1.The Development of a Town of Safety, Security and Health Project in an Area with a Very High Population Aging Rate
Akiko Hoshino ; Kanae Usui ; Toshiki Katsura
Journal of Rural Medicine 2011;6(2):65-70
Objective: The aim of this study was to assess the "Health Care Town in Kyoto" project designed to promote health and safety for health conscious people in a small community. We conducted a survey involving the users of the salon and local residents to examine the effects of the activities in the salon.Methods: We recorded the activities of salon and conducted semi-structured interviews with ten local residents to ask their opinions about the salon. The data from the interviews were analyzed using the Grounded Theory Approach. We distributed a questionnaire and collected 215 valid responses (valid response rate: 67.8%).Results: 1) Purpose of using the salon was categorized into health consultation, conversation with others, rest and other purpose. 2) The significance of the salon for users was categorized into usability, acquisition of useful information, changes in daily habits and their maintenance, diversion, interaction with other people and acceptance by the shopping center. 3) The results of the questionnaire survey showed marked relations between Well-Being Index (WHO-5), age, employment and family budget, self-rated health and ability to perform daily activities (TMIG), whereas use of the salon was not associated with Well-Being Index (WHO-5). On the other hand, there were marked relations between loneliness (LSO), educational background and use of the salon, demonstrating that the facility helped its users reduce loneliness (LSO).Conclusion: In this town, the salon has served as a place providing effective preventive support for the health of individual users.
2.Comparison of QOL Factors Between So-Called ‘Younger old’ and ‘Older old’ Community Residents
Nao TANIGUCHI ; Toshiki KATSURA ; Akiko HOSHINO ; Kanae USUI
Journal of the Japanese Association of Rural Medicine 2013;62(2):91-105
This study evaluates the quality of life (QOL) for elderly community residents on both health-related and subjective QOLs, while comparing QOL-related factors between so-called “younger old” (residents in the age bracket of 65-74) and “older old” (those in that of 75 and over) in regard to QOL-related factors. Questionnaires were distributed to 929 residents in both age groups who affiliated themselves with a senior citizens’ club in City “K” in 2009. Data on 596 persons were analyzed in this study. Results pertinent to basic attributes, health status, lifestyle habits, social exchange, and QOL were analyzed in a multivariate method. Among residents in the age bracket of 65-74, the subjective sense of well-being, the frequency of going out, gender, the frequency of conversations with neighbors, financial security, and bedtime hours were looked upon as factors contributory to improvements in QOL, whereas low back pain, the frequency of mutual support among neighbors, high GDS scores, personal activities, and numbness were taken in as factors deteriorative to QOL. Among the over-75s, the subjective sense of well-being, cardiac disorders, and financial security were regarded as factors contributory to improvements in QOL, whereas low back pains and cardiac disorders were looked upon as factors deteriorative to QOL. To improve the elderly’s QOL, it is considered essential to step up their efforts to manage and relieve depression and low back pains.
3.Factors Affecting Mental Health of Old People Living in Newly Developed Residential Area
Hanae SUMIDA ; Toshiki KATSURA ; Akiko HOSHINO ; Kanae USUI
Journal of the Japanese Association of Rural Medicine 2015;64(2):140-154
This study was carried out to clarify the effects of the sense of community and living environment on elderly citizens’ mental health. We conducted a self-administered questionnaire survey targeting 820 men and women aged 65 and over, who were a member of “A” seniors’ club or participant of a daily service event organized by “A” Council of Social Welfare. Valid responses came from 577 people, who were enrolled in this study. Univariate and multivariate analyses revealed that elderly citizens’ life satisfaction was positively correlated with “subjective sense of well-being”, “hypertension”, “junior high school district”, “love for the region”, “social supports&rdqul;, and “no medical problems”, and negatively correlated with “neuroticism” and &ldqip:stress”. In addition, risk factors for depression were “single life”, “neuroticism”, and “stress”, whereas improvement factors were “subjective sense of well-being”, “hobby”, “fine views”, and “sociability”. Our findings showed that elderly adults’ mental health status was associated with various factors such as their “love for the region” “living environment with fine views”, “subjective sense of well-being”, and “personality”. These results suggested that community networks could favorably affect elderly people’s mental health.
4.Can Priority Items of the Basic Checklist Predict New Issuance of a Certificate of Needed Long-term Care?
Toshiki KATSURA ; Megumi FUJIMOTO ; Miho SHIZAWA ; Akiko HOSHINO ; Kanae USUI
Journal of the Japanese Association of Rural Medicine 2017;66(4):462-471
In a cohort study of 7,820 elderly residents, we explored whether the priority items of the basic checklist predict new issuance of a certificate of needed long-term care. We analyzed data using Cox’s proportional hazard regression, with new issuance of a certificate of needed longterm care as the dependent variable, need for secondary prevention services (determined by the basic checklist results) and required level of specific health guidance as independent variables, and sex, age, place of residence, and use of long-term care prevention services as moderator variables. The results were as follows. The priority items of the basic checklist to assess need for secondary prevention services were useful for screening in both the younger and older elderly populations. Also, more certificates of needed long-term care were issued to those individuals who received secondary prevention services. Furthermore, partial functional impairment was also significantly associated with issuing a new certificate.
5.Does Health Locus of Control Have a Correlation With Weight Gain or Loss in Adults
Yuki NOGUCHI ; Toshiki KATSURA ; Akiko HOSHINO ; Kanae USUI
Journal of the Japanese Association of Rural Medicine 2014;63(4):565-587
This study was conducted to clarify whether the health locus of control (HLC) is associated with body weight change after adjusting effects of different factors in a general adult population. In male subjects with a normal weight, external locus of control was associated with weight gain, whereas internal locus of control was not significantly correlated with weight loss, after adjusting the effects of factors related to body weight change. Although the external locus of control was associated with weight gain, HLC had a limited effect on body weight change in adults. Besides HLC, the factors significantly correlated with body weight change. Skipping breakfast, napping, and a weight cycling are related to weight gain, whereas obesity and stress were connected with weight loss. A look at gender differences showed that weight gain was associated with marriage, skipping breakfast, napping, and a variable body weight, whereas weight loss was associated with obesity and the declaration of weight reduction in male subjects. In female subjects, weight gain was associated with eating speed and smoking.
6.An Analytical Model / Emotional Intelligence Quotient and QOL in Mothers with Infants in Japan
Junko Ohashi ; Toshiki Katsura ; Akiko Hoshino ; Kanae Usui
Journal of Rural Medicine 2013;8(2):205-211
Objective: The purpose of this study was to examine the relationship between the emotional intelligence quotient and health-related quality of life using structural equation modeling.
Methods: A self-administered questionnaire survey was conducted among 1,911 mothers who visited the Health Center for an infant medical examination. A hypothetical model was constructed using variables of the emotional intelligence quotient, social support, coping, parenting stress, and perceived health competence.
Result: There were a total of 1,104 valid responses (57.8%). Significant standardized estimates were obtained, confirming the goodness of fit issues with the model. The emotional intelligence quotient had a strong impact on physical and psychological quality of life, and showed the greatest association with coping. This study differed from previous studies in that, due to the inclusion of social support and explanatory variables in coping, an increase in coping strategies was more highly associated with emotional intelligence quotient levels than with social support.
Conclusion: An enhanced emotional intelligence quotient should be considered a primary objective to promote the health of mothers with infant children.
7.A retrospective cohort study on the risk assessment of newly certificated long-term care need of elderly individuals in a community: Basic checklist and specific health checkup
Toshiki Katsura ; Megumi Fujimoto ; Miho Shizawa ; Akiko Hoshino ; Kanae Usui ; Eri Yokoyama ; Mayumi Hara
Journal of Rural Medicine 2017;12(2):68-84
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.
8.Visual Recognition of the Elderly Concerning Risks of Falling or Stumbling Indoors in the Home
Toshiki Katsura ; Norio Miura ; Akiko Hoshino ; Kanae Usui ; Yasuro Takahashi ; Seiichi Hisamoto
Journal of Rural Medicine 2011;6(2):71-80
Objective: The objective of this study was to verify the recognition of dangers and obstacles within a house in the elderly when walking based on analyses of gaze point fixation.Materials and Methods: The rate of recognizing indoor dangers was compared among 30 elderly, 14 middle-aged and 11 young individuals using the Eye Mark Recorder.Results: 1) All of the elderly, middle-aged and young individuals showed a high recognition rate of 100% or near 100% when ascending outdoor steps but a low rate of recognizing obstacles placed on the steps. They showed a recognition rate of about 60% when descending steps from residential premises to the street. The rate of recognizing middle steps in the elderly was significantly lower than that in younger and middle-aged individuals. Regarding recognition indoors, when ascending stairs, all of the elderly, middle-aged and young individuals showed a high recognition rate of nearly 100%. When descending stairs, they showed a recognition rate of 70-90%. However, although the recognition rate in the elderly was lower than in younger and middle-aged individuals, no significant difference was observed. 2) When moving indoors, all of the elderly, middle-aged and young individuals showed a recognition rate of 70%-80%. The recognition rate was high regarding obstacles such as floors, televisions and chests of drawers but low for obstacles in the bathroom and steps on the path. The rate of recognizing steps of doorsills forming the division between a Japanese-style room and corridor as well as obstacles in a Japanese-style room was low, and the rate in the elderly was low, being 40% or less.Conclusion: The rate of recognizing steps of doorsills as well as obstacles in a Japanese-style room was lower in the elderly in comparison with middle-aged or young individuals.
9.Community Resident-centered Health Promotion Activities
Toshiki KATSURA ; Akiko HOSHINO ; Kanae USUI ; Miho SHIZAWA ; Megumi FUJIMOTO ; Rikuya HOSOKAWA ; Mika NISHIZAWA ; Atsushi ODAGAWA ; Tomohito ISHIKAWA ; Tomoko NAKAGAWA ; Saki MINAMIKAWA ; Rena OZAKI ; Satoko KOMATA-SATOH
Journal of the Japanese Association of Rural Medicine 2016;65(2):228-236
The process of creating health promotion activities in the community was analyzed by means of document examination. The results showed that the process has four periods, namely, the preparation period, consensus period, planning-implementation period, and continuation period. Based on our results, we propose a general-purpose design for community resident-centered health promotion activities in areas with different characteristics.
10.Relationship Between Physical Activity and Mild Cognitive Impairment in Community-Dwelling Elderly Adults Sampled Randomly From a Cohort
Atsushi ODAGAWA ; Toshiki KATSURA ; Akiko HOSHINO ; Miho SHIZAWA ; Kanae USUI
Journal of the Japanese Association of Rural Medicine 2020;68(6):781-
The increase in dementia is becoming a serious health-related issue in Japan. The Ministry of Health, Labour and Welfare has indicated that the most effective method for preventing dementia is to detect and manage mild cognitive impairment (MCI). Accordingly, this study focused on “low physical activity”, which is a risk factor for dementia, and aimed to clarify the correlation between physical activity and MCI by analyzing the amount of physical activity among community-dwelling elderly adults sampled randomly from a cohort. A door-to-door survey was conducted of 26 physically housebound elderly adults and 26 physically nonhousebound elderly adults matched for sex, age, and living quarters who were randomly sampled from a 2013 cohort. Housebound status was assessed using a basic checklist. The survey was conducted at the participants’ homes. Components of the survey included basic attributes, basic checklists, the International Physical Activity Questionnaire, Japanese version of the Montreal Cognitive Assessment (MoCA-J), Kohs Block Design Test (Kohs), Revised Hasegawa’s Dementia Scale, Geriatric Depression Scale─Short Version-Japanese, Instrumental Activities of Daily Living Scale, and grip strength. The chi-squared or Mann─Whitney U test was used for comparisons between the elderly adults with low physical activity and those with high physical activity. The chi-squared test was used to compare the relationships between physical activity and MCI assessments (MoCA-J, Kohs). Statistical analysis was performed using SPSS for Windows, with significance established at p < 0.05. Physically inactive elderly adults were engaged in significantly physical activities and had significantly more inactive periods compared with physically active elderly adults. The inactive elderly adults did not fulfill the level of physical activity needed to maintain fitness. In addition, a significantly higher percentage of inactive elderly adults had MCI compared with active elderly adults according to MoCA-J score. When MCI was assessed using the Kohs, on the other hand, there was no significant difference between the active and inactive elderly adults. Inactive elderly adults were not able to fulfill the level of physical activity necessary to maintain fitness and prevent MCI. There is a need to urgently consider ways to identify inactive community-dwelling elderly adults and to detect and manage MCI at an early stage.