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Objectives: To examine the association between knee pain and function and depressive symptoms in older Japanese adults., Design: Community-based prospective cohort study., Setting: Kurabuchi Town, Gumma Prefecture, Japan., Participants: Individuals aged 65 and older (N = 573; n = 260 men, n = 313 women) without depressive symptoms participated in baseline examinations in 2005 and 2006; 95.6% participated in follow-up interviews (2007-08)., Measurements: Degree of knee pain and functional impairment was assessed at baseline using a self-administered questionnaire in Japanese based on an English version of the Western Ontario and McMaster Universities Osteoarthritis Index. The Geriatric Depression Scale was used to identify depressive symptoms in face-to-face home-visit interviews conducted 2 years later, and the association between knee pain and functional impairment and depressive symptoms was assessed using logistic regression., Results: During the 2-year follow-up, 11.9% of participants developed depressive symptoms, and pain and functional impairment were found to be associated with development of these symptoms. Pain at night while in bed (adjusted odds ratio (aOR) = 2.6, 95% confidence interval (CI) = 1.4-4.9) and difficulty putting on socks (aOR = 3.7, 95% CI: 1.8-7.5), getting into and out of a car (aOR = 3.4, 95% CI = 1.8-6.5), and taking off socks (aOR = 3.1, 95% CI = 1.5-6.5) were found to be most strongly associated with development of depressive symptoms., Conclusion: Examining elderly people's responses to questions about pain at night and difficulties performing daily activities may be an efficient way of identifying those at high risk of developing depressive symptoms., (© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.)

Background/objectives: Few published studies have investigated the possibility of an association between depressive symptoms and dependence in activities of daily living (ADLs) in elderly adults. The objective of the study was to examine the association between depressive symptoms and future ADL dependence and to investigate how this association varies according to living circumstances and marital status., Design: Community-based prospective observational study., Setting: Kurabuchi Town, Gunma Prefecture, Japan., Participants: A total of 769 residents aged 65 and older were surveyed at baseline in 2005/06; they were followed up annually during the 7.5-year study period (follow-up rate, 99% (n = 763)., Measurements: Presence of depressive symptoms was defined as a score of 2 or greater on the five-item Geriatric Depression Scale, and dependence in ADLs was defined as admission to a nursing home (institutionalization), eligibility for long-term care (LTC), or need for help in any of the six basic ADL items in the Katz Index of Independence in ADLs., Results: Depressive symptoms were observed in 232 of the 763 participants (30.4%). Those with depressive symptoms were more prone to future ADL dependence than those without (adjusted risk ratio = 1.29, 95% confidence interval = 1.04-1.61). There was no clear evidence of any effect modification according to living circumstances or marital status on this association, although living with other people or marriage was found to be associated with greater risk of institutionalization., Conclusion: Our findings suggest that depressive symptoms are associated with future ADL dependence and that living circumstances (except for institutionalization) and marital status do not affect the association., (© 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.)

Objectives: To examine the association between four markers of overall nutritional status (a serum biomarker (albumin) and three anthropometric indices (body mass index (BMI), midarm circumference (MAC), calf circumference (CC))) and incident hearing impairment in older Japanese adults., Design: Community-based prospective cohort study., Setting: Kurabuchi Town, Gunma Prefecture, Japan., Participants: Individuals aged 65 and older (143 men, 195 women) without hearing impairment at baseline examination (2005-06) who participated in repeated examinations 4 years later (2009-10) (N = 338)., Measurements: The three anthropometric indices were measured at baseline, and nephelometry was used to assess serum albumin levels. Hearing impairment was defined as failure to hear a 30-dB hearing level signal at 1 kHz and a 40-dB signal at 4 kHz in the better ear on pure-tone audiometry., Results: Over the 4-year period, 16.3% of participants developed hearing impairment. Those with lower marker values had greater risk of hearing impairment than those with higher marker values (multivariable adjusted odds ratio (aOR) = 2.18, 95% confidence interval (CI) = 1.05-4.57 for albumin ≤4.0 g/dL; aOR = 2.72, 95% CI = 1.10-6.71 for BMI <19.0 kg/m(2) ). The pattern of association showed a similar tendency for MAC and CC. Excluding obese participants did not changed the results substantially., Conclusion: Further research is needed to determine whether interventions that improve markers of nutritional status may help prevent age-related hearing loss in older adults., (© 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.)

Objectives: To examine the association between glycemic levels (glycosylated hemoglobin (HbA1c)) and hearing impairment in a general older population., Design: Community-based prospective longitudinal cohort study., Setting: Kurabuchi Town, Gunma Prefecture, Japan., Participants: Residents (N = 831; 350 men, 481 women) aged 65 and older were examined in 2005 and 2006 and analyzed in a cross-sectional study. Residents without hearing impairment at baseline who participated in audiometric re-examinations 4 years later were analyzed (n = 338)., Measurements: Hearing impairment was defined as failure to hear a 30-dB signal at 1 kHz and a 40-dB signal at 4 kHz in the better ear in pure-tone audiometric tests., Results: Mean HbA1c level (National Glycohemoglobin Standardization Program) was 5.8 ± 0.8% (40 mmol/mol). Odds ratios (ORs) and 95% confidence intervals (CIs) of hearing impairment associated with HbA1c were estimated using a logistic regression model. In the cross-sectional analysis, HbA1c levels were positively associated with hearing impairment (OR per 1.0% increase in HbA1c = 1.30, 95% CI = 1.00-1.68). This association persisted even after excluding 58 participants with a self-reported history of diagnosed diabetes mellitus. Longitudinal analysis revealed the temporality of the discussed association (OR = 1.52, 95% CI = 1.03-2.23)., Conclusion: The present study provides supportive evidence for a causal link between hyperglycemia and age-related hearing loss., (© 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.)

Objectives: To investigate whether self-reported hearing loss in older adults is associated with a decline in their ability to perform instrumental activities of daily living (IADL) or a decline in social participation., Design: Prospective follow-up., Setting: Community., Participants: One thousand two hundred fifty-four adults aged 65 to 98., Measurements: Self-reported hearing loss, IADL, and social participation were evaluated through home-visit surveys. Self-reported hearing loss was measured according to responses to the question, "Do you have difficulty hearing and understanding what a person says to you in a quiet room if they speak normally to you, even when wearing your hearing aid?" Levels of IADL and social participation were measured using the subscales of the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC)., Results: Of the 921 participants with a perfect baseline IADL score and valid follow-up scores, 105 also self-reported hearing loss at baseline. Of this group, 44.8% (total n = 105) reported a decline in their IADL score over the 3-year follow-up period. After adjusting for major confounders, a statistically significant difference in experiencing an IADL decline over the 3-year period was found between those with hearing loss at baseline and those without (odds ratio (OR) = 1.79, 95% confidence interval (CI) = 1.12-2.87). Self-reported hearing loss at baseline did not have a statistically significant effect on decline in social participation (OR = 1.05, 95% CI = 0.63-1.76) over the 3-year follow-up period., Conclusion: Self-reported hearing loss was associated with a decline in IADL, but not with social participation., (© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.)

Objectives: To examine the association between hearing handicap and depressive symptoms in older community-dwelling Japanese., Design: Community-based cohort study., Setting: Kurabuchi Town, Gunma Prefecture, Japan., Participants: Five hundred eighty residents (261 men, 319 women) aged 65 and older without depressive symptoms., Measurements: In a baseline examination performed in 2005/06, participants answered the 10-item screening version of the Hearing Handicap Inventory for Elderly (HHIE-S). They were divided into two groups according to their scores: a group with no hearing handicap (HHIE-S scores of < or =8) and a hearing handicap group (HHIE-S scores of > or =10). The Geriatric Depression Scale was used to identify depressive symptoms in face-to-face home visit interviews conducted in 2008, and the association between hearing handicap and depressive symptoms was assessed using logistic regression., Results: The incidence of depressive symptoms was 19.6% in the group with a hearing handicap and 8.0% in the group without a hearing handicap. When compared with the subjects without hearing handicap, subjects with a hearing handicap had a multiadjusted odds ratio of depressive symptoms of 2.45 (95% confidence interval=1.26-4.77). The association remained significant even when hearing impairment measured with pure-tone audiometry was added to the multiadjusted model., Conclusion: A hearing handicap can predict future depressive symptoms in older community-dwelling people.