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Purpose: To determine whether there is a significant association between prior cataract surgery and cognitive function in an elderly Japanese cohort. Setting: Nara Medical University, Nara, Japan. Design: The Fujiwara-kyo Eye Study was a cross-sectional epidemiological study. Methods: The subjects were ≥ 68-years who lived in the Nara Prefecture and responded to recruitment notices. All of the subjects received comprehensive ophthalmological examinations, and answered questionnaires on their socio-demographic and medical history including prior cataract surgery. The association between prior cataract surgery and cognitive function was determined. Results: A total of the 2764 subjects whose mean age was 76.3±4.8 years (±standard deviation) was studied. Of these, 668 individuals (24.2%) had undergone cataract surgery. Of these, 150 (5.4%) had dementia as determined by the Mini-Mental State Examination (MMSE) score ≤23, and 877 individuals (31.7%) had mild cognitive impairment (MCI; MMSE score 24–26). The subjects who had prior cataract surgery had significantly lower odds ratio (OR) of having MCI (OR = 0.78, 95% confidence interval; CI 0.64–0.96, P = 0.019) than those who had not had cataract surgery after adjusting for age, sex, body mass index, education, hypertension, diabetes, depression, and history of stroke. The OR was still lower when the visual acuity was also added to the adjusted factors (OR 0.79, 95% CI 0.64–0.97, P = 0.025). However, prior cataract surgery did not contribute significantly to the low OR for dementia. Conclusions: Cataract surgery may play a role in reducing the risk of developing MCI independently of visual acuity but not for dementia. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated the natural history of nocturia and determined factors influencing the incidence or remission of nocturia. Materials and Methods: Study subjects were 4,427 volunteers 65 years old or older who participated in the Fujiwara-kyo Study. The nocturia prevalence was assessed at baseline and 1 year later. Nocturia incidence and remission rates were calculated and factors influencing these results were evaluated based on characteristics, including gender, age, body mass index, HbA1c, creatinine clearance, life style, comorbidities, depressive status, metabolic syndrome and voiding symptoms. Independent factors were determined by multivariate analysis. Results: Of the 4,427 subjects 3,685 provided complete replies to self-administered questionnaires at baseline and 1 year later. The prevalence of nocturia at baseline and 1 year later was 47.0% and 50.3%, and nocturia incidence and remission rates were 20.0% and 15.4%, respectively. Male gender, high body mass index, voiding symptom deterioration and new onset overactive bladder were independent factors associated with the nocturia incidence. Male gender, sum of the voiding symptoms, age and new onset overactive bladder were independent negative factors associated with nocturia remission. Conclusions: The prevalence of nocturia worsened with time, although nocturia in older subjects progressed dynamically. Male gender, age, body mass index, sum of voiding symptoms, voiding symptom deterioration and new onset overactive bladder influence the natural history of nocturia. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the risk factors for new-onset overactive bladder (OAB) in older subjects. Methods: The present study enrolled 4427 subjects aged ≥65 years who had participated in the Fujiwara-kyo study. The prevalence of OAB at baseline and 1 year later was evaluated using the OAB symptom score questionnaire. The incidence and remission rate of OAB were calculated. We identified the risk factors for OAB by evaluating the difference in characteristics (including sex, age, body mass index, life style, comorbidities, depressive status, metabolic syndrome, and sum of voiding symptoms) between those with and without new-onset OAB. In addition, the independent risk factors were determined by multivariate analysis. Results: Of the 4427 subjects, 3685 completely replied to the self-administrated questionnaires at baseline and 1 year later. The incidence and remission rate of OAB was 11.9% and 29.8%, respectively. The male/female ratio, sum of voiding symptoms, alcohol consumption and smoking, hypertension, and depressive status in subjects with new-onset OAB, were significantly greater than those in subjects without new-onset OAB. A multivariate analysis, including sex (odds ratio 2.0, P < .0001), sum of voiding symptoms (odds ratio 1.1, P < .0001), and depressive status (odds ratio 1.8, P < .0001) were independent factors for new-onset OAB in older subjects. Conclusion: The results of the present study have demonstrated that male sex, the sum of voiding symptoms, and depression were independent factors for new-onset OAB. It is necessary to determine whether the treatment of patients with voiding symptoms or depression controls for new-onset OAB. [ABSTRACT FROM AUTHOR]

Abstract: Screening for low bone mass is important to prevent fragility fractures in men as well as women, although men show a much lower prevalence of osteoporosis than women. The purpose of this study was to establish a screening model for low bone mineral density (BMD) using a quantitative ultrasound parameter and easily obtained objective indices for elderly Japanese men. We examined 1633 men (65–84yr old) who were subjects of the Fujiwara-Kyo Study. Speed of sound (SOS) at the calcaneus was determined, and BMD was measured by dual-energy X-ray absorptiometry at the lumbar spine (LS), total hip (TH), and femoral neck (FN). Low BMD was defined as >1 standard deviation below the young adult mean, in accordance with World Health Organization criteria. We performed receiver operating characteristic (ROC) analysis to identify a better screening model incorporating SOS and determined the optimal cutoff value using Youden index. Prevalences of low BMD at the 3 skeletal sites were 27.8% (LS), 33.5% (TH), 48.6% (FN), and 43.3% at either LS or TH. The greatest area under the ROC curve (0.806, 95% confidence interval: 0.785–0.828) and smallest Akaike''s information criterion were obtained in the multivariate model incorporating SOS, age, height, and weight for predicting low BMD at all skeletal sites. This model predicted low BMD at TH with the sensitivity of 0.726 and specificity of 0.739, whereas a similar model predicted low BMD at LS with much lower validity. We conclude that the multivariate model for TH could be used to screen for low BMD in elderly Japanese men. [Copyright &y& Elsevier]

Abstract: It has been reported that tooth loss is associated with Alzheimer''s disease (AD) and dementia. The purpose of this study was to investigate the association between tooth loss and mild memory impairment (MMI) among the elderly. We examined 3,061 community residents aged 65years or older who had a score of 24 or more on the Mini-Mental State Examination. The subjects were divided according to their score for the three-word delayed recall test into control (score: 3 or 2) and MMI (score: 1 or 0) subjects. The subjects underwent a dental examination, an interview to determine their medical history, a self-administered questionnaire (inclusive of higher-level functional capacity, drinking and smoking habits, and frequency of going out), and a 10-m walking test. Fewer remaining teeth, going out once a week or less frequently, and a slow walking speed on a 10-m walking test were found at a significantly higher prevalence in the MMI group (n =101) than in the control group (n =2,960), after adjustment for sex, age, and the level of education. Multiple logistic regression analysis using these items revealed that the odds ratio of 0–10 remaining teeth for MMI was 1.71 (95% CI 1.05–2.78), compared to individuals with 22–32 remaining teeth. A significant increase was also found in a trend test to examine the increasing odds ratios of 22–32, 11–21, and 0–10 remaining teeth. We consider that tooth loss is associated with MMI later in life. [Copyright &y& Elsevier]