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Background: To examine longitudinal changes in accelerometer-measured moderate to vigorous physical activity (MVPA) and associated factors of changes in MVPA among community-dwelling older Japanese men and women over 2 years of follow-up. Methods: In total, 601 participants (72.2 [5.4] y, 40.6% men) were included. MVPA was assessed at baseline (2011) and follow-up (2013) using triaxial accelerometers. Sex-stratified multiple linear regression models were used to identify associated factors of changes in MVPA. Results: On average, a significant decrease in MVPA over 2 years was observed only in women (P <.001). Higher baseline MVPA levels and older age were significantly associated with a decrease in MVPA over 2 years in both men and women. Men who were currently drinking (vs no) and had faster maximum gait speed showed statistically significant increases in MVPA. Women who had very poor/poor economic status (vs fair/good) and were socially isolated (vs no) showed statistically significant increases in MVPA over 2 years, while those who had fear of falling (vs no) and poor/fair self-rated health (vs good/very good) showed statistically significant decreases in MVPA over 2 years. Conclusions: Our findings showed different associated factors of changes in MVPA by sex, suggesting the importance of accounting for sex differences in terms of developing specific intervention strategies for promoting MVPA among older men and women. [ABSTRACT FROM AUTHOR]

Purpose: Older men have higher prostate-specific antigen levels than younger men. However, the current Japanese Urological Association guidelines recommend secondary screening at a cutoff value of 4.0 ng/mL, even in older men. Here, we reexamined the cutoffs for older men using a prostate screening cohort in Japan and first performed an analysis to determine the indication cutoffs for detecting positive biopsies. Methods: Data from 68,566 prostate cancer screenings in the city in 2018 were combined with cancer registration data. The optimal prostate-specific antigen levels to predict prostate cancer in different age groups were calculated using receiver operating characteristic curves after determining whether a cancer was registered within one year of screening. Results: At the conventional prostate-specific antigen threshold of 4.0 ng/mL, the sensitivity, specificity, and negative predictive value were 94.9%, 91.7%, and 91.7%, respectively. The optimal prostate-specific antigen cutoff values for patients aged 50–59 years, 60–69 years, 70–79 years, and over 80 years were 3.900 ng/mL, 4.014 ng/mL, 4.080 ng/mL, and 4.780 ng/mL, respectively. Conclusions: The sensitivity and specificity of prostate cancer screening in the city were high, indicating a highly accurate screening. The prostate-specific antigen threshold was 4.78 ng/mL in patients older than 80 years. A higher prostate-specific antigen threshold may be useful in men over 80 years of age to avoid excess biopsy and reduce costs. Our results suggest that the current Japanese method of using PSA 4.0 ng/mL as a cutoff regardless of age may not be preferable for older men. [ABSTRACT FROM AUTHOR]

The book "Urban Food Deserts in Japan" by Nobuyuki Iwama, Tatsuto Asakawa, Koichi Tanaka, et al. explores the factors causing food deserts in Japan, focusing on socially vulnerable elderly people and existing conditions such as decreased access to food and weakened humanitarian relations. The book includes case studies of several cities in Japan and efforts to prevent and solve food desert problems. It discusses the relationship between food deserts and bad eating habits, as well as the impact of environmental changes and social capital. The authors also propose strategies for addressing food desert issues in Japan, including improving food access and implementing new business models. Overall, the book provides detailed information and is highly recommended for understanding urban food deserts in Japan. [Extracted from the article]

Background: Saw palmetto extract (SPE) is one of the most widely used supplements for benign prostatic hyperplasia (BPH) due to its pharmacological effects. ß-sitosterol-enriched saw palmetto oil (VISPO™) contains more than 3% ß-sitosterol and 85% total fatty acids and has been shown to improve symptoms in patients with BPH. Lower urinary tract symptoms (LUTS) require primary preventive measures in countries with accelerated population aging, including Japan. VISPO™ is expected to be effective against the early symptoms of LUTS. However, the effect of VISPO™ on urinary function in healthy individuals has not been elucidated. Objective: This clinical study evaluated the efficacy and tolerability of VISPO™ in the management of urinary complaints among healthy middle-aged and older men who did not require treatment. Methods: We conducted a randomized, double-blind, placebo-controlled trial that included 54 male participants who were assigned to consume VISPO™ or placebo (olive oil) capsules for 12 weeks. Biometric data, uroflowmetry results, and salivary hormone levels were assessed at weeks 1 and 12. Urinary function and quality of life were assessed at weeks 1, 4, 8, and 12 using the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), Core Lower Urinary Tract Symptom Score (CLSS), and WHOQOL-26. Results: Two-way analysis of variance revealed that IPSS and OABSS were significantly lower in the VISPO™ group that in the placebo group. However, there were no significant differences in urine volume, urinary flow rate, or salivary hormone levels. In addition, no participants reported adverse effects (diarrhea, abdominal pain, etc.). Conclusion: The results of the present study, which is the first randomized controlled trial of VISPO™ conducted among healthy participants, demonstrate the effectiveness of VISPO™ in the management of lower urinary tract complaints that do not require treatment. [ABSTRACT FROM AUTHOR]

Cancer can cause many problems in all family, economic, social, psychological, and physical dimensions for the elderly. The present research was conducted to examine the supportive care requirements of the elderly with cancer. In this descriptive-analytical study, a total of 248 elderly (144 men and 104 women) with an average age of 67.17 ± 6.94 years with cancer were referred to Seirei Mikatahara General Hospital, Japan, using non-probability and available sampling in 2023. The data collection tool includes a reliable and valid supportive care requirements survey of cancer patients, which has five areas of daily functioning and physical needs of the health system and support information and care of sexual and mental patients. Based on the obtained results, a statistically significant relationship was reported between the physical areas and the daily performance of the sexual area of support and care and the information and health system with gender (P<0.05). Elderly women needed more help in daily and physical functioning and elderly men in the areas of support and care, sex, health system, and information. The conclusion of this study stated that the unmet needs of the elderly with cancer are high, especially in the physical and daily performance areas. [ABSTRACT FROM AUTHOR]

This study examines the impacts of demand-side (the improved employment protection law) and supply-side (pension reform) government interventions on older male workers' employment outcomes in Japan. To identify the effects of interventions implemented concurrently, we employ a difference-in-difference-in-differences (DDD) approach with variation in the bindingness of the revision of employment protection law as our specification strategy. Our results show that the revised employment protection law had a significant positive impact on employment. However, the results of the event study's DDD model show that the treatment effects do not last over time. [ABSTRACT FROM AUTHOR]

With the growing elderly population who are susceptible to poor health, improvement of their quality of life is essential. In the post-disaster setting of the 2011 Fukushima Dai-ichi nuclear power plant (FDNPP) accident, affected municipalities such as Okuma town commenced their recovery processes and lifted evacuation orders in 2019. This study examines the differences in self-reported mental and physical health status, social functioning, risk perception, and intention to return between elderly (age ≥65 years) and non-elderly (age 20–64 years) residents. Questionnaires were distributed to current residents and evacuees of Okuma. Results revealed that the elderly had a 1.4 times higher odds ratio (95%CI 1.0–1.8, p = 0.034) for having anxiety regarding radiation-related health effects on future generations and a 1.3 times higher odds ratio (95%CI 1.1–1.5, p = 0.001) for wanting to know about the release of FDNPP-treated water into the environment than the younger group. Elderly residents also demonstrated a 2.2 times higher odds ratio for reporting poor physical health than younger residents. Clearing misconceptions and disseminating coherent information will reduce risk perception among this group. Further in-depth research regarding the disposal of FDNPP-treated water and its perceived risks is required. Health promotion through the encouragement of social participation, improvement of surroundings to facilitate healthy behaviors, and enhanced access to health services will improve the quality of life of elderly Okuma residents. [ABSTRACT FROM AUTHOR]

Purpose: Despite the potential burden of social isolation on mental health, it is unclear which component of social isolation (living alone, lack of social support, and lack of social participation) is mostly associated with depression among older adults and whether it varies by gender. Moreover, previous observational studies have suffered from several systematic biases such as confounding, misclassification, and selection bias. We thus aimed to investigate the risk of social isolation on subsequent depressive symptoms among older men and women, fully taking account of such systematic biases simultaneously.Methods: This study included 15,311 adults from a nationwide longitudinal cohort study of older adults aged ≥65 years in Japan. We employed modified Poisson regression models to estimate the adjusted risk ratio (aRR) of elevated depressive symptoms (the Geriatric Depression Scale: ≥5 vs. <5) in 2016 according to the social isolation index (SII) score (0-5 points) in 2013. Non-probabilistic multiple bias analyses with weighting approach and bounding factor were conducted to adjust for possible confounding, exposure misclassification, and selection biases.Results: The mean age (SD) of participants was 72.1 (4.9) years. Adults with the SII score ≥2 showed an increased risk of elevated depressive symptoms than those with the SII score <2 (aRR [95% CI] = 1.57 [1.41-1.76]). All components of SII were associated with elevated depressive symptoms except living alone for women. Our multiple bias analysis showed that an unmeasured confounder needed to have at least moderate relationship (RR=2.0-3.0) with both exposure and outcome to explain away the observed association particularly when social isolation status was independently and non-differentially misclassified.Conclusion: Among older adults in Japan, social isolation was associated with an increased risk of elevated depressive symptoms, even after taking account of systematic biases simultaneously. Increasing social connection may mitigate the risk of depression, which should be the subject of future research. [ABSTRACT FROM AUTHOR]

While previous studies suggest that women have higher anxiety than men regarding COVID-19, underlying mechanisms remain unclear. This study tries to explain the mechanisms by gender difference in social interaction based on a theory of social amplification of risk framework (SARF). We surveyed older adults in Japan regarding their anxiety regarding COVID-19, as well as the frequencies of their direct and indirect social interaction in July 2020 (N = 1,587, aged 78–99 years). To explore the way in which gender and anxiety regarding COVID-19 were mediated by these two types of social interactions, MODEL4 of SPSS's Process MACRO was applied to the data. We found that older women interacted more directly and indirectly with others than did older men. And, direct social interaction was negatively and related, but indirect social interaction was positively related to older adults' anxiety regarding COVID-19. Furthermore, direct social interaction was related to older women's low anxiety regarding COVID-19, whereas indirect social interaction was related to older women's high anxiety regarding COVID-19. The findings of our study suggest that the degree of anxiety regarding COVID-19 among older women may be dependent upon the types of social interaction they have with others. [ABSTRACT FROM AUTHOR]

Background: Although there is evidence of improvements in health expectancy among the Japanese population, existing estimates are based on the prevalence of morbidity taken from cross-sectional survey data. Objectives: This study employed a multistate life table approach to compute incidence-based health expectancy measures, namely active and inactive life expectancy (LE), for two longitudinal survey cohorts from 1990 to 2009. Methods: This study used data from two longitudinal surveys of older adults in Japan: the National Survey of the Japanese Elderly (1990–1999) and the Nihon University Japanese Longitudinal Study of Aging (1999–2009). We employed the Interpolation of Markov Chains technique to compute the number of years at age 65 years to be spent with and without difficulty in performing activities of daily living (ADLs) or instrumental ADLs. Results: We documented significant increases in active LE for men and women at age 65 years over the 10-year study period. There were significant changes in total LE for men and in the percentage of active life for women. Inactive LE did not significantly change across the two survey cohorts during the study period. Conclusions: Our results show that the health status of older adults in Japan has largely improved over the 10-year study period, with increases in both the duration of life and time spent in an active state. This finding offers evidence of compression of morbidity among older men and women in Japan. [ABSTRACT FROM AUTHOR]

This study aims to elucidate the structure of support for social policies (redistribution and free competition), focusing on the role of community interests (especially demographic decline). To this end, Japan was selected as a case study because it has the highest proportion of the elderly population in the world. The author analyzed data from the National Survey of Social Stratification and Social Mobility in 2015 and the Population Census for the same year, employing ordered logit models. The results revealed that people living in demographically declining communities were more likely to support redistribution and less likely to endorse free competition, compared to individuals from other communities. Furthermore, compared to the underprivileged, wealthy individuals were more likely to consider community interests irrespective of individual benefits. This finding demonstrates that community interests may have a significant influence on individuals' policy preferences. [ABSTRACT FROM AUTHOR]

Dyslipidemia (DL) is one of the most common lifestyle-related diseases. There are few reports showing the causal relationship between gut microbiota (GM) and DL. In the present study, we used a linear non-Gaussian acyclic model (LiNGAM) to evaluate the causal relationship between GM and DL. A total of 79 men and 82 women aged 40 years or older living in Shika-machi, Ishikawa Prefecture, Japan were included in the analysis, and their clinical information was investigated. DNA extracted from the GM was processed to sequence the 16S rRNA gene using next-generation sequencing. Participants were divided into four groups based on sex and lipid profile information. The results of one-way analysis of covariance, linear discriminant analysis effect size, and least absolute value reduction and selection operator logistic regression model indicated that several bacteria between men and women may be associated with DL. The LiNGAM showed a presumed causal relationship between different bacteria and lipid profiles in men and women. In men, Prevotella 9 and Bacteroides were shown to be potentially associated with changes in low- and high-density lipoprotein cholesterol levels. In women, the LiNGAM results showed two bacteria, Akkermansia and Escherichia/Shigella, had a presumptive causal relationship with lipid profiles. These results may provide a new sex-based strategy to reduce the risk of developing DL and to treat DL through the regulation of the intestinal environment using specific GM. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the epidemiological features of reported tuberculosis (TB) infections in a western prefecture (Nagasaki Prefecture) from 2007 to 2018, and to identify the high-risk group for TB infection. The characteristics of 12 years of reported TB infections from the Nagasaki Prefectural Informational Center of Infectious Diseases were summarized by median (interquartile range [IQR]) and proportion; the annual TB infections' notification rate regarding sex/age was calculated accordingly. The diagnosis of TB infection was made according to clinic symptoms and laboratory examination. In total, 4364 TB infections were reported in 2007 and 2018, with a median age (IQR) of 74 (55–84) years. The majority of TB infections were male (52.6%, 2297/4364), > 65 years (65.8%, 2869/4364), and indigenous (98.1%, 4276/4364). Among active TB, 66.9% (1833/2740) had pulmonary TB, and 25.3% (694/2740) were diagnosed as extrapulmonary TB. The highest notification rate of TB infection was observed in the elderly male population (> 85 years). The annual notification rate of TB infections ranged between 19.4/and 34.0/100,000 for 12 years. The notification rates of TB infections were high in older people of both sexes, especially in men aged > 85. Therefore, appropriate interventions and health management are essential for TB control in (and with a focus on) the elderly population. [ABSTRACT FROM AUTHOR]

Maintaining a social environment that enables going out freely is important for older people and aids the prevention of frailty syndrome. However, losing a driver's license can increase the long-term care needs of older people. Therefore, outing support systems are important. However, the utilization rate of these systems is currently relatively low. We conducted a demonstration experiment among older people aged 70 years and over, living in Iruma City, Saitama Japan, by implementing the Choisoko outing support system developed by Aisin Co., Ltd., in conjunction with an approach for improving motivation. Using this system, elderly people were able to go shopping freely whenever they chose, without a driver's license. Participants in the demonstration experiment exhibited higher Functional Independence Measure scores after the intervention, irrespective of whether or not they used the Choisoko system. The number of uses per person increased over time, and the subjective well-being of Choisoko users improved. However, few male participants engaged with the system. Although improving motivation is important for inducing positive behaviors and enabling the elderly to go out, motivation-improving factors differ between men and women. [ABSTRACT FROM AUTHOR]

Background: Strokes are common in people with atrial fibrillation (AF), and can have devastating consequences, especially in the elderly and if AF is untreated. However, community-based studies on screening for untreated AF have not been conducted in Japan, and there has been no evaluation of the effectiveness of early screening for AF in the elderly (≥65 years). Methods: The Kyoto Prefectural University of Medicine (KPUM) Education Initiative has conducted an AF awareness campaign consisted of screening tests using a blood pressure (BP) monitor with electrocardiogram (ECG) (the Complete, Omron Healthcare Co., Ltd., Kyoto, Japan) and educational lectures for the elderly (≥65 years) from 2019 to 2020. A modeled effectiveness analysis was performed comparing the life-years and QALYs (quality-adjusted life-years) between direct-acting oral anticoagulation (DOAC)-treated AF and untreated AF in a Japanese setting. The basic description of the Markov model was used for the analysis. Results: A total of 1648 participants were screened, and after excluding those with missing information or data (n = 41), 1607 were finally enrolled. The mean (± standard deviation) age of participants was 72.4±5.8 years, 827 (51.5%) were female, 628 (39.1%) had hypertension, and 1368 (85.1%) had CHA2DS2-VASc score ≥2. After cardiologists' evaluation of all ECG recordings of the Complete, 15 (0.93%) AF were newly detected. For each AF treated with DOAC, 0.859 QALYs gained over the lifetime for 65 years-old men, and 0.856 QALYs for 65 years-old women compared to non-treatment. Conclusion: A moderate number of untreated AF were identified in the community-based study. Identification of an increased number of patients with AF, if properly treated with DOAC, ultimately leads to a reduction in the number of strokes occurred over subjects' lifetime. [ABSTRACT FROM AUTHOR]

This article examines how social beliefs about language use and users influence writing-restricted variation in contemporary Japan by analyzing ojisan gokko ('impersonating middle-aged men'), a practice where young Japanese women playfully message each other as though they were lecherous men. While the production of a stylized ojisan voice during ojisan gokko involves many traditional Japanese indexes (markers) of 'male' language, it also relies prominently on particular uses of script, emoji, kaomoji, and punctuation, ultimately creating a form of mocking which is bound to the written mode. Using indexicality as a framework, the article analyses 195 screenshots of ojisan gokko acts shared on Twitter to establish which writing-restrict forms are key to the practice, and examines the multiple social motives and origins behind these forms. Ultimately, ojisan gokko is noted to involve a complex interplay of variants traditionally linked to distinct social groups, with this combined use traced to a series of Japanese social actors observing, imitating, discussing, or parodying how others write. Consequently, ojisan gokko shows that writing-restricted variation can be highly motivated by social concerns, ideologies, and conflicts, including the desire to establish, contest, and modify which identities and forms of language use are appropriate or 'cool'. [ABSTRACT FROM AUTHOR]

Historically, a right bundle branch block has been considered a benign finding in asymptomatic individuals. However, this conclusion is based on a few old studies with small sample sizes. We examined the association between a complete right bundle branch block (CRBBB) and subsequent cardiovascular mortality in the general population in Japan. In this large community-based cohort study, data of 90,022 individuals (mean age, 58.5 ± 10.2 years; 66.2% women) who participated in annual community-based health check-ups were assessed. Subjects were followed up from 1993 to the end of 2016. Cox proportional hazards' models and log-rank tests were used for the data analysis. CRBBB was documented in 1,344 participants (1.5%). Among all included participants, CRBBB was associated with an increased risk of cardiovascular mortality after adjustment for all potential confounders (hazard ratio [HR] 1.21; 95% confidence interval [CI] 1.06–1.38). The increased risk of cardiovascular mortality was particularly evident in women aged < 65 years (HR 2.00; 95% CI 1.34–2.98) and men aged ≥ 65 years (HR 1.28; 95% CI 1.06–1.55). CRBBB is associated with an increased risk of cardiovascular mortality in women aged < 65 years and men aged ≥ 65 years. Clinicians should be aware of the presence of CRBBB in young women and elderly men, even if they exhibit no symptoms. [ABSTRACT FROM AUTHOR]

This study investigates the influence of living alone on the elderly's subjective well-being (SWB), using longitudinal survey data from China and Japan. The main findings are as follows. First, the influence of living alone on SWB is not statistically significant for elderly Chinese women, while elderly Japanese women who live alone are likely to feel significantly happier. Second, living alone does not affect SWB of elderly Chinese men, while it significantly negatively affects the SWB of elderly Japanese men. In addition, for elderly Japanese men, the negative effect of living alone disappears when marital status is controlled for in a fixed effects ordered logit model. Third, the random effects ordered logit model shows that the negative associations between living alone and SWB are stronger for elderly men than for elderly women both in China and Japan. This suggests that the effect of living alone differs by gender among the elderly in both countries. [ABSTRACT FROM AUTHOR]

Background: While esophageal squamous cell carcinoma (ESCC) is the predominant histological type in Japan, concern has been expressed over an increase in the proportion of esophageal adenocarcinoma (EAC), especially in middle‐aged populations. This study aimed to assess long‐term trends in esophageal cancer incidence by histological type. Methods: We used data from three population‐based cancer registries in Japan with 10,642 esophageal cancer cases diagnosed between 1993 and 2014. The multiple imputation approach was used to impute a specific histological type (ESCC, EAC, and others) for cases with "Unknown" or missing status. We calculated the age‐standardized incidence rates by histological type from 1993 to 2014 and fitted age‐period‐cohort models to estimate the annual percent changes (APCs) and adjusted incidence rate ratios (IRRs). Results: After imputation of missing data, the largest mean APC increase was seen in the incidence of EAC in men aged 40–49 years (7.1%) followed by those aged 50–59 years (5.5%). The age‐period‐cohort analysis showed that men who were born in the 1960s and later were more likely to develop EAC relative to men who were born in 1950–1959 (1960–1969 cohort, IRR: 1.42; 1970–1974 cohort, IRR: 2.23), with a period effect indicating a constant increase after 2003. For women, no significant trend in EAC incidence was observed. Conclusions: The incidence of EAC has increased more prominently compared with that of ESCC, especially in men aged 40–59 years, suggesting the impact of increasing obesity in men and a reduction in H. pylori prevalence in Japan. [ABSTRACT FROM AUTHOR]

Background: Shogi is a traditional board game in Japan. A preventive stress management program based on Shogi-assisted cognitive behavioral therapy (S-CBT) was applied in the Japanese municipality of Kakogawa City. The study aimed to develop an S-CBT preventive stress management program for the elderly and determine its efficacy. Methods: The participants were 67 elderly men with amateur-level Shogi skills. They were randomly assigned to either the S-CBT group (n = 33) or the waiting-list control group (n = 34). The S-CBT program was conducted over six 90-min sessions. The outcome measures were recorded using K6 instrument, the Japanese version of the abbreviated Lubben Social Network Scale, five items on cognitive behavioral functioning, and subjective well-being scale. Results and conclusions: The dropout rates of the S-CBT group and waiting-list control groups were 36.4 and 44.1%, respectively. Effect sizes (Cohen's d) and 95% confidence intervals (CIs) were calculated for each group. Domains that changed immediately after the S-CBT intervention were problem-solving skills, self-reinforcement, and negative automatic thoughts. Future research should promote mental and physical health through the design of intervention programs using familiar materials. Trial registration: University Hospital Medical Information Network (UMIN CTR) UMIN000036003. [ABSTRACT FROM AUTHOR]

Background: Income inequality has dramatically increased worldwide, and there is a need to re-evaluate the association between socio-economic status (SES) and depression. Relative contributions of household income and education to depression, as well as their interactions, have not been fully evaluated. This study aimed to examine the association between SES and depressive symptoms in Japanese adults, focusing on interactions between education and household income levels.Methods: This cross-sectional study used data from baseline surveys of two cohort studies. Participants were 38,499 community-dwelling people aged 40-74 years who participated in baseline surveys of the Murakami cohort study (2011-2012) and Uonuma cohort study (2012-2015) conducted in Niigata Prefecture, Japan. Information regarding marital status, education level, household income, occupation, activities of daily living (ADL), and history of cancer, myocardial infarction, stroke, and diabetes was obtained using a self-administered questionnaire. Depressive symptoms were examined using the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regression analysis was used to obtain odds ratios (ORs). Covariates included age, sex, marital status, education, household income, occupation, ADL, and disease history.Results: Individuals with higher education levels had lower ORs (adjusted P for trend = 0.0007) for depressive symptoms, independently of household income level. The OR of the university-or-higher group was significantly lower than that of the junior high school group (adjusted OR = 0.79). Individuals with lower household income levels had higher ORs (adjusted P for trend< 0.0001) for depressive symptoms, independently of education level. The type of occupation was not associated with depressive symptoms. In subgroup analyses according to household income level, individuals with higher education levels had significantly lower ORs in the lowest- and lower-income groups (adjusted P for trend = 0.0275 and 0.0123, respectively), but not in higher- and highest-income groups (0.5214 and 0.0915, respectively).Conclusions: Both education and household income levels are independently associated with the prevalence of depressive symptoms, with household income levels showing a more robust association with depressive symptoms than education levels. This suggests that a high household income level may offset the risk of depressive symptoms from having a low education level. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to investigate the association between financial literacy and age as well as gender differences in financial literacy. Methods: We analyse a sample of 25,000 individuals from 'The Financial Literacy Survey 2016' conducted by the Central Council for Financial Services Information (Bank of Japan). The analysis focuses on the relationship of age and financial literacy as well as that of age and self-rated financial knowledge. To consider factors accounting for gender differences in financial literacy, we use the Blinder-Oaxaca decomposition method. To further our understanding of financial literacy, we conduct additional analyses on financial behaviour and attitude. Results: Although age is associated with increased financial literacy (Men, β: 0.249, standard error [SE]: 0.030; Women, 0.354, SE: 0.026), the growth rate decreases among the older respondents (Men, β: -0.002, SE: 0.000; Women, -0.003, SE: 0.000). However, the association between age and self-rated financial knowledge among men moves in the opposite direction (Age, β: -0.021, SE: 0.009, Age2, β: 0.000, SE: 0.000). Furthermore, female respondents are likely to be less financially literate than their male counterparts (β: -0.586, SE: 0.095) due to gender differences in the distribution of the factors that affect financial literacy (specifically education), their responses to financial literacy, and the interactions of these effects. In contrast to knowledge-based financial literacy, financial behaviour and attitudes among women are more preferable to those among men, namely, more premeditated. Conclusion: Financial literacy increases until about one's early 60s, after which it declines, while confidence in financial literacy reflects the inverse trend, especially among men. Additionally, men are more financially literate than women; however, these differences could be mitigated through education. Meanwhile, financial behaviour and attitudes among men are less premeditated. Thus, policies are needed that can help older adults with their financial decision-making, enhance women's financial literacy, and improve men's financial behaviours and attitudes. [ABSTRACT FROM AUTHOR]

Background: It is very important to understand the acetabular morphology of the normal hip joint to assist in diagnosis and surgical planning of hip disorders. The purpose of the present study was to obtain gender-based reference values for the acetabular measurements of a normal hip using computed tomography data and investigate the effect of aging on the measurement values.Methods: We measured acetabular parameters (center-edge angle, Sharp angle, vertical center anterior angle, acetabular anteversion) on computed tomography corrected for changing the obliquity, rotation, and tilt of the pelvis. We performed measurements in 245 patients (490 joints; 120 men [240 joints] and 125 women [250 joints]). The mean age was 64.7 ± 14.3 (31-88) years for men and 63.2 ± 15.2 (30-88) years for women.Results: In men and women, the mean center-edge angle was 31.8° ± 6.4° and 30.6° ± 6.5°, the mean Sharp angle was 38.6° ± 3.2° and 40.6° ± 3.8°, the mean vertical center anterior angle was 44.3° ± 7.9° and 40.0° ± 8.5°, and the mean acetabular anteversion angle was 14.3° ± 5.2° and 18.8° ± 5.4°, respectively. All differences were statistically significant. The center-edge angle increased with age in women; however, such an effect was not observed in men. The other measurements showed a similar trend, such as larger vertical center anterior angle and smaller Sharp and acetabular anteversion angles, with aging in both men and women.Conclusions: We used computed tomography data to quantitatively assess the coverage and shape of the acetabulum in adult Japanese subjects and obtain the estimated reference ranges by gender. The results also proved that the measurements changed with aging in both sexes. These facts must be taken into account during the diagnosis of hip disease and planning of surgery. [ABSTRACT FROM AUTHOR]

Background: Lower socioeconomic status (SES) may be related to inactivity lifestyle; however, the association between SES and physical inactivity has not been sufficiently investigated in Japan. Methods: The study population is the participants of NIPPON DATA2010, which is a prospective cohort study of the National Health and Nutrition Survey 2010 in Japan. They were residents in 300 randomly selected areas across Japan. This study included 2,609 adults. Physical activity was assessed by physical activity index (PAI) calculated from activity intensity and time. The lowest tertile of PAI for each 10-year age class and sex was defined as physical inactivity. Multivariable logistic regression analyses were conducted to examine the association of SES (employment status, educational attainment, living status, and equivalent household expenditure (EHE)) with physical inactivity. Results: In the distribution of PAI by age classes and sex, the highest median PAI was aged 30–39 years among men (median 38.6), aged 40–49 years among women (38.0), and median PAI was decreased with increasing age. Multivariable-adjusted model shows that not working was significantly associated with physical inactivity after adjustment for age in all age groups and sexes. Not living with spouse for adult women and elderly men was significantly associated with physical inactivity compared to those who living with spouse. However, neither educational attainment nor EHE had any significant associations with physical inactivity. Conclusions: The result indicated that physical inactivity was associated with SES in a general Japanese population. SES of individuals need to be considered in order to prevent inactivity lifestyle. [ABSTRACT FROM AUTHOR]

This article aimed to compare the sports participation of populations from two distinct societies with huge cultural differences: France and Japan. At a macro-statistical level and using a societal approach based on two national ad-hoc surveys–in contrast with functionalist and culturalist analyses–it analysed the differences in sports participation between the two populations. The angle adopted for analysing sports participation was that of voraciousness (number and types of sports and physical activities practised). We performed a secondary analysis of a Japanese national ad-hoc survey and a French national ad-hoc survey (quotas sampling, June/July 2016), which reported activities precisely over the preceding 12 months. The two reconstructed samples for comparison concerned people aged between 18 and 70, and 46 PSAs and PSA families, making it possible to evaluate sports participation. The Japanese sample consisted of 2,612 individuals and the French sample of 3,791 individuals. To identify statistically significant differences between the two samples, Fisher's exact test and bootstrap approaches was used (boot package in R software). Sports participation and voraciousness for sport are higher in the French population than in the Japanese one. For the overall rate of sports practice, there is a difference of 8.2 points (95%CI[6.0;10.3], p<0.001), and the difference concerning the average number of activities practised by practitioners is 1.7 activity (95%CI[1.9;1.5], p<0.001). In both countries, young males have the highest level of sportiness. Age is an important variable with a lower difference between the youngest and oldest age groups for sports participation in Japan than in France: when compared to France, the difference in difference for the rate of no activity is 13.7 points (95%CI[6.3;21.1], p<0.001) and -2.3 activities for the average number of activities among practitioners (95%CI[-3.0;-1.7], p<0.001). Some physical and sports activities (PSAs) are specific to France (e.g. skiing with 12.7 points difference, 95%CI[11.3;14.1], p<0.001) and others to Japan, such as baseball (with 9.8 points difference 95%CI[8.6;11.0], p<0.001) or more traditional PSAs like Japanese calisthenics and radio exercise (at 15.9%). In contrast to France, Japan is still in the process of greatly modernising its sporting tradition as a result of its particular cultural dimensions. We can identify physical and sports activities which are specific to each country, as well as similar activities in the two countries and wider diversification in France. Voraciousness for sport is higher in France than in Japan. In both countries, the youngest age groups and men have the highest level of sportiness. Yet, the difference between the youngest and the oldest group is smaller in Japan due to the pressure of work. [ABSTRACT FROM AUTHOR]

Background: Few studies have compared factors related to cognitive function among people with similar genetic backgrounds but different lifestyles.Objective: We aimed to identify factors related to lower cognitive scores among older Japanese men in two genetically similar cohorts exposed to different lifestyle factors.Methods: This cross-sectional study of community-dwelling Japanese men aged 71-81 years included 2,628 men enrolled in the Kuakini Honolulu-Asia Aging Study based in Hawaii and 349 men in the Shiga Epidemiological Study of Subclinical Atherosclerosis based in Japan. We compared participant performance through Cognitive Abilities Screening Instrument (CASI) assessment in Hawaii (1991-1993) and Japan (2009-2014). Factors related to low cognitive scores (history of cardiovascular disease, cardiometabolic factors, and lifestyle factors) were identified with questionnaires and measurements. Multivariable logistic regression analysis was used to calculate the adjusted odds ratios (ORs) of a low (< 82) CASI score based on different factors.Results: CASI scores were lower in Hawaii than in Japan [21.2%(n = 556) versus 12.3%(n = 43), p < 0.001], though this was not significant when adjusted for age and educational attainment (Hawaii 20.3%versus Japan 17.9%, p = 0.328). History of stroke (OR = 1.65, 95%confidence interval = 1.19-2.29) was positively associated with low cognitive scores in Hawaii. Body mass index ≥25 kg/m2 tended to be associated with low cognitive scores in Japan; there was a significant interaction between the cohorts.Conclusion: Cognitive scores differences between cohorts were mostly explained by differences in educational attainment. Conversely, cardiovascular diseases and cardiometabolic factors differentially impacted cognitive scores among genetically similar older men exposed to different lifestyle factors. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is prevalent in patients with chronic kidney disease (CKD). The indices of physical function, such as grip power and gait speed, decreased according to the decline in the estimated glomerular filtration rate (eGFR). Methods: We examined the relationships between cystatin C-based GFR (eGFRcys), creatinine-based GFR (eGFRcre), their ratio (eGFRcys/eGFRcre) and sarcopenia in community-dwelling older adults in Japan. This cross-sectional study included 302 men aged 73.9 ± 6.2 years and 647 women aged 72.9 ± 5.8 years from a rural area in Hyogo Prefecture, Japan. eGFRcys and eGFRcre were simultaneously measured, and sarcopenia based on the Asia Working Group for Sarcopenia (AWGS) 2019 criteria was evaluated. Results: eGFRcys and the eGFRcys/eGFRcre ratio were significantly correlated with grip power and gait speed (p < 0.001). The eGFRcys/eGFRcre ratio was also correlated with skeletal muscle mass index (SMI) (p < 0.01). Univariate logistic regression analysis showed eGFRcys and eGFRcys/eGFRcre ratio but not eGFRcre were associated with sarcopenia (p < 0.01). The presence of low eGFRcys (CKDcys) and low eGFRcys/eGFRcre ratio (< 1.0) but not that of low eGFRcre (CKDcre) were associated with sarcopenia (p < 0.01). In the multivariate logistic regression analysis, when the eGFRcys/eGFRcre ratio was added as a covariate to the basic model, it was significantly associated with sarcopenia in women (p < 0.05). Moreover, low eGFRcys/eGFRcre ratio (< 1.0) was associated with a higher risk of sarcopenia in men (p < 0.01). Conclusion: In conclusion, CKDcys but not CKDcre is associated with sarcopenia. A lower eGFRcys/eGFRcre ratio may be a practical screening marker of sarcopenia in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Background: Physical fitness and motor ability are associated with the incidence of locomotive syndrome (LS) in older adults. The relationships between physical fitness and motor ability at a young age to LS risk in later life remain unclear. This study examined the association between physical fitness and motor ability among university students and their risk of LS in middle and old age.Methods: The participants were 231 male alumni aged 48-65 years from the Department of Physical Education of a university in Japan. Physical fitness and motor ability test results during their fourth year at the university were used. Physical fitness tests included the side-step test, vertical jump test, back muscle, grip strength, trunk lift, standing trunk flexion, and step-test. Motor ability was tested using the 50-m and 1500-m run, running long jump, hand-ball throw, and pull-up test. LS risk was assessed using a seven-question standardized self-administered Loco-check questionnaire. Participants were divided into three groups (low, medium, and high) based on physical fitness and motor ability test results at young age, and LS risk was assessed at an older age across the three groups using Cox proportional hazards models.Results: From the 2017 follow-up survey, the median follow-up period was 37 years (interquartile range, 33-41), and LS risk was suspected for 31 (13.4%) participants. Better performance on the side-step test was associated with the reduced risk of LS (hazard ratio 0.32; 95% confidence interval, 0.101-0.983, P = 0.047).Conclusions: Good agility (side-step test) at a young age may reduce the future risk of LS among middle-aged and older men. [ABSTRACT FROM AUTHOR]

Previous studies have indicated that older men often experience disconnection from the community after retirement. Social activities have been shown to be effective in preventing social isolation among older urban men. Nevertheless, it has been reported that they often do not participate in community social activities and tend to be reluctant to do so. We explored the values and meanings of social activities for retired older men living in an urban area of Japan to understand support using social activities that are more suitable for them. Semi-structured interviews were conducted with 15 older men (aged 68–80 years; M = 74.6 ± 3.79 years) about their interactions with family and non-family members, and their participation in various community social activities. The grounded theory approach was used for the analysis. As a result, the following five categories were derived as the values that participants place on the social activities that they engage in: "health as a resource and reward for social activities," "feeling I am still useful," "feeling that something is my responsibility," "feeling of time well spent," and "finding interest through interactions." In addition, the following three categories were extracted as meanings of social activities: "fulfilling social life," "maintaining stable family relationships," and "maintaining safety and peace in the community." When considering the social activities that older urban retired men are interested in and likely to participate in, these five values can be considered indicators. In contrast, to maintain stable family relationships and safety and peace in the community, participants sometimes used strategies to stop or abandon social activities. Therefore, in situations where a peaceful life within a family or neighborhood is threatened, it may be useful to help set aside sufficient time and allow for psychological leeway in advance to incorporate social activities into their lives. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between handgrip strength (HGS) and albuminuria in the general population of Japan as per sex and age. This population-based, cross-sectional study enrolled 916 Japanese participants aged ≥40 years. Albuminuria was measured and expressed as the urinary albumin-to-creatinine ratio (UACR). Biochemical, nutritional, and anthropometric profiles as well as HGS were measured using standardised protocols. Four hundred and thirty-two (47%) of the study participants were men, and 484 were women, with respective mean ages of 62 ± 11 years and 63 ± 11 years. HGS, older age, high body mass index, presence of hypertension or diabetes, and a decreased estimated glomerular filtration rate were correlated with the log-transformed UACR in subjects of both sexes. Multivariate linear regression analysis showed that HGS was independently associated with the log UACR in both, men [beta coefficient −0.43; 95% confidence interval (CI) −0.73, −0.13] and women (beta coefficient −0.50; 95% CI −0.90, −0.10) aged ≥65 years; however, a similar association was not observed in younger participants. Low HGS was associated with albuminuria in older men and women in Japan. [ABSTRACT FROM AUTHOR]

Background: Swallowing disorders are a serious health concern among older adults. Previous studies reported that sarcopenia may affect swallowing disorders; however, whether sarcopenia is related to the capacity to swallow (measured according to swallowing speed) in community-dwelling older adults is unclear.Objectives: The aim of this study was to investigate the relationship between sarcopenia and swallowing capacity in community-dwelling older women.Methods: This cross-sectional observational study was conducted among community-dwelling older women in Japan. The inclusion criteria were as follows: women aged ≥65 years, with the ability to walk independently, and without dysphagia. The exclusion criterion was a history of stroke or Parkinson's disease that directly caused dysphagia. The participants were divided into a sarcopenia and a healthy group based on the criteria of the Asian Working Group for Sarcopenia 2019. We measured swallowing speed (mL/s) as the swallowing capacity by conducting a 100-mL water-swallowing test. To assess the relationship between sarcopenia and swallowing capacity, we performed a multiple regression analysis.Results: Two-hundred and sixty participants were enrolled in the study. Their mean age was 82.3 ± 6.9 years, and 61 (23.5%) of them displayed sarcopenia. The mean swallowing speed was 11.5 ± 4.9 mL/s, and 17 women (6.5%) exhibited choking or a wet-hoarse voice. Multiple regression analysis revealed that sarcopenia was related to the swallowing capacity after adjusting for age, the Mini-Mental State Examination, and the number of comorbidities (β = -0.20, 95% CI -3.78 to -0.86, p = 0.002).Conclusions: We found that sarcopenia was related to the swallowing capacity in older women in this study. Future research should clarify whether a similar relationship exists in older men as well as the effect of sarcopenia on the swallowing capacity in older adults over a period of time. [ABSTRACT FROM AUTHOR]

Objective: To examine associations between protein intake per day and at different meals and skeletal muscle mass declines. Design: Two-year prospective cohort study among older community dwellers. Setting: National Institute for Longevity Sciences–Longitudinal Study of Aging (NILS-LSA) in Japan. Participants: Older men (n 292) and women (n 363) aged 60–87 years who participated in the baseline (2006–2008) and follow-up studies (2008–2010) of NILS-LSA and did not exhibit low skeletal muscle mass at baseline. Muscle mass was assessed using dual-energy X-ray absorptiometry at baseline and follow-up. Low muscle mass was defined as skeletal muscle mass index <7·0 kg/m2 for men and <5·4 kg/m2 for women at follow-up. Daily protein intake and protein intake at each meal were calculated from 3 d dietary records at baseline and sex-stratified tertiles were determined. Results: Mean (sd) protein intake at breakfast, lunch and dinner was 22·7 (7·8), 26·7 (9·3) and 37·4 (10·5) g for men and 19·3 (6·3), 23·2 (7·3) and 28·5 (7·0) g for women, respectively. After adjusting for age, baseline skeletal muscle mass and other confounders in logistic modelling, greater total protein intake was associated with lower prevalence of skeletal muscle mass decline among men at follow-up (P = 0·024). Particularly, the OR (95 % CI) for high lunchtime protein intake was low (0·11 (0·02, 0·61); P = 0·01). No significant association between total protein intake and prevalence of skeletal muscle mass decline was found among women. Conclusions: High total protein intake, particularly at lunchtime, is associated with retention of skeletal muscle mass in men. [ABSTRACT FROM AUTHOR]

• Falls are a public health issue that needs to be addressed globally, especially in rapidly aging populations such as Japan. However, Japanese evidence on fall-related mortality trends among whole population, the association of socio-demographic factors and medical resources on fall-related mortality, and geographical differences are lacking. • We found that fall-related mortality among the overall population has decreased over time, but has remained unchanged in recent years among men and women aged over 65 years. Seasonal and spatial patterns were also observed, and it was found that demographic data and healthcare resources in the prefectures affected fall-related mortality rates. • An adequate supply of physicians and physical therapists, and health promotion by these professionals to ensure that the community-dwelling older adults are healthy enough to continue living independently, may reduce fall-related mortality. Public campaigns in winter and public information campaigns aimed at reducing the severity of risk taken by men. Falls are a significant public health issue in aging societies. This study aimed to examine the temporal, seasonal, and spatial patterns in fall-related mortality in Japan, and to investigate the potential factors associated with fall-related mortality. The number of unintentional fall-related deaths from 1979 to 2019 were obtained from Japanese vital statistics and crude and direct age-standardized mortality rates (DSR) were calculated. We also calculated the standardized mortality ratio (SMR) to determine seasonal and prefectural differences. In addition, spatial regression was conducted to examine the potential factors associated with fall-related mortality. The DSR among those over 65 years old showed a decreasing trend from 1979, but remained unchanged from 1990 to 2019. Based on the spatial regression model, the factors significantly associated with SMRs were the proportion of the aged population (Coefficient: 0.049), the number of hospitals (0.118), the number of clinics (1.169), the number of hospital beds (-0.060), and the number of physiotherapists (-0.069) for men; and the proportion of aged single households (-0.060), the number of hospitals (0.132), the number of clinics (1.498), the number of hospital beds (-0.051), and the number of physicians (-0.308) for women. Fall-related mortality among Japanese elderly people has remained unchanged in recent years. In addition, seasonal and spatial patterns were also observed, and it was found that demographic data and healthcare resources in the prefectures affected fall-related mortality rates. Appropriate prevention measures of fall-related deaths should be considered according to the region-specific characteristics and issues. [ABSTRACT FROM AUTHOR]

Framed by international concerns about obesity and overweight, Japanese officials highlight rising trends of men aged between 40 and 60 suffering from metabolic syndrome. Theoretically grounded in symbolic interactionism and the concept of 'biopedagogy' Wright (Biopolitics and the 'obesity epidemic' governing bodies, Routledge, London and New York, 2009), this article explores the symbolism attached to a metabolic self through a textual and iconographic analysis of 805 media reports and Internet sites produced between 2009 and 2017. Definition, guidance and gender are three axes that orient the analysis, whose outcomes suggest that from a definitional viewpoint a medical and 'scientifically valid' causal link between a metabolic self and disease cannot be established, but the origin of metabolic syndrome is allegedly ignorance and indolence, suggesting that metabolic syndrome is presocial. Guidance is largely underpinned by the formula dieting + exercise = bodyweight control, the retrieval of traditional Japanese food and the commodification of a metabo self. The case history of a married older man grappling with metabolic syndrome challenges the presociality thesis, and at the same time points up the feminisation of care. To conclude, the paper underscores that a metabo self has been largely scripted as a Westernised, commodified, weak-willed, male self largely depending on women. [ABSTRACT FROM AUTHOR]

Dry mouth, caused by decreased salivary gland function and/or weak salivary stimulation, can severely affect oral health in older individuals. Therefore, the aim of this study is to evaluate whether a lip trainer device and sonic toothbrush can improve salivary flow and oral wetness in older patients complaining of dry mouth. Overall, 39 subjects aged ≥60 years who had at least 20 natural teeth were randomly assigned to use a lip trainer device (group P, n = 13) or a sonic toothbrush (group S, n = 13). The subjects who did not experience oral dryness were included as controls (group C; n = 13). The unstimulated and stimulated salivary flow rates and oral wetness were measured at baseline, 1 and 6 months. The unstimulated salivary flow significantly increased in both groups at 1 and 6 months (P < 0.05). The stimulated salivary flow was also significantly increased in group P (P < 0.01) compared with the level at baseline. However, no significant difference was observed over time in group S. Oral wetness of the tongue and buccal mucosa in group P had significantly improved at 1 and 6 months (P < 0.05). Dry mouth in older individuals may be improved by using a lip trainer device or a sonic toothbrush. [ABSTRACT FROM AUTHOR]

Aim: The consideration of patients' needs in terms of research outcomes is emphasized in research promotion to eradicate hepatitis B virus according to the Basic Act on Hepatitis Measures in Japan. This study analyzed patients' attitudes toward experienced antiviral therapies for chronic hepatitis B and their need for future therapies. Methods: A self‐administered questionnaire comprising 124 questions was completed among patients with chronic hepatitis B from 61 core‐center hospitals designated to implement and research policies on hepatitis in 47 prefectures from August 2013 to January 2014 (n = 3021, response rate = 51%). Results: In decision‐tree models with 333 variables generated from the questionnaire data, patients' satisfaction with therapy and reduction in anxiety about therapy were dependent on favorable therapeutic effects, sufficient information provided by the physician, and fewer lifestyle disturbances. Medical expenses were not selected at a superior branch because subsidy for antiviral therapy started in 2010. In correspondence analysis of free text answers, patients' need for therapy and support mechanisms differed among their attributes, including a great need for novel therapy in older men, hope for avoidance of lifestyle disturbance in younger men, and alleviation of painful experience with the disease in women. Conclusions: Continual provision of sufficient information is necessary to improve the utility of antiviral therapy for chronic hepatitis B as well as for favorable therapeutic effects. The patients believed that novel drugs and support would reduce the diverse burden of the disease on their lives. [ABSTRACT FROM AUTHOR]

Double balloon endoscopy ( DBE) is useful for diagnosing many intestinal diseases and for endoscopic procedures. We report a case of chronic diarrhea in a 58-year-old Japanese man. He was initially suspected to have malabsorption syndrome. DBE showed reduction of folds, scalloping, mucosal nodularity and granularity. Pathological examinations of biopsies from the jejunum showed severe villous atrophy with subepithelial collagen bands. These findings led to the final diagnosis of collagenous sprue ( CS). With1 month of total parenteral nutrition followed by a low-gluten diet, his symptoms gradually improved. CS has never been reported before in Japan. DBE is useful for making a diagnosis of CS, and may be considered for patients who are suffering from diarrhea of unknown cause. [ABSTRACT FROM AUTHOR]

Interventions that involve key aspects of community organizing, such as quantitative community assessments and organizational partnership support for the community, may promote residents' health. We evaluated the effectiveness of this form of intervention on mortality and its variability across individual-level household equivalized income tertiles, comparing 52,858 residents aged 65 and above in 12 intervention municipalities to 39,006 residents in nine control municipalities in Japan. During 1,166 days of follow-up, the adjusted hazard ratio for cumulative mortality among men in the intervention municipalities was 0.92 (95% confidence interval: 0.86, 0.99) compared to those in the control group, with similar results being observed across all income levels. Active utilization of data to evaluate communities and building intersectoral partnerships might lower older male residents' mortality risk, regardless of their income status. [ABSTRACT FROM AUTHOR]

The article looks at bullfighting in the Oki Islands, Japan. Particular focus is given to the significance of bullfighting and bull-rearing to human participants in these activities and to the factors that distinguish elderly male participants from their peers who are not involved in bullfighting. According to the author, participation in bullfighting activities gives these men a sense of purpose, which leads to an increased level of ikigai, or quality of life, in comparison to others in their cohort. Details on the social and physical activities associated with bullfighting and the personal qualities valued in participants, such as perseverance and patience, are also presented. Other topics include women's participation in bullfighting and traditions associated with the sport.

We present the first case report of the use of sorafenib and S-1 for the treatment of renal cell carcinoma (RCC) producing granulocyte colony-stimulating factor (G-CSF). This entity is clinically rare and has a poor outcome. A 78-year-old Japanese man presented with macrohematuria, left flank pain, and a palpable mass. Laboratory data showed marked leukocytosis with increased serum and urinary G-CSF. The histopathological diagnosis was unclassified RCC. New combination therapy with sorafenib and S-1 exerted a therapeutic effect and apparently decreased serum and urinary G-CSF levels, although the patient died of gastrointestinal perforation. The use of combined sorafenib and S-1 may be worthy of consideration in the treatment of RCC producing G-CSF. [ABSTRACT FROM AUTHOR]

A 74-year-old healthy Japanese man had noticed an itchy lesion with two tiny thick brown scales on the fourth interdigital web of his right foot 3 months earlier. The brown fungus isolated from the scales had demonstrated brown, ellipsoidal, obovoid or clavate, 3-septate conidia. Morphologically, the fungus was identified as Curvularia sp., and was differentiated from other human pathogenic species of the genus, such as C. lunata, C. pallescens, C. trifolii, C. clavata, and C. brachyspora, by molecular analysis based on the DNA sequence data. The fungus grows well on keratotic materials (hairs, nails, and callus), which indicates that it might have the ability to infect the skin surface. [ABSTRACT FROM AUTHOR]

In Japan, the ratio of never-married men to married men has risen rapidly since the second half of the 1980s. In this paper, we focus on the disruption of the gender balance, and on the effect that this and education level have on marriage behaviour. We confirmed that the rise in the population of never-married men has a negative influence on the probability that men will marry; however, it does not affect women’s behaviour. The effects of education in relation to the probability of marrying are positive for men, and negative for women. Generally, a low educational background is associated with low income and our results predict that elderly single men will tend to be of low socio-economic status. The present social security system is substantially reliant on the assumption that most single older people have families. An increase in aged single men in recent years means a new social security system is required. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence (UI) is a distressing problem for older people. To investigate the relationship between UI and respiratory symptoms among middle-aged and older men, a community-based study was conducted in Japan. Methods: A convenience sample of 668 community-dwelling men aged 40 years or above was recruited from middle and southern Japan. The International Consultation on Incontinence Questionnaire-Short Form, the Medical Research Council's dyspnoea scale and the Australian Lung Foundation's Feeling Short of Breath scale, were administered by face-to-face interviews to ascertain their UI status and respiratory symptoms. Results: The overall prevalence of UI was 7.6%, with urge-type leakage (59%) being most common among the 51 incontinent men. The presence of respiratory symptoms was significantly higher among incontinent men than those without the condition, especially for breathlessness (45% versus 30%, p = 0.025). The odds of UI for breathlessness was 2.11 (95% confidence interval 1.10-4.06) after accounting for age, body mass index, smoking and alcohol drinking status of each individual. Conclusions: The findings suggested a significant association between UI and breathlessness in middle-aged and older men. [ABSTRACT FROM AUTHOR]

How and why do major natural disasters affect suicide? This study revisits this question by focusing on the Great East Japan Earthquake (GEJE) in March 2011 as a historically important natural disaster. Using an event-study analysis, we assessed how the GEJE changed the suicide rates in the regions affected by it and whether its effect persisted, attenuated, or escalated over time. In addition, we explored the political and social channels underlying the relationship between the GEJE and suicide. Using prefecture-level data, our analysis reveals that suicide by men aged 40–64 years and 65 years and over showed a large decline in the GEJE-affected prefectures in the years following the earthquake, and this decline attenuated over time. Furthermore, following the GEJE, government spending increased while divorce rates decreased in the affected prefectures, both of which were correlated with male suicide rates. These findings indicate that suicide after major natural disasters is preventable when political and social reactions to disasters provide a safety net, especially for men. • We examined how the Great East Japan Earthquake (GEJE) affected suicide deaths. • The GEJE decreased male, but not female, suicide rates in the affected region. • The negative effects of the GEJE on male suicide rates attenuated over time. • The GEJE increased local government spending and decreased divorce rates. • These political and social changes were correlated with lower male suicide rates. [ABSTRACT FROM AUTHOR]

Increased longevity is associated with an increase in multiple chronic conditions. Given the importance of regular physical activity in the prevention or control of these conditions in old age, the aim of this study was to compare the cardiorespiratory fitness [CRF] and plasma lipids (i.e., total cholesterol [TC], low density lipoprotein cholesterol [LDLC], high density lipoprotein cholesterol [HDLC], and triglycerides [TG]) in age matched, physically active Japanese older men (i.e., runners [R, n = 21] and walkers [W, n = 21]) and sedentary (controls [C, n = 23]. Oxygen uptake corresponding to lactate threshold (R 23.2 ± 4.0 ml/kg/min, W 17.0 ± 2.3 ml/kg/min, C 15.0 ± 2.9 ml/kg/min) and maximal oxygen uptake (R 41.3 ±; 6.4 ml/kg/min, W 31.6 ± 2.7 ml/kg/min, C 25.4 ± 4.9 ml/kg/min) were both significantly higher in R and W than C (R > W). LDLC (R 109 ± 20 mg/dl, W 139 ± 38 mg/dl, C 173 ± 36 mg/dl) was significantly higher in C than W and R (W > R). TG (R 88 ± 52 mg/dl, W 122 ± 63 mg/dl, C 138 ± 66 mg/dl) was significantly lower in R than C, and tended (p = 0.07) to be lower than W. HDLC (R 70 ± 17 mg/dl, W 52 ± 12 mg/dl, C 54 ±10 mg/dl) was significantly higher in R than C or W. These findings confirm that better CRF and blood lipid levels are associated with physical activity in old age, and provide further evidence that greater benefits are associated with higher exercise intensities in Japanese older men. [ABSTRACT FROM AUTHOR]

Presents a study that compared the time-course of development and progression of physical disability between men and women based on prospective observation of elderly people in Japan. Difference of active life expectancy between men and women; Discussion on Japanese caregivers; Information on long-term care insurance in Japan.

Most research by gerontologists into the relationship between religion and aging has focused upon the potential health benefits of religious participation among Americans who follow Judeo-Christian oriented forms of worship and belief. This research has shown that both as a social institution and source of existential meaning, religion provides an important resource for older people in terms of fellowship and as a means of coping and adapting to social change and personal loss. Other religious traditions and other aspects of salience of religious participation for older people have been less thoroughly considered. This article investigates a religious ritual in Japan, that, rather than being a source of consolation, is an expression of symbolic capital associated with elder status and, thus, gerontocratic power. The ritual contributes to representing and reproducing the power of older residents in a rural Japanese community, partly due to its being administratively situated within an age-grade system that is a part of neighborhood political organization. Through its performance, the ritual visually reproduces and represents stratified social structures that concentrate power in the hands of male members of the senior age grade. [ABSTRACT FROM AUTHOR]

Abstract A common mutation, C677T, in the methylene tetrahydrofolate reductase gene (MTHFR) reduces the activity of MTHFR and increases total homocysteine levels in plasma. Increased homocysteine levels are reportedly associated with high serum uric acid levels. The relationship between the MTHFR mutation and uric acid metabolism remains unclear, however. To investigate whether the C677T MTHFR mutation is a risk factor for hyperuricemia, we performed MTHFR genotyping and clinical laboratory determinations, including serum uric acid, in 271 elderly Japanese men (age range, 40-79 years; mean, 52.6 years). The mean uric acid levels for the C/C, C/T, and T/T genotypes were 5.67, 6.00, and 6.39 mg/dl, respectively (P = 0.012). The T/T genotype was more frequent in subjects with high uric acid levels than in those with low uric acid levels (P = 0.038). These findings suggest that the C677T MTHFR mutation contributed to higher uric acid levels in subjects enrolled in this study. In conclusion, the mutation of the MTHFR gene may be a risk factor for hyperuricemia in elderly men. [ABSTRACT FROM AUTHOR]