Mortality in relation to the type of household among elderly people living in a community.

The objective of this study was to determine whether there is an association of mortality with the type of household in elderly people. A cohort of 1,352 elderly people aged 65 years and over at baseline in October 1992 was followed for 42 months. Follow-up was completed for 1,266 (93.6%) (172 deceased and 1,094 alive). From the analysis using the Kaplan-Meier method and the log-rank test, male sex, older age group (75 years and over), no satisfaction with present dwelling, disability, no use of health checks, no practices of daily preventive health promotion, no participation in social activities, and no finding life worth living (no Ikigai) were univariately statistically significantly related to mortality. Furthermore, elderly people living with their spouse only or living alone had higher survival rates than those living with their spouse and children or living with their children, and the curves among the four subclasses of household were significantly different. From the Cox proportional hazards model, living with a spouse only remained as an independent predictor for survival, and living alone was not an increased risk factor for mortality, controlling for sex, age, housing conditions, disability, use of health management, and psychosocial conditions.

[Relation between dietary behavior and body mass index, serum lipids and socioeconomic factors in urban residents].

The purpose of this study was to obtain basic information of factors which improve the dietary behavior of urban residents. For this reason, we studied the relation between dietary behavior and BMI, serum lipids and socioeconomic factors. We surveyed the dietary behavior of those who underwent medical examinations at a health center in the city of A. The subjects for this study were 2,627 persons aged 30 to 69 years. For purposes of analysis, the data derived in the survey was divided into two types of categories. One category is that of practicing and non-practicing group relative to specific dietary behaviors. The other is that of better dietary behaviors group and worse dietary behaviors group. (1) A comparison between the practicing and non-practicing group showed that the mean value of the total cholesterol values for the former was lower than for the latter. Similar results for the triglyceride values was obtained. The mean value of the HDL-cholesterol values for the practicing group was higher than for the non-practicing group. (2) We also compared the better dietary behaviors group with the worse group. For women, the mean value of the body mass indices in the better dietary behaviors group was lower than in worse group. We obtained similar differences for women with regard to the mean values of total cholesterol values and triglyceride values. (3) More of Breslow's health practices were followed by the better dietary behaviors group than by the worse group. (4) The number of good dietary practices was significantly related to the following socioeconomic factors: marital status, floor area of residence, steady employment, and working hours. Better dietary behaviors showed parallel correlation with better health status. Dietary behaviors of younger generations and temporary workers showed a tendency of needing to be improved.

[Demand by the elderly for "meals-on-wheels" services].

A survey was performed to assess the demand for "meals-on-wheels" services by elderly persons living alone in N. city (Osaka Prefecture). The purpose of this study was to identify the factors which are related to the demand for such services. Subjects of this study were 1,853 elderly persons of whom responses were received from 1,783 (95.2%). The percentage of the subjects who needed meal delivery services was 64.5%. Physical condition, living conditions, and dietary habits all correlated significantly with the demand. Elderly who were in poor health, were less affluent, or had trouble preparing meals and performing other housework, expressed a need for "meals-on-wheels" services and asked for more services than others. Those who requested meal delivery services had poorer dietary habits than those who did not. Also, there was more demand for these services by elderly male, as well as those elderly with poor dietary habits. The poorer the quality of life of the elderly person correlated with a greater desire for "meals-on-wheels" services. This study showed that there was a great demand among the elderly living alone for "meals-on-wheels" services. While food is one of the basic elements in life, it is often taken for granted, and meal delivery services for the elderly have been largely neglected. The need for urgent improvement and expansion of meal delivery services for this population is indicated by this study.