to evaluate sclerotic lesions of common carotid arteries. C.pneumoniaeinfection was determined by measuring antics pneumoniae IgG specific antibody level (IgG index) using enzyme-linked immunosorbent assay (ELISA) method with serum of fasting blood, which had been preserved at -70°C.Results IgG index (p=0.0263), from multiple regression analysis using various risk factors as explanatory variables, wasa significant independent contributing factor (R2=0.3465, p<0.0001) along with known risk factors such as male (p=0.0289), age (p=0.0007), Brinkman index (p=0.0067), hypertension (p=0.0443) and T-Chol (p=0.0220). Conclusion This study confirmed that the observations of an association between antibody against C. pneumoniae and commoncarotid atherosclerosis in Western nations is also present in Japan. Our results suggests that C. pneumoniae infection is also an important risk factor for commoncarotid atherosclerosis. (Internal Medicine 40: 208-213, 2001)
Anti-inflammatory, analgesic and anti-pyretic effects of d-2-[4-(3-methyl-2-thienyl)phenyl]propionic acid (M-5011), a new non-steroidal anti-inflammatory drug (NSAID), were compared with those of indomethacin, diclofenac sodium and ketoprofen in rats and guinea pigs. Anti-inflammatory effect of M-5011 on ultraviolet-induced erythema in guinea pigs was 11.7 and 1.8 times more potent than that of indomethacin and ketoprofen, respectively. Inhibitory effect of M-5011 on carrageenin-induced paw edema was 2 and 1.5 times more potent than that of indomethacin and diclofenac sodium, respectively. Analgesic effect of M-5011 on dry yeast-induced hyperalgesia or adjuvant-induced arthritic pain was equipotent to that of indomethacin, diclofenac sodium or ketoprofen. Anti-pyretic effect of M-5011 on yeast-induced pyrexia in rats was 4.2 and 4.6 times more potent than that of indomethacin and ketoprofen, respectively. Inhibitory effect of M-5011 on prostaglandin E2 production in the exudate of air-pouch inflammation induced by carrageenin was 1.75 times more potent than that in the non-inflamed site (stomach). As a result, gastric ulcerogenic activity of M-5011 was half that of indomethacin in rat. These results suggest that M-5011 shows more potent anti-inflammatory and anti-pyretic effects and equipotent analgesic effect with low gastro-ulcerogenic activity compared with classical NSAIDs.
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