Objective: This study aimed to examine the factors influencing the requirement of a certificate of long-term care using a basic checklist and items listed in the Special Health Checkup.

Method: This study included 7,820 individuals living in Uji city, who were selected from among 8,000 elderly individuals who, in 2008, underwent a specific health checkup (hereafter referred to as the ‘specific health checkup for the old-old elderly individuals’) for those aged 75 years and above. They answered questions from basic checklists at the time, and 180 individuals were excluded as they had already qualified for requiring the certificate of long-term care at the time of the checkup. The follow-up period extended from the day of the specific health checkup for the old-old elderly individuals to March 31, 2013. The data were analyzed using the certificate of needing long-term care as the response variable. The explanatory variables were the basic attributes, items listed in the specific health checkup for the old-old elderly individuals, interview sheets, and basic checklists. Cox proportional hazards regression analysis was conducted.

Results: In total, 1,280 elderly individuals qualified for requiring the certificate of needing long-term care. The risk factors for the young-old elderly individuals aged 65 to 74 years were as follows: hepatic dysfunction (hazard ratio {HR}=1.69), the presence of subjective symptoms (HR=1.41), an above-normal abdominal circumference (HR=1.36), old age (HR=1.13), a reduced frequency of going out since the previous year (HR=1.87), the use of support for standing up after being seated on a chair (HR=1.86), no deposit or withdrawals made (HR=1.84), the anxiety of falling down (HR=1.50), an inability to climb stairs without holding a railing or wall (HR=1.49), as well as an increased difficulty in eating tough food items compared with 6 months prior (HR=1.44). The risk factors for the old-old elderly individuals were as follows: a positive reaction on proteinuria (HR=1.27), anemia (HR=1.18), old age (HR=1.10), inability to travel on a bus or train by themselves (HR=1.53), the inability to climb stairs without holding a railing or wall (HR=1.48), weight loss (HR=1.36), a reduced sense of appreciation of the activities they had previously participated in, over a span of 2 weeks (HR=1.30), the use of support for standing up after being seated on a chair (HR=1.23), and the anxiety of falling down (HR=1.20).

Conclusion: The items listed in the specific medical checkup as well as the basic checklists were found to be risk factors for both the young-old elderly individuals and the old-old elderly individuals, indicating the need to utilize these lists for the prevention of nursing even in the late stages of life. Moreover, these results suggest the importance of screening elderly individuals suffering from hyperkinesis using the basic checklist and conducting preventive interventions in order to maintain and improve their physical functions.

Objective : The Mini-Balance Evaluation Systems Test (Mini-BESTest) is an assessment tool for dynamic balance dysfunction developed by simplifying the Balance Evaluation Systems Test (BESTest). The purpose of our study was to examine the validity of the Japanese version of the Mini-BESTest (J-Mini-BESTest) we translated. Methods : The J-Mini-BESTest was produced using a translation and back translation method referring to a guideline proposed by Guillemin et al. We tested 20 patients with balance dysfunction due to various diseases and 7 healthy persons with the J-Mini-BESTest, the Berg Balance Scale (BBS), the Falls Efficacy Scale-International (FES-I) and the Activities-specific Balance Confidence Scale (ABC Scale). We assessed the concurrent validity of the J-Mini-BESTest by comparing it with the other measures using the Spearman's correlation method. Results : The average assessment time when using the J-Mini-BESTest was 20.0 minutes. The J-Mini-BESTest was correlated with the BBS (r=0.82, p<0.01), FES-I (r=-0.72, p<0.01) and ABC Scale (r=0.80, p<0.01). The distribution of the BBS scores was more skewed compared to the J-Mini-BESTest (BBS skewness=-1.30 vs. J-Mini-BESTest skewness=-0.47) and the BBS also had a ceiling effect (9 participants had a perfect score in the BBS versus none in the J-Mini-BESTest). Conclusion : The J-Mini-BESTest was suggested as a clinically useful tool for detecting subtle dynamic balance deficits with good concurrent validity.

Objective : The Balance Evaluation Systems Test (BESTest) is a new balance assessment set based on systems theory. The purpose was to examine the validity of the Japanese version of the BESTest (J-BESTest) that we translated. Methods : The J-BESTest was produced using a translation and back translation method referenced from a guideline proposed by Guillemin et al. We tested 20 patients with balance dysfunction due to various diseases and 5 healthy persons with the J-BESTest, the Berg Balance Scale (BBS), the Falls Efficacy Scale-International (FES-I) and the Activities-specific Balance Confidence Scale (ABC Scale). We assessed the concurrent validity of the J-BESTest by comparing it with the other measures using Spearman's correlation method. Furthermore, we compared the ability of the J-BESTest to discriminate balance dysfunction with that of the BBS using receiver operating characteristic (ROC) analyses. Results : The J-BESTest was highly correlated with BBS (r=0.84, p<0.01), FES-I (r=-0.61, p<0.01) and ABC Scale (r=0.63, p<0.01). The distribution of the BBS score was more skewed compared with the J-BESTest and had a ceiling effect (6 participants had perfect scores with BBS versus none with the J-BESTest). The area under the ROC curve (AUC) of the J-BESTest was significantly larger than that of BBS (BBS 0.75, 95% confidence interval 0.56-0.94 versus J-BESTest 0.94, 95% confidence interval 0.84.1.0, p<0.05). Conclusion : The J-BESTest was suggested as a clinically useful tool, with good concurrent validity and better sensitivity and specificity than BBS, to identify people with mild balance dysfunction.

  The purpose of this study was to clarify effects of the water fall bath on muscle blood flow, muscle hardness at the shoulder and body temperature after muscle contraction in human.   The subjects of this study were eight young males (average 20.4years old). Blood flow and hardness in middle fiber of trapezius were measured using the monitor of spectroscopy and a handy battery-run device, skin blood flow rate using the laser doppler flowmetry, and tympanic temperature using the thermistor during control period 10 minutes, for five minutes during four conditions (40°C water fall bath, massage using the knocking machine, 40°C hot pack and rest) after muscle contraction and moreover 30 minutes. Subjects wore a swimming trunk while these experiments. The ambient temperature and relative humidity were set to 27°C, 42% in control room.   During the water fall bath, the muscle blood flow was tend to increased compared with after muscle contraction. The skin blood flow was increased and the muscle hardness was decreased significantly. During the massage, the skin blood flow was increased and the muscle hardness was decreased significantly. During the hot pack, the muscle hardness was decreased significantly. The tympanic temperature was no changed in three conditions except from the rest.   These findings suggest that water fall bath is lessened the muscle hardness causing increase of the muscle and the skin blood flows. Therefore, the water fall bath can use one of the method to relief muscle fatigue.

Objective: The rates of care-needs certification were mainly compared between two cohorts: 7,820 specific health checkup examinees/basic checklist respondents and 29,234 non-examinees/non-respondents.Subjects and Methods: Among approximately 37,000 elderly citizens of X City, the number of individuals newly certified as requiring long-term care were observed from the date of the first specific health checkup in 2008 to March 31, 2013. The aggregated totals of these individuals and associated factors were evaluated.Results: 1. Support Required 1, Support Required 2, and Long-term Care Required (level 1) certified individuals accounted for approximately 80% of newly certified individuals aged 65–74 years. Newly certified individuals aged 75 years and over had similar results with 37.2% of them being certified Support Required 1, 19.4% certified Support Required 2, and 22.9% certified Long-term Care Required (level 1). 2. The primary factors for care-needs certification in individuals aged 65–74 years were arthritic disorder in 27.6%, falls and bone fractures in 11.3%, and malignant neoplasm and cerebrovascular disease, among others. This was similar for individuals aged 75 years or over. 3. Of the 7,820 specific health checkup examinees/basic checklist respondents, 1,280 were newly certified as requiring long-term care (16.4%) compared to 7,878 (26.9%) of the 29,234 non-examinees/non-respondents. Therefore, the latter cohort had a significantly higher rate of individuals who were newly certified as requiring long-term care.Conclusion: Both specific health checkups and basic checklists are effective health policies to protect frailty in community elderlies.

This study aimed to verify whether the incidence of frailty in elderly individuals is higher among those who are housebound than those who are not. This study found no correlation between elderly people’s houseboundedeness and physical, mental, social, and overall frailty. However, the Tilburg Frailty Indicator (TFI) frailty score and grip strength value were higher in non-housebound elderly persons than in housebound elderly ones. This suggests that being housebound may lead to frailty. On the other hand, it is thought that individual interaction with family and friends, and lack of anxiety about falls correlates with the prevention of frailty in housebound elderly persons. The results of the study also suggest that the basic checklist may be effective for ascertaining the actual situation of housebound elderly people who may be manifesting frailty.