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ABSTRACT: BACKGROUND: The longer healthy life expectancy observed in Japan may be partly attributed to the Japanese diet. The researchers sought to examine whether serum isoflavone levels are associated with disability and death. METHODS: The researchers used a nested case-control study to compare serum isoflavones (daidzein, genistein, glycitein, and equol) levels between 165 participants that died or were certificated as disabled (cases) and 177 controls. Disability was defined by certification of long-term care insurance. Conditional logistic regression models were used to calculate the risk of isoflavones for the composite outcome. RESULTS: The proportion of cases was lower in the group with the highest levels of equol (34/91, 37%) compared with equol nonproducers (84/161, 52%). The risk of disability or death among equol producers remained reduced after adjusting for age and sex (odds ratio: 0.55, 95% confidence interval: 0.33-0.93). In a multivariate model, this risk was also unchanged (odds ratio: 0.51, 95% confidence interval: 0.27-0.96). There were no significant associations between daidzein, genistein, and glycitein with the composite endpoint. CONCLUSIONS: Higher serum equol levels, but not any other isoflavones, were inversely associated with the composite endpoint of disability and death. Although it cannot be concluded that equol per se has preventive effects on disability or death, higher equol levels appear associated with better health.
The Journals of Gerontology Series A Biological Sciences and Medical Sciences 10/2012; · 4.60 Impact Factor
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Kaijun Niu,
Hui Guo,
Masako Kakizaki,
Yufei Cui, Kaori Ohmori-Matsuda,
Lei Guan,
Atsushi Hozawa,
Shinichi Kuriyama,
Toru Tsuboya,
Takashi Ohrui,
Katsutoshi Furukawa,
Hiroyuki Arai,
Ichiro Tsuji,
Ryoichi Nagatomi
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ABSTRACT: BACKGROUND: Enhanced oxidative stress or defective anti-oxidant defenses are related to the pathogenesis of depressive symptoms. Lycopene is the most powerful antioxidant amongst the carotenoids. The aim of this study was to investigate the relationship between different vegetables, including tomatoes/tomato products (a major source of lycopene), and depressive symptoms in a community-based elderly population. METHODS: We analyzed a cross-sectional survey including 986 community-dwelling elderly Japanese individuals aged 70 years and older. Dietary intake was assessed using a valid self-administered diet-history questionnaire, and depressive symptoms were evaluated using the 30-item Geriatric Depression Scale with 2 cut-off points: 11 (mild and severe) and 14 (severe) or use of anti-depressive agents. RESULTS: The prevalence of mild and severe and severe depressive symptoms was 34.9% and 20.2%, respectively. After adjustments for potentially confounding factors, the odds ratios of having mild and severe depressive symptoms by increasing levels of tomatoes/tomato products were 1.00, 0.54, and 0.48 (p for trend <0.01). Similar relationships were also observed in the case of severe depressive symptoms. In contrast, no relationship was observed between intake of other kinds of vegetables and depressive symptoms. LIMITATIONS: This is a cross-sectional study, and not for making a clinical diagnosis of depressive episodes. CONCLUSIONS: This study demonstrated that a tomato-rich diet is independently related to lower prevalence of depressive symptoms. These results suggest that a tomato-rich diet may have a beneficial effect on the prevention of depressive symptoms. Further studies are needed to confirm these findings.
Journal of affective disorders 07/2012; · 3.76 Impact Factor
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Kaijun Niu,
Atsushi Hozawa,
Hui Guo, Kaori Ohmori-Matsuda,
Yufei Cui,
Satoru Ebihara,
Naoki Nakaya,
Shinichi Kuriyama,
Toru Tsuboya,
Masako Kakizaki,
Takashi Ohrui,
Hiroyuki Arai,
Ichiro Tsuji,
Ryoichi Nagatomi
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ABSTRACT: Because CRP is a strong independent predictor of various diseases, it was hypothesized that CRP may be a useful predictor or treatment target for medical-care expenditures. The aim of this study was to investigate the relationship between CRP and medical-care expenditures in a community-dwelling elderly population. This prospective cohort study was conducted including 925 Japanese subjects aged ≥70 years. A high-sensitivity CRP assay was used by applying the nephelometric method. Hospitalizations, outpatient visits, and expenditures were ascertained through computerized linkage with claims lodged between August 2002 and March 2008 with the Miyagi National Health Insurance (NHI) Association. Since medical-care expenditures were not normally distributed, the category of high medical-care expenditures (>75th percentile of medical-care expenditures: inpatient expenditures >$494/month; outpatient expenditure >$522/month; total expenditures >$1103/month) was used to examine the relation of CRP levels with medical-care expenditures. Multiple logistic regression analysis was used to examine the relationship between CRP cutoff points (low concentrations: <1.0mg/L; intermediate concentrations: 1.0-3.0mg/L; or high concentrations: ≥3.0 mg/L) and medical-care expenditures during 6 year-follow up period. After adjustment for potential confounding factors, a positive association of CRP with hospitalization, and total expenditures (p for trend=0.03 and 0.02, respectively) was found. An elevated baseline CRP level is an independent predictor of increases in prospective medical-care expenditures among community-dwelling elderly. Further study is required to clarify whether reducing CRP by intervention is a cost-effective measure.
Archives of gerontology and geriatrics 02/2012; 54(3):e392-7. · 1.36 Impact Factor
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ABSTRACT: People who are obese have higher demands for medical care than those of the normal weight people. However, in view of their shorter life expectancy, it is unclear whether obese people have higher lifetime medical expenditure. We examined the association between body mass index, life expectancy and lifetime medical expenditure.
Prospective cohort study using individual data from the Ohsaki Cohort Study.
Miyagi Prefecture, northeastern Japan.
The 41 965 participants aged 40-79 years. PRIMARY AND SECONDARY OUTCOME MEASURES: The life expectancy and lifetime medical expenditure aged from 40 years.
In spite of their shorter life expectancy, obese participants might require higher medical expenditure than normal weight participants. In men aged 40 years, multiadjusted life expectancy for those who were obese participants was 41.4 years (95% CI 38.28 to 44.70), which was 1.7 years non-significantly shorter than that for normal weight participants (p=0.3184). Multiadjusted lifetime medical expenditure for obese participants was £112 858.9 (94 954.1-131 840.9), being 14.7% non-significantly higher than that for normal weight participants (p=0.1141). In women aged 40 years, multiadjusted life expectancy for those who were obese participants was 49.2 years (46.14-52.59), which was 3.1 years non-significantly shorter than for normal weight participants (p=0.0724), and multiadjusted lifetime medical expenditure was £137 765.9 (123 672.9-152 970.2), being 21.6% significantly higher (p=0.0005).
According to the point estimate, lifetime medical expenditure might appear to be higher for obese participants, despite their short life expectancy. With weight control, more people would enjoy their longevity with lower demands for medical care.
BMJ open. 01/2012; 2(3).
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Satoru Ebihara,
Kaijun Niu,
Takae Ebihara,
Shinichi Kuriyama,
Atsushi Hozawa, Kaori Ohmori-Matsuda,
Naoki Nakaya,
Ryoichi Nagatomi,
Hiroyuki Arai,
Masahiro Kohzuki,
Ichiro Tsuji
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ABSTRACT: Dyspnea is an alarming symptom responsible for millions of patient visits each year. Poor perception of dyspnea might be reasonably attributed to an inappropriately low level of fear and inadequate earlier medical treatment for both patients and physicians, resulting in subsequent intensive care. This study was conducted to evaluate medical care use and cost, and mortality according to the perception of dyspnea in community-dwelling elderly people. We analyzed baseline data from a community-based Comprehensive Geriatric Assessment in 2002. The perception of dyspnea in 479 Japanese community-dwelling elderly people with normal lung function was measured in August 2002. The sensation of dyspnea during breathing with a linear inspiratory resistance of 10, 20, and 30 cmH(2)O/L/s was rated using the Borg scale. According to the perception of dyspnea, we divided the elderly into tertiles and compared all hospitalizations, out-patient visits, costs, and death through computerized linkage with National Health Insurance beneficiaries claims history files between August 2002 and March 2008. In-patient hospitalization days and medical care costs significantly increased with the blunted perception of dyspnea, resulting in an increase in total medical-costs with blunted perception of dyspnea. With low perception group as reference, the hazard ratios of all-cause mortality were 0.65 (95% CI 0.23-1.89) for intermediate perception group and 0.31 (0.10-0.97) for high perception group, indicating the mortality rate also significantly increased with the blunted perception of dyspnea after multivariates adjustment (p = 0.04). The blunted perception of dyspnea is related to hospitalization, large medical costs, and all-cause mortality in community-dwelling elderly people. These findings provide a rational for preventing serious illness with careful monitoring of objective conditions in the elderly.
Frontiers in physiology. 01/2012; 3:238.
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Masayuki Hoshi,
Atsushi Hozawa,
Shinichi Kuriyama,
Naoki Nakaya, Kaori Ohmori-Matsuda,
Toshimasa Sone,
Masako Kakizaki,
Kaijun Niu,
Kazuki Fujita,
Shouzoh Ueki,
Hiroshi Haga,
Ryoichi Nagatomi,
Ichiro Tsuji
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ABSTRACT: Background and Aims: To compare the predictive power of physical function assessed by questionnaire and physical performance measures for subsequent disability in community-dwelling elderly persons. Methods: Prospective cohort study. Setting was elderly Japanese residing in the community, included in the Tsurugaya Project. We analyzed 813 participants, aged 70 years and older, who were not disabled at the baseline in 2003. Physical function was assessed by questionnaire, the "Motor Fitness Scale". Physical performance measures consisted of maximum walking velocity, the timed up and go test (TUG), leg extension power, and the functional reach test. Area under the curve (AUC) of the receiver operating characteristic curve for disability was used to compare the screening accuracy between the Motor Fitness Scale and the physical performance measures. Incident disability defined as certification for long-term care insurance was used as the endpoint. Results: We observed 135 cases of incident disability during follow-up. The third or fourth quartile for each measure was associated with a significantly increased risk of disability in comparison with the highest score quartile. AUC was 0.70, 0.72, 0.70, 0.68, 0.69 and 0.74, for the Motor Fitness Scale, maximum walking velocity, TUG, leg extension power, the functional reach test, and the total performance score, respectively. Conclusions: The predictive power of physical function assessed using the Motor Fitness Scale was equivalent to that assessed using the physical performance measures. Because the Motor Fitness Scale can evaluate physical function safely and simply in comparison with physical performance tests, it would be a practical tool for screening persons at high risk of disability.
Aging - Clinical and Experimental Research 11/2011;
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ABSTRACT: Mortality risk tends to be higher among elderly individuals with higher serum adiponectin levels. The objective of this study was to clarify whether the relationship between adiponectin and a higher risk of disability or death can be explained by physical function, bone mineral density, depression, and malnutrition.
We analyzed 505 individuals who underwent comprehensive geriatric assessment and who agreed to provide information on long-term care insurance. The endpoint was the composite outcome of death and incident disability defined as a first certification for any level of care need. Relationships between adiponectin and incident disability or death were estimated using the Cox proportional hazards model.
During 6 years of follow-up, 179 incident disabilities or deaths occurred. Among them, 20 and 23 died with and without disability, respectively. The risk of incident disability or death was significantly higher among participants with adiponectin greater than or equal to 22.4 (90%) than 8.0 or less (25%) mg/L (Hazard ratio: 95% confidence interval, 1.92: 1.01-3.64) in the model adjusted for age, sex, and metabolic risk factors. Adjustment for N-terminal pro-B-type natriuretic peptide and nutritional status did not substantially alter this risk estimate, although the association ceased to be statistically significant. Adjustment for physical function did attenuate the relationship, however, which ceased to be apparent upon exclusion of disability or death occurring within 3 years of follow-up.
The relationship between adiponectin and the composite outcome of incident disability and death was at least partly explained by reduced physical function and wasting in participants with higher adiponectin levels.
The Journals of Gerontology Series A Biological Sciences and Medical Sciences 10/2011; 67(5):530-6. · 4.60 Impact Factor
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Guang Yang,
Kaijun Niu,
Kazuki Fujita,
Atsushi Hozawa, Kaori Ohmori-Matsuda,
Shinichi Kuriyama,
Naoki Nakaya,
Satoru Ebihara,
Tatsuma Okazaki,
Hiu Guo,
Chihaya Miura,
Hideko Takahashi,
Hiroyuki Arai,
Ichiro Tsuji,
Ryoichi Nagatomi
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ABSTRACT: Physical activity (PA) is known to be inversely associated with medical care costs. The amount of PA is strongly associated with the level of physical performance among the elderly population. Therefore, it is possible that known relation between PA and medical care merely shows the relation between physical performance and medical care. To know whether PA itself relates to medical care, considering physical performance is necessary. The aim of this study was to ascertain the impact of PA on medical care expenditure by considering the physical performance in an elderly community-dwelling population.
We investigated 483 subjects who did not have any history of diseases relating to limited PA and who completed both a self-administered questionnaire including questions on PA and underwent a physical performance measurement. We ascertained the total medical care costs through a computerized linkage with claims lodged between August 2002 and March 2008 with the Miyagi National Health Insurance Association.
The physical performance was positively associated with their level of PA. After multivariate adjustment for covariables including the levels of physical performance, the per capita medical care costs were found to be $US 827.3 (598.0-1056.7) (mean, 95% confidence interval), $US 711.1 (476.4-945.8) and $US 702.0 (461.6-942.4) (P for linear trend = 0.02) per month for those who had the lowest, average and the highest level of PA, respectively.
This prospective study indicates that a higher level of PA is associated with lower medical care costs among the Japanese elderly irrespective of physical performance.
Geriatrics & Gerontology International 04/2011; 11(2):157-65.
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ABSTRACT: The aim of this study was to measure the prevalence of and risk factors for overactive bladder (OAB) in the elderly.
A cross-sectional study of elderly subjects was conducted by analyzing data from a community-based Comprehensive Geriatric Assessment on people aged 70 years or older. Trained interviewers performed face-to-face interviews for the assessment of urological symptoms. OAB definition was based on urgency and eight or more episodes of urination per day. The subjects completed a self-administered questionnaire including lifestyle evaluation, Geriatric Depression Scale, Mini-Mental Status Examination and medical history. Brachial-ankle pulse wave velocity was recorded to assess atherosclerotic disease. The analysis included 833 subjects, after the exclusion of 115 subjects who provided insufficient information.
Based on the definition of OAB, 153 subjects (18.4%) were identified as having OAB. Univariate analysis showed a significant association between OAB and depressive symptoms. Multivariate analysis showed that the risk of having OAB was significantly higher in subjects with depressive symptoms, current drinkers, and overweight subjects with odds ratios of 2.37 (1.60-3.52, 95% confidence interval), 1.65 (1.04-2.62), and 1.51 (1.02-2.24), respectively.
This is the first report to show an association between OAB and depressive symptoms and alcohol intake in an epidemiological study of elderly people. The reasons for these correlations remain unclear, but should be the foci of future OAB studies.
International Journal of Urology 03/2011; 18(3):212-8. · 1.75 Impact Factor
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ABSTRACT: People who spend a longer time walking have lower demands for medical care. However, in view of their longer life expectancy, it is unclear whether their lifetime medical expenditure increases or decreases. The present study examined the association between time spent walking, life expectancy and lifetime medical expenditure.
The authors followed up 27,738 participants aged 40-79 years and prospectively collected data on their medical expenditure and survival covering a 13-year-period. Participants were classified into those walking <1 and ≥1 h per day. The authors constructed life tables and estimated the life expectancy and lifetime medical expenditure from 40 years of age using estimate of multiadjusted mortality and medical expenditure using a Poisson regression model and linear regression model, respectively.
Participants who walked ≥1 h per day have a longer life expectancy from 40 years of age than participants who walked <1 h per day. The multiadjusted life expectancy for those who walked ≥1 h per day was 44.81 years, significantly lower by 1.38 years in men (p=0.0073) in men and 57.78 years in women, non-significantly lower by 1.16 years in women (p=0.2351). In addition to their longer life expectancy, participants who walked ≥1 h per day required a lower lifetime medical expenditure from 40 years of age than participants who walked <1 h per day. The multiadjusted lifetime medical expenditure for those who walked ≥1 h per day was £99 423.6, significantly lower by 7.6% in men (p=0.0048) and £128 161.2, non-significantly lower by 2.7% in women (p=0.2559).
Increased longevity resulting from a healthier lifestyle does not necessarily translate into an increased amount of medical expenditure throughout life. Encouraging people to walk may extend life expectancy and decrease lifetime medical expenditure, especially for men.
BMJ open. 01/2011; 1(2):e000240.
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ABSTRACT: Previous studies have suggested that outside temperature affects blood pressure (BP) levels. However, recently, due to a spreading heating system, the seasonal variation in BP levels might be smaller, especially in colder seasons when more heat is used. We used continuous measurements of home BP data to track seasonal variations of BP to analyze the relation between outside temperature and BP values. Among 213 volunteers who were asked to measure BP in September 2000, 79 participants (mean age 72.7 years, 60.0% women) measured BP at least once per month until August 2003 (36 months). The mean number of measurements was 19.0 times/month. Information on outside temperature was provided by the Japan Meteorological Agency. We used general linear models to analyze the relation between outside temperature and BP values. Blood pressure levels were lowest in the warmest months. However, the highest BP levels were not observed in the coldest month, but rather in March. A clear inverse association between temperature and BP values was evident only in periods when outside temperatures were above 10°C. When the outside temperature was ≥ 10°C, 1°C increment of outside temperature correspond to 0.40 and 0.28 mmHg decrease of systolic blood pressure (SBP) and diastolic blood pressure (DBP), whereas the corresponding values were 0.06 and 0.01 mmHg when the outside temperature was <10°C. In conclusion, inverse association between outside temperature and BP was observed only in warmer seasons.
Clinical and Experimental Hypertension 01/2011; 33(3):153-8. · 1.07 Impact Factor
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ABSTRACT: The "Kihon Checklist" (a frailty checklist), consisting of 25 items, is used for screening frail elderly, based on the Japanese long-term care insurance system. However, few reports have investigated predictive ability of incident long-term care insurance certification in the Kihon Checklist. The purpose of this study was to investigate inter-relationships and accuracy as a screening test of individual items and criteria in the Kihon Checklist for incident long-term care insurance certification.
In December 2006, we distributed a questionnaire including the Kihon Checklist to individuals older than 65 years living in Ohsaki City, Japan. Among the valid respondents, we followed those who gave informed consent to follow-up, had more than 1 item of response on the Kihon Checklist, and were not qualified for long-term care insurance certification at the baseline. We further excluded individuals who died or moved away in the one year follow-up, analyzing 14,636 elderly. The age- and sex-adjusted odds ratio (OR) and 95% confidence interval (95%CI) for newly incident long-term care insurance certification were estimated by logistic regression analysis. Independent variables were each of the items and criteria in the Kihon Checklist used for screening of "frail elderly". In addition, we estimated the sensitivity and specificity, and conducted receiver operating characteristic (ROC) analysis for each criteria domain.
5,560 (38.0%) matched the criteria of "frail elderly". During the one year of follow-up, 483 (3.3%) required newly incident long-term care insurance certification. All of the items in the Kihon Checklist were significantly associated with incident long-term care insurance certification (range of ORs: 1.45-4.67). In addition, all of the criteria also significantly predicted the risk of incident long-term care insurance certification (range of OR: 1.93-6.54). The OR (95%CI) for "frail elderly" was 3.80 (3.02-4.78). Among the various domains, "20 items other than five related to prevention and support for depression" had the largest area under the ROC curve.
All items and criteria used for screening frail elderly in the Kihon Checklist are useful for predicting the risk of incident long-term care insurance certification during a one-year period. However, the strength of the relation and accuracy for screening test were variable among items or domains, and criteria values could be improved.
[Nippon kōshū eisei zasshi] Japanese journal of public health 01/2011; 58(1):3-13.
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Journal of the American Geriatrics Society 12/2010; 58(12):2439-41. · 3.74 Impact Factor
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Akemi Nitta,
Atsushi Hozawa,
Shinichi Kuriyama,
Naoki Nakaya, Kaori Ohmori-Matsuda,
Toshimasa Sone,
Masako Kakizaki,
Satoru Ebihara,
Masataka Ichiki,
Hiroyuki Arai,
Ichiro Tsuji
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ABSTRACT: The aim of this study was to investigate whether peripheral arterial disease (PAD) is predictive of disability and whether the relationship between PAD and disability can be fully explained by baseline physical functions.
We followed for five years 783 Japanese aged 70 years or older without a disability at baseline in 2003. We defined participants certificed as requiring long-term care as having incident disability. The hazard ratio (HR) and 95% confidence interval (95% CI) for incident disability were calculated using the Cox proportional hazards model.
After adjusting for possible confounders other than physical function, the HR of incident disability among participants with PAD was 1.86 (95%CI: 1.06 to 3.26).Although the risk was attenuated (HR=1.63, 95%CI: 0.92 to 2.86) after adding baseline physical function as a covariate, the HR was still high. Furthermore, the relation was not statistically significant, but the group with higher physical function and PAD also had a higher HR of incident disability than those who had higher physical function without PAD.
PAD is an important predictor of disability even if the level of baseline physical function is high.
Journal of atherosclerosis and thrombosis 11/2010; 17(12):1290-6. · 2.69 Impact Factor
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Atsushi Hozawa,
Shinichi Kuriyama,
Ikue Watanabe,
Masako Kakizaki, Kaori Ohmori-Matsuda,
Toshimasa Sone,
Masato Nagai,
Yumi Sugawara,
Akemi Nitta,
Qiang Li,
Takayoshi Ohkubo,
Yoshitaka Murakami,
Ichiro Tsuji
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ABSTRACT: All Japanese aged ≥40 years are eligible for free annual health check-ups including blood pressure and cholesterol measurements. It is well known that health check-up screenees are more likely to have healthy lifestyles and better health conditions than non-screenees. Therefore, controlling these factors is required to investigate whether screenees have a lower mortality risk than non-screenees independent of their lifestyles or health conditions.
We followed 48,775 Japanese National Health Insurance beneficiaries aged 40-79 years since 1994 for 11 years. We used Cox proportional hazard models adjusted for possible confounding factors. We also performed propensity for use of the health check-up matched cohort analyses.
Compared to non-screenees, multiple-adjusted hazard ratios (95% confidence intervals) for all-cause and cardiovascular disease mortality among screenees were 0.74 (0.62-0.88) and 0.65 (0.44-0.95) for men and 0.69 (0.52-0.91) and 0.61 (0.36-1.04) for women, respectively. These relations were also observed when we used propensity matched cohort analyses.
This is the first study to show that mortality rates are lower among screenees than non-screenees in Japanese health check-ups when propensity matched cohort analyses were used for adjusting confounding factors. Further prospective studies, including randomized controlled trials, are required to confirm whether screening lowers mortality.
Preventive Medicine 11/2010; 51(5):397-402. · 3.22 Impact Factor
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Haruo Nakagawa,
Kaijun Niu,
Atsushi Hozawa,
Yoshihiro Ikeda,
Yasuhiro Kaiho, Kaori Ohmori-Matsuda,
Naoki Nakaya,
Shinichi Kuriyama,
Satoru Ebihara,
Ryoichi Nagatomi,
Ichiro Tsuji,
Yoichi Arai
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ABSTRACT: We evaluated the association of nocturia with fracture and death in a large, community based sample of Japanese individuals 70 years old or older.
The baseline in this population based study was determined in 2003 by an extensive health interview with each participant. In this study we followed 784 individuals with a mean ± SD age of 76.0 ± 4.6 years (range 70 to 97). Information on mortality and fracture during the study period was provided by the National Health Insurance system and details on fractures were collected from medical records. We compared the risk of bone fracture and death with or without nocturia in a multivariate Cox proportional hazard model.
Nocturia (2 or greater voids per night) was present in 359 of the 784 participants (45.7%). Fracture was observed in 41 cases, including 32 fall related cases. For all fractures and fall related fractures with nocturia the HR was 2.01 (95% CI 1.04-3.87) and 2.20 (95% CI 1.04-4.68, each p = 0.04). Death occurred in 53 cases. The mortality rate in individuals with nocturia was significantly higher than in those without nocturia. For mortality in patients with nocturia the age-gender adjusted HR was 1.91 (95% CI 1.07-3.43, p = 0.03). Even when further adjusted for diabetes, smoking status, history of coronary disease, renal disease and stroke, tranquilizers, hypnotics and diuretics, the positive relationship was unchanged (HR 1.98, 95% CI 1.09-3.59, p = 0.03).
During a 5-year observation period elderly individuals with nocturia were at greater risk for fracture and death than those without nocturia.
The Journal of urology 10/2010; 184(4):1413-8. · 4.02 Impact Factor
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ABSTRACT: The purpose of this study was to examine the relationship between depressive status and subsequent certification of long-term care insurance use, and to investigate sex differences in this relationship in an elderly Japanese population.
The Tsurugaya Project was a comprehensive geriatric assessment conducted for community-dwelling elderly persons aged 70 years or older in the Tsurugaya area, Sendai, Japan (N = 2,925). Of those who participated (N = 958), the 841 who gave informed consent and were not qualified for certification of long-term care insurance use at the baseline survey were analyzed. Depression was asessed using the 30-item Geriatric Depression Scale (GDS). We classified the subjects into three categories: normal (GDS less than 10), mild depression (GDS between 10 and 13), and moderate to severe depression (GDS more than 13 and/or taking antidepressive medication). The hazard ratio of incident certification of long-term care insurance use by depressive status was calculated using the Cox proportional hazards model.
During 4 years of follow-up, a total of 151 subjects were certificated for long-term care insurance and 46 subjects died. Particularly in men, the depressive status was related to subsequent incident certification of long-term care insurance use. In men, the age-adjusted hazard ratios (HRs) were 1.77 (95% confidence interval (CI): 0.91-3.48) for mild depression, and 2.26 (1.11-4.64) for moderate to severe depression (P for trend = 0.023). The relationship between depressive status and subsequent certification of long-term care insurance use in men was significant even after adjustment for age, comorbid conditions, social factors and lifestyle (multivariate-adjusted HR: 1.31 (95% CI: 0.65-2.65); mild depression 2.19 (1.06-4.54); moderate to severe depression: P for trend= 0.034). In women, there was no significant association between depressive status and certification of long-term care insurance use. In both sexes, there was no significant association between depressive status and death.
The relationship between depressive status and subsequent certification of long-term care insurance use was significant only in men. In men, the relationship was significant even after adjustment for age, comorbid conditions, social factors and lifestyle. These results suggest a sex difference in the relationship between depressive status and subsequent certification of long-term care insurance use in elderly Japanese.
[Nippon kōshū eisei zasshi] Japanese journal of public health 07/2010; 57(7):538-49.
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ABSTRACT: To examine the association between green tea consumption and tooth loss.
We analyzed cross-sectional data from the Ohsaki Cohort 2006 Study. Usable self-administered questionnaires about green tea consumption and tooth loss were returned from 25,078 persons (12,019 men and 13,059 women) aged 40 to 64 years in Japan. Multivariate logistic regression analysis was used to calculate odds ratios (ORs) for tooth loss using 3 cut-off points of 10, 20, and 25 teeth relative to each category of green tea consumption.
Consumption of > or = 1 cup/day of green tea was significantly associated with decreased odds for tooth loss, and the association appeared to fit a threshold model. In men, the multivariate-adjusted ORs for tooth loss with a cut-off point of <20 teeth associated with different frequencies of green tea consumption were 1.00 (reference) for <1 cup/day, 0.82 (95% CI, 0.74-0.91) for 1-2 cups/day, 0.82 (95% CI, 0.73-0.92) for 3-4 cups/day, and 0.77 (95% CI, 0.66-0.89) for > or = 5 cups/day. The corresponding data for women and the results for cut-off points of 10 and 25 teeth were essentially the same.
The present findings indicate an association of green tea consumption with decreased odds for tooth loss.
Preventive Medicine 04/2010; 50(4):173-9. · 3.22 Impact Factor
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Kemmyo Sugiyama,
Shinichi Kuriyama,
Munira Akhter,
Masako Kakizaki,
Naoki Nakaya, Kaori Ohmori-Matsuda,
Taichi Shimazu,
Masato Nagai,
Yumi Sugawara,
Atsushi Hozawa,
Akira Fukao,
Ichiro Tsuji
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ABSTRACT: Coffee contains various compounds that have recently been reported to exert beneficial health effects. However, the conclusion of its relation with mortality has not yet been reached. In this study, we aimed to investigate the associations between coffee consumption and all-cause and cause-specific mortality in Japan. We included 37,742 participants (18,287 men and 19,455 women) aged 40-64 y without a history of cancer, myocardial infarction, or stroke at baseline in our analysis, based on the Miyagi Cohort Study initiated in 1990. The outcomes were mortality due to all causes, cardiovascular disease (CVD), and cancer. During the 10.3 y of follow-up, 2454 participants died, including 426 due to CVD and 724 due to cancer. In women, the multivariate hazard ratios (HR) (95% CI) for all-cause mortality in participants who drank coffee never, occasionally, 1-2 cups (150-300 mL)/d, and > or =3 cups/d were 1.00, 0.88 (0.73-1.06), 0.82 (0.66-1.02), and 0.75 (0.53-1.05), respectively (P-trend = 0.04). For CVD mortality in women, the multivariate HR (95% CI) were 1.00, 0.56 (0.36-0.86), 0.48 (0.29-0.80), and 0.45 (0.20-1.03), respectively (P-trend = 0.006). Of the specific CVD diseases, there was a strong inverse association between coffee consumption and mortality due to coronary heart disease (CHD) in women (P-trend = 0.02) but not in men. Death due to cancer was not associated with coffee consumption in either men or women, except for colorectal cancer in women. Our results suggest that coffee may have favorable effects on morality due to all causes and to CVD, especially CHD, in women.
Journal of Nutrition 03/2010; 140(5):1007-13. · 3.92 Impact Factor
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Qiang Li,
Shinichi Kuriyama,
Masako Kakizaki,
Hong Yan,
Toshimasa Sone,
Masato Nagai,
Yumi Sugawara, Kaori Ohmori-Matsuda,
Atsushi Hozawa,
Yoshikazu Nishino,
Ichiro Tsuji
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ABSTRACT: The association between diabetes mellitus and the risk of prostate cancer has been tested in previous prospective cohort studies in western populations. However, no evidence from cohort studies is available for Asian populations, whose lifestyle is very different from that of westerners.
The authors examined the relationship between diabetes mellitus and the risk of prostate cancer in the Ohsaki cohort followed from 1995 to 2003, in which 230 new cases of prostate cancer were identified among 22,458 Japanese men. Baseline information including diabetes mellitus status was collected using a self-administered questionnaire. The Cox proportional hazards regression model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
Although a history of diabetes mellitus was not associated with the risk of total prostate cancer in this population, after stratification based on the clinical stage of prostate cancer, patients with diabetes mellitus showed a higher risk of advanced prostate cancer with a multivariate adjusted HR = 1.89 (95% CI: 1.02-3.50). The relationship remained robust when we excluded from the analysis cases arising in the first 2 years.
This population-based prospective cohort study indicates that a history of diabetes mellitus is associated with an increased incidence of advanced prostate cancer.
Cancer Causes and Control 03/2010; 21(7):1025-32. · 2.88 Impact Factor
