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1.
Res Aging ; 44(2): 144-155, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-33845689

RESUMO

Although retirement age is increasing in aging societies, its impact on individuals and communities is unclear. This study examined how age moderates the linkage between transition into retirement and participation in productive and non-productive social activities after retirement, using a nationwide longitudinal survey with a probability sample of Japanese aged 60 and over (n = 3,493). Multinomial logistic regression analyses were performed to predict changes in volunteering and hobbies/learning during 3-5 years of follow-up and their participation level at the follow-up. The significant interactions between change in work status (remained working as reference, full/partial retirement, remained not-working) and age at baseline showed that fully retired persons were more likely to increase these activities than remained workers only when they retired by their early seventies. Thus it is important to encourage engagement in social activities before retirement and remove psychological and environmental barriers that hinder starting new activities at old age.


Assuntos
Aposentadoria , Comportamento Social , Idoso , Envelhecimento/psicologia , Humanos , Japão , Pessoa de Meia-Idade , Voluntários
2.
J Gerontol A Biol Sci Med Sci ; 76(11): 2039-2046, 2021 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33626135

RESUMO

BACKGROUND: Recent studies, predominantly in Western populations, suggest that both weight loss and weight gain are associated with an increased mortality risk in old age. However, evidence of this association in older Asian populations remains sparse. This study aimed to examine the association between weight change and all-cause mortality in a nationally representative sample of community-dwelling older Japanese people. METHODS: Data were obtained from the National Survey of the Japanese Elderly, which included 4869 adults aged ≥60 years. Participants were followed for up to 30 years. We considered 3 indicators of weight change according to the follow-up interval: short-term (3 years), medium-term (6-7 years), and long-term (12-13 years). Weight change was classified as loss ≥ 5%, loss 2.5%-4.9%, stable (±2.4%), gain 2.5%-4.9%, and gain ≥ 5%. Cox proportional hazards models were used to calculate the relative mortality risk of each weight change category. RESULTS: Weight loss ≥ 5% for all intervals was associated with higher mortality than stable weight and the effects were largely similar across all 3 intervals (hazard ratio [95% confidence interval]: 1.36 [1.22-1.51] for short-term, 1.36 [1.22-1.51] for medium-term, and 1.31 [1.11-1.54] for long-term). A similar pattern of results was observed among the young-old and old-old, and among men and women. The effect of weight loss on higher mortality was greater among those with a lower body mass index at baseline. CONCLUSIONS: These findings could inform clinical and public health approaches to body-weight management aimed at improving the health and survival of older adults, particularly in Asian populations.


Assuntos
Aumento de Peso , Redução de Peso , Idoso , Índice de Massa Corporal , Peso Corporal , Feminino , Humanos , Vida Independente , Japão/epidemiologia , Masculino , Modelos de Riscos Proporcionais , Fatores de Risco
3.
BMC Geriatr ; 21(1): 38, 2021 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-33423660

RESUMO

BACKGROUND: It is well known that females generally live longer than males, but women tend to suffer from more illnesses and limitations than men do, also for dementia. However, limited empirical evidence is available why this 'male-female health-survival paradox' is observed. This study aimed to investigate factors which account for gender differences in health, particularly cognitive functioning and decline among older adults. METHODS: Data were retrieved from the National Survey of the Japanese Elderly, which is a longitudinal survey of a nationwide representative sample of Japanese adults aged 60 or over. Gender differences in cognitive functioning and decline in three-year follow-ups were decomposed using Blinder-Oaxaca decomposition analysis, regarding demographic, socioeconomic, and health-related factors into the 'explained' component, by differences in individual attributes listed above, and the 'unexplained' component. RESULTS: Empirical analyses showed that women's lower cognitive functioning was partly explained by the endowment effect. Moreover, a shorter duration of formal education and a larger proportion with their longest occupation being domestic worker accounted for steeper cognitive decline and more prevalent mild cognitive impairment in women than in men. CONCLUSION: This empirical study suggested that gender differences in cognitive functioning and decline account for different individual attributes of social determinants among men and women. Particularly, men seem to be more engaged in activities which accumulate intellectual experiences through education and occupation, as suggested by the cognitive reserve hypothesis.


Assuntos
Disfunção Cognitiva , Reserva Cognitiva , Idoso , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Escolaridade , Feminino , Humanos , Japão/epidemiologia , Masculino , Caracteres Sexuais , Fatores Sexuais
4.
Arch Gerontol Geriatr ; 93: 104286, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33171327

RESUMO

OBJECTIVE: To examine whether co-existing social isolation and homebound status influence medical care utilization and expenditure in older adults. METHODS: Postal surveys on social isolation and homebound status were performed on older adults aged ≥65 years residing in a Japanese suburban city. Information on medical care utilization and expenditure was obtained from insurance claims data. These outcomes were examined over a three-year period (December 2008 to November 2011) for all participants (Analysis I, n = 1386) and during the last year of life for mortality cases (Analysis II, n = 107). A two-part model was used to analyze the influence of social isolation and homebound status on medical care utilization (first model: logistic regression model) and its related expenditure (second model: generalized linear model). RESULTS: Almost 12 % of participants were both socially isolated and homebound. Analysis I showed that these participants were significantly less likely to use outpatient and home medical care than participants with neither characteristic (odds ratio: 0.536, 95 % confidence interval: 0.303-0.948). However, Analysis II showed that participants with both characteristics had significantly higher daily outpatient and home medical expenditure in the year before death than participants with neither characteristic (risk ratio: 2.155, 95 % confidence interval: 1.338-3.470). DISCUSSION: Older adults who are both socially isolated and homebound are less likely to regularly utilize medical care, which may eventually lead to serious health problems that require more intensive treatment. Measures are needed to encourage the appropriate use of medical care in these individuals to effectively manage any existing conditions.


Assuntos
Pacientes Domiciliares , Isolamento Social , Idoso , Gastos em Saúde , Humanos , Japão/epidemiologia , Inquéritos e Questionários
5.
Arch Gerontol Geriatr ; 91: 104220, 2020 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-32810734

RESUMO

BACKGROUND: Japan has the largest aging population in the world, thus, a focus on frailty is important in clinical geriatric practice. Using a nationally representative sample, this study provided national estimates of the prevalence of frailty among community-dwelling older Japanese people. We also examined variations in the prevalence by sociodemographic characteristics, health conditions, and geographical regions. METHODS: Data came from the National Survey of the Japanese Elderly in 2012. The data were collected using a home visit and face-to-face interviews with trained interviewers. The sample consisted of 2206 adults aged ≥65 years. We used the widely accepted definition of physical frailty phenotype and calculated weighted estimates of the prevalence of frailty. RESULTS: Overall estimated prevalence was 8.7 % (7.5 %-9.9 %) for frail, 40.8 % (38.7 %-42.9 %) for prefrail, and 50.5 % (48.4 %-52.6 %) for robust. Frailty was more prevalent in older groups, women, and those with lower socioeconomic status, which was measured by education and household income. Frail people tended to have worse health. We also observed a regional variation: frailty prevalence tended to be higher in eastern than western Japan. CONCLUSIONS: This study provides important evidence on the prevalence of frailty in older Japanese people and found substantial disparities by sociodemographic characteristics, health conditions, and geographical regions.

6.
J Am Med Dir Assoc ; 21(6): 734-739.e1, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32312679

RESUMO

OBJECTIVES: There is limited research on long-term changes in functional capacity among older Japanese, who differ significantly from their counterparts in Western, developed nations. This study aimed to identify distinct trajectories of functional capacity over a 25-year period and to explore socioeconomic differences in trajectory-group membership probabilities, using a national sample of older Japanese. DESIGN: Longitudinal panel study with 8 observation points from 1987 to 2012. SETTING AND PARTICIPANTS: The data came from the National Survey of the Japanese Elderly, which consisted of 6193 samples of community-dwelling Japanese aged 60 years and older at baseline. METHODS: Functional capacity measure included basic and instrumental activities of daily living. Group-based mixture models were used for data analysis. RESULTS: Among participants aged 60 to 74 years at baseline, 4 trajectories were identified: minimal disability (80.3%), late-onset disability (11.6%), early-onset disability (6.2%), and moderate disability (1.9%). Those aged ≥75 years at baseline experienced higher levels of disability but somewhat parallel trajectories, including minimal disability (73.3%), early-onset disability (11.2%), moderate disability (11.3%), and severe and worsening disability (4.2%). Lower socioeconomic status, including education and household income, was associated with a higher risk of experiencing trajectories of poorer functional capacity among those aged 60 to 74 years, but no such association existed among those aged ≥75 years. CONCLUSIONS AND IMPLICATIONS: We found that approximately 70% to 80% of older Japanese maintained healthy functional capacity over time. Although we could not follow those who dropped out during the observation period, this study provided useful evidence that socioeconomic disparities in functional health converge with age. Our findings inform the design of health policies and interventions aiming to maintain functional health among older adults with diverse socioeconomic backgrounds. In particular, public policies aiming to reduce socioeconomic disparities should be emphasized to promote healthy aging.


Assuntos
Atividades Cotidianas , Pessoas com Deficiência , Idoso , Avaliação da Deficiência , Humanos , Japão , Estudos Longitudinais , Pessoa de Meia-Idade , Classe Social
7.
Ethn Health ; 25(6): 874-887, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-29726279

RESUMO

ABSTRACTObjective: Increasing evidence suggests a reverse J-shaped association between body mass index (BMI) and all-cause mortality among the older population. However, findings from non-Western societies including Japan are still sparse. Furthermore, little evidence regarding variation by age and gender in the BMI-mortality relationship in old age exists. This study aimed to examine age and gender variations in the relationship between BMI and all-cause mortality among older Japanese. Design: Data came from a national representative sample of community-dwelling Japanese aged 60 years and older at baseline (n = 4,869). Participants were followed for up to 25 years. We categorized BMI into seven categories: < 18.5, 18.5-19.9, 20.0-21.4, 21.5-22.9, 23.0-24.9, 25.0-26.9, and ≥ 27.0. Cox proportional hazards models were used to assess the relative mortality risk associated with BMI categories. Results: Lower BMI (< 18.5 and 18.5-19.9) was associated with higher mortality, compared to the mid-normal weight category (BMI: 21.5-22.9), after adjusting for covariates. In contrast, high-normal weight (BMI: 23.0-24.9) and overweight (BMI: 25.0-26.9 and ≥ 27.0) were not associated with mortality. Relative to old-old (aged ≥ 75 years), the higher mortality risk associated with lower BMI (< 20) appeared to be more prominent among young-old (aged 60-74 years). A moderately increased mortality risk associated with low BMI (18.5-19.9) was identified among men but not among women. Conclusion: Among older Japanese, low BMI (< 20.0) was associated with higher mortality, while high BMI (≥ 27.0) was not. The increased mortality risk associated with low BMI is more apparent among young-old and men. These age and gender differences need to be considered in assessing healthy body weight in old age.


Assuntos
Índice de Massa Corporal , Nível de Saúde , Mortalidade/tendências , Fatores Etários , Idoso , Feminino , Humanos , Vida Independente , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Fatores Sexuais
8.
Arch Gerontol Geriatr ; 84: 103904, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31302504

RESUMO

OBJECTIVES: To examine the association of physical performance measures and self-rated health with multimorbidity among older Japanese adults aged ≥60 years using cross-sectional data from a nationwide longitudinal survey. METHODS: Using respondents' self-reported data from the 2012 National Survey of the Japanese Elderly, we analyzed multimorbidity involving nine major chronic diseases (heart disease, arthralgia, hypertension, diabetes, stroke, cataract, cancer, respiratory disease, and low back pain). Respondents who reported having two or more of these diseases were identified as having multimorbidity. Multivariate logistic regression analysis was used to examine if physical performance (grip strength and walking speed) and self-rated health were independently associated with multimorbidity after adjusting for potential confounders (e.g., demographic, physiological, and lifestyle-related variables). RESULTS: The responses of 2525 participants who responded to the survey by themselves (i.e., without proxies) were analyzed (response rate: 57.9%). Among the chronic diseases examined, hypertension had the highest prevalence (44.1%), followed by low back pain (25.7%) and cataract (24.7%). Approximately 44.4% of the respondents had multimorbidity. The regression analysis revealed that multimorbidity was significantly associated with both poor grip strength (P = 0.006) and self-rated health (P < 0.001), but not with walking speed (P = 0.479). CONCLUSIONS: Multimorbidity is prevalent in older Japanese adults, and poor grip strength and self-rated health were independently and significantly associated with multimorbidity. Health assessments that include these indicators may provide insight into the health status patterns of older adults with multimorbidity and inform the development of health management strategies.


Assuntos
Multimorbidade , Desempenho Físico Funcional , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade
9.
Nihon Koshu Eisei Zasshi ; 66(3): 129-137, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-30918204

RESUMO

Objectives The aim of this research is to classify elderly adults who live alone by their marital status type and to clarify how those types affect their higher-level functional capacity and mental health with a 2-year follow-up survey.Methods This research is based on the results from a survey in 2013. The base-line scores were from 757 participants who completed a survey by mail, carried out in B area of A ward, Tokyo, within the jurisdiction of community general support centers, with people who were not at nursing care levels 4 or 5 and who were not residents of welfare facilities. This study analyzed data for 517 of 527 participants, who answered all questions in the 2015 survey and indicated their marital status. This research categorized the respondents into 4 types of marital status: separation, divorce, bereavement, and unmarried groups. This study adopted the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) as the index of higher-level functional capacity, and the WHO-Five Well-Being Index (WHO-5-J) as the mental health index. In the analysis of the causes of 2-year variations in TMIG-IC total scores and WHO-5-J scores, the dependent variable was each variation. This study used an analysis of covariance in which the fixed factors were types of living alone, sex, annual income, and having children who lived separately in the 2013 survey, and the covariance comprised the base-line scores for the dependent variables, age, and chronic diseases in the 2013 survey.Results With regards to the variation in TMIG-IC total scores, main effects of the types of living alone were observed. The adjusted variation of covariance decreased most in the separation group (-0.95). For the variation in WHO-5-J scores, main effects of the types of living alone were indicated. In the divorce group, the adjusted variation of covariance was significantly higher than for the unmarried group (2.33 vs. -0.55).Conclusion The results revealed that the types of marital status: separated, divorced, bereaved, and unmarried, affect changes in the higher-level functional capacity and mental health status of elderly adults living alone, 2 years later. Thus, although previously regarded as a single category, types of marital status should be considered in the analysis of elderly adults who live alone.


Assuntos
Nível de Saúde , Estado Civil , Cura Mental , Características de Residência , Isolamento Social , Cônjuges , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Fatores de Tempo , Tóquio
10.
J Gerontol B Psychol Sci Soc Sci ; 74(7): 1245-1255, 2019 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-28575472

RESUMO

OBJECTIVE: This study examines relationships between municipal age structure and two types of self-rated health: general (SRH) and comparison with similar-aged peers (C-SRH). METHODS: Using a national sample of almost 5,000 Japanese older adults over two decades, we employ hierarchical growth curve models to estimate health trajectories. For municipal age structure, we consider both the relative prevalence of elderly adults in the local population and the pace of aging over time. RESULTS: Living in the oldest municipalities was generally associated with worse health, particularly between the ages of 70 and 80 years. For SRH, the speed of municipal population aging was also independently associated with worse health. For C-SRH, worse health in older areas was partially explained by less favorable economic conditions in those municipalities. Results also suggest that higher levels of employment and social integration among older adults living in the oldest municipalities operate in the opposite direction. That is, these attributes partially "protect" individuals from other factors that contribute to worse health. DISCUSSION: Relative differences in municipal age structure and the pace of population aging are largely unexplored and potentially important correlates of older adult health. This line of research is increasingly salient in a world with substantial and growing regional variation in population aging.


Assuntos
Envelhecimento , Autoavaliação Diagnóstica , Nível de Saúde , Meio Social , População Urbana/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Cidades/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos , Humanos , Japão , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
11.
Int Psychogeriatr ; 31(5): 703-711, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30022745

RESUMO

ABSTRACTBackground:Social isolation and homebound statuses are possible risk factors for increased mortality among older adults. However, no study has addressed the impact of accumulation of these two factors on mortality. The aim of this study was to examine whether such accumulation increased the risk of all-cause mortality. METHODS: The analyzed sample was drawn from a mail survey of 1,023 older adults without instrumental activities of daily living disability. Participants were classified into four groups according to the frequency of both face-to-face and non-face-to-face interactions with others (social isolation and non-social isolation) and the frequency of going outdoors (homebound and non-homebound). Social isolation and homebound statuses were defined as having a social interaction less than once a week and going outdoors either every few days or less, respectively. All-cause mortality information during a six-year follow-up was obtained. RESULTS: In total, 78 (7.6%) participants were both socially isolated and homebound. During the follow-up period, 65 participants died, with an overall mortality rate of 10.6 per 1000 person-years. Cox proportional hazards regression analyses demonstrated that older adults who were socially isolated and homebound showed a significantly higher risk of subsequent all-cause mortality compared with healthy adults who were neither socially isolated nor homebound, independent of potential covariates (aHR, 2.19; 95% CI: 1.04-4.63). CONCLUSION: Our results suggest that the co-existence of social isolation and homebound statuses may synergistically increase risk of mortality. Both active and socially integrated lifestyle in later life might play a major role in maintaining a healthy status.


Assuntos
Pacientes Domiciliares/psicologia , Vida Independente/psicologia , Mortalidade , Isolamento Social , Idoso , Idoso de 80 Anos ou mais , Feminino , Nível de Saúde , Humanos , Japão/epidemiologia , Masculino , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco
12.
Geriatr Gerontol Int ; 18(8): 1259-1266, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29998492

RESUMO

AIM: Identifying factors that influence participation in social group activities in older adults might be helpful in promoting social participation in this population. We examined factors related to new or continuous participation in social group activities according to group type. METHODS: We carried out a community-based, longitudinal study with a 2-year follow-up period. Of 7608 older adults aged ≥65 years, 3380 completed the follow-up survey and were included in the analysis. We examined private group (hobbies, sports and volunteering; PrG) and public group (neighborhood associations and senior citizen clubs; PuG) activity. RESULTS: For PrG, 39.6% of the participants were engaged at baseline, 25.5% initiated participation and 9.5% withdrew during the study period. For PuG, 20.8% of the participants were engaged at baseline, 10.8% initiated participation and 31.5% withdrew during the study period. Logistic regression analysis showed mental health, self-rated health, employment, relationships with neighbors, subjective economic status, educational attainment and participation in PuG were related to new participation in PrG. Mental health, employment and relationships with neighbors were significantly related to continuous participation. For PuG, mental health, sex and relationships with neighbors were significantly related to new participation, whereas sex, relationships with neighbors and educational attainment were related to continuous participation. CONCLUSIONS: The rate of new and continuous participation in PrG was higher than that in PuG, and different related factors were identified as existing between social group types. Geriatr Gerontol Int 2018; 18: 1259-1266.


Assuntos
Nível de Saúde , Vida Independente/psicologia , Saúde Mental , Qualidade de Vida , Participação Social/psicologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Seguimentos , Avaliação Geriátrica/métodos , Humanos , Japão , Modelos Logísticos , Estudos Longitudinais , Masculino , Análise Multivariada , Fatores de Risco , Comportamento Social , Fatores de Tempo
14.
Geriatr Gerontol Int ; 17(11): 2008-2016, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28276623

RESUMO

AIM: Although the modification of lifestyle factors might facilitate weight control, the effects of health behaviors on the trajectory of bodyweight among older adults have been understudied. We examined the effect of changes in smoking, alcohol use and physical activity on the long-term trajectory of body mass index (BMI) among older Japanese adults. METHODS: Data came from a national sample of 4869 Japanese adults aged 60 years and older at baseline, with up to seven repeated observations over a period of 19 years (1987-2006). Hierarchical linear modeling was used to analyze the intrapersonal and interpersonal differences in BMI trajectory. RESULTS: The average BMI among older Japanese adults was 22.3 at baseline, and decreased with an accelerating rate over time. Smoking was significantly associated with lower BMI over time, whereas smoking cessation was associated with higher BMI. Drinking and physical activity were not associated with BMI. We found significant interactions between age and smoking status, and between sex and physical activity, on BMI trajectory: the association between smoking and lower BMI was stronger in younger participants compared with older participants. The association between physical activity and higher BMI was more pronounced among men compared with women. CONCLUSION: The present findings yield important new information regarding the complex dynamics underlying the linkage between lifestyles factors and BMI trajectory among older Japanese, and suggest that there might be cross-cultural differences in these linkages. Geriatr Gerontol Int 2017; 17: 2008-2016.


Assuntos
Índice de Massa Corporal , Trajetória do Peso do Corpo , Comportamentos Relacionados com a Saúde , Idoso , Consumo de Bebidas Alcoólicas/psicologia , Exercício Físico/psicologia , Feminino , Humanos , Japão , Estilo de Vida , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fumar/psicologia
15.
Geriatr Gerontol Int ; 17(3): 500-508, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26799166

RESUMO

AIM: Decreased frequency of going outside the home and being socially isolated are regarded as predictors of poor health. The object of the present study was to clarify whether these factors have synergistic or independent impacts on future functional decline. METHODS: We examined a prospective cohort of 2427 community-dwelling persons, aged ≥65 years, who responded to the baseline mail survey in Wako City, in 2008. Participants were asked about the frequency of going outside the home, social isolation status (having contact less than once a week with anyone outside household), functional capacity (Tokyo Metropolitan Institute of Gerontology-Index of Competence), age, sex, annual income, self-rated health, depressive mood and mobility. RESULTS: Of 1575 persons (72.1%) who completely responded to the follow-up survey (T2) in 2012, we defined the groups as follows: group 1, not isolated and going outside the home every day (n = 897); group 2, not isolated and going outside the home less than every day (n = 311); group 3, isolated and going outside the home every day (n = 224); and group 4, isolated and going outside the home less than every day (n = 143). Multiple logistic regression analyses showed that the variables identifying group 3 for men and group 2 for women with reference to group 1 were predictors of subsequent functional decline even after adjustment for confounders (odds ratios 2.01, 1.63; 95% CI 1.20-3.38, 1.03-2.56, respectively). CONCLUSION: Social isolation regardless of going outside the home every day for men and going outside the home less than every day regardless of being not socially isolated for women might predict functional decline. Geriatr Gerontol Int 2017; 17: 500-508.


Assuntos
Atividades Cotidianas , Vida Independente/psicologia , Isolamento Social/psicologia , Caminhada/estatística & dados numéricos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Estudos Transversais , Feminino , Avaliação Geriátrica/métodos , Humanos , Relações Interpessoais , Japão , Modelos Logísticos , Estudos Longitudinais , Masculino , Análise Multivariada , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Fatores Sexuais , Inquéritos e Questionários , Tóquio , População Urbana
17.
Nihon Koshu Eisei Zasshi ; 63(3): 101-12, 2016.
Artigo em Japonês | MEDLINE | ID: mdl-27040002

RESUMO

OBJECTIVES: Isolation and anxiety among child-rearing mothers in Japan are a current social problem. Involving diverse people in the community is recognized as an important factor in successful child rearing. This study aimed to develop a scale to measure supportive behavior for child rearing among older adults in the community and examine its reliability and validity. METHODS: Items were selected to measure supportive behaviors for child rearing in the community in accordance with constructs introduced via literature reviews and a preliminary investigation. Participants were asked to evaluate the frequency of each behavior on a four-point scale in a mail-based survey. Of a random sample of 1,500 individuals aged 60-69, living in the Tokyo metropolitan area, 813 (54%) responded. Construct validity and reliability of the scale were examined by a confirmatory factor analysis and Cronbach's reliability coefficient. The validity was also examined by clarifying whether the assumed positive associations between the scale and the following variables were observed: frequency of contact with community residents; the generativity scale, which measured concern for the next generation; and experience of child rearing measured by number of own children and level of support for grandchildren. Pearson's correlation and multiple regression analyses were performed for the analysis of the results. RESULTS: The literature review and preliminary investigation revealed three constructs of supportive behaviors: "children's security and sound growth," "instrumental support to parents," and "emotional support to parents." A second-order factor analysis that modeled "child-rearing support in the community" as a higher-order factor above these three factors showed a good model fit when one item was deleted. The reliability coefficient was high enough (alpha=0.87) with the remaining seven items. As expected, the total score positively and significantly correlated with the frequency of contact with residents, especially with the younger generation, including children and their parents; generativity score; number of children; and care for grandchildren. Multiple regression analyses revealed that the measured child-rearing support in the community was largely explained by the frequency of contact with the younger generation. However, being female, taking care of grandchildren, and a higher generativity correlated with a higher child-rearing support score even after controlling for the frequency of contact. CONCLUSION: Reliability and validity of the community child-rearing support scale, consisting of seven items, were confirmed. Further studies are required to show applicability of the scale to diverse communities and age groups, and investigate the effects of the measured supportive behaviors on the child-rearing generation.


Assuntos
Educação Infantil , Redes Comunitárias , Comportamento de Ajuda , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Inquéritos e Questionários
18.
J Epidemiol ; 26(6): 307-14, 2016 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-26902165

RESUMO

BACKGROUND: The health benefits of bicycling in older adults with mobility limitation (ML) are unclear. We investigated ML and functional capacity of older cyclists by evaluating their instrumental activities of daily living (IADL), intellectual activity, and social function. METHODS: On the basis of interviews, 614 community-dwelling older adults (after excluding 63 participants who never cycled) were classified as cyclists with ML, cyclists without ML, non-cyclists with ML (who ceased bicycling due to physical difficulties), or non-cyclists without ML (who ceased bicycling for other reasons). A cyclist was defined as a person who cycled at least a few times per month, and ML was defined as difficulty walking 1 km or climbing stairs without using a handrail. Functional capacity and physical ability were evaluated by standardized tests. RESULTS: Regular cycling was documented in 399 participants, and 74 of them (18.5%) had ML; among non-cyclists, 49 had ML, and 166 did not. Logistic regression analysis for evaluating the relationship between bicycling and functional capacity revealed that non-cyclists with ML were more likely to have reduced IADL and social function compared to cyclists with ML. However, logistic regression analysis also revealed that the risk of bicycle-related falls was significantly associated with ML among older cyclists. CONCLUSIONS: The ability and opportunity to bicycle may prevent reduced IADL and social function in older adults with ML, although older adults with ML have a higher risk of falls during bicycling. It is important to develop a safe environment for bicycling for older adults.


Assuntos
Atividades Cotidianas , Ciclismo , Limitação da Mobilidade , Idoso , Idoso de 80 Anos ou mais , Cognição/fisiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pesquisa Qualitativa , Participação Social
19.
J Gerontol B Psychol Sci Soc Sci ; 71(2): 378-88, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25577567

RESUMO

OBJECTIVES: This research analyzed the body mass index (BMI) level and rate of change, and their association with socioeconomic status among older Japanese adults. METHODS: Data came from a national sample of over 4,800 Japanese adults aged 60 and older at baseline, with up to 7 repeated observations over a period of 19 years (1987-2006). Hierarchical linear modeling was used to analyze the intrapersonal and interpersonal differences in BMI. RESULTS: Average BMI among older Japanese was 22.26 at baseline and decreased with an accelerating rate over time. Relative to those with less education, BMI among older Japanese with more education was lower and it declined linearly at a faster rate over time. In contrast, higher household income at baseline was associated with a higher level of BMI but similar rates of decline over time. Furthermore, we found no evidence for age variations in the SES-BMI linkage as predicted by prior investigators. DISCUSSION: These findings provide new insights into the complex relationship between socioeconomic factors and BMI, and help to inform the design of health policies and interventions related to weight control among older adults with diverse socioeconomic backgrounds.


Assuntos
Índice de Massa Corporal , Fatores Socioeconômicos , Idoso , Envelhecimento/fisiologia , Povo Asiático , Estudos de Coortes , Humanos , Japão , Pessoa de Meia-Idade
20.
PLoS One ; 10(12): e0144069, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26633033

RESUMO

BACKGROUND: Working at old ages is regarded as a good way to keep one's health according to the idea of productive aging. However, there is not enough evidence yet whether retirement is good or bad, or the kind of effects it has on the health of older adults aged 65 and over. We examined it by using a recent data of Wako city, a suburb area near Tokyo in Japan. METHODS: One thousand seven hundred sixty-eight participants answered to 3 waves of survey questionnaires: 2008, 2010, and 2012, successively. We considered 3 indicators of health; self-rated health, mental health (GDS15) and HLFC (Higher-Level Functional Capacity: TMIG-IC). In cross-sectional analysis, we compared these 3 indicators by three groups: full-time worker, part-time worker, and non-worker. In longitudinal analysis, we compared these three indicators by two groups: subjects who successively worked in 2008, 2010, 2012, and subjects who worked in 2008 but retired before 2010. We used one-way and two way repeated measures ANCOVA for these analyses, respectively. RESULTS: It was significantly clear that retirement worsened both mental health and HLFC in people aged 65 years and over; especially, mental health worsened rapidly and HLFC gradually. However, these indicators didn't worsen in subjects who changed from full-time jobs to part-time jobs. Quitting from part-time jobs deteriorated mental health gradually and HLFC moderately compared to full-time jobs. CONCLUSION: The results support the activity theory that older adults who quit from full-time jobs deteriorated both mental health and HLFC, though at different speeds. If they make a transit to part-time jobs, the deterioration would be moderate. It shows that working is an effective way of social participation for older people aged 65 years and over in Japan.


Assuntos
Emprego , Nível de Saúde , Idoso , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino
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