Effect of soymilk consumption on serum estrogen concentrations in premenopausal Japanese women.

BACKGROUND: Estrogens have been implicated in the development of breast cancer. Preliminary evidence suggests that consumption of soy products, which contain isoflavones (phytoestrogens), can reduce serum estrogen levels. Our purpose was to determine the effect of soy consumption on serum estrogen levels in premenopausal women by use of a dietary intervention approach. METHODS: Premenopausal Japanese women were randomly assigned to receive either a soymilk-supplemented diet (n = 31) or a normal (control) diet (n = 29). The women in the soymilk-supplemented group were asked to consume about 400 mL of soymilk (containing about 109 mg of isoflavones) daily during a study period that involved three consecutive menstrual cycles. Follicular-phase blood samples were to be obtained in the menstrual cycles preceding (cycle 1) and following (cycle 3) the 2-month dietary intervention. All statistical tests were two-sided. RESULTS: At the end of the study period, estrone and estradiol levels were decreased by 23% and 27%, respectively, in the soymilk-supplemented group and were increased by 0.6% and 4%, respectively, in the control group. The changes for each hormone between the two groups were not statistically significantly different. In the soymilk-supplemented group, menstrual cycle length was increased by nearly 2 days, and, in the control group, it was decreased by approximately 1 day, a difference that was not statistically significant. A subgroup analysis restricted to subjects who provided follicular-phase blood samples on the same day or 1 day apart in menstrual cycles 1 and 3 showed a reduction in serum estrone levels in the soymilk-supplemented group that was of borderline statistical significance (P = .07 for change in serum estrone level in soymilk-supplemented group versus control group). CONCLUSION: Much larger studies will be required to confirm the ability of soy products to reduce serum estrogen levels.

Depressive symptoms and occurrence of type 2 diabetes among Japanese men.

OBJECTIVE: To examine the relationship between depressive symptoms and the incidence of type 2 diabetes. RESEARCH DESIGN AND METHODS: In 1984, 2,764 male employees of an electrical company in Japan completed a self-administered questionnaire including the Zung Self-Rating Depression Scale (SDS). They were followed for the next 8 years, and 2,380 (86%) responded to the follow-up survey in 1992. During the follow-up survey, occurrence of type 2 diabetes was diagnosed according to World Health Organization criteria. RESULTS: A total of 41 cases of type 2 diabetes were identified during the 8-year follow-up survey. After controlling for other known risk factors for type 2 diabetes, a proportional hazard analysis indicated that subjects who had moderate or severe levels of depressive symptoms (> or = 48 on the SDS) at baseline had a 2.3 times higher risk of having type 2 diabetes at the follow-up survey than those who were not depressed (< or = 39 on the SDS) (P < 0.05). CONCLUSIONS: Depressive symptoms may be associated with the onset of type 2 diabetes.

Effect of soymilk consumption on serum estrogen and androgen concentrations in Japanese men.

Soy consumption has been associated with a reduced risk of prostate cancer. The mechanism for this association may involve the effect of soy on the endocrine system. We conducted a randomized dietary intervention study to determine the effects of soy consumption on serum levels of steroid hormones in men. Thirty-five men were randomly assigned to either a soymilk-supplemented group or a control group. The men in the soy-supplemented group were asked to consume 400 ml of soymilk daily for 8 weeks. The men in the control group maintained their usual diet. Blood samples were obtained just before the initiation of the dietary period and thereafter every two weeks for 12 weeks. Changes in hormone concentrations were analyzed and compared between the two groups using the mixed linear regression model against weeks from the start of the dietary period. The mean (SD) soymilk intake estimated from dietary records during the dietary study period was 342.9 (SD, 74.2) ml in the soymilk-supplemented group. There was a significant difference between the two groups in terms of changes in serum estrone concentrations, which tended to decrease in the soy-supplemented group and increase in the control group over time. None of the other hormones measured (estradiol, total and free-testosterone, or sex hormone-binding globulin) showed any statistical difference between the two groups in terms of patterns of change. The results of the study indicate that soymilk consumption may modify circulating estrone concentrations in men.

Anti-arrhythmic effects of (-)-carnitine chloride and its acetyl analogue on canine late ventricular arrhythmia induced by ligation of the coronary artery as related to improvement of mitochondrial function.

Using the two-stage coronary ligation method, first described by Harris, (1950), anti-arrhythmic effects (AAE) of (-)-carnitine chloride (LCC) and acetyl (-)-carnitine chloride (ALCC) were studied in conscious unrestrained dogs in comparison with those of disopyramide (D). Two-stage ligation of the coronary artery resulted in a significant decrease in the myocardial free carnitine content. Intravenous administration of LCC (300 mg kg-1) and D (5 mg kg-1) suppressed the ventricular arrhythmia induced by coronary ligation after 24 hours. ALCC (300 mg kg-1) was found to be less potent. An improvement of the mitochondrial function (respiratory control index (RCI) and oxidative phosphorylation rate (OPR) ) was noted with LCC and ALCC and there was a linear correlation between AAE expressed as reduction of arrhythmic ratio and improvement in the OPR, whereas there was no improvement in mitochondrial function after D. Plasma carnitine concentration was increased after administration of LCC, attaining the value of around 8 mM at 10 min after 300 mg kg-1. At 60 min, the plasma carnitine concentration was still about half as high as at 10 min. After ALCC, both acetyl carnitine and free carnitine were found in the plasma. The concentration of the former was decreased after attaining a peak value of around 0.2 mM at 10 min, while the plasma concentration of free carnitine was gradually increased. The anti-arrhythmic effects of LCC and ALCC were ascribed to the improvement of mitochondrial oxidative phosphorylation, while effects other than the improvement of the mitochondrial activity were suggested as mechanisms of anti-arrhythmic effects of D.

A modified agar plate method for detection of Strongyloides stercoralis.

The agar plate method is a new technique with high detection rates for coprological diagnosis of human strongyloidiasis. This report details modifications of the technique and establishes a standardized procedure. We recommend that all plates should be carefully observed using a microscope because macroscopic observation can lead to false negative results. It is also advisable to pour formalin solution directly into microscopically positive dishes to collect worms by sedimentation. This procedure enables one to observe worms otherwise hidden. Sealing dishes with adhesive tape prevents larvae from crawling out of the dishes, eliminating any possibility in the reduction of detection rates, and greatly improves the safety conditions for the technician performing the procedure. We consider the agar plate method to be superior to the filter paper method in detecting Strongyloides, and we believe that it will eventually become the technique of choice.

Galanin analogues: agonist and antagonist.

23 galanin-related peptides were synthesized by solid phase technology or conventional solution method. The purity of the products was carefully assessed by routine analytical criteria. Using these synthetic peptides, we have investigated the effects of galanins and structurally modified galanin peptides on glucose-stimulated insulin release using the isolated perfused rat pancreas, gastrin and somatostatin release using the isolated perfused rat stomach, the neurally-evoked muscle contractions in guinea pig ileum and the C-fiber response in the isolated spinal cord of the new born rat. The results suggest that the galanin amino-terminal 1-15 sequence is crucial for its activity in the above four systems. With the goal of developing a specific antagonist of galanin, synthetic galanin (1-15) analogues [D-Thr6,D-Trp8,9]galanin(1-15)ol, and [D-Trp8,9]galanin(1-15)ol were found to be a potent antagonist for inhibitory effect of galanin on glucose-induced insulin release.

Life-time prevalence and risk factors of tobacco/nicotine dependence in male ever-smokers in Japan.

UNLABELLED: To estimate the life-time prevalence rate of tobacco/nicotine dependence and demographic variables and smoking habits associated with the disorder in male ever-smokers in Japan. DESIGN: A cross-sectional community-based interview study. SETTING: Takayama city, Gifu Prefecture, Japan. PARTICIPANTS: A total of 170 male ever-smokers aged 35 years or older selected randomly from a community in Japan were interviewed. The response rate was 85%. MEASUREMENTS: The WHO Composite International Diagnostic Interview (CIDI) was used to make diagnoses of tobacco/nicotine dependence according t ICD-10, DSM-III-R and DSM-IV. The Fagerstrom Tolerance Questionnaire (FTQ) was also administered and those who had a FTQ score of 7 or above were identified. FINDINGS: The life-time prevalence rates of tobacco/nicotine dependence in male ever-smokers were 42%, 26% and 32% according to ICD-10, DSM-III-R and DSM-IV criteria, respectively; 19% had a FTQ score of 7 or above. The ICD-10 diagnosis was significantly and negatively associated with quitting smoking (p < 0.05). Multiple logistic regression analyses indicated that number of cigarettes per day when they smoked the most was significantly associated with higher life-time risks of the disorder according to DSM-III-R, DSM-IV and Fagerstrom's classification (p < 0.05). The length of cigarette smoked was associated with higher life-time risks of ICD-10 and DSM-IV diagnoses, and years of smoking were associated with higher life-time risks of ICD-10, DSM-III-R and DSM-IV diagnoses (p < 0.05). Younger birth cohorts had higher cumulative rates of the disorder according to DSM-IV (p for trend < 0.05). CONCLUSIONS: Life-time prevalence rates of tobacco/nicotine dependence according to ICD-10, DSM-III-R and DSM-IV in male ever-smokers in Japan were within the range of rates reported in previous US studies; rates of FTQ score of 7 or above were lower. Fagerstrom scores and diagnostic criteria appear to reflect different aspects of dependence.

Overtime, psychosocial working conditions, and occurrence of non-insulin dependent diabetes mellitus in Japanese men.

OBJECTIVES: To ascertain the effects of overtime and psychosocial job conditions on the occurrence of non-insulin dependent diabetes mellitus (NIDDM) in Japan. DESIGN: An eight year prospective cohort study. SETTING: An electrical company in Japan. PARTICIPANTS: In 1984, a mailed questionnaire was sent to industrial workers of an electrical company in Japan. After excluding those who had a history of diabetes mellitus or other chronic diseases, 2597 male respondents were prospectively followed up for the succeeding eight years. Data from 2194 (84%) who were completely followed up were analysed. The occurrence of NIDDM during the follow up period was assessed according to the WHO criteria on the basis of an annual screening programme. MAIN RESULTS: The age adjusted incidence of NIDDM was significantly higher in those who worked overtime more than 50 hours per month than in those who worked 25 hours or less per month (p < 0.05). It was significantly higher in those who worked with new technology at baseline than in those who did not (p < 0.05). Cox's proportional hazard model indicated that those who worked overtime more than 50 hours per month had 3.7 times higher risk of NIDDM after controlling for known risk factors (p < 0.01) and those who worked with new technology had 2.4 times higher risk of NIDDM (p < 0.05). CONCLUSIONS: It is suggested that longer overtime and use of new technology are risk factors of NIDDM in Japanese men.

Soy product intake and premenopausal hysterectomy in a follow-up study of Japanese women.

OBJECTIVE: The estrogenicity of dietary soy may increase the risk of diseases, such as uterine leiomyoma and endometriosis, which originate from uterine tissue and are predominant indications for hysterectomy. We sought to determine whether soy product intake is associated with an increased risk of premenopausal hysterectomy. DESIGN: Prospective cohort study. SETTING: Takayama City, Gifu, Japan. SUBJECTS: A cohort of 1172 female residents randomly selected from participants in the Takayama Study who were aged 35-54 and premenopausal at the time they entered the study in 1992. MEASUREMENTS: Diet including soy product and isoflavone intake was assessed by a validated semiquantitative food frequency questionnaire at baseline. Information on the onset of menopause and hysterectomy were obtained by a follow-up mail questionnaire in 1998. RESULTS: During the 6 y study period, 31 women underwent premenopausal hysterectomies. The second tertile of isoflavone intake was significantly associated with an decreased risk of premenopausal hysterectomy compared to the lowest tertile of intake after controlling for age and total energy (rate ratio=0.35, 95% confidence interval 0.13-0.97), although the dose-response relationship was not statistically significant. CONCLUSIONS: It is possible that soy product intake may be inversely associated with diagnoses leading to hysterectomy. Future studies focusing on specific diseases will be required to examine this possibility. SPONSORSHIP: Grants from the Ministry of Education, Science, Sports and Culture, Japan.

Rationality/antiemotionality personality and selected chronic diseases in a community population in Japan.

OBJECTIVE: To clarify the relationships of the rationality/antiemotionality (R/A) personality with past histories of seven chronic diseases and current smoking habits in a community population in Japan. METHODS: A questionnaire survey was conducted of all residents aged 35 years old or over (n = 37,287) in Takayama city, Gifu prefecture, Japan; the response rate was 90.3%. Data from 13,091 males and 14,061 females who completed all relevant questions were analyzed. The subjects were asked to complete an 11-item R/A personality scale developed by Grossarth-Maticek et al. (1985). Past histories of seven major chronic diseases and current smoking habit were also asked in the questionnaire. RESULTS: Among males, the R/A scale score was significantly lower in those who had stroke, diabetes or allergy than in those who did not. Among females, the R/A scale score was significantly lower in those who had stroke, allergy or stomach cancer than in those who did not. Among females, current smokers had significantly lower R/A scores than non-smokers. After controlling for age, smoking and drinking, the R/A score was significantly and negatively associated with stroke among males and females; it was significantly and negatively associated with diabetes and allergy among males. CONCLUSION: Our findings are contrary to those observed in Yugoslavia and West Germany, and suggest a cultural difference in the relationship between the R/A personality and disease occurrence.

Association of dehydroepiandrosterone sulfate with serum HDL-cholesterol concentrations in post-menopausal Japanese women.

OBJECTIVES: Positive association between serum dehydroepiandrosterone sulfate (DHEAS) and high-density lipoprotein (HDL) cholesterol has been observed in men but not women. We aimed to examine the cross-sectional relationships of DHEAS, estradiol (E2), and sex hormone-binding globulin (SHBG) to serum lipid concentrations in post-menopausal Japanese women. METHODS: A total of 56 post-menopausal Japanese women were derived from female residents in Takayama City in Japan. The information on body size, disease history, reproductive history, diet, and physical activity were obtained by a self-administered questionnaire. RESULTS: DHEAS was significantly and positively correlated with HDL-cholesterol after controlling for age and body mass index (BMI) (r = 0.28). There was no correlation between DHEAS and total-cholesterol (r = -0.02). E2 was not significantly correlated with total- and HDL-cholesterol and triglyceride. However, SHBG-unbound E2 was significantly positively correlated with HDL-cholesterol (r = 0.34) and negatively correlated with triglyceride (r = -0.27) after controlling for age and BMI. SHBG was negatively correlated with triglyceride, although the correlation was not statistically significant (r = -0.22). CONCLUSION: These data suggest favorable effect of DHEAS as well as E2 and SHBG on lipid profile in Japanese post-menopausal women.

Association of diet and other lifestyle with onset of menopause in Japanese women.

OBJECTIVES: To evaluate the cross-sectional relationships of dietary and other lifestyle variables to menopause. METHODS: A total of 4186 female residents aged 45-55 in Takayama City, Japan, responded to a self-administered questionnaire (the response rate was 89.3%). Diet in the past year was assessed by semiquantitative food frequency questionnaire. Using the logistic regression model, associations between study variables and menopausal status were estimated in terms of odds ratio (OR). RESULTS: Nulliparity and lower relative weight were significantly associated with menopause after controlling for age (P < 0.05). The association of smoking with menopause was marginally significant after controlling for age (P = 0.06). Higher intakes of fat, cholesterol, and coffee were inversely and significantly associated with later menopause after controlling for age, total energy, parity, menarche age, and relative weight (ORs for the highest tertiles of fat, cholesterol and coffee intakes were 0.78, 0.79, and 0.70, respectively, P < 0.05). The highest tertiles of calcium and soy product intakes were significantly associated with menopause after controlling for the covariates (ORs = 1.25 and 1.42, respectively, P < 0.05), but postmenopausal women who had menopause at later age showed higher calcium intake than those who had menopause at early age. CONCLUSION: Dietary factors appear to be associated with onset of menopause.

Development of a screening questionnaire for tobacco/nicotine dependence according to ICD-10, DSM-III-R, and DSM-IV.

A 10-item questionnaire (the Tobacco Dependence Screener; TDS) for screening of tobacco/nicotine dependence according to ICD-10, DSM-III-R, and DSM-IV was newly developed. The reliability and validity were assessed in three samples of smokers in Japan. A total of 58 male smokers completed the TDS and the Fagerstrom Tolerance Questionnaire (FTQ), and they were interviewed using the World Health Organization's Composite International Diagnostic Interview (Sample 1). A total of 118 male and 36 female smoking outpatients completed the TDS and the FTQ and provided a breath sample for carbon monoxide measurement (Sample 2). A total of 194 male smokers joined a health education program using a health risk appraisal (HRA) and reported their smoking status and completed the TDS 6 months after receiving the HRA results (Sample 3). The Cronbach's alpha coefficients for the TDS ranged from .74 to .81 among the samples, whereas those for the FTQ ranged from .41 to .64. Receiver operator characteristic analyses indicated that the TDS had a better screening performance for ICD-10, DSM-III-R, and DSM-IV diagnoses than did the FFQ. The TDS score significantly and positively correlated with the severity of the diagnoses, the carbon monoxide levels, number of cigarettes smoked per day, and years of smoking. The TDS score was significantly lower in those who quit smoking than in those who did not quit smoking after the HRA. It is suggested that the TDS is a reliable and useful screening questionnaire for tobacco/nicotine dependence according to ICD-10, DSM-III-R, and DSM-IV.

Eysenck's personality and tobacco/nicotine dependence in male ever-smokers in Japan.

To examine the relationship between Eysenck's personality traits and tobacco/nicotine dependence in a male population, a random sample of 200 male ever-smokers aged 35 or older from a community in Japan were interviewed using the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI), which yielded ICD-10, DSM-III-R and DSM-IV diagnoses of tobacco/nicotine dependence. They were also asked to complete the Fagerstrom Tobacco Questionnaire (FTQ) and the short-form Eysenck Personality Questionnaire-Revised. A total of 136 subjects completed both the interview and the questionnaire. Neuroticism scores were significantly higher in those who had lifetime diagnosis of tobacco/nicotine dependence according to ICD-10, DSM-IV, or FTQ criteria than nondependent ever-smokers (p < 0.05). Lie scores were significantly lower in DSM-III-R or DSM-IV tobacco/nicotine dependence than in nondependent ever-smokers (p < 0.05). Multiple logistic regression indicated that neuroticism was significantly associated with a higher risk of ICD-10 tobacco/nicotine dependence (p < 0.05), after controlling for age, education, employment status and smoking behaviors; lie score was significantly associated with a lower risk of DSM-III-R tobacco/nicotine dependence (p < 0.05). It is suggested that neuroticism is associated with a higher risk of tobacco/nicotine dependence in male Japanese ever-smokers. A nonconforming and rebellious attitude or reporting bias represented by higher lie score may be associated with lower rates of tobacco/nicotine dependence.

Cutaneous T cell lymphoma differing from classical mycosis fungoides and Sézary syndrome: clinical, histological and immunohistochemical studies of six cases.

Six cases of cutaneous T cell lymphoma (CTCL), differing from classical mycosis fungoides (MF) and Sézary syndrome (SS), were studied. Initial skin eruptions were erythematoplaques, papules and tumors. Some cases showed frequent spontaneous regressions without any specific therapy; however, the prognosis was not always good. Surface phenotypes of neoplastic cells were markedly heterogeneous from the onset of initial skin eruption. Three cases expressed the T helper/inducer (Th/i) phenotype, one case had both the Th/i and T suppressor/cytotoxic phenotypes, and the other two cases lacked both surface markers. These results suggest that CTCL other than MF and SS displays marked heterogeneous clinical behavior and diverse morphological and immunophenotypical characteristics of the postthymic T cells.

Serum concentrations of carotenoids, alpha-tocopherol, fatty acids, and lipid peroxides among Japanese in Japan, and Japanese and Caucasians in the US.

Serum concentrations of carotenoids, alpha-tocopherol, fatty acids, and thiobarbituric acid-reactive substances (TBARS) were measured in 217 Japanese residents of Japan, and in 99 Japanese and 100 Caucasian residents of the US, aged from 50 y to 74 y. In females, serum values of carotenoids such as beta-carotene (BC) and zeaxanthin & lutein (ZL) were highest among Japanese in Japan, followed by Japanese in the US and Caucasians in the US. In males, these values, except for serum BC values, were also highest among Japanese in Japan. Moreover, serum values of n-3 polyunsaturated fatty acids (n-3PUFAs) such as eicosapentaenoic acid and docosahexaenoic acid were significantly higher among Japanese in Japan than among Japanese and Caucasians in the US in both sexes. In contrast, serum values of n-6 polyunsaturated fatty acids such as linoleic acid and arachidonic acid were lowest among Japanese in Japan. For women, serum levels of n-9 unsaturated fatty acids were lowest among Japanese living in Japan. Serum TBARS values were highest among Japanese in Japan, followed by Japanese in the US and Caucasians in the US. A significant positive correlation was observed between serum values of TBARS and n-3 PUFAs among Japanese both in Japan and in the US. Serum TBARS values showed a significant inverse relationship with the serum values of BC and ZL among Japanese in Japan and with those of BC among Japanese in the US. These relationships were not always observed among Caucasians in the US. The results of this study suggest that the high TBARS values among Japanese in Japan may depend in part on lipid peroxidation induced in vitro by n-3PUFAs, while high reduction of lipid peroxidation could be expected among Japanese in Japan with high antioxidants such as BC and ZL. In conclusion, serum levels of nonprovitamin A carotenoids such as ZL may be a useful intake marker of vegetables. Dietary intakes of dark green vegetables and fish rich in n-3PUFAs might be more important in the prevention of some sites of cancer and of ischemic heart disease.

Occupational factors, smoking habits and tobacco withdrawal symptoms among male Japanese employees.

The aim of the study is to know the effects of occupational factors and smoking habits on tobacco withdrawal symptoms among male Japanese employees. A total of 2,862 male employees in a company in Japan completed questionnaires concerning tobacco withdrawal symptoms, occupational factors (occupation, shift work, work stress) and smoking habits. Data from 1,443 male ever-quitters were analyzed. Among male ever-quitters, 67% had ever experienced tobacco withdrawal symptoms. Significantly higher age-adjusted rates of tobacco withdrawal symptoms were found in those who experienced frequent exhaustion after work, current smokers, those who smoked 20 or more cigarettes per day, smoked for 20 years or longer and tried to quit smoking twice or more (p < 0.05). Multiple logistic regression analysis indicated that younger age, technical/clerical occupation, exhaustion after work, number of cigarettes smoked per day, duration of smoking, currently smoking and number of trials to quit smoking, were significantly associated with tobacco withdrawal symptoms (p < 0.05). It is suggested that younger age, technical/clerical occupation, exhaustion after work, number of cigarettes smoked and duration of smoking are risk factors of tobacco withdrawal symptoms in male Japanese employees.

[Clinical efficacy of arbekacin in patients with methicillin-resistant Staphylococcus aureus infections. Research Group of MRSA Forum].

We investigated the clinical efficacy of arbekacin (ABK) in patients with methicillin-resistant Staphylococcus aureus (MRSA) infections, and also studied coagulase types, beta-lactamase producing activity and drug sensitivity of MRSA isolated from various clinical specimens. A total of 23 patients with MRSA infections (13 cases of pneumonia, 1 case of sepsis, 1 case of pneumonia and sepsis and 8 cases of the others) who were hospitalized from April 1992 to September 1993 were enrolled in this study. They were 14 males and 9 females, and the mean age was 66.9 years (range, 18-91 years). All patients had underlying diseases (mainly malignant tumors and cerebrovascular diseases). ABK was given intravenously at doses ranging from 75 to 100 mg twice daily. The clinical efficacy rate was 90%; 8 cases showed excellent responses, 10 cases good, 1 case fair, 1 case poor and 3 cases were unevaluable. The eradication rate of MRSA was 81.8%; 16 cases were judged as eradicated, 3 cases decreased, 2 cases replaced, 1 case unchanged and in 1 case the bacteriological response was unknown. Side effects were not observed, but S-GPT was elevated in 1 case. Coagulase types of MRSA (123 strains) isolated at the institutes involved in the study were type II (56 strains), type IV (12 strains), type VII (13 strains) and other types (2 strains), but coagulase types of 40 strains could not be determined. Eighty-four strains (68.3%) produced beta-lactamases. MICs of ABK were 0.5 microgram/ml against 43 strains and 1 microgram/ml against 37 strains, and all of the MICs were under 4 micrograms/ml. In summary, ABK showed high antimicrobial activity against MRSA and clinical usefulness in the infections investigated.

[Environmental factors possibly associated with onset of senile dementia].

Factors associated with senile dementia have not been clarified, and factors, especially those in the living environment which seem to have a close link to the dementia need to be analysed. We conducted a case-control study targeting patients within the jurisdiction of Nagahama Public Health Center in Shiga and Hikone city, who are diagnosed to have senile dementia of the Vascular type, senile dementia of the Alzheimer type, and senile dementia of the Mixed type, and compared them to age matched controls. The outcome of the study by Matched pair analysis (McNemar's test) before the onset of the senile dementia were as follows. 1 The factors related to senile dementia of the vascular type were: Previous histories (Matched Odds Ratio (MOR): 8.0 p < 0.05), disturbance of the lower limbs (MOR = 8.0 p < 0.05). Environmental factors were: strong preference for sweets (MOR = 8.0 p < 0.05 female), smoking (MOR = 3.7 p < 0.10), lower utilization of health care (MOR = 3.3 p < 0.10), such as periodic medical check (MOR = 0/6 p < 0.10), sleep (MOR = 0/5 p < 0.10), less commitment to hobbies (MOR = 2.6 p < 0.10), such as handicrafts (MOR = 0/5 p < 0.10) etc, less intercourse with relatives (MOR = 0/9 p < 0.01), not living together with children's family (MOR = 0.20 p < 0.05 female), and death (MOR = 8/0 p < 0.05) or hospitalization (MOR = 9.0 p < 0.05) of a family member. 2 The factors related to senile dementia of the Alzheimer type and the Mixed type were: some previous histories (MOR = 8.0 p < 0.05), less disturbance of gait (MOR = 0/5 p < 0.10). Environmental factors were: lower utilization of health care, such as periodic medical check (MOR = 0.18 p < 0.05), and lower participation in exercise (MOR = 0/5 p < 0.10) etc, less association with neighbors (MOR = 0.11 p < 0.05), less participation in community activities (MOR = 0.11 p < 0.05), not living together with children's family (MOR = 0/8 p < 0.05), relocation (MOR = 5/0 p < 0.10) and retirement (MOR = 5/0 p < 0.10).