Search

Aim: This study aimed to examine the relationships between levels of competence and impaired physical and cognitive functions in older adults. Methods: We used a data set of the Integrated Longitudinal Studies on Aging in Japan for 2017 including 5475 community-dwelling older adults. Levels of competence were assessed using the Japan Science and Technology Agency Index of Competence (JST-IC). Grip strength (low grip strength: <28 kg for men and <18 kg for women) and gait speed (slow gait speed: <1.0 m/s for both sexes) were evaluated as physical function measurements, and the Mini-Mental State Examination (cognitive decline: <24 on the Mini-Mental State Examination) was used to assess cognitive function. Results: The JST-IC had areas under the curve estimated from receiver operating characteristic analysis ranging from 0.65 to 0.73 for detecting low function as assessed by these tests. Restricted cubic spline curves showed that the shape of the association between the JST-IC and impaired function depended on sex and the test used. The comparison between perfect and imperfect JST-IC scores showed significant differences in the prevalence of low grip strength in both sexes, slow gait speed in women, and cognitive decline in men. Conclusions: It may be insufficient to identify those with impaired physical or cognitive function using the JST-IC. The shape of the association with the JST-IC varies across their measurements. Our findings can help interpret JST-IC scores in the context of low physical and cognitive functions. [ABSTRACT FROM AUTHOR]

Purpose: Although examining the dose-response curves of physical activity (PA) and sitting time with health-related outcomes is an important research agenda, the results for older Japanese adults are extremely limited. We examined the dose-response associations of PA and sitting time with all-cause mortality among older Japanese. Methods: Initially, 8,069 non-disabled residents (4,073 men; 3,996 women) aged 65-84 years of Ota City, Japan, were analyzed. Moderate-to-vigorous PA (MVPA) and sitting time were evaluated using the International Physical Activity Questionnaire-Short Form. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of MVPA and sitting time for allcause mortality were calculated, and the dose-response curves were examined using restricted cubic splines (RCS). Results: During 4.1 years of follow-up, 458 participants (5.7%; 331 men and 127 women) died. Compared with the low MVPA (<600 metabolic equivalents [METs]·minutes/week) group, HR for mortality gradually reduced in moderate (600-3,000 METs·minutes/week) and high (>3,000 METs·minutes/week) MVPA groups (moderate: HR 0.66; 95% CI, 0.54-0.82; high: HR 0.58; 95% CI, 0.45-0.75; P < 0.001 for trend). RCS showed that the HR for mortality reduced linearly up to approximately 2,000 METs·minutes/week of MVPA, and maximal risk reduction was seen at approximately 3,000-4,500 METs·minutes/week of MVPA. No significant dose-response association of sitting time with mortality was observed. Conclusion: Higher MVPA levels reduced all-cause mortality risk, in a significant inverse non-linear dose-response manner. Sitting time was not significantly associated with all-cause mortality. It is important to disseminate the significance of even a slight increase in the MVPA for reducing mortality risk. [ABSTRACT FROM AUTHOR]

Objectives: Effective brief instructions for self-management of chronic knee pain are needed. Methods: Forty-six participants with chronic knee pain were randomly allocated into two programmes: material-based education alone or brief self-exercise education (brief-See), which comprised a 100-minute instruction for self-exercise combined with compact pain education. Total function (KOOS4, 4-subscale average of knee injury and osteoarthritis outcome score), pain intensity (NRS, numeric rating scale), self-efficacy (PSEQ, pain self-efficacy questionnaire), and health-related quality of life (EQ-5D, European quality of life-5 dimensions) were evaluated at baseline and 4 and 12 weeks after the initial intervention. A generalized mixed linear model estimated average group differences in changes from baseline and 95% confidence intervals (95% CIs) using intention-to-treat principle. Results: Compared to material-based education alone, the brief-See provided significant additional improvements of 9.4% (95% CI: 2.3 to 16.4) on the KOOS4 and 5.4 points (0.3 to 10.4) on the PSEQ at 12 weeks but did not on the NRS and EQ-5D. Adherence and satisfaction were favourable in the brief-See without any notable adverse event. Conclusions: Adding the brief-See to material-based education could be more acceptable and restore total function and self-efficacy, which could contribute to the self-management of chronic knee pain in primary care. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to develop and assess additional effects of brief self-exercise education (brief-See) for individuals with chronic low back pain (CLBP). The brief-See comprised 100-minute consultation, individualized self-exercise program, and direct short teaching. Methods: We conducted a 6-month, community-based, randomized, parallel-group trial in a community setting, and allocated into a brief-See or material-based education alone. Pain intensity (NRS, numeric rating scale), functional limitation (RDQ, Roland-Morris disability questionnaire), self-efficacy (PSEQ, pain self-efficacy questionnaire), and quality of life (EQ-5D, European quality of life-5 dimensions) were evaluated at 4, 12, and 24 weeks after the initial consultation. Results: The brief-See did not show additional improvement over material-based education on the NRS, but it did on the RDQ, PSEQ, and EQ-5D; the estimated mean group differences in changes from the baseline were -2.1 (-3.5 to -0.7, p=.005) on the RDQ, 6.9 (1.7-12.1, p=.010) on the PSEQ, and 0.07 (0.02-0.12, p=.004) on the EQ-5D. Conclusion: The 100 minutes' education program could be more acceptable, and restores functional limitation, self-efficacy, and quality of life in addition to the effects of material-based education. This has the potential to contribute to the management of CLBP in a community. [ABSTRACT FROM AUTHOR]

This study aimed to investigate associations between Brief Job Stress Questionnaire (BJSQ)-measured job stress factors and sickness absence in Japanese workers. Among 551 healthy, employed Japanese men and women (age range : 21-73 years) who underwent mental health examinations at the Osaka Medical Center for Health Science and Promotion between 2006 and 2009, 197 (67 men, 130 women) consented to participate in this study. Their sickness absences until the end of March 2010 were then followed-up via postal mail survey, with 112 participants effectively responding to the question on sickness absence (56.9%). The hazard ratio (HR) and 95% confidence interval (CI) were calculated using the Cox proportional hazards model, adjusting for age, sex, and lifestyle factors. Among the 112 respondents, 12 took sickness absence after their study entry, as found during the mean 2.3 years of follow-up (258.8 person-years). Among all sickness absences, those of eight participants were because of mental illness. Physical demands were positively associated with increased risks of all sickness absence (adjusted HR : 2.78, 95% CI : 1.01-7.64). Physical demands were predictive for all sickness absence, and should be alleviated at workplaces to prevent such absence. [ABSTRACT FROM AUTHOR]

Objectives: Working is a common cause of chronic pain for workers. However, most of them need to continue working despite the pain in order to make a living unless they get a sick leave or retirement. We hypothesised that the therapeutic effect of vocational rehabilitation may depend on psychosocial factors related to the workplace. To test this hypothesis, we examined the association of work-related psychosocial factors with the prevalence of chronic pain or health-related quality of life (HRQoL) among workers with chronic pain. Methods: We examined 1764 workers aged 20-59 years in the pain-associated cross-sectional epidemiological survey in Japan. The outcomes were (1) chronic pain prevalence among all workers and (2) low Euro QoL (EQ-5D <0.76; mean value of the current study) prevalence among workers with chronic pain according to the degree of workplace social support and job satisfaction. Workplace social support and job satisfaction were measured using the Brief Job Stress Questionnaire. Multivariable-adjusted ORs were calculated using a logistic regression model including age, sex, smoking, exercise, sleep time, work hours, body mass index, personal consumption expenditure, intensity of pain and the presence of severe depressive symptoms. Results: Chronic pain prevalence was higher among males reporting job dissatisfaction compared with those reporting job satisfaction. No difference was observed among women. Chronic pain prevalence did not differ between workers of either sex reporting poor workplace social support compared with those reporting sufficient support. Among workers with chronic pain, low HRQoL was more frequent in those reporting job dissatisfaction. Similarly, low HRQoL was more frequent in patients with chronic pain reporting poor social support from supervisors or co-workers compared with patients reporting sufficient support. Conclusions: Work-related psychosocial factors are critical for HRQoL in patients with chronic pain. [ABSTRACT FROM AUTHOR]

Background: Although several cross-sectional and intervention studies showed that sodium intake or excretion was associated with blood pressure levels, no prospective study has examined the long-term association between sodium excretion in spot urine and blood pressure changes.Methods: We conducted a prospective study of 889 normotensive subjects (295 men and 594 women, mean age 57.3 years) who underwent the baseline survey including spot urine test in 2005 and the follow-up survey in 2009 to 2011 (mean follow-up period: 5.8 years). We examined the association between sodium concentration in spot urine, a validated index of sodium excretion occurring over 24-h, and blood pressure changes between baseline and follow-up survey in all, non-overweight (body mass index(BMI) ≤ 25 kg/m(2)) and overweight normotensives.Results: For all subjects, sodium concentrations in spot urine were not associated with either systolic or diastolic blood pressure changes. When stratified by BMI at baseline survey, sodium concentrations were positively associated with systolic blood pressure changes in non-overweight subjects, but not in overweight subjects. After adjustment for age, sex, BMI, alcohol intake status, current smoking and estimated glomerular filtration rate, the multivariable-adjusted mean values of the systolic blood pressure change among non-overweight subjects was +7.3 mmHg in the highest quartiles of sodium concentrations, while it was +3.9 mmHg in the lowest quartile (P for difference = 0.021, P for trend = 0.040). After further adjustment of baseline blood pressure levels, the association was slightly weakened; the multivariable-adjusted mean values of the systolic blood pressure changes were +7.0 mmHg and +4.2 mmHg (P for difference = 0.047, P for trend = 0.071).Conclusions: High sodium concentrations in spot urine were associated with subsequent systolic blood pressure increases among non-overweight normotensive individuals. (272 words). [ABSTRACT FROM AUTHOR]

Background: In Japan, a traditional herbal medicine, Tokishigyakukagoshuyushokyoto (TJ-38), is often used for the treatment of peripheral coldness, which is a common complaint among Japanese women. However, the effects of this herbal medicine have yet to be examined in a randomized controlled trial. In the current study, the effect of TJ-38 on the peripheral blood flow in women experiencing peripheral coldness was investigated using a parallel-group randomized controlled trial. Methods: Fifty-eight women aged 23 to 79 years with peripheral coldness were randomly divided into the intervention or control group. They were examined using cold bathing tests, physical examinations, and questionnaires in January 2010 for the baseline and in March 2010 for the follow-up, and January 2011 and March 2011, respectively. Results: At the baseline, there were no differences in clinical characteristics between the two groups. In the intervention group, peripheral coldness improved after the intervention term; however, it persisted in the control group. Mean values of percentage recovery of the peripheral blood flow after cold bathing tests were 17.2% and -28.2% for the intervention and control groups, respectively (p = 0.007), and the proportions for percentage recovery of >50% were 32% and 0%, respectively (p = 0.0007). Mean values of percent recovery of skin temperature did not differ between the two groups. Conclusions: The present clinical trial supports that a traditional herbal medicine relieves peripheral coldness in women probably through the improvement of peripheral blood flow. [ABSTRACT FROM AUTHOR]

To examine the relationship between systemic immune status and carotid atherosclerosis in elderly men, differential leukocyte counts and lymphocyte subpopulations were measured in 557 apparently healthy Japanese men aged 60–75 years. Each individual also underwent high-resolution ultrasonography for measurement of intima-media thickness (IMT) of the common carotid arteries. The increased numbers of circulating lymphocyte subpopulations, including memory T cells (CD4+CD45RO+T cells) and late-phase activated B cells (CD19+CD80+B cells) correlated significantly and positively with the mean IMT of the common carotid artery after adjustment for age, smoking, and other cardiovascular risk factors. The positive associations of CD19+CD80+B and CD4+CD45RO+ T cell counts with mean IMT were more evident among nonsmokers, hypertensives, and men with lower HDL-cholesterol levels. The present epidemiological study provided the evidence that alterations in lymphocyte subpopulations, in particular memory T cells and late-phase activated B cells concur with carotid atherosclersosis among free-living elderly men. [ABSTRACT FROM AUTHOR]