Asae Oura

Kochi Medical School, Kôti, Kochi, Japan

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Publications (30)25.97 Total impact

  • M. Washio · K. Takeida · Y. Arai · E. Shang · A. Oura · M. Mori
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    ABSTRACT: Objectives: To investigate factors related to depression among caregivers of the frail elderly who received visiting nursing services in the northernmost city of Japan with a subarctic climate. Design: Cross-sectional study Method: The data includes 67 pairs of the frail elderly and their caregivers who received visiting nursing services in Wakkanai City, Hokkaido Prefecture, Japan. Caregivers answered a self-Administered questionnaire about various factors that may affect their depression and also completed a Center for Epidemiologic Studies Depression Scale evaluation (CES-D). Caregivers were divided into two groups according to their CES-D score (i.e., the cut-off point of the CES-D being 16 as defined above): (i) depressed (n = 29), and (ii) non-depressed (n = 38). This study was approved by the Ethics Committees of Sapporo Medical University and St. Mary's College. Results: Compared with non-depressed caregivers, depressed caregivers felt significantly burdened (ZBI: 40.5 ± 19.3 vs. 25.4 ± 14.4, p < 0.01) and more likely to consult with physicians for their own diseases (75.8% vs 42.1% p < 0.01). Depressed caregivers used more public services than non-depressed caregivers (8.8 ± 3.0 vs. 7.2 ± 3.1, p = 0.03); although, they were less likely to care nothing about what neighbors would say when they use public services than their counterparts (69.0% vs. 97.4%, P < 0.01). Conclusion: The result of the present study may suggest that having some chronic diseases and minding what neighbors say may be related to the depression among caregivers. Home-visiting nurses should care for not only the frail elderly but also for their family caregivers. In addition, public health professionals should advise caregivers not to feel inferior when using social services.
    No preview · Article · Jan 2015
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    ABSTRACT: Objectives: A prospective study was conducted to assess factors associated with risk of turnover among care workers in group homes (GHs) for elderly individuals with dementia. Methods: In January, 2010, 51 out of 238 GHs in Sapporo City responded to our request for participation in a survey. During February and March of 2010, 438 out of 700 care workers (62.6%) in the GHs returned a completed questionnaire to us. They were followed up with until March of 2012, and 395 subjects (90.1%) responded to our survey, which was conducted twice. Over the course of 2 years, 91 subjects left their jobs. Cox's proportional hazards model was used for analysis, adjusting for gender and age. Results: Less provision of social support by supervisors, colleagues, family or friends was significantly associated with increased risk of turnover. Financial aids for off-the-job training was marginally significantly associated with reduced risk of turnover. Longer duration of working for frail elderly care was significantly associated with decreased risk of turnover. Habitual smoking was significantly associated with increased risk of turnover. Conclusions: Social support in the workplace may be important to reduce the risk of turnover in care workers at GHs. Further prospective studies are required in other areas in Japan.
    No preview · Article · Oct 2013 · Journal of Occupational Health
  • Mika HARAI · Asae OURA · Mitsuru MORI
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    ABSTRACT: Objectives The aim of this study is to clarify risk factors of urinary incontinence (UI) in elderly Japanese women. Methods We randomly selected 1600 women, aged between 65 and 74 years, from the resident registration of Sapporo City and we analyzed 746 women, who responded twice on surveys in 2010 and 2011. UI was defined as frequent UI when it occurred at least once a week in both 2010 and 2011. ResultsMultivariate logistic regression analysis revealed that the past maximum body weight, smoking index, past history of bladder disease or hemorrhoids, and the participant's mother's history of UI were significantly associated with an increased risk of UI. Conclusion Lifestyle habits such as weight gain and smoking habits were associated with an increased risk of UI in Japanese women. Further study is needed, because modification of these risk factors may possibly result in reducing risk of UI.
    No preview · Article · Jul 2013 · Lower urinary tract symptoms
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    ABSTRACT: A cross-sectional study was conducted to explore the potential association between work environment and/or stress coping ability, and depressive status among caregivers working for "group homes (GHs)" in Japan. In January 2010, 438 out of 700 caregivers working at GHs in Sapporo City returned completed questionnaires to us. The questionnaires consisted of the Center of Epidemiological Scales-Depression, items about worker's attributions, Ozeki's coping scale, and so on. An analysis using a logistic regression model was used to find the associations adjusting for gender and age. Subjects who were 45 yr or older, had a spouse, had job training, a standard workload and scored high in emotion-oriented coping were significantly associated with a decreased risk of depression. Subjects who were less proud of their job, less willing to continue care for the frail elderly and had fewer acceptances by their supervisors or colleagues for consultation were significantly associated with an increased risk of depression. This study supports our hypothesis that there can be possible variables among individual factors, work environment and/or coping style for stress which may modulate a risk on the depressive status of caregivers.
    No preview · Article · May 2013 · Industrial Health
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    ABSTRACT: Urination diseases--particularly urinary incontinence (UI)--strongly affect individuals' quality of life (QOL). It is important to maintain overall QOL in societies with an increasing number of long-living elderly people, such as in Japan. Thus, this study aims to clarify the risk factors concerning UI in elderly women. For this study, we obtained the approval of the Ethical Committee of Sapporo Medical University. In October 2010, we randomly selected 1,600 women, aged between 65 and 74 years, from the registry of Sapporo city residents and mailed out a self-administered questionnaire. Our questionnaire consisted of five subsections (24 items in total), including fundamental attributes, health condition, past history, present illness, and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). The self-reported prevalence of UI was defined as frequent UI being at least once a week. A logistic regression analysis was used to assess the risk factors for UI. Among those who received the questionnaire, 802 women (response rate: 50.1%) returned a completed questionnaire with written informed consent. Their mean age (+/- standard deviation) was 69.8 +/- 2.6 years, and the prevalence of UI was found to be 29.7%. The mean scores (+/- standard deviation) of ICIQ-SF were 1.7 +/- 2.9 for all participating subjects, and 5.55 +/- 2.50 and 0.09 +/- 0.53 for the groups with or without UI, respectively. The results of the multiple logistic regression analysis were as follows: the odds ratio (95% confidence interval) was 1.94 (1.32, 2.85) for a past maximum weight heavier than or equal to 60 kg; 1.98 (1.18, 3.32) for a smoking index more than or equal to 300; 2.54 (1.47, 4.39) for a poor self-perceived health status; 1.62 (1.09, 2.40) for having a past history of bladder diseases; 1.72 (1.11, 2.69) for having a past history of hemorrhoidal disease; and 2.05 (1.36, 3.10) for a history of UI in one's mother. The self-reported prevalence rate of UI was 29.7% in women aged 65-74 years. In the future, we plan to conduct a follow-up survey to further clarify the risk factors of UI that have been implicated in this cross-sectional study.
    No preview · Article · Feb 2013 · [Nippon kōshū eisei zasshi] Japanese journal of public health

  • No preview · Article · Jan 2013 · Japanese Journal of Health and Human Ecology
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    ABSTRACT: Background: In April 2000, a new public long term care insurance system (LTCIS) was launched in Japan, making it the third country, after the Netherlands and Germany. Purpose: In this paper, we introduce our studies on the care burden among caregivers before and after the introduction of this system. Methods: A series of studies on depression among family caregivers is introduced. Results: Neither the rate of depressive caregivers nor time spent on caregiving decreased under the LTCIS. Although the elderly and their caregivers have right to use services under the LTCIS, they use only small part of these services which they had the right to use. Conclusion: We should remove the barriers for the frail elderly and their caregivers to use social services under the LTCIS. In addition, municipal services and/or informal services should be provided when the elderly and their caregivers cannot afford to use social service under the LTCIS. © 2012 Japan International Cultural Exchange Foundation & Japan Health Sciences University.
    No preview · Article · Sep 2012
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    ABSTRACT: The proportion of Japanese adults aged 65 years or older is predicted to increase; thus, it is becoming more important to identify factors that influence health status among elderly adults in Japan. We conducted a follow-up study of community-dwelling elderly adults to assess the relationship of hobby activities with mortality and incident frailty. We randomly selected 3583 individuals aged 65 to 84 years from the residential registries of 7 study areas in Hokkaido, Japan in August 2007. Among them, 1955 (54.6%) returned completed questionnaires with written informed consent by mail. The baseline assessment questionnaire comprised questions on current and past involvement in hobby activities, self-perceived health status, smoking and drinking habits, and body height and weight. Questions on hobby activities were from 4 categories: solitary physical, group physical, solitary cultural, and group cultural activities. We later conducted a follow-up survey of the participants to ascertain all-cause mortality and incident frailty. A Cox proportional hazards model was used for analysis of data from September 2007 to May 2010. After adjusting for potential confounders, the risk of incident frailty among respondents participating in solitary physical activities was significantly lower than in those who did not participate in such activities (hazard ratio = 0.57; 95% CI 0.33, 0.99). Furthermore, the risk of incident frailty among respondents taking part in group cultural activities was significantly lower than in those who did not participate in such activities (0.41; 0.19, 0.87). These findings may be important for programs that seek to promote good health among elderly adults.
    Full-text · Article · May 2012 · Journal of Epidemiology
  • M. Washio · Y. Arai · A. Oura · M. Mori
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    ABSTRACT: Improvements in public health and advances in medicine after World War II have given Japan one of the highest life expectancies in the world. The dramatic increase in the number of older people in this country is well documented. Because the birth rate dropped sharply after the postwar baby boom, population aging is proceeding more rapidly than in any other industrialized nation. Due to the increased population, the number of elderly in need of care has also increased. It is estimated that the number of elderly in need of care will reach 5.2 million in 2020. Therefore, in April 2000, a new public long-term care insurance system (LTCIS) was launched in Japan, making it the third country to do so, after the Netherlands and Germany. Although Japanese LTCIS follows the German LTCIS, there are some differences between the two countries. First, the elderly in need of care and their caregivers choose to receive care services or cash payment for family-based caregiving in German, while only care services are available in Japan. Second, caremanager, who arranged care services as well as assess the effect of care services, help users to make a care plan in Japan, although the idea of care management was adopted from the United Kingdoms' system. In this chapter, we introduce Japanese LTCIS and our studies on the care burden among caregivers before and after the introduction of this system.
    No preview · Article · Jan 2012
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    ABSTRACT: Depression affecting caregivers is a risk factor for discontinuing at-home care. The present cross-sectional study was conducted to evaluate factors related to depression among family caregivers. A cross-sectional study was conducted to evaluate factors related to depression among family caregivers of the frail elderly. The study included caregivers whose relatives received periodic visits from a nurse from one of seven Sapporo-based home-visiting nursing service stations in October 2008 or from one of nine Kochi-based home-visiting nursing service stations between June 2009 and March 2010. Caregivers were asked to answer a self-administered questionnaire about various factors that might affect their depression and to complete a Center for Epidemiologic Studies Depression Scale evaluation. We analyzed 127 pairs of responses in total. After we adjusted the results for the caregivers' gender and age, the factors that decreased the risk of depression in the Sapporo group related to relieving the stress that results from being a caregiver (OR = 0.12, 95%CI = [0.03, 0.42]) and the ability to independently pay more than ¥10 000 for part of care service costs (OR = 0.17, 95%CI = [0.05, 0.58]). In contrast, feeling ill was a factor that increased caregivers' risk of depression in the Kochi group (OR = 4.23, 95%CI = [1.29, 13.9]), but not in Sapporo group (OR = 2.53, 95%CI = [0.91, 7.08]). Caregivers in the Sapporo group were more likely to feel ill (P < 0.01) than their counterparts in Kochi. The Japanese government should take measures to reduce caregivers' depression. Otherwise family members will increasingly discontinue to provide at-home care.
    No preview · Article · Oct 2011 · Geriatrics & Gerontology International
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    ABSTRACT: In accordance with nutritional improvement, the environmental sanitation, and advance in medical technology after World War II, Japan has achieved almost the longest lifespan in the world. This change has two implications. Firstly, this has led to a drastic increase in elderly population in Japan. Secondly, a part of Japanese has faced the problem of over-nutrition due to e.g. an inappropriately increased intake of total energy and total fat, a more sedentary lifestyle or insufficient physical activity in association with use of various mechanic devices or transportation including a car in their life. Their lifestyles are not only associated with an increased risk of lifestyle-related morbidity, but also with increased medical expenditure. Some studies reported higher prevalences of obesity, glucose intolerance (Kawamori 2002), hypertension (Ueshima et al. 2000), and/or hyperlipidemia (Koba and Sasaki 2006) in recent years as compared to past. These lifestyles factors and morbidity are suggested as possible risk factors for a higher mortality related to cardiovascular diseases and certain types of cancer.
    No preview · Chapter · Jan 2011
  • M. Washio · C. Kiyohara · A. Oura · M. Mori
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    ABSTRACT: Smoking-related disease is recognized as one of today's major preventable health problems. In Japan, adolescent smoking rates are still high although the minor under the age of 20 has been prohibited by the law. In this paper, we introduce our previous studies on smoking among Japanese youth. Although more than 90% of senior high school boys knew that smoking caused lung cancer and nearly 90% thought that environmental tobacco smoke exposure was harmful to non-smoker's health, smoking rate increased with the grade (i.e., 6.3% for 1st grade, 11.3% for 2nd grade and 15.5% for 3rd grade). A total of 35.1% of senior high school boys had the experience of smoking and 30% experienced before entering senior high school. Of the students with smoking experience, 28.6% smoked because their friends gave them cigarettes. Other study also revealed that having a friend who smoked was associated with an increased risk of being introduced to smoking for first time up to the 3rd grade of elementary school (odds ratio=16.4), from the 4th to 6th grade of elementary school (OR=9.0), throughout junior high school(OR=6.1), and throughout senior high school(OR=2.8). The implementation and enforcement of smoke-free school policies should be strongly recommended.
    No preview · Article · Jan 2011
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    ABSTRACT: To investigate the relationship between dietary intake of minerals and the risk of chronic obstructive pulmonary disease (COPD), a case-control study was conducted in central Japan. A total of 278 referred patients (244 men and 34 women) aged 50-75 years with COPD diagnosed within the past four years and 340 community-based controls undertook spirometric measurements of lung function. A structured questionnaire was administered face-to-face to obtain information on demographics and habitual food consumption. Dietary intakes of six major minerals were derived from the Japanese food composition tables. The COPD patients had lower habitual energy-adjusted intakes of calcium, phosphorus and iron than controls, but not sodium. A significant reduction in prevalence of COPD was observed for calcium, with adjusted odds ratio 0.65 (95% confidence interval: 0.37- 0.98) for the highest level versus lowest level of intake. A high iron intake was also inversely associated with the COPD risk. In conclusion, an inverse association was evident between dietary calcium intake and the risk of COPD for Japanese adults.
    Full-text · Article · Dec 2010 · Asia Pacific Journal of Clinical Nutrition
  • A. Oura · M. Mori · H. Izumi · M. Washio
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    ABSTRACT: Background: Depression affecting caregivers is a risk factor for discontinuing at-home care. Objective: The present cross-sectional study was conducted to evaluate factors related to depression of family caregivers. Methods: A cross-sectional study was conducted in order to evaluate factors related to depression among family caregivers for the frail elderly with periodic nurse service in 2008, in 7 home-visiting nursing service stations in Sapporo, Japan. Caregivers were asked to answer a self-administered questionnaire about various factors that might affect their depression, and also to complete a Center for Epidemiologic Studies Depression Scale Evaluation (CES-D). We analyzed 71 pairs in total. Results: Factors related to poor health (OR=3.40, 95%CI: 1.13, 10.18) and a longer time spent physically caregiving (OR=3.08, 95%CI: 1.02, 9.35) were associated with being depressed. On the other hand, factors related to a good or fair economic position (OR=0.30, 95%CI: 0.10, 0.91), having a sister or brother who could help from the outside (OR=0.21, 95%CI: 0.05, 0.91), being able to relieve irritation caused by caregiving (OR=0.10, 95%CI: 0.03, 0.36), using the care service at home well (OR=0.24, 95%CI: 0.06, 0.98), and being able to pay more than 10,000 Japanese Yen by themselves as part of the total care service costs (OR=0.15, 95%CI: 0.04, 0.57) were associated with not being depressed. Conclusion: Caregivers should be supported not only informally but also by a new government funded system.
    No preview · Article · Dec 2010

  • No preview · Article · Jan 2010
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    ABSTRACT: Background: Annual vaccinations are recommended for groups with high-risk medical conditions, as well as the residents of nursing homes. In general, little is known about the vaccine effectiveness of vaccines for Influenza-like illness (ILI) in community-dwelling elderly. Methods: A population based cohort study was conducted during the 2006-2007 (06/07) influenza season to examine the effectiveness of an influenza vaccine among community-dwelling elderly. We selected 1,000 elderly citizens ranging from 65 to 74 years old randomly from a population registry of Sapporo in September 2006. Baseline survey for them was conducted in October or November 2006, and 542 (54.2%) subjects responded with an informed consent. We excluded one person because he passed away before the follow-up survey. Thus, we analyzed 541 subjects. We followed-up the participants concerning acute febrile illnesses, hospitalizations, and so on every prior month from December 2006 to April 2007 though telephone interviews. The Chi-square test and Mann-Whitney U-test were used to compare vaccinated group to non-vaccinated group, and Cox's hazard model was conducted to control for potential confounding factors. Results: After adjusting for confounders, the vaccination decreased acute fevers higher than or equal to 37.5°C (Hazard ratio (HR) =0.42, 95% confidence interval (CI)=(0.20, 0.90)) from December 2006 to March 2007, but was not associated with the risk of ILI (HR=1.25, 95%CI=(0.29, 5.37)). Conclusion: An influenza vaccination may decrease an acute fever during an influenza epidemic season in community-dwelling elderly.
    No preview · Article · Dec 2009
  • A. Oura · F. Sakauchi · E. Shang · M. Mori
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    ABSTRACT: Background: Physical activity is very important for disease prevention, and improves quality of life (QOL). However, it is reported that many people do not have the habit of exercise in Sapporo in 2000. Objective: To compare exercise groups (a home-based and a gym-based exercise training program) with the control group. Design: Intervention study. Intervention for 6 months, and follow up for 2 years. Setting: a community-based health promotion project in Sapporo, Japan. Subjects: A total of 547 people (named "Tanoshiku" course, a home-based training program: 114 people, "Genkini" course, a gym-based training program, once a week: 268 people, "Shikkari" course, a gym-based training program, twice a week: 165 people) whose conditions met 24.2 Body mass index (BMI) <35 and one or more of the following criteria: 1) systolic blood pressure S 130mmHg, 2) LDL cholesterol 120mg/dl, 3) fasting glucose level HOmg/dl, or glucose level 5 140 mg/dl and HbAic 5.5% in 2003. A control group was matched for age (5-years interval) and sex in the intervention group. Subjects were selected among participants who attended the municipal health screening program. Main outcome measures: BMI, systolic and diastolic blood pressure, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, fasting glucose level, and HbAic. Results: At 6 months, 495 (90.5%) of the subjects had completed the exercise training program. Repeated measured analysis of variances showed a significant time and group interaction. The BMI of the "Tanoshiku" course and the "Shikkari" course showed a significantly different pattern (decreased) when compared to the control group. Fasting glucose level of the "Genkini" course was significantly different pattern when compared to the control group. Conclusions: Home-based and gym-based exercise training programs may be effective ways to reduce BMI and fasting glucose level in middle-aged and elderly people.
    No preview · Article · Dec 2008
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    ABSTRACT: Confounding is a kind of bias which occurs in a research. Confounding is less frequent in randomized controlled trials (RCT) for evaluation of influenza vaccines. However, there are obstacles or difficulties in conducting RCT for evaluation of influenza vaccines, particularly, in the elderly people. Therefore, a retrospective or prospective cohort study has been primarily performed to evaluate effectiveness of influenza vaccine in elderly people. Confounding by indication or other confounding exist in most observational studies. Accordingly, at the stage of designing or analyzing a study, confounding should be controlled with a restriction, matching, stratified or multivariate analysis technique.
    No preview · Article · Jul 2008 · Vaccine
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    Masakazu Washio · Asae Oura · Mitsuru Mori
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    ABSTRACT: Ecological studies lack the ability to control for the effects of confounding factors. The findings of a linear relationship between average exposure and disease frequency in ecological studies do not imply that such a linear relationship will be present at the individual levels. This is known as the 'ecological fallacy'. Despite these limitations, ecological studies may be the best approach to studying exposures that are easier to measure at the group rather than the individual level because most ecological studies make use of routinely collected data. They are also useful for monitoring the effectiveness of population interventions such as vaccination programs, health education campaigns and mass screening programs. Thus, ecological studies are useful epidemiologic tools for public health surveillance if we know their limitations and interpret their results carefully. Ecological studies often help to generate hypotheses, although they rarely provide a strong test of a causal hypothesis.
    Full-text · Article · Jul 2008 · Vaccine
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    ABSTRACT: In Asia there are few reports considering time intervals in the examination of clinical features of primary biliary cirrhosis (PBC). Therefore, we tried to compare the characteristics of patients with PBC in two different years. In two fiscal years (1999 and 2004), 9,761 and 13,142 patients with symptomatic PBC were registered to receive public financial aid from the Ministry of Health, Labour and Welfare of Japan, respectively. For the present study, clinical data from 2,127 patients in 1999 and 6,423 ones in 2004 were available. We compared the data in the two different years, including sex, age, major symptoms, and laboratory data. Male/female ratios were the same figure (0.13 for 1999 and 2004). The median age was significantly older in 2004 than in 1999 (59 years for 1999, 63 years for 2004, respectively, p<0.01). Jaundice and esophageal varices were found significantly less frequent in 2004 than in 1999 (p<0.01 for each item). Levels of total bilirubin,gamma-glutamyl transpeptidase (gamma-GTP), total cholesterol, and immunoglobulin M were significantly lower in 2004 than in 1999 (p< 0.02 for total bilirubin, and p<0.01 for other each item). The positive rate of antimitochondrial antibodies was significantly higher in 1999 than in 2004 (87.0% for 1999, 83.5% for 2004, respectively, p<0.01)). Complicated autoimmune diseases such as Sjögren's syndrome, rheumatoid arthritis, and chronic thyroiditis were found significantly more frequent in 2004 than in 1999 (p<0.01 for each item). Among the patients with PBC in 2004, an increase in median age, and lower levels of laboratory data such as gamma-GTP have been found compared to 1999. These results may show an accumulation of patients with better prognosis and the recent medical progress in controlling patients with PBC.J Epidemiol 2007; 17: 210-214.
    No preview · Article · Nov 2007 · Journal of Epidemiology

Publication Stats

99 Citations
25.97 Total Impact Points


  • 2013
    • Kochi Medical School
      Kôti, Kochi, Japan
    • Kochi University
      Kôti, Kochi, Japan
  • 2011-2012
    • National Cerebral and Cardiovascular Center
      Ōsaka, Ōsaka, Japan
  • 2006-2011
    • Sapporo Medical University
      • Department of Public Health
      Sapporo, Hokkaidō, Japan