Psychosocial mediators between socioeconomic status and dietary habits among Japanese older adults.

OBJECTIVES: The purpose of this study was to examine psychosocial mediators between socioeconomic status (SES) and eating habits in older Japanese adults. SUBJECTS AND METHODS: A questionnaire was mailed to a representative sample of people who were 60 years and older (N=1,000) living in a suburban area within the Tokyo city metropolitan limits, in Japan. There were 552 effective participants in the study. DESIGN: Dietary habits were evaluated by assessing the diversity of food that was consumed. SES was evaluated by educational attainment and household income. Four dimensions of psychosocial mediators were assessed: control expectancy, self-efficacy, social influence, and social support. Indirect effects of SES through the mediators were evaluated by using a multiple mediator model. RESULTS: The relationship between education and dietary habits was mediated by three variables excluding social support. Especially, social influence had the strongest mediating effect. These three significant variables explained the majority of differences in dietary habits resulting from education. The effects of household income were also similarly mediated by the identical variables. CONCLUSIONS: Control expectancy, self-efficacy, and social influence mediate the relationship between SES and dietary habits.

A low-molecular-weight fraction of bovine colostrum and milk enhances the oxidative burst activity of polymorphonuclear leukocytes.

Bovine colostrum and milk contain many immunomodulatory components. The low-molecular-weight fraction (< 10 kDa) was separated from colostrum and milk by gel filtration chromatography, and its effect on the oxidative burst of bovine polymorphonuclear leukocytes (PMNL) was investigated in vitro. The oxidative burst activity induced by Staphylococcus aureus was considerably enhanced when PMNLs were incubated with this low-molecular-weight fraction. However, phorbol 12-myristate 13-acetate did not trigger a burst after priming with this fraction. The oxidative burst activity enhanced by this fraction was reduced after heating. These results confirmed that a low-molecular-weight substance(s) of less than 10 kDa, present in bovine milk and colostrum, enhances the oxidative burst activity of PMNL.

[What characteristics have the elderly who contact friends at hospitals?].

PURPOSES: The purposes of this study are to examine two points; 1) What effects do regular visits to hospitals have on the existence of friend?. and 2) Do the elderly use hospitals as substitutes for other meeting places or independent of other places?. METHODS: Data concerning 2,447 older adults were obtained from a national survey for the elderly aged 60 and over, conducted in 1996. 1) To examine effects of regular visits to hospitals on friends, friendships as a dependent variable, regular visits to hospitals as a confounding variable, and some two way-interaction terms as independent variables were entered in logistic regression analysis. 2) To analyze relationships between hospitals and other meeting places, correspondence analyses and logistic regression were used. 3) Existence of friends whom the elderly contact at hospitals as a dependent variable, existence of friends whom they meet at other places as a confounding variable, and some two way-interaction terms as independent variables were entered in logistic regression analysis. 3) Relationships between clinics and other meeting places were also analyzed using correspondence analyses and logistic regression. RESULTS: 1. Although regular visits to hospitals did not have a significant direct impact on existence of friends, the respondents with low activities of daily living who regularly visits hospitals were more likely to have friends than ones did not visits hospitals. 2. The respondents who meet friends at hospitals were also more likely to have contacts with friends at community centers for the elderly or community organization. 3. The respondents who meet friends at clinics had similar characteristics to those who meet friends at hospitals. CONCLUSIONS: Regular visits to hospitals may contribute to maintain contacts with friends, especially in the elderly with low ADL. The elderly may use hospitals as meeting places with friends independent of other places. Hospitals may have similar functions to what clinics as meeting places with friends.

Molecular cloning and functional characterization of bottlenose dolphin (Tursiops truncatus) tumor necrosis factor alpha.

Bottlenose dolphin tumor necrosis factor alpha (doTNF-alpha) cDNA was cloned by reverse transcription polymerase chain reaction (RT-PCR) and the nucleic and deduced amino acid sequences were determined. The sequence of the cDNA clones shows that doTNF-alpha has an open reading frame of 699bp encoding 233 amino acids. The nucleic acid sequence of doTNF-alpha indicates 90, 88, 87, and 79% similarity with the cattle, pig, human, and mouse TNF-alpha gene, respectively. Based on the analysis of human and mouse TNF-alpha molecules, doTNF-alpha is processed to a mature protein with 157 amino acids. The 233 amino acids precursor has a hydrophobic region that could serve as a transmembrane domain. The recombinant doTNF-alpha expressed in Escherichia coli as a glutathione S-transferase fusion protein reacted with anti-human TNF-alpha antibody and exerted cytotoxity to the TNF-alpha sensitive murine cell line L929.

Promoting effect of colostrum on the phagocytic activity of bovine polymorphonuclear leukocytes in vitro.

Bovine colostrum contains a variety of essential nutrients, antibodies, cytokines, hormones, and growth factors that are important for nutrient supply, host defense, growth and for general neonatal adaptation. We have investigated the effect of bovine colostrum on the phagocytic activity for latex particles by normal peripheral blood polymorphonuclear leukocytes using flow cytometric analysis. The phagocytosis promoting effect was observed in colostrum. The promoting activity showed dose-dependent increase up to 25% at a concentration of colostrum. This activity was maximum in the colostrum obtained at parturition and gradually decreased with the time course of lactation as well as IgG level. Colostrum possessed the higher promoting activity than milk and normal serum. These results indicate that bovine colostrum strongly activates polymorphonuclear leukocyte phagocytosis, suggesting the concernment with development of nonspecific immune system in newborns.

Oxygen radical generation and expression of NADPH oxidase genes in bottlenose dolphin (Tursiops truncatus) neutrophils.

Oxygen radical generation by stimulation with phorbol myristate acetate (PMA) was evaluated in bottlenose dolphin neutrophils. A Cypridina luciferin analog-dependent chemiluminescent assay demonstrated that dolphin neutrophils generate superoxide by the addition of PMA, and that its superoxide-forming activity is completely suppressed by diphenylene iodonium, a specific inhibitor of NADPH oxidase. These results indicate that dolphin neutrophils possess NADPH oxidase activity. Furthermore, the NADPH oxidase activity (hydrogen peroxide production) in dolphin neutrophils, as well as in human neutrophils, was greater at 37 degrees C than at a lower temperature. RT-PCR with specific primers revealed that dolphin neutrophils expressed the mRNAs of the major NADPH oxidase components, which included membrane-associated flavocytochrome b (gp91(phox) and p22(phox)) and cytosolic factors (p40(phox), p47(phox), and p67(phox)), implying the existence of these protein homologues in dolphin neutrophils.

[Characteristics of the elderly transferees in a resort area from metropolitan areas: comparison to the elderly in a rural non-resort area and in a metropolitan area].

PURPOSES: This study examines characteristics of elderly transferees in a resort area who moved from metropolitan areas, comparing them to two groups: elderly living in a rural non-resort area and elderly living in a metropolitan area. METHODS: Both the resort area and the non-resort area were located in Ito, Shizuoka Prefecture. The metropolitan area was in Nerima ward, Tokyo. From each area, 400, 400 and 600 random samples aged 65 and over were selected for face-to-face interview surveys separately. The number of the effective samples in each of the three groups was 176 (excluding transferees from rural area), 267, and 423, respectively. Characteristics were measured from five aspects; demographic aspects, health status, health habits, social networks, and social support. RESULTS: Almost indicators of health status did not show significant differences between respondents living in the resort area and each of the remaining two groups. Respondents living in the resort area were significantly less likely to attend community groups than those living in non-resort rural areas, and they also were less likely to have a home physician or persons who provided care. CONCLUSIONS: Transferees living in a resort area who moved from metropolitan areas may have extra health and welfare needs, compared to the elderly living in non-resort rural areas or the elderly living in metropolitan areas. Possible reasons for these extra needs may be relate to their urbanized life style, lower amount of medical resources in a rural area, or lower level of informal support possessed within a household.

[Comparison of physical, psychological, and social resources and their effects on mental well-being between young-old and old-old Japanese elderly].

PURPOSES: We compared the availability of physical, psychological, and social resources, and effects of those resources on mental well-being both directly and as stress buffers between the young-old (the age of 65 to 74 years) and the old-old (the age of 75 years and over) people. In addition, if there were a significant difference in level of mental well-being by the age categories, we examined whether the difference could be explained from the different amount of resources possessed by the age groups. METHODS: We utilized an effective sample of 923 young-old and 417 old-old persons excluding cases with missing variables, from 2,200 respondents of a national survey of Japanese adults aged 60 and over. This survey was conducted in 1987. While measure of physical resources included existence of chronic diseases and activities of daily living, psychological resources included self-esteem and locus of control. Social resources were measured by social support. The Center for Epidemiologic Scale-Depression (CES-D) was chosen as an indicator of mental well-being. RESULTS: 1. Although the old-old possessed a smaller amount of physical resources, they had almost the same amount of psychological and social resources as compared with the young-old respondents. 2. There were few differences in the effects of those resources on mental well-being between the young-old and the old-old. 3. Lower amount of physical resource was related to a lower level of well-being in the old-old more than in the young-old. CONCLUSION: The old-old appear to possess similar psychological and social resources as the young-old, quantitatively, and in effects on successful adaptation. Lack of physical resources may be associated with a low level of mental well-being in the old-old.

[Characteristics of dropouts and participants in a twelve-year longitudinal research of Japanese elderly].

PURPOSES: The attrition of respondents in panel studies of the elderly can create bias in data analysis. The purposes of this study are two fold; 1) to examine characteristics of dropouts, from a particular panel lost except due to natural attrition (by death) by comparison with continuing participants in that wave, and 2) to assess representativeness of those actually continuing in a particular panel by comparison with those eligible for inclusion in that wave. Only those who died were excluded from the group of respondents at the baseline survey because they constituted natural attrition in this longitudinal survey. METHOD: At baseline (1987), 2,200 individuals age 60+ from 3,288 national representative sample were interviewed. Non-response status to three contacts (1990, 1993, 1996) with the panel was examined in relation to variables included in the baseline interview. A number of characteristics of demographic background, health, life-style, and social relations obtained in the baseline survey (1987) were compared between those re-interviewed in a particular panel and subjects lost through unnatural attrition until that wave. To study the influence of unnatural attrition on variable distributions and each related factors of two health indicators (self-rated health and depressive symptoms), baseline responses were compared between those re-interviewed in a particular panel and all who were eligible to respond in that wave. RESULTS: 1) Dropouts lost to each wave were significantly older and had a lower level of social participation than persons remaining in that wave. Significant differences in health and life-style variables appeared between dropouts lost and continuing participants until third or later waves. 2) Continuing participants in a particular panel were likely to be younger, to be more physically, mentally, or socially healthy than those eligible to respond in the wave. Each related factors of two health indicators were almost same between those re-interviewed in a particular panel and those eligible to respond in that wave. CONCLUSION: Dropouts in longitudinal research were found to appear nonrandomly. While distributions of age and health indicators in those re-interviewed were influenced by respondent attrition, related factors of health indicators may be free of bias that can be created by it.

[The impact of relocation on well-being of the elderly].

OBJECTIVE: This study examined direct and indirect effects, mediated by social contact, of residential relocation on well-being of the elderly. METHODS: We used longitudinal data of a national representative sample of individual aged 60 years and over (N = 1,474). The initial survey was conducted in 1987, and the follow-up survey was conducted three years later. Well-being was measured with the Center for Epidemiologic Studies-Depression Scale (CES-D) and the Life Satisfaction Index A (LSIA). Social contacts were measured in terms of frequency of contacts with relatives, friends and neighbors, as well as frequency of social participation. RESULTS: Relocation had a positive direct effect on well-being, assessed by both CES-D and LSIA, but a negative indirect effect mediated by decline of social contacts. CONCLUSION: Our results suggest that residential relocation indirectly has a detrimental effect on well-being of the elderly through decline in social contacts, though it may directly improve well-being of the elderly.

[Factors related to attitudes toward medical facility choice by the elderly why do the elderly favor large hospitals?].

PURPOSE: Factors associated with large hospital choice by the elderly were examined. Possible factors were divided among three domains; predisposing factors, need factors, and enabling or restraining factors. Both direct effects and interactive effects of those factors on choice attitudes were examined. METHODS: The data were obtained from a face-to-face interview survey with a national sample aged 60 and over. The survey was conducted in 1996, and 2,447 elderly were interviewed. Choice attitudes were measured in two ways: 1) preference to use a large hospital regardless of disease, and 2) complaint of not being able to use a large hospital without an referral system by a clinic. Predisposing factors were age, sex and educational attainment. Need factors were assessed in terms of activities of daily living (ADL) and number of illnesses. Enabling or restraining factors included attitudes toward medical care, accessibility of medical facilities, home doctor existence at a clinic, and labor force participation. RESULTS: 18.5 percent of respondents reported a preference for large hospitals regardless of disease, and 51.3 percent had complaints about the referral system. Respondents with a higher number of illnesses were more likely to report a preference for use of a large hospital, regardless of the type of disease, and respondents with low ADL had more complaints about the referral system than those with higt ADL. The group who employed high technology as a criteria in choosing medical facilities, did not have a home doctor at a clinic, and had good access only to a large hospital, reported a strong preference for use of a large hospital regardless of disease type, and they also complained about the referral system. Regarding preference, an interactive effect between the number of illnesses and the existence of home doctor at a clinic was observed. CONCLUSION: Existence of a home doctor in a clinic, attitudes toward medical care, and accessibility to medical facilities might have direct effects on choice of a large hospital, and only the existence of a home doctor at a clinic might have a strong influence decreasing this preference among the elderly with a higher number of illnesses.

[A longitudinal study on social support and life satisfaction among Japanese elderly].

The purpose of this study was to examine the impact of social support on life satisfaction among Japanese elderly aged 60 and over (N = 1,285), using the longitudinal data of a national representative sample. An initial survey was carried out in 1987, and a follow-up was conducted in 1990. We measured life satisfaction by the Life Satisfaction Index A. Social support was measured from two aspects, providing support and receiving support. The impact of social support and changes in support during a period of three years on life satisfaction were assessed by sex after controlling for influences of socioeconomic status, physical functioning, and initial life satisfaction. Providing support predicted a high life satisfaction three years later only in females. Receiving support was not significantly associated with life satisfaction for either males or females. However changes in providing and receiving support had a significant impact on life satisfaction of the elderly. The findings of this study suggest that the effects of social support on life satisfaction differ by sex and the impacts of changes in support are strong determinant predicting life satisfaction of the elderly.

[Comparison of characteristics between respondents and nonrespondents in a national survey of Japanese elderly using six year follow-up study].

PURPOSES: The purpose of this study were twofold: 1) to examine differences between respondents and nonrespondents in sociodemographic or health characteristics, 2) to study nonresponse effects on relationships between variables, using a 6 year follow-up study for both respondents and nonrespondents at the initial survey. METHODS: The data were collected in 1987 through a national survey of Japanese adults aged 60 and over. A total of 2,200 interviews were completed from the list of 3,288 names. In 1993, 1,010 nonrespondents excluding persons who had died, moved, or whose addresses were unknown in the prior interview, were recontacted through a mail questionnaire. A total of 559 persons completed the mail questionnaire. Of the original 2,200 baseline interviewees, some by proxy interviews, 2,260 persons were reinterviewed, at the same time as the mail survey. Sociodemographic and health variables (age and sex), social indicators (educational attainment, marital status, and job status), health status (mortality, existence of diseases, and activities of daily living), subjective well-being (life satisfaction, self-rated health, and economic satisfaction) were compared between respondents and nonrespondents. Relationships between self-rated health and sociodemographic or health variables were examined by multiple regression analysis. RESULTS: 1. Compared to people who participated in the survey, norespondents were likely to be male, in the lower age categories, and with higher educational attainment at the follow-up survey. Also, life satisfaction and self-rated health were lower in nonrespondents than in respondents. Reasons for nonresponse varied but appeared to be somewhat related to characteristics of nonrespondents. 2. No significant relationships between self-rated health and sociodemographic or health variables appeared for the respondent group and also when including the nonrespondent group. CONCLUSION: While differences between respondents and nonrespondents on certain variables were significant, relationships between self-rated health and sociodemographic variables were not observed.

[The factor structure of coping strategies and their effects on burnout among primary caregivers of impaired elderly persons].

The purpose of this study was to extract the factor structure of coping strategies and to examine their direct and indirect effects on burnout. Eight hundred thirty four valid responses obtained from primary caregivers of impaired persons aged 65 years old and over living in the community were analyzed. The results of covariance structural analysis were as follows: Three second order factors, including "Approach", and "Avoidance," and "Support seeking," were extracted. Five factors, "Keeping their own pace," "Positive acceptance of caregiving role," "Diversion," "Informal support seeking," and "Formal support seeking," were extracted as first order factors. "Keeping their own pace," directly decreased burnout and "Diversion" indirectly decreased burnout through caregiving in involvement. "Informal support seeking" directly increased burnout and "Positive acceptance of caregiving role" indirectly increased burnout through caregiving involvement.

[Mental health among elderly relocated to a rural resort area].

OBJECTIVE: This study examined mental health and its related factors comparing elderly relocated to a rural resort area to elderly living in a rural old area. METHODS: Each sample of 400 aged 65 and over were randomly obtained. Valid responses obtained from the resort area and the old area were 193 and 242 respectively. Mental health was measured from two aspects: Geriatric Depression Scale (GDS) and Life Satisfaction Index A (LSIA). We used self-evaluated living environment, social support, social activities, Activities of Daily Living (ADL), economic status, decision to move, and reason for move (push- and pull-factor), as factors which seem to be related to mental health. RESULTS: The findings were as follows: 1) Respondents in the resort area showed lower GDS and higher LSIA than respondents in the old area. 2) Although for the respondents in the resort area assessment that their community was safe, participation in community groups, or involvement in recreational activities occupied a significant higher level in their mental health, these factors had no significant impact on the mental health among the respondents in the old area. 3) A difference in self-evaluated housing condition, ADL, and economic status between both groups had a cause for the area differences in mental health among the elderly. 4) Push-factor had both a direct effect and an indirect effect mediated by decision to move on GDS. Pull-factor had both a direct and an indirect effect on LSIA. CONCLUSION: Elderly relocated to a rural resort area had better mental health than elderly living in an old area, partly because they had better physical health, better economic status, and better housing condition. Self evaluated living environment and social activities were related to the mental health of the elderly in the resort area stronger than that of the elderly in the old area. Reason for move was related to the mental health of the elderly both directly and indirectly mediated by decision to move.

207Pb chemical shift thermometer at high temperature for magic angle spinning experiments.

The temperature dependence of 207Pb chemical shift in magic angle spinning (MAS) NMR spectrum of Pb(NO3)2 provides a sensitive method to calibrate sample temperatures in MAS NMR. The temperature dependence is uniform in the temperature range between 30 degrees C and 400 degrees C. The NMR sensitivity and the line width are also favorable.

[Analysis of items missing in responses to a series of follow-up surveys in Japanese elderly].

PURPOSES: We examined whether the percentage of items missing and the factors related to item missing differ across follow-up surveys, Variables targeted to examine missing items included health indicators (activities of daily living, cognitive function, self-rated health, Center for Epidemiologic Studies--Depression, and PGC Morale Scale), health habits (cigarette smoking, alcohol consumption, physical exercise, and relative weight), and socioeconomic indicators (educational attainment, income, and social networks). METHODS: Longitudinal data were collected at intervals of three years since 1987 through a national survey of Japanese adults aged 60 and over, At the baseline survey, a total of 2,200 interviews were completed from the list of 3,288 names. At the following three follow-up surveys, 1,671, 1,369, and 1,068 persons were reinterviewed respectively. Possible factors related to appearance of a missing item consisted of five aspects; 1) demographic variables (age and sex), 2) social status (educational attainment, existence of a spouse, and job status), 3) health status (activities of daily living and cognitive function), 4) cooperative attitude toward a survey, and 5) whether an item had been missing at the previous survey (s). Those factors were analyzed for each variable respectively. If a group with scaled or collective items had one or more missing items, we classified that group as a missing item group. RESULTS: 1. The percentage of cases with items missing was 5 percent or more for four variables; CES-D, PGC Morale Scale, income, and health habits. Those percentages were almost constant over the four surveys. 2. Factors related to appearance of items missing differed by psychological variables such as, CES-D and PGC Morale Scale, income, or health habits. Those factors had constant impact on appearance of items missing over follow-up surveys. 3. Regarding CES-D, PGC Morale Scale, income, or health habits, persons with an item missing at a previous survey, or who did not have a cooperative attitude toward the survey had a significant impact on an increase in the percentage of missing items. CONCLUSION: Characteristics of persons with items missing differs among the variables, and those characteristics may contribute to the incidence of items missing in subsequent surveys.

Religion, social support, and health among the Japanese elderly.

We address three issues in this paper: (1) Is religion related to self-rated health, (2) do these salubrious effects arise because religion encourages people to provide help to significant others, and (3) is the relationship between religion and helping others more evident among older men than elderly women? We analyze the relationships among religion, support giving, and health with data provided by a national probability sample of 2,153 older people in Japan who were interviewed face-to-face in 1996. Greater involvement in religion is associated with providing help to others more often, but these effects emerge for older men only. Regardless of gender, elders who provide assistance to others more often rate their health more favorably than older adults who are less involved in helping others. These results confirm that religion is related to health, and that helping others may explain at least part of the reason for this relationship.

[Impact of duration of caregiving on stress among primary caregivers of elderly].

This study examined (1) the direct effect of the duration of caregiving on caregiver psychological distress, and (2) two- or three-way interactions between duration, stressors (elderly's physical and cognitive impairments), and personal (caregiver's economic or work status) or social (informal or formal supports) resources. We interviewed 833 primary family caregivers of non-institutionalized frail elderly who had been selected through a screening process of all residents aged 65 and over (21,567 persons) in a suburban area of Tokyo. Caregiver psychological distress was evaluated by "Caregiving Burden Scale" as a caregiving-specific psychological measurement, and "Center for Epidemiologic Studies Depression Scale (CES-D)" as a general psychological measurement. The results were as follows. 1. For Caregiving Burden, duration showed a direct effect, as those who had been providing care for a longer duration of time reported higher burden. We found no interactions between duration, stressors, and resources on caregiving burden. 2. For CES-D, duration had interactions, but no direct effect. (1) Two-way interactions were observed between duration and caregiver's economic or work status, as caregivers with a low economic status or who were unemployed showed a stronger negative impact from duration of caregiving. (2) Three-way interactions were observed between duration, the elderly's ADL impairment, and informal support. Informal support, such as a secondary caregiver, buffered the negative impact of the elderly's ADL impairment in cases with a shorter duration of caregiving, but not for those with longer duration. (3) Three-way interactions were observed between duration, the elderly's cognitive impairment, and formal emotional support. Formal emotional support buffered the negative impact of the elderly's cognitive impairment for those with a longer duration of caregiving, but not for those with a shorter duration. These findings suggest that stress-buffering resources differ according to duration of caregiving.

[Impact of health practices on changes in the physical and mental well-being of older adults].

Previous studies on young and middle-aged adults have demonstrated a correlation between certain personal health practices and reduced mortality. However, we have little knowledge to what extent the findings can be generalized to older adults. Our purpose was to investigate the impact of health practices on subsequent changes in the physical and mental well-being of the elderly. We used longitudinal data of a national representative sample of 2,200 older adults aged 60 and over at baseline. This six-year prospective study examined the associations of six items related to personal health habits--cigarette smoking, alcohol consumption, physical exercise, eating breakfast, hours of sleep, and relative weight--with subsequent health status change. Not smoking was the only health practice that achieved a statistically significant relationship with the reduction of future mortality risk. Obesity (20% or more overweight) was a risk factor for the subsequent impairment in activities of daily living. Those who reported a high frequency of exercise and sleeping 7 or 8 hours per night at baseline were less likely to show decreases in their levels of mental well-being. These results suggest that not smoking, weight control, physical exercise, and sleep patterns may have an important role in maintaining physical and mental well-being in older adults.