Purpose We aimed to evaluate the risk to clarify the seasonal variations in the circulatory dynamics of community-dwelling older people performing early morning outdoor exercises. Participants and ...Methods This study included 76 community-dwelling older adults (42 men, mean age: 76.9 ± 5.0 years; 34 women, mean age: 74.0 ± 4.2 years) who perform early morning exercises. The prevalence of hypertension among these adults was assessed, and their blood pressure and pulse rate were obtained before and after performing a 30-minute exercise using automatic and aneroid type sphygmomanometers while sitting on a chair. Further, we calculated the double product by multiplying systolic blood pressure and pulse rate. We analyzed the changes in the pre- and post-exercise systolic blood pressure, diastolic blood pressure, pulse rate, double product, diagnosis of hypertension, and seasonal factors (moderate-temperature season/low-temperature season). Results Thirty-five participants were assigned in the hypertension diagnosis group, while 40 participants were in the non-hypertension group. There was no significant difference in the mean age between the two groups. The main effects and interactions were not confirmed in relation to systolic blood pressure, diastolic blood pressure, pulse rate, and double product. Conclusion Essentially, blood pressure should be obtained before exercise, as individuals with hypertension are more likely to have an increase in baseline systolic blood pressure while exercising in the early morning during the low-temperature seasons.
Herein, we report the case of an adolescent patient with nephrotic-range proteinuria and hypoproteinemia caused by tiopronin. The patient was a 13-year-old adolescent girl who had been diagnosed with ...cystinuria at the age of 9-years. Initial treatment comprised urinary alkalization and tiopronin. Urinalysis showed 3+ proteinuria 43 months after the initiation of tiopronin treatment. Proteinuria was accompanied by 2.2 g/dL of hypoalbuminemia, hyperlipidemia, and high adiponectin levels. Considering the adverse effects of tiopronin, it was immediately withdrawn. Ten days after withdrawal of the drug, proteinuria and hypoproteinemia had completely resolved, and steroid therapy was therefore not required. These findings are consistent with those of nephrotic syndrome secondary to medication in our patient. Tiopronin, which is a common treatment for cystinuria, may cause nephrotic-range proteinuria and hypoproteinemia. Therefore, periodic urine analyses and patient follow-ups are warranted during tiopronin therapy for cystinuria.
Previous studies have shown a relationship between physical and social aspects of the neighborhood environment (e.g., built environment, safety) and physical function in older adults. However, these ...associations are unclear in older Asian adults because longitudinal studies are lacking. This study examined the effects of neighborhood physical and social environment on longitudinal changes in physical function among Japanese older adults. We analyzed 299 Japanese community-dwelling adults aged ≥65 years. Neighborhood environment was assessed using the International Physical Activity Questionnaire Environment Module. Physical function was assessed using handgrip strength, knee extension muscle strength, 5-m walking time, and a timed up-and-go test (TUG) in baseline and follow-up surveys. Changes in physical function over one year were calculated and classified into decline or maintenance groups based on minimal detectable changes. Multiple logistic regression analysis showed that even after adjusting for confounding factors, good access to recreational facilities affected the maintenance of 5-m walking time (odds ratio OR = 2.31, 95% confidence interval CI: 1.02–5.21) and good crime safety affected the maintenance of TUG (OR = 1.87, 95%CI: 1.06–3.33). Therefore, it is important to assess both physical and social environmental neighborhood resources in predicting decline in physical function among Japanese older adults.
Aim
Working in old age not only solves the labor shortage in Japan, but also benefits the health of the older workers; however, work‐related accidents are a major concern. Functional impairment is an ...important factor in such accidents. The first aim was to examine the association between frailty status and work‐related accidents, and the second aim was to identify those who utilize the opportunity to learn about safe work.
Methods
The participants were 7265 members of the Silver Human Resource Center in Tokyo, engaged in non‐regular and indeterminate paid work. The frailty status (robust, pre‐frail and frail) was assessed using the frailty screening index. We obtained data on self‐reported work‐related accidents that occurred in the past year, and the experience of participation in workshops and reading brochures for safe work. Modified Poisson regression analysis was carried out to calculate the prevalence ratio.
Results
The prevalence of robust, pre‐frailty and frailty were 26.3%, 63.3% and 10.4%, respectively. The percentage of participants who reported work‐related accidents was 9.4%. Relative to robust participants, pre‐frail and frail participants showed 1.57‐fold (95% confidence interval CI 1.28–1.93) and 2.31‐fold (95% CI 1.79–2.98) higher prevalence ratios of work‐related accidents, respectively. The prevalence ratio in pre‐frail and frail participants were 1.08 (95% CI 1.04–1.11) and 1.14 (95% CI 1.09–1.20), respectively, for non‐participation in workshops, and 1.17 (95% CI 1.06–1.29) and 1.39 (95% CI 1.20–1.61), respectively, for not reading brochures.
Conclusions
These findings suggest the importance of support for older workers with functional impairment, as well as those without to continue to work safely. Geriatr Gerontol Int 2023; 23: 234–238.
Our primary aim was to examine the association between frailty status and work‐related accidents. This study found that pre‐frail and frail are associated with a high prevalence of work‐related accidents, especially fall‐related accidents.
Abstract
Background
As there is a shortage of care staff in elderly care homes, seniors are expected to work as assistants to help the care staff. This study examined the influence of older assistant ...workers in intermediate elderly care facilities on care staff, specifically focusing on emotional exhaustion which is a sign of burnout. These facilities provide long-term nursing and supportive care to older residents.
Methods
Data from a mail survey of intermediate elderly care facilities with older assistant workers were analyzed. Care staff were asked about the advantages and disadvantages of introducing older assistant workers in elderly care work, and their degree of emotional exhaustion. We also assessed work self-evaluations of older assistant workers, including the benefits of the work, and physical and mental burdens.
Results
A significantly large number of care staff reported improvements in workload with the employment of older assistant workers. Intermediate elderly care facilities enrolling more older assistant workers showed lower mean emotional exhaustion among care staff, independent of possible covariates. While older assistant workers felt that their work contributed to helping both care users and staff, they also reported a mental burden.
Conclusions
Our results suggest that older assistant workers can play a significant role in reducing the physical and mental burden of intermediate elderly care facility staff. Thus, employing older assistant workers can be an effective approach to addressing shortages of care staff in elderly care homes.
Background
The newly developed Functional Independence and Difficulty Scale is a tool for assessing the performance of basic activities of daily living in terms of both independence and difficulty. ...The reliability of this new scale has not been assessed.
Aims
The aim of this study was to examine the relative reliability and absolute reliability of the newly developed scale in community-dwelling frail elderly people in Japan.
Methods
Participants were 47 community-dwelling elderly subjects (22 for assessing test–retest reliability and 25 for assessing inter-rater reliability). As relative reliability indices, intra-class correlation coefficients were used. From an absolute reliability perspective, we conducted Bland–Altman analysis and calculated the limit of agreement or minimal detectable change to determine the acceptable range of error.
Results
Intra-class correlation coefficients for test–retest and inter-rater reliability were 0.90 (
P
< 0.001) and 0.97 (
P
< 0.001), respectively. The limit of agreement for test–retest reliability was −5.2 to 1.8, representing an increase of over six points for improvement and a decrease of over two points for decline of basic activities of daily living ability. The minimal detectable change for inter-rater reliability was 3.7, indicating that a three-point difference might be existed between difference raters. The results of this study demonstrated that the FIDS appeared to be a reliable instrument for use in Japanese community-dwelling frail elderly people.
Conclusions
While further research using a large and more diverse sample of participants is needed, our findings support the use of FIDS in clinical practice or clinical research targeting frail elderly Japanese people.
Abstract
Background
Accumulating social capital in urban areas is essential to improve community health. Previous studies suggested that intergenerational contact may be effective for enhancing ...social capital. However, no study has examined the effect of intergenerational contact on social capital through a population-based evaluation. This study aimed to investigate the effects of a community-based intervention to increase the frequency of intergenerational contact on social capital among adults aged 25–84 years.
Methods
This study used a non-randomized controlled trial design to conduct a community-based intervention (from March 2016 to March 2019). The study area was Tama ward, Kawasaki city, Kanagawa, Japan. The area comprises five districts; one district was assigned as the intervention group and the other four districts as the control group. We provided the intervention to residents in the intervention group. The intervention comprised three phases: Phase 1 was the preparation term (organizing the project committee); Phase 2 was the implementation term (trained volunteer staff members, conducted the intergenerational greeting campaign, and held intergenerational contact events); and Phase 3 was the transition term (surrendering the lead role of the project to the city hall field workers). In the control group, field workers provided public health services as usual. We conducted mail surveys in September 2016 and November 2018 to assess the effects of the intervention on social capital during Phase 2. Eligible participants were randomly selected from community-dwelling adults aged 25–84 years according to age (10,620 control group individuals and 4479 intervention group individuals). We evaluated social trust, norm of reciprocity, and social support as outcome variables.
Results
In total, 2518 participants completed both surveys and were analyzed (control group: 1727; intervention group: 791). We found that social trust (coefficient = 0.065; 95% confidence interval CI: 0.006, 0.125) and norm of reciprocity (coefficient = 0.084; 95% CI: 0.020, 0.149) positively changed in the intervention group compared with the control group.
Conclusions
This community-based intervention may contribute to sustaining and improving social capital among community-dwelling adults.
Trial registration
: UMIN000046769 (UMIN-CTR); first registered on January 28, 2022 (retrospectively registered).
Background
Serum adiponectin circulates in three multimeric isoforms: high-molecular-weight (HMW), middle-molecular-weight (MMW), and low-molecular-weight (LMW) isoforms. Potential change in the ...circulating adiponectin levels in patients with nephrotic syndrome (NS) remain unknown. This study aimed to assess the levels of total adiponectin and the distribution of its isoforms in pediatric patients with NS.
Methods
We sequentially measured total adiponectin and each adiponectin isoform levels at the onset of NS, initial remission, and during the remission period of the disease in 31 NS patients. We also calculated the ratios of HMW (%HMW), MMW (%MMW), and LMW (%LMW) to total adiponectin incuding 51 control subjects.
Results
The median of total serum adiponectin levels in patients were 36.7, 36.7, and 20.2 μg/mL at the onset, at initial remission, and during the remission period of NS, respectively. These values were significantly higher than those in control subjects. The median values of %HMW, %MMW, and %LMW values were 56.9/27.0/14.1 at the onset, 62.0/21.8/13.4 at the initial remission, and 58.1/21.7/17.5 at during the remission period of NS, respectively. Compared with control subjects, %HMW at initial remission and %MMW at the onset were high, and the %LMW values at the onset and at initial remission were low.
Conclusions
In patients with NS, total serum adiponectin levels increase at the onset of the disease, and the ratio of adiponectin isoforms changes during the course of the disease. Further studies are needed to delineate the mechanisms between proteinuria and adiponectin isoforms change.
Aim
To examine whether engaging in paid work is a predictor of maintaining good functional health among Japanese older adults in both urban and rural communities.
Methods
We used the 8‐year ...longitudinal Tokyo Metropolitan Institute of Gerontology Longitudinal Interdisciplinary Study on Aging with 306 and 675 persons aged 65–84 years from Koganei City (urban) and Nangai Village (rural), respectively, who are independent in basic activities of daily living (BADL). In order to examine the declining patterns in BADL and evaluate the predictive value of working status for future BADL disability, we applied the log–rank test of cumulative proportion curves and the Cox proportional hazard model by sex, controlling for age, research fields, years of education, marital state, chronic medical conditions, pain, instrumental activities of daily living (IADL), smoking status, exercise habits, life satisfaction, usual walking speed and serum albumin for evaluating the predictive value of working status at baseline for future BADL disability.
Results
In both areas, participants who were not working were more likely to decline in BADL than those working (P < 0.05), except for women in urban Koganei. Male participants who did not engage in paid work had a higher adjusted hazard ratio of onset of BADL disability, compared with those working, but this was not seen for female participants.
Conclusions
Working might be protective from a decline in BADL only for men, but not for women. Regarding the difference of sex roles in conventional Japanese society, working would be an effective solution especially for men to participate in social activities. Geriatr Gerontol Int 2016; 16: 126–134.
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