How Long Would You Like to Live? A 25-year Prospective Observation of the Association Between Desired Longevity and Mortality.

BACKGROUND: Desired longevity represents how strongly people esteem possible extensions of their own lifetime. The association between desired longevity and mortality risk has been reported in only one prospective study, which examined a small sample of older participants. We aimed to examine the hypothesis that desired longevity at middle-age predicted long-term survival. METHODS: In the prospective cohort study, residents aged 40-64 years were asked how long they would like to live and asked to choose one from three options: longer than, as long as, or shorter than the life expectancy. We used Cox proportional hazards model to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality according to the three groups for desired longevity, treating the "longer than" group as the reference. We conducted mediation analysis to investigate the mechanism for the association between desired longevity and mortality. RESULTS: We recruited 39,902 residents to the study. Risk of all-cause mortality was significantly higher in the "shorter than" group (HR 1.12; 95% CI, 1.04-1.21). The association was independent of sex, age, marital status, education, medical history, and health status. Regarding cause of death, mortality risk of cancer (HR 1.14; 95% CI, 1.00-1.29) and suicide (HR 2.15; 95% CI, 1.37-3.38) were also higher in the "shorter than" group. The unhealthy lifestyle mediated this association with all-cause mortality by 30.4%. CONCLUSION: Shorter desired longevity was significantly associated with an increased risk of all-cause mortality, and mortality from cancer and suicide. Lifestyle behaviors particularly mediated this association.

Dairy intake and incident functional disability among older Japanese adults: the Ohsaki Cohort 2006 Study.

PURPOSE: Previous studies have investigated the association between dairy intake and functional disability, but their results were inconsistent. Our study aimed to investigate whether dairy intake may protect against incident functional disability among Japanese older adults. METHODS: We conducted a longitudinal analysis of dairy intake with incident functional disability in a prospective cohort study of 11,911 Japanese individuals aged ≥ 65 years who were followed up for 8.2 years on average. Data on milk, yogurt, and cheese intake were collected using a validated food frequency questionnaire. Total dairy intake was the sum of the daily intake of milk, yogurt, and cheese, which was sex-specifically categorized in quintiles. Data on functional disability were retrieved from the public Long-term Care Insurance database. The Cox proportional hazards model was used to estimate the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (95%CIs) for incident functional disability. RESULTS: During 97,234 person-years of follow-up, 4874 persons (40.9%) were ascertained as having functional disability. Our study suggested a null association between total dairy intake and incident risk of functional disability; compared to Q1 (the lowest quintile) group, the multivariable-adjusted HRs (95%CIs) were 0.96 (0.88-1.05) for Q2, 0.93 (0.85-1.02) for Q3, 0.93 (0.85-1.02) for Q4, and 1.01 (0.92-1.10) for Q5 (p-trend = 0.840). We did not find any associations between milk, yogurt, or cheese intake and incident risk of functional disability. CONCLUSION: We found no evidence showing that dairy intake was associated with functional disability among Japanese older adults.

Association Between Social Participation and Disability-free Life Expectancy in Japanese Older People: The Ohsaki Cohort 2006 Study.

BACKGROUND: Although social participation has been reported to be associated with significantly lower risks of mortality and disability, to our knowledge, no study has estimated its impact on disability-free life expectancy (DFLE). Therefore, this study aimed to investigate the association between social participation and DFLE in community-dwelling older people. METHODS: We analyzed 11-year follow-up data from a cohort study of 11,982 Japanese older adults (age ≥65 years) in 2006. We collected information on the number of social participations using a questionnaire. Using this information, we categorized the participants into four groups. DFLE was defined as the average number of years a person could expect to live without disability. The multistate life table method using a Markov model was employed for calculating DFLE. RESULTS: The results revealed that DFLE according to the number of social participations was 17.8 years (95% confidence interval [CI], 17.3-18.2) for no activities, 20.9 (95% CI, 20.4-21.5) for one activity, 21.5 (95% CI, 20.9-22.0) for two activities, and 22.7 (95% CI, 22.1-23.2) for three activities in men, and 21.8 (95% CI, 21.5-22.2), 25.1 (95% CI, 24.6-25.6), 25.3 (95% CI, 24.7-25.9), and 26.7 years (95% CI, 26.1-27.4), respectively, in women. This difference in DFLE did not change after the participants were stratified for smoking, body mass index, physical activity, and depression. CONCLUSION: Social participation is associated with longer DFLE among Japanese older people; therefore, encouraging social participation at the population level could increase life-years lived in good health.

Time spent walking and disability-free survival in older Japanese: The Ohsaki Cohort 2006 Study.

The extent to which long disability-free survival (DFS) time can be extended according to the amount of time spent walking has not been investigated. The aim of this study was to examine the association between time spent walking per day and DFS time in older adults. We conducted a cohort study of 14 342 disability-free individuals (aged ≥ 65 years) living in Ohsaki City, Japan. The amount of time spent walking per day (<0.5 h, 0.5-1 h, ≥1 h) by each individual in 2006 was assessed by a self-reported questionnaire. Data on 11-year incident functional disability were retrieved from the public Long-Term Care Insurance database. After estimating the multivariable-adjusted hazard ratios (HRs) of the composite outcome (incident functional disability or death), the multivariable-adjusted 50th percentile differences (50th PDs; difference in the period until the first 50% of the composite outcome occurred) were estimated according to time spent walking. Among 114 764 person-years, the composite outcome occurred in 7761 persons (67.6 per 1000 person-years). The HRs (95% confidence intervals) of the composite outcome were 1.00 (reference) for <0.5 h, 0.84 (0.79, 0.88) for 0.5-1 h, and 0.78 (0.74, 0.83) for ≥1 h (p-trend < 0.001). The 50th PDs (95% confidence intervals) of DFS time were 238 (155, 322) days longer for 0.5-1 h and 360 (265, 454) days longer for ≥1 h, in comparison with <0.5 h. The results suggest that longer time spent walking per day contributes to longer DFS time.

Similarities in cardiometabolic risk factors among random male-female pairs: a large observational study in Japan.

BACKGROUND: Previous observational studies have shown similarities in cardiometabolic risk factors between spouses. It is still possible that this result reflects the age similarity of spouses rather than environmental factors of spouses (e.g. cohabitation effect). To clarify the importance of mate cardiometabolic risk factors for similarity of environmental factors, it is necessary to examine whether they are observed in random male-female pairs while maintaining the age of the spousal pairs. This study aimed to determine whether the similarities found between spousal pairs for cardiometabolic risks were also observed between random male-female pairs. METHODS: This cross-sectional study included 5,391 spouse pairs from Japan; data were obtained from a large biobank study. For pairings, women of the same age were randomly shuffled to create new male-female pairs of the same age as that of the original spouse pairs. Similarities in cardiometabolic risk factors between the random male-female pairs were analysed using Pearson's correlation or age-adjusted logistic regression analyses. RESULTS: The mean ages of the men and women were 63.2 and 60.4 years, respectively. Almost all cardiometabolic risk factors similarities were not noted in cardiometabolic risk factors, including the continuous risk factors (anthropometric traits, blood pressure, glycated haemoglobin level, and lipid traits); lifestyle habits (smoking, drinking, and physical activity); or diseases (hypertension, type 2 diabetes mellitus, and metabolic syndrome) between the random male-female pairs. The age-adjusted correlation coefficients ranged from - 0.007 for body mass index to 0.071 for total cholesterol. The age-adjusted odds ratio (95% confidence interval) for current drinkers was 0.94 (0.81 - 1.09); hypertension, 1.07 (0.93 - 1.23); and type 2 diabetes mellitus, 1.08 (0.77 - 1.50). CONCLUSION: In this study, few similarities in cardiometabolic risk factors were noted among the random male-female pairs. As spouse pairs may share environmental factors, intervention strategies targeting lifestyle habits and preventing lifestyle-related diseases may be effective.

Interactions of Cognitive and Physical Functions Associated with Toilet Independence in Stroke Patients.

OBJECTIVES: The purpose of this study was to clarify the interaction among cognitive and physical functions associated with toilet independence in stroke patients. MATERIALS AND METHODS: We retrospectively examined 125 stroke patients. We performed decision tree analysis to detect the interaction associated with toilet independent using assessment of motor function on the affected side, muscle strength on unaffected side, trunk function, neglect, motivation, and cognitive function. The interactions detected via decision tree confirmed the existence and influence using logistic regression. RESULTS: The verticality test of the Stroke Impairment Assessment Set (3 or ≤2 points) was selected at the first level, and the Revised Hasegawa's dementia scale (≥19 or ≤18 points) and age (≥70 or ≤69 y) were selected at the second level of decision tree. Interaction terms created by these factors were significantly associated with toilet independence after adjusting for the independent influence of each factor using logistic regression. CONCLUSIONS: Our results show an interaction of trunk and cognitive functions or trunk function and age associated with toilet independence. The probability of toilet independence dramatically changes if two factors of each interaction were satisfied in stroke patients.

Functions necessary for gait independence in patients with stroke: A study using decision tree.

BACKGROUND: Little is known about the existence and impact of interactions among multiple impairments to gait independence. The purpose of this study is to reveal the interaction of physical functions and its impact on gait independence in stroke patients. METHODS: This retrospective study included 108 subacute stroke patients. We conducted a decision tree analysis to examine the existence of interactions in relation to gait independence among the gross motor function of lower limb, knee extension strength, sensory function, and trunk function. Further, we confirmed the existence and impact of interaction detected via the decision tree after adjusting for the effects of confounding factors using logistic regression. RESULTS: The knee extension strength and proprioception on the affected side were selected in the first and second level of the decision tree. In addition, the knee extension strength was selected in the third level. The interaction of the knee extension strength and proprioception on the affected side was significantly associated with gait independence, both before and after adjusting for age, visuospatial perception, and cognitive functions. CONCLUSIONS: Our results suggest that the interaction of the knee extension strength and proprioception on the affected side is strongly associated with gait independence in stroke patients.

All-cause mortality among Japanese whose cohabiting partners are diagnosed with cancer: the Ohsaki Cohort 2006 study.

BACKGROUND: It has been noted that not only adverse psychosocial health effects but also mortality might increase for a person living with a spouse with cancer. This study examined the association between a partner's cancer diagnosis and mortality among a Japanese population. METHODS: In December 2006, a survey was conducted on participants aged 40 years or older who were residing in northeastern Japan. We identified couples using municipality-specific household ID numbers by searching public records and confirmed partner's cancer diagnosis after the baseline measurement using regional cancer registration information. After following up for a maximum of 4.0 years with the participants regarding mortality and emigration by reviewing the Residential Registry Record, we used Cox's proportional hazards regression to estimate the hazard ratio (HR) of all-cause mortality. RESULTS: We identified 25,938 participants (12,969 pairs) and included them in the analyses. A total of 1,308 (5.0%) participants had partners with a cancer diagnosis after baseline. The study found no association between a partner's cancer diagnosis and all-cause mortality; multivariable HRs of all-cause mortality for individuals in exposed subjects compared with those in unexposed subjects were 1.35 (95% confidence interval [CI] = 0.99-1.83; p = .055). Contrarily, sensitivity analyses of mortality attributed to having partners diagnosed with cancer based on the time since entry showed that all-cause mortality significantly increased only within one year from spouse cancer diagnosis; HR = 2.18 (95% CI = 1.44-3.30; p < .01). CONCLUSIONS: Our findings reveal that the mortality rate from partner's cancer diagnosis was significantly high during the early period of diagnosis and multidisciplinary teams for cancer treatment might be important for preventing death among the partner.

Differences between Japan and Taiwan in the treatment of pregnant women with depressive symptoms by omega-3 fatty acids: An open-label pilot study.

OBJECTIVES: Although safe approaches for improving depression in pregnancy are required and the efficacy of omega-3 polyunsaturated fatty acids (PUFAs) has been suggested, the amount of supplemental omega-3 PUFAs has varied among previous studies and adequate amount might be different among countries. The aim of this pilot study is to explore the feasibility of using 1800 mg of omega-3 PUFAs supplementation for our future double-blind, placebo-control trial, and to clarify the clinical difference and the similarity between two sites of Japan and Taiwan. METHODS: Pregnant women between 12 and 24 weeks' gestation with depressive symptoms were recruited. Participants were supplemented daily with omega-3 PUFAs capsules containing 1206 mg eicosapentaenoic acid and 609 mg docosahexaenoic acid for 12 weeks. The primary outcome was change in total score on the 17-item Hamilton Rating Scale for Depression (HAMD) at 12 weeks after supplementation. RESULTS: Eight pregnant women in Japan and five in Taiwan participated in the study. A substantial proportion of pregnant women reported high consumption of omega-3 supplements and dietary fish were excluded in Taiwan rather than in Japan sites. The decrease in HAMD score from baseline to 12 weeks after the start of the intervention was significantly larger in Japanese participants than in Taiwanese participants (Wilcoxon rank sum test; P = 0.045). DISCUSSION: The improvement of depressive symptoms was smaller at the Taiwan site than at the Japan site. Differences in psychopathology of recruited participants identified by self-rating scales might affect the degree of population heterogeneity and the treatment efficacy. A randomized-controlled trial is needed to confirm these findings. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01948596.

Effects of the Interaction among Motor Functions on Self-care in Individuals with Stroke.

BACKGROUND: No study to date has focused on what combinations of motor functions are strongly associated with self-care independence in individuals with stroke. The purpose of this study is to clarify the impact of motor function interactions on self-care independence in individuals with stroke. METHODS: This retrospective observational study included 132 individuals with first stroke. We conducted a decision tree analysis to examine the impact on daily living skills of numerous key functions - the upper and lower limbs on the affected side, bilateral grip strength and lower limb muscle strength on the unaffected side, bilateral upper limb and trunk function, and balance. Further, we confirmed the interaction effects detected via the decision tree approach using logistic regression. RESULTS: As per the decision tree analysis, the interaction between balance and upper limb function of the affected side showed an association with self-care independence. The interaction terms of balance and upper limb function we analyzed were significantly associated with the ability to achieve self-care independence, after some adjustments to eliminate the influence of confounding factors. CONCLUSIONS: These results suggest that the combination of functional status of balance and upper limb function of the affected side are strongly associated with the independence of self-care. The decision tree created in this study could serve as an effective guide when implementing a remedial approach for individuals with stroke aiming to achieve self-care independence.

Use of a multilayer perceptron to create a prediction model for dressing independence in a small sample at a single facility.

[Purpose] This study aimed to assess the accuracy of a prediction model for dressing independence created with a multilayer perceptron in a small sample at a single facility. [Participants and Methods] This retrospective observational study included 82 first-stroke patients. The prediction models for dressing independence at hospital discharge were created using a multilayer perceptron, logistic regression, and a decision tree, and compared for predictive accuracy. Age, dressing performance, trunk function, visuospatial perception, balance, and cognitive function at admission were used as variables. [Results] The area under the receiver operating characteristic curve, classification accuracy, sensitivity, specificity, positive-predictive value, and negative-predictive value for training data were highest with the multilayer perceptron model. Cochran's Q and multiple comparison tests revealed a significant difference between logistic regression and multilayer perceptron models. Testing of data in 10-fold cross-validation yielded the same results, except for sensitivity. [Conclusion] The present study suggested that higher accuracy could be expected with a multilayer perceptron than with logistic regression and a decision tree when creating a prediction model for independence of activities of daily living in a small sample of stroke patients.

Psychological Distress among Individuals Whose Partners Have Cancer.

Cancer diagnosis influences both patients and their closest relatives. This cross-sectional study examined psychological distress among individuals whose partners had cancer in a population-based sample. Participants in the survey were citizens residing in Ohsaki City, Miyagi, Japan. Spouse pairs were identified by information of participants' relationship to the householder and address provided by municipality, and we collected self-report information on cancer history and current pain (but not the cause of pain). Psychological distress was evaluated using the Kessler 6 scale (K6). We identified 29,410 potential participants (14,705 couples), of which 23,766 (11,690 men and 12,076 women) were included in the analyses. A total of 1,374 participants (581 male and 793 female participants) had partners with history of cancer. Logistic regression analyses revealed that these participants, regardless of sex, did not show significantly higher risk of psychological distress (K6 score ≥ 13). When stratifying the analysis by partners' current pain, men whose partners had cancer and pain showed greater odds of psychological distress (odds ratio = 1.5, p = 0.04), compared with men whose partners had no cancer and had pain. However, male subjects whose partners had cancer but no pain did not show greater odds of psychological distress compared with men whose partners had no cancer and no pain. By contrast, in women whose partners had cancer, psychological distress was not associated with pain status. In conclusion, men whose partners had cancer and pain have higher risk of psychological distress, and its screening to these individuals may reduce the risk.

Cardiovascular Responses Associated with the Moving Beans Task: Influence of Psychological Characteristics.

BACKGROUND AND OBJECTIVE: High blood pressure (BP) after stroke is associated with a poor outcome. However, exercise training or speech therapy for patients with stroke can raise the BP. The aim of this study was to examine cardiovascular responses during the moving beans task (MBT) used in occupational therapy and to study the influence of psychological characteristics on cardiovascular responses during this task in healthy subjects. MATERIALS AND METHODS: In 34 healthy volunteers, the BP and the heart rate (HR) were continuously measured during the baseline period, the 5-minute MBT, and the 1-minute cold pressor test (CPT). All subjects completed self-reported questionnaires, including the Center for Epidemiologic Studies Depression Scale (CES-D), the State Trait Anxiety Inventory Y-2, and the Japanese version of the 20-item Toronto Alexithymia Scale (TAS-20). RESULTS: The systolic blood pressure (SBP), the diastolic blood pressure (DBP), and the mean blood pressure (MBP) significantly increased during the MBT and the CPT compared with the baseline values. SBP, DBP, and MBP responses during the MBT significantly correlated with the TAS-20 scores. Moreover, DBP response during the MBT correlated with the CES-D scores. CONCLUSIONS: The MBT significantly raised BP without increasing the HR. BP responses during this task were influenced by the psychological characteristics of depression and alexithymia.

Attitude and practice of physical activity and social problem-solving ability among university students.

BACKGROUND: Effective social problem-solving abilities can contribute to decreased risk of poor mental health. In addition, physical activity has a favorable effect on mental health. These previous studies suggest that physical activity and social problem-solving ability can interact by helping to sustain mental health. The present study aimed to determine the association between attitude and practice of physical activity and social problem-solving ability among university students. METHODS: Information on physical activity and social problem-solving was collected using a self-administered questionnaire. We analyzed data from 185 students who participated in the questionnaire surveys and psychological tests. Social problem-solving as measured by the Social Problem-Solving Inventory-Revised (SPSI-R) (median score 10.85) was the dependent variable. Multiple logistic regression analysis was employed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for higher SPSI-R according to physical activity categories. RESULTS: The multiple logistic regression analysis indicated that the ORs (95% CI) in reference to participants who said they never considered exercising were 2.08 (0.69-6.93), 1.62 (0.55-5.26), 2.78 (0.86-9.77), and 6.23 (1.81-23.97) for participants who did not exercise but intended to start, tried to exercise but did not, exercised but not regularly, and exercised regularly, respectively. This finding suggested that positive linear association between physical activity and social problem-solving ability (p value for linear trend < 0.01). CONCLUSIONS: The present findings suggest that regular physical activity or intention to start physical activity may be an effective strategy to improve social problem-solving ability.

The synchronized trial on expectant mothers with depressive symptoms by omega-3 PUFAs (SYNCHRO): Study protocol for a randomized controlled trial.

BACKGROUND: Maternal depression can be harmful to both mothers and their children. Omega-3 polyunsaturated fatty acid (PUFA) supplementation has been investigated as an alternative intervention for pregnant women with depressive symptoms because of the supporting evidence from clinical trials in major depression, the safety advantage, and its anti-inflammatory and neuroplasticity effects. This study examines the efficacy of omega-3 PUFA supplementation for pregnant women with depressive symptoms in Taiwan and Japan, to provide evidence available for Asia. The rationale and protocol of this trial are reported here. METHODS: The Synchronized Trial on Expectant Mothers with Depressive Symptoms by Omega-3 PUFAs (SYNCHRO) is a multicenter, double-blind, parallel group, randomized controlled trial. Participants will be randomized to either the omega-3 PUFAs arm (1,200 mg eicosapentaenoic acid and 600 mg docosahexaenoic acid daily) or placebo arm. Primary outcome is total score on the Hamilton Rating Scale for Depression (HAMD) at 12 weeks after the start of the intervention. We will randomize 56 participants to have 90 % power to detect a 4.7-point difference in mean HAMD scores with omega-3 PUFAs compared with placebo. Because seafood consumption varies across countries and this may have a major effect on the efficacy of omega-3 PUFA supplementation, 56 participants will be recruited at each site in Taiwan and Japan, for a total number of 112 participants. Secondary outcomes include depressive symptoms at 1 month after childbirth, diagnosis of major depressive disorder, changes in omega-3 PUFAs concentrations and levels of biomarkers at baseline and at 12 weeks' follow-up, and standard obstetric outcomes. Data analyses will be by intention to treat. The trial was started in June 2014 and is scheduled to end in February 2018. DISCUSSION: The trial is expected to provide evidence that can contribute to promoting mental health among mothers and children in Asian populations. TRIAL REGISTRATION: Clinicaltrials.gov: NCT02166424 . Registered 15 June 2014; University Hospital Medical Information Network (UMIN) Center: UMIN000017979. Registered 20 May 2015.

Propensity-matched analysis of the gap between capacity and actual performance of dressing in patients with stroke.

[Purpose] Dressing is an activity of daily living for which stroke patients often show discrepancies between capacity and actual performance. The aim of this study was to elucidate the physical function and unilateral spatial neglect in stroke patients that reduce their level of actual performance despite having the capacity for dressing independently. [Subjects and Methods] This retrospective study included 60 first-time stroke patients judged by occupational therapists as able to dress independently. The patients were divided into two groups according to their FIM(®) instrument scores for dressing the upper and lower body: an independent group with both scores ≥6 and an assistance group with one or both scores ≤5. After adjusting for confounding factors through propensity score matching, the groups were compared by using Stroke Impairment Assessment Set items, the Simple Test for Evaluating Hand Function of both upper limbs, and the Berg balance scale. [Results] The assistance group had a significantly lower score for the Berg balance scale than the independent dressing group (31.0 ± 12.3 vs. 47.8 ± 7.4). [Conclusion] The results of the present study suggested that the balance function has an effect on the discrepancy between dressing capacity and performance.

Personality traits and coping styles explain anxiety in lung cancer patients to a greater extent than other factors.

OBJECTIVE: Although various factors thought to be correlated with anxiety in cancer patients, relative importance of each factors were unknown. We tested our hypothesis that personality traits and coping styles explain anxiety in lung cancer patients to a greater extent than other factors. METHODS: A total of 1334 consecutively recruited lung cancer patients were selected, and data on cancer-related variables, demographic characteristics, health behaviors, physical symptoms and psychological factors consisting of personality traits and coping styles were obtained. The participants were divided into groups with or without a significant anxiety using the Hospital Anxiety and Depression Scale-Anxiety, and a binary logistic regression analysis was used to identify factors correlated with significant anxiety using a multivariate model. RESULTS: Among the recruited patients, 440 (33.0%) had significant anxiety. The binary logistic regression analysis revealed a coefficient of determination (overall R(2)) of 39.0%, and the explanation for psychological factors was much higher (30.7%) than those for cancer-related variables (1.1%), demographic characteristics (2.1%), health behaviors (0.8%) and physical symptoms (4.3%). Four specific factors remained significant in a multivariate model. A neurotic personality trait, a coping style of helplessness/hopelessness, and a female sex were positively correlated with significant anxiety, while a coping style of fatalism was negatively correlated. CONCLUSIONS: Our hypothesis was supported, and anxiety was strongly linked with personality trait and coping style. As a clinical implication, the use of screening instruments to identify these factors and intervention for psychological crisis may be needed.

Prediction of upper limb recovery in the acute phase of cerebrovascular disease: evaluation of "functional hand" using the manual function test.

BACKGROUND: Prediction of upper limb function recovery in the acute phase of cerebrovascular disease can help clarify goal setting in rehabilitation and subsequently shorten hospital stay. The present study aimed to develop regression equations that can be used to predict the Manual Function Test (MFT) score 3 weeks after onset and to determine the optimal cutoff MFT score for the identification of "Functional Hand." METHODS: In all, 190 patients with cerebrovascular disease were included in this study. The baseline survey performed within 1 week after onset assessed sociodemographic profiles, medical profiles, and acute symptoms. MFT was performed to determine the cutoff score to indicate Functional Hand. We used stepwise multiple regression analysis to establish the prediction equations with the best fit for the MFT score 3 weeks after onset. In addition, the sensitivity and specificity of the MFT as an indicator of Functional Hand with cutoff values were determined. RESULTS: The multiple regression analysis showed that the following factors had a significant influence on the MFT: Brunnstrom recovery stage, cognitive function, range of motion, age, and sensation. The area under the curve was .93 for the MFT score as an indicator of Functional Hand. The cutoff MFT score to identify Functional Hand was 22/21 points, with a sensitivity and specificity of 91.1% and 82.1%, respectively. CONCLUSIONS: Our findings helped develop regression equations that can be used to predict the MFT score 3 weeks after onset of cerebrovascular disease by evaluating factors reportedly associated with upper limb function recovery.

The association between self-reported history of physical diseases and psychological distress in a community-dwelling Japanese population: the Ohsaki Cohort 2006 Study.

BACKGROUND: Patients with physical disease are known to suffer considerable psychological distress. Social support may confound the association between physical disease and psychological distress. Population-based epidemiological studies have not been conducted on the association between history of physical disease, psychological distress and social support. METHODS: Using cross-sectional data from 2006, we studied 43 487 community-dwelling people aged ≥40 years living in Japan. We examined the association between 13 self-reported histories of physical disease and psychological distress evaluated using the Kessler 6-item psychological distress scale (K6), defined as ≥13 points out of 24. To investigate the association, we performed multiple logistic regression analyses adjusted for age, gender, social support and possible confounders. Social support, as the interaction between physical disease and psychological depression, was tested through the addition of cross-product terms to the multivariate-adjusted model. RESULTS: The following histories of physical disease were found significantly and positively associated with psychological distress: cancer, diabetes mellitus, hyperlipidemia, hypertension, myocardial infarction, stroke, gastric or duodenal ulcer, liver disease, arthritis, osteoporosis, kidney disease and fall or fracture (odds ratio, 1.2-2.3). Social support did not modify the association between most histories of physical disease and psychological distress. CONCLUSIONS: Subjects with a history of physical disease were significantly and positively associated with psychological distress, and social support did not modify this association for most physical diseases. Even after patients have left hospital following treatment for physical disease, they require continuous monitoring for psychological distress by doctors and paramedics.