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The article describes the diaspora of Kibei, which refers to U.S.-born individuals of Japanese ancestry who have lived for a period of time in Japan before returning to the U.S., particularly prior to World War II, is presented, as indicated in Masao Yamashiro's "The Kibei Nisei." Topics include a rendering of a Kibei caught between Hawai'i and Okinawa, problematizing what Japanese American and Japanese identify and the Pacific as a realm of fragmentation as of unity.

OBJECTIVES: To determine the effect of walking on incident depressive symptoms in elderly Japanese-American men with and without chronic disease. DESIGN: Prospective cohort study. SETTING: The Honolulu-Asia Aging Study. PARTICIPANTS: Japanese-American men aged 71 to 93 at baseline. MEASUREMENTS: Physical activity was assessed according to self-reported distance walked per day. Depressive symptoms were measured using an 11-question version of the Centers for Epidemiologic Studies Depression Scale (CES-D 11) at the fourth examination (n=3,196) and at the seventh examination 8 years later (1999/00, n=1,417). Presence of incident depressive symptoms was defined as a CES-D 11 score of 9 or greater or taking antidepressants at Examination 7. Subjects with prevalent depressive symptoms at baseline were excluded. RESULTS: Age-adjusted 8-year incident depressive symptoms were 13.6%, 7.6%, and 8.5% for low (<0.25 miles/day), intermediate (0.25–1.5 miles/day), and high (>1.5 miles/day) walking groups at baseline (P=0.008). Multiple logistic regression analyses, adjusted for age, education, marital status, cardiovascular risk factors, prevalent diseases, and functional impairment, showed that those in the intermediate and highest walking groups had significantly lower odds of developing 8-year incident depressive symptoms (odds ratio (OR)=0.52, 95% confidence interval (CI)=0.32–0.83, P=.006 and OR=0.61, 95% CI= 0.39–0.97, P=.04, respectively). Analysis found that this association was significant only in participants without chronic diseases (coronary heart disease, cerebrovascular accident, cancer, Parkinson's disease, dementia, or cognitive impairment) at baseline. CONCLUSION: Daily physical activity (≥0.25 mile/day) is significantly associated with lower risk of 8-year incident depressive symptoms in elderly Japanese-American men without chronic disease at baseline. [ABSTRACT FROM AUTHOR]

The article offers information on Apolipoprotein E ε4 allele genotype and the effect of depressive symptoms on the risk of dementia in men. It is said that Apolipoprotein E ε4 (APOE ε4) allele is a genetic risk factor for Alzheimer's disease. The Honolulu-Asia Aging Study, a population-based cohort study of Japanese American men, is conducted. It is mentioned that since individuals with depressive symptoms and the APOE ε4 allele had an increased risk of dementia, it is suggested that one should be watchful for early signs of dementia in the older person with depression.

The objective of this study is to investigate the relationship between low levels of human serum albumin (HSA) and the incidence of coronary heart disease (CHD) in a cohort of elderly Japanese-American men. Using data from the Honolulu Heart Program's fourth examination (1991-1993), HSA levels of 998 Japanese American men aged 71-93 years was compared with plasma levels of fibrinogen, total cholesterol HDL cholesterol, LDL cholesterol triglycerides, diastolic BP, BMI, and fasting blood glucose. HSA was significantly negatively associated with age and fibrinogen, and significantly positively associated with total cholesterol, HDL cholesterol LDL cholesterol triglycerides, diastolic BP, BMI and fasting blood glucose. After adjusting for age, tertiles of HSA were significantly positively associated with total cholesterol, HDL cholesterol and triglycerides, and significantly negatively associated with fibrinogen. Using multivariate stepwise regression, significant correlations were seen between HSA and fibrinogen, cholesterol age, HDL cholesterol and triglycerides, and a borderline correlation was seen with systolic blood pressure. However, the model R-square for all variables was only 0.10. In conclusion, HSA levels are significantly associated with several traditional cardiovascular risk factors, particularly serum lipid levels. [ABSTRACT FROM AUTHOR]

Objective: The authors analyzed data on 1,049 men aged 71–93 years (excluding those with prevalent Parkinson’s disease and stroke) from the Honolulu Heart Program (1965–1968) and the Honolulu-Asia Aging Study (1991–1999) to determine whether occupational exposures to pesticides, solvents, metals, manganese, and mercury during middle age were associated with 14 movement abnormalities 25 years later. Methods: Analyses of variance and multivariate logistic regression were used to assess associations of interest. Results: After adjustment for age, BMI, cognitive functioning, smoking, alcohol drinking, education, and physical activity, there was a positive association between abnormal ‘facial expression’ and the highest exposure to metals [odds ratio (OR) = 2.62; 95% confidence interval (CI) = 1.35–5.11; trend, p = 0.02], and the highest exposure to mercury (OR = 1.91; 95% CI = 1.04–3.49; trend, p = 0.03). Age was positively associated with all movement abnormalities, and cognitive function, body mass index and physical activity were inversely associated with most movement abnormalities. Conclusion: Higher exposure to any metal, and specifically mercury, was associated with abnormal facial expression. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

To examine the relationship between total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) and the incidence of coronary heart disease (CHD) in elderly men.Prospective.Population based.A sample of 2,424, Japanese-American men aged 71 to 93 was used.Six years of data on incident fatal plus nonfatal CHD were examined.Analysis revealed a significant U-shaped relationship between age-adjusted CHD rates and both TC and LDL-C. The ranges of TC and LDL-C with the lowest risk of CHD were 200 to 219 mg/dL and 120 to 139 mg/dL, respectively. As cholesterol concentrations declined and increased beyond these ranges, the risk of CHD increased. These U-shaped relationships remained significant after adjusting for age and other risk factors.The U-shaped associations between TC and LDL-C and CHD imply a complex relationship between lipids and CHD in late life. The results indicate that elevated lipid levels should continue to be treated in healthy elderly individuals, as they are in those who are younger, although pharmacologically lowering lipids to excessively low levels in the elderly may warrant further study, as does the contribution of subclinical frailty to the relationship of lipids to CHD risk. [ABSTRACT FROM AUTHOR]

Energy restriction extends life span and lowers mortality from age-related diseases in many species, but the effects in humans are unknown. We prospectively examined this relationship in a large epidemiological study of Japanese-American men. We followed 1915 healthy nonsmokers, aged 45-68 years at study onset, for 36 years. Twenty-four-hour recall of diet was recorded at baseline, and follow-up was for all-cause mortality. After adjustment for age and other confounders, there was a trend toward lower mortality in the second quintile of energy intake, suggesting that men who consumed 15% below the group mean were at the lowest risk for all-cause mortality. Increased mortality was seen with intakes below 50% of group mean. Thus, we observed trends between low energy intake and reduced risk for all-cause mortality in humans until energy intake fell to less than half the group mean, consistent with previous findings in other species. [ABSTRACT FROM AUTHOR]

Dopamine is involved in the regulation of food intake, and obese persons have decreased dopamine D2 receptor availability in the striatum. Furthermore, midlife triceps skinfold thickness has been found to be positively associated with the risk of Parkinson’s disease (PD) among Japanese-American men in Hawaii. The authors prospectively investigated whether obesity was associated with PD risk in two large cohorts of US men and women. They documented 249 cases of PD in men (1986–2000) and 202 cases in women (1976–1998). Neither baseline body mass index (weight (kg)/height (m)2) nor early adult body mass index was associated with PD risk. The multivariate relative risk for a baseline body mass index of ≥30 versus <23 was 0.8 (95% confidence interval (CI): 0.6, 1.2; p for trend = 0.3). Overall, waist circumference and waist-to-hip ratio were not related to PD risk. However, among never smokers, both variables showed significantly positive associations with PD risk. The relative risks for comparisons of extreme quintiles were 1.9 (95% CI: 1.0, 3.4; p for trend = 0.03) for waist circumference and 2.0 (95% CI: 1.1, 3.6; p for trend = 0.03) for waist-to-hip ratio. The results do not support a role of overall obesity in PD pathogenesis; however, central obesity may be associated with higher PD risk among never smokers, and this finding merits further investigation. [ABSTRACT FROM AUTHOR]

Presents information on a study which investigated the prevalence and correlates of sleep disturbances in elderly Japanese American men in Hawaii. Prevalence of insomnia and excessive daytime sleepiness; Methodology; Results and discussion.

OBJECTIVE: To examine the association between baseline testosterone levels and changes in visceral adiposity in Japanese-American men. DESIGN: Prospective observational study. SUBJECTS: Second-generation Japanese-American males enrolled in a community-based population study. MEASUREMENTS: At baseline, 110 men received a 75g oral glucose tolerance test (OGTT), and an assessment of body mass index (BMI); visceral adiposity measured as intra-abdominal fat area (IAF) using computed tomography (CT); fasting insulin and C-peptide levels; and total testosterone levels. IAF was re-measured after 7.5 y. Subcutaneous fat areas were also measured by CT in the abdomen, thorax and thigh. The total fat (TF) was calculated as the sum of IAF and total subcutanous fat areas (SCF). RESULTS: After 7.5y, IAF increased by a mean of 8.0cm² (95% CI: 0.8, 15.3). Baseline total testosterone was significantly correlated with change in IAF (r=-0.26, P= 0.006), but not to any appreciable degree with change in BMI, TF, or SCF. In a linear regression model with change in IAF as the dependent variable, baseline testosterone was significantly related to this outcome while adjusting for baseline IAF, SCF, BMI, age, diabetes mellitus status (OGTT by the WHO diagnostic criteria) and fasting C-peptide (regression coefficient for baseline testosterone [nmol/I] = -107.13, P = 0.003). CONCLUSIONS: In this Japanese-American male cohort, lower baseline total testosterone independently predicts an increase in IAF. This would suggest that by predisposing to an increase in visceral adiposity, Iow levels of testosterone may increase the risk of type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Abstract: In a population-based cohort of Japanese American men in Hawaii, the 450 joggers differed from 6,171 nonjoggers in being younger, taller, heavier. and more obese; in having larger vital capacity, higher socioeconomic status, and a higher prevalence of certain electrocardiographic abnormalities: and in being more health conscious as demonstrated by less smoking and a higher frequency of special diets. Blood pressure, serum total cholesterol hematocrit and high density lipoprotein cholesterol (HDL-C) did not differ significantly between the two groups. Multiple regression analysis showed HDL-C to be inversely related to obesity and cigarettes, and directly related to alcohol consumption but to have no relationship to jogging or age. Temporal analyses suggested thai initiation of jogging was followed by a reduction in heart rate. but there was no significant change in other measured parameters. Coronary heart disease (CHD) prevalence was increased in joggers, perhaps because the diagnosis of CHD predisposes to this activity. We conclude that jogging has probably had little impact on the health of this cohort. [ABSTRACT FROM AUTHOR]

Examines the differences in the incidence of prostate cancer in the Japanese American men in the United States. Environmental risk factors of the disease; Prostate-specific antigen levels determined in community-based samples of serum from men without prostate cancer; Estimated number of Japanese-Americans with.

Factor analysis has previously identified four independent factors that characterize the insulin resistance syndrome in women, interpreted as 1) weight/waist, 2) lipids, 3) insulin/glucose, and 4) systolic and diastolic blood pressure. Because it is not known whether similar factors emerge for men, or for diabetics, factor analysis was used to investigate the clustering of features characterizing the insulin resistance syndrome using data from 3,159 elderly (71–93 years) Japanese-American men participating in the fourth examination of the Honolulu Heart Program during 1991–1993. Consistent with previous results, factor analysis reduced eight risk factors (insulin, glucose, systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol, weight, and waist circumference) to four uncorrelated factors that explained 78.2% and 74.7% of the variance in nondiabetics (n = 2,760) and diabetics (n = 399), respectively. These factors were interpreted as 1) weight/waist, 2) blood pressure, 3) lipids, and 4) insulin/glucose. Modest differences in the associations between fasting insulin and factors 1, 3 and 4 were noted for diabetics. These consistently identified composite factors may represent markers for underlying pathophysiologic mechanisms of the insulin resistance syndrome and risk of non-insulin-dependent diabetes mellitus. Am J Epidemiol 1998; 147:441–7. [ABSTRACT FROM PUBLISHER]

Measurement error in the exposure under investigation is an important but often ignored source of bias in observational studies. The authors examined the impact of measurement error in the association between total serum cholesterol and 16-year coronary heart disease and all-cause mortality in a cohort of 6,137 middle-aged men of Japanese descent in the Honolulu Heart Program (1973–1988). A Cox regression model that enables modeling of survival time with correction for measurement errors in multiple covariates was employed. After controlling for age, body mass index, systolic blood pressure, smoking status, alcohol consumption, dietary cholesterol, and total calorie intake, a difference of one standard deviation (38 mg/dL) in total cholesterol was associated with a significant increase in the risk of coronary disease death (uncorrected hazard ratio = 1.35). After correction for measurement errors in total cholesterol and covariates (except smoking and age), the estimated hazard ratio increased to 1.65 (a 22% increase). A U-shaped relation was observed between total cholesterol levels and the risk of all-cause mortality. This association was then examined with a quadratic model and with a two-slope or V-shaped regression model. In the quadratic fit, the magnitude of the quadratic total cholesterol term increased threefold after the adjustment for measurement error. In the V fit, the hazard ratio of all-cause death corresponding to a change in one standard deviation above 214 mg/dL (the nadir of the V) was 1.15, and increased to 1.49 (by 29%) after the correction. The corresponding hazard ratio of a change in one standard deviation below 214 mg%dL was 1.11, and increased to 1.37 (by 23%) after the correction. The authors conclude that the impact of elevated total cholesterol on the risk of coronary disease and all-cause mortality may be greater than previously estimated with standard methods of analysis. In addition, the correction for measurement error in total cholesterol and covariates did not explain the excess mortality associated with low total cholesterol. More research is needed to elucidate the fundamental issues underlying the U-shaped association, i.e., confounding versus causal implications. Am J Epidemiol 1996;143:463–71. [ABSTRACT FROM AUTHOR]

This article discusses research done on the potential effect of coffee and caffeine on the development of Parkinson disease (PD). It refers to a study by G. W. Gross and colleagues in a 2000 issue of the "Journal of the American Medical Association." The study involved Japanese American men aged between 45 and 68 who were enrolled in the Honolulu Heart Program between 1965 and 1968. Clinical outcomes of PD that might be considered valuable for primary care physicians include functional status or quality of life.

Background: Challenging cases in geriatrics often involve lack of communication regarding end-of-life preferences and cultural issues. There have been no previous population-based studies on acculturation and end-of-life preference discussions among older Japanese-Americans. Methods: The Honolulu-Asia Aging Study is a continuation of the Honolulu Heart Program, a longitudinal cohort study in Japanese-American men in Hawai'i that began in 1965. In the 2009-10 exam, participants identified a proxy informant who answered questions about their knowledge of the men's end-of-life preferences. We studied the relationship between end-of-life preference discussions and completion of a written advance directive and actual preferences for end-of-life care, as well as associations between discussions and demographic and cultural factors. The Cultural Assimilation Scale (CAS) consisted of 8 questions assessing degree of Japanese identity and lifestyle. Results: Among 350 participants aged 89-108 years, proxy informants were wives (29.4%), daughters (29.4%), sons (22.0%), other relatives (8.0%) and others (mostly paid caregivers, 11.1%). On proxy interview, 70.7% reported end-of-life preference discussions and 29.3% did not. Those who had end-of-life preference discussions were more likely to have completed a written advance directive compared to those without discussions (93.6% vs 61.5%, P < .0001). Even among those with discussions, many proxies were unsure about certain preferences, including tube feeding (27.4%), nursing home care (23.8%) and dementia care (20.2%). Factors associated with having end-of-life preference discussions included Christian religion (vs Buddhist/Shinto, OR = 1.85, 95% CI = 1.00-3.41, P < .05) and daughter as proxy informant (vs wife, OR = 2.34, 95% CI = 1.20-4.54, P = .01), but no associations with age, education, marital status or acculturation scores. Conclusion: Among this oldest-old population, there were almost 30% who did not have end-of-life preference discussions. Among those who did have these discussions, almost a quarter did not know about preferences regarding tube feeding, nursing home care or dementia care. Religion was the only acculturation factor associated with end-of-life preference discussions. Participants with daughters as proxy informants had higher odds of end-of-life preference discussions. [ABSTRACT FROM AUTHOR]

Introduction Elevated heart rate is a significant predictor for cardiovascular death in many studies. We studied whether resting heart rate in mid-life and in late-life is a risk for mortality in Japanese-American men, a population that has not been previously studied. Methods The Honolulu Heart Program is a longitudinal cohort study of Japanese-American men in Hawai'i which started in 1965. Resting heart rate was measured as ventricular rate on EKG in mid-life (ages 45-68 years) in 7,997 men at exam 1 (1965-68). Late-life resting heart rate was measured in 3,729 men ages 71-93 years at exam 4 (1991-93). Subjects were divided into quartiles of mid-life and late-life resting heart rate. All-cause mortality data were available through December 2007, providing 42 years of follow-up for the mid-life analysis, and 16 years of follow-up for the late-life analysis. We used chi square, t-tests and Cox proportional hazards models. This study was approved by the IRB of Kuakini Medical Center. Results Late-life heart rate was significantly associated with mortality (72.9%, 74.7%, 76.5%, 82.8% died during 16 years of follow-up from lowest to highest quartile respectively, p < 0.0001). In multivariate Cox proportional hazards regression models adjusting for age, BMI, hypertension, diabetes, pack-years smoking, physical activity index, cholesterol, alcohol consumption, and prevalent CHD, stroke and cancer, all-cause mortality was significantly higher in subjects in the second (RR = 1.08, 95% CI = 1.01-1.16, p = 0.03), third (RR = 1.08, 95% CI = 1.01-1.16, p = 0.02) and fourth quartiles (RR = 1.12, 95% CI = 1.04-1.20, p = 0.002) of mid-life heart rate (reference = lowest quartile). Similarly, multivariate Cox proportional hazards models adjusting for the above factors and prevalent dementia found a significant increase in all-cause mortality in the fourth quartile of late-life heart rate (RR = 1.20, 95% CI = 1.06-1.35, p = 0.003), using the lowest quartile as reference. Conclusions All-cause mortality was highest in subjects in the highest quartiles of heart rate in both mid-life and late-life in elderly Japanese-American men. High heart rate may be a marker of underlying disease, and it is not clear whether slowing of heart rate will modify this association. [ABSTRACT FROM AUTHOR]

Presents the study `Visceral adiposity and incident coronary heart disease in Japanese-American men: The 10-year follow-up results of the Seattle Japanese-American Community Diabetes Study,' by W.Y. Fujimoto, R.W. Bergstrom et al., from the November 1999 issue of `Diabetes Care.'

Discusses a study which showed that Japanese-American men living in Hawaii who retain a Japanese lifestyle have a decreased risk in non-insulin-dependent diabetes. Details of the study; The possible, though unknown, effects of early life factors.