The Relationship Between Meaningful Occupation and Self-Rated Health in Japanese Individuals: The Wakayama Study.

In this study, we conducted a quantitative cross-sectional evaluation of the relationships between self-related health and occupational form, occupational performance, and occupational satisfaction. The participants were 675 community-dwelling subjects (283 men, 392 women) who completed a self-administered questionnaire. From this data, we performed a multiple logistic regression analysis using the high and low values of self-rated health as the dependent variables and the characteristics of occupational form, occupational performance, and occupational satisfaction as the independent variables. There were three analysis models: Model 1, which mutually adjusted for all the independent variables; Model 2, with adjustment of the basic attributes, in addition to the first model; and Model 3, which was based on Model 2, but also adjusted for diseases. In all three models, high self-rated health was significantly correlated with high occupational performance scores. These findings confirmed that supporting occupational performance improvement is useful for improving self-rated health.

Age and gender differences in the influences of eNOS T-786C polymorphism on arteriosclerotic parameters in general population in Japan.

OBJECTIVE: The influence of T-786C polymorphism in the promoter region of endothelial nitric oxide synthase (eNOS) on arteriosclerotic parameters by age and gender were examined. METHODS: Brachial-ankle pulse wave velocity (baPWV), heart-rate adjusted augmentation index (AIx@75), pulse pressure (PP) and albumin-creatinine ratio (ACR) were assessed as arteriosclerotic parameters in addition to non-high-density lipoprotein cholesterol (non-HDL-C) to HDL-C (non-HDL-C/HDL-C) ratio in 1499 participants. T-786C polymorphism (rs2070744) was screened using a TaqMan allelic discrimination assay. Analyses of covariance were carried. RESULTS: Women with the non-C allele showed significantly lower AIx@75 in participants aged <65 years and baPWV in participants aged ≥65 years than those with C allele. In contrast, men with the non-C allele showed significantly higher PP in participants aged <65 years, and higher ACR and non-HDL-C/HDL-C ratio in participants aged ≥65 years. In men on cholesterol-lowering medication, the non-C allele carriers showed significantly higher non-HDL-C compared to those in the C allele carriers. CONCLUSIONS: eNOS T-786C polymorphism is significantly associated with arteriosclerotic parameters accompanied with age and gender differences, possibly involving antioxidative and/or endothelial signaling other than inflammatory signaling.

Relationships of alcohol dehydrogenase 1B (ADH1B) and aldehyde dehydrogenase 2 (ALDH2) genotypes with alcohol sensitivity, drinking behavior and problem drinking in Japanese older men.

OBJECTIVES: Many East Asians have the genetic polymorphisms rs1229984 in alcohol dehydrogenase 1B (ADH1B) and rs671 in aldehyde dehydrogenase 2 (ALDH2). Here we analyzed the relationships of the two genotypes with alcohol sensitivity, drinking behavior and problem drinking among older and younger men living in rural areas of Japan. METHODS: The subjects were 718 Japanese men aged 63.3 ± 10.8 (mean ± SD), categorized into the older (≥65 years, n = 357) and younger (<65 years, n = 361) groups. Facial flushing frequency, drinking behavior and positive CAGE results were compared among the genotypes using Bonferroni-corrected χ(2) test and a multivariate logistic regression analysis adjusting for age, BMI and lifestyle factors. RESULTS: The frequency of 'always' facial flushing among the ADH1B*1/*2 carriers was significantly lower than that among the ADH1B*2/*2 carriers in the older group (P < 0.01). The alcohol consumption (unit/day) in the ADH1B*1/*2 carriers tended to be higher compared with that in the ADH1B*2/*2 carriers among the older group (P = 0.050). In the younger group, no significant differences in alcohol sensitivity and drinking habits were generally found among the ADH1B genotypes. The ADH1B*1/*1 genotype tended to be positively associated with problem drinking in the older group (P = 0.080) but not in the younger group. The ALDH2 genotypes consistently and strongly affected the alcohol sensitivity, drinking behavior and problem drinking in both the younger and older group. CONCLUSIONS: We for the first time observed a significant difference in alcohol sensitivity between ADH1B*1/*2 and ADH1B*2/*2 in older men aged 65 and above.

Relationship between blood pressure response during step exercise test and atherosclerotic markers.

Abstract The relationship between blood pressure (BP) response to exercise and atherosclerotic markers were evaluated in a population based sample of 426 normotensive subjects. The subjects with greater increase of SBP during exercise and delayed recovery of SBP after exercise showed higher hs-CRP and SBP2. Multiple regression analysis revealed that the greater BP response and delayed BP recovery were independently associated with SBP2 after adjusting for resting SBP, age, and gender. These results suggest that early atherosclerosis may contribute to greater BP responses to exercise, supporting the concept that exercise BP adds incremental information of cardiovascular risks to resting BP.

The comparison of dementia patient's quality of life and influencing factors in two cities.

AIMS AND OBJECTIVES: To determine the current status of dementia patient's quality of life and compare influencing factors in China and Japan to inform nursing care and potentially improve the patient's quality of life. BACKGROUND: The prevalence of dementia is increasing related to lack of a cure, thus prompting some researchers and clinicians to focus on patient's quality of life. DESIGN: A cross-sectional study. METHODS: A convenience sample of 200 mild-to-moderate dementia patients was obtained in Jinan city and 205 ones in Wakayama city. Then, we measured patient's quality of life and analysed the relation between general demographic information, cognitive function, activities of living, behavioural and psychological symptoms, and the patient's quality of life. RESULTS: The total score of Dementia Quality of Life in Jinan city was 89·82 ± 15·11; multiple linear regression showed that the influencing factors of quality of life were marital, economics, characteristics, activities of living, hypertension and irritability. And the total score in Wakayama city was 118·30 ± 14·56; the influencing factors were education, body mass index, activities of living and depression. CONCLUSIONS: The total score of Dementia Quality of Life in Jinan city was significantly lower than Wakayama city. The same influencing factor between these two cities was activities of living. RELEVANCE TO CLINICAL PRACTICE: Nurses could implement interventions to focus on many of the patient's influencing factors, so that to improve their mental and physical health, which may slow the disease process and further improve the patient's quality of life. In addition, Chinese government could learn some experience from Japanese government, such as perfect the system of nursing insurance for elderly and introduce professional geriatric nursing talents to provide better service for the elderly.

[Association of Cigarette Smoking with Muscle Mass Reduction and Low Muscle Strength in Community-Dwelling Elderly Men].

OBJECTIVES: Recently, attention has been paid to the impact of cigarette smoking on skeletal muscles, as its underlying pathophysiological mechanism has been gradually elucidated. In this study, we aimed to examine whether cigarette smoking is associated with muscle mass reduction and low muscle strength in elderly men. METHODS: The study participants comprised 417 community-dwelling elderly men (aged 73±6 years) without severe glucose intolerance, chronic kidney disease, or liver disease. Bioelectrical impedance analysis was performed to estimate appendicular skeletal muscle mass (ASM), which was normalized for height (ASM index, kg/m2). Handgrip strength (HGS) was measured using a Smedley grip dynamometer. Cumulative smoking exposure level during a lifetime was expressed in pack-years, which is a product of the average number of packs of cigarettes smoked per day and smoking duration in years. RESULTS: When the participants were stratified on the basis of cumulative smoking exposure (<10 pack-years, 10-39 pack-years, ≥40 pack-years), the ASM index and HGS progressively decreased with increasing exposure level (P for trend <0.01). In multiple regression analysis, heavy smoking (defined as ≥40 pack-years) was found to be a significant determinant of the ASM index and HGS, independent of potential confounding factors. Among former smokers, the subgroup that quit smoking for ≥20 years had a significantly higher ASM index and HGS than the subgroup that quit smoking for <10 years. The duration of smoking cessation was significantly associated with the ASM index and HGS, even after adjusting for cumulative smoking exposure. CONCLUSIONS: These findings suggest that cigarette smoking contributes to the loss of muscle mass and function in elderly men and that smoking cessation could reverse the impact of cigarette smoking on skeletal muscles.

Relationship between Fall History and Self-Perceived Motor Fitness in Community-Dwelling People: A Cross-Sectional Study.

History of falling is an important fall risk factor. If a relationship between fall history and self-perceived motor fitness could be established, then treating it as a correctable risk of re-fall due to falls may be possible. We conducted a cross-sectional study of the relationship between fall history and self-perceived motor fitness in daily life among 670 community-dwelling people (mean age 62.0 ± 9.6 years, 277 men and 393 women) who had participated in health examinations. They completed a self-administered questionnaire that asked about their history of single or multiple falls and included a 14-item motor fitness scale. The responses were analyzed using multivariate logistic regression analysis. The results showed that in both younger and older (<65 years) subjects, a history of single or multiple falls was associated with a negative response to "being able to put on socks, pants or a skirt while standing without support". For subjects ≥65 years, an association was also observed with "shortness of breath when climbing stairs". Self-perceived motor fitness related to fall history can easily be noticed by an individual and may help them become aware of fall-related factors earlier in everyday life.

Ability for Self-Care among Elderly Patients with Diabetes Mellitus and Its Association with Health Locus of Control and Social Support.

OBJECTIVES: In this study, we attempted to evaluate the ability of self-care among elderly patients with diabetes mellitus and its association with the health locus of control and social support. METHODS: Participants comprised 173 community-dwelling outpatients with type-2 diabetes, aged over 50 years (M±SD: 67±9 years). Data on self-care ability, health locus of control, and social support were collected using self-administered questionnaires and by structured interviews, and were analyzed by structural equation modeling to verify the interrelationships between variables. RESULTS: Elderly patients (≥65 years, n=109) exhibited significantly higher scores on the self-care ability scale than middle-aged patients (<65 years, n=67). Among elderly patients, those with high scores of self-care ability tended to attribute their health to external agents such as their family or supernatural phenomena rather than their own actions. On the basis of structural equation modeling, the belief that a participant's health was dependent on family members and the family members' actual assistance were found to be significant factors for providing effective support to elderly patients' health-care behaviors. Furthermore, close friendships contributed to the improvement of health-care ability among elderly patients, whereas the spouse's aid was crucial for middle-aged patients. CONCLUSIONS: These results suggest that the health locus of control and social support are important considerations when providing health guidance or counseling to improve the self-care ability among elderly patients with diabetes mellitus.

Job stress and behavioral characteristics in relation to coronary heart disease risk among Japanese police officers.

This study examined the association between job-related behavioral characteristics and the risk of coronary heart diseases (CHD) in Japanese male police officers. Compared to office clerks, police officers exhibited greater age-related increases of the prevalence of CHD risk factors, and a clustering number of CHD risk factors was significantly higher in the group of those over 45 yr of age. Among the police officers, coronary-prone behavior was more frequent than that seen in office clerks. The police officers with coronary-prone behavior tended to engage in shift work and to work overtime more; yet they were less likely to perceive job stress and to express the relevant physical and psychological symptoms than those without coronary-prone behavior. The subjects with such behavioral characteristics had a significantly greater number of CHD risk factors. In a multiple regression analysis, coronary-prone behavior together with age, social support, walking hours per day, and amount of alcohol consumption were selected as significant determinants of a cluster of CHD risk factors. These results suggest that coronary-prone behavior may contribute to the higher prevalence of CHD risk factors in police officers via leading the long working hours and the work-related unfavorable lifestyles, such as alcohol drinking and physical inactivity.

Effect of metabolic syndrome components and their clustering on carotid atherosclerosis in a sample of the general Japanese population.

The objective of this study was to investigate the impact of metabolic syndrome (MS) on carotid atherosclerosis in a Japanese population. A total of 1727 subjects (805 males and 922 females) were included. Intima-media thickness (IMT) was measured using ultrasonography. To evaluate the independent determinants of IMT, a stepwise multiple regression analysis was employed that included age, current smoking habit, LDL-C, HbA1c and the MS components (SBP, DBP, TG, HDL-C, FBG, and WC) as independent variables. Multivariate regression analyses were performed to determine the independent associations of the MS components with IMT. In males, age (ß=0.383, P<0.001), SBP (ß=0.237, P<0.001), LDL-C (ß=0.188, P<0.001), current smoking habit (ß=0.124, P=0.007) and HbA1c (ß=0.110, P=0.014) were significantly associated with IMT. In females, age (ß=0.474, P<0.001), SBP (ß=0.130, P=0.003) and FBG (ß=0.110, P=0.038) were significantly associated with IMT. The present study demonstrated that an elevated number of MS components, with or without central obesity, is associated with higher IMT. Among the analyzed components, hypertension has the strongest association with higher IMT.