1.Investigation of Current Status and Risk Factors for Hospitalization-Associated Disability
Journal of the Japanese Association of Rural Medicine 2017;65(5):924-931
This study investigated the incidence and risk factors for hospitalization-associated disability (HAD) in a rural general hospital. To investigate the incidence of HAD, we compared the activities of daily living (ADL) of inpatients between the time of admission to the Department of General Medicine, Ohchi Municipal Hospital and discharge. We also evaluated nutritional status, cognitive function, blood examinations, presence or absence of care certification at the time of admission, and length of hospital stay in order to analyze the relationship with onset of HAD. HAD was observed in 8 of 53 patients (15%). These 8 patients were significantly older and had lower ADL scores, poor nutritional status, cognitive function, and serum albumin levels. Nutritional status and cognitive function were independent risk factors for HAD in multivariate logistic regression analysis. In addition, all patients with HAD possessed care certification. The incidence of HAD in this study was 15%, which is lower than that reported in other countries. Poor cognitive function and nutritional status appear to be risk factors for HAD, independent of age and ADL at admission.
2.Prevalence of lifestyle-related chronic diseases among agricultural and non-agricultural workers in ruralareas of Japan: the Shimane CoHRE study
Masayuki YAMASAKI ; Shozo YANO ; Miwako TAKEDA ; Takafumi ABE ; Minoru ISOMURA ; Tsuyoshi HAMANO ; Toru NABIKA ; Kuninori SHIWAKU
Journal of Rural Medicine 2020;15(1):1-7
Objective: Engaging in agriculture greatly affects workers’ lifestyles, particularly related to physical activity. This study aimed to clarify the prevalence of lifestyle-related chronic diseases among workers engaging and not engaging in agriculture in rural areas of Japan.Methods: A total of 4,666 consecutive participants aged ≥40 years (1,929 men and 2,737 women) were recruited during health examinations conducted from 2006 to 2014. For analysis, the participants were divided by sex and age into those engaging in agriculture and those not engaging in agriculture.Results: Engaging in agriculture may be contributing with a low prevalence of dyslipidemia, a constitutive factor of metabolic syndrome, in both sexes between the ages of 40 and 64 years. In the elderly aged ≥65 years, engaging in agriculture may influence the low prevalence of hypertension in men. Hypertension, a strong risk factor for stroke and cardiovascular disease, is very frequent among the Japanese elderly and, therefore, engaging in agriculture may have a significant impact on its prevention and control.Conclusion: In rural areas of Japan, engaging in agriculture may contribute to the control of lipid metabolism in middle-aged individuals and blood pressure in the elderly.
3.Combined association of oral and skeletal muscle health with type 2 diabetes mellitus among community-dwelling older adults in Japan: a cross-sectional study
Miwako TAKEDA ; Takafumi ABE ; Yuta TOYAMA ; Kazumichi TOMINAGA ; Shozo YANO ; Toru NABIKA ; Masayuki YAMASAKI
Journal of Rural Medicine 2022;17(2):67-72
Objective: Although oral health and skeletal muscle status are known to be risk factors for type 2 diabetes mellitus (T2DM), there is limited information on their combined effects among community-dwelling older adults. The purpose of this study was to investigate the association between oral health and skeletal muscle status among older adults with T2DM in Japan.Participants and Methods: This cross-sectional study included data from individuals aged ≥60 years. T2DM was defined as a glycosylated hemoglobin A1c level ≥48 mmol/mol (≥6.5%) or the use of hypoglycemic agents. For oral health status, dental hygienists assessed the number of teeth (NT) and masticatory function (MF). Skeletal muscle status was assessed using skeletal muscle mass index (SMI) and handgrip strength (HGS). Logistic regression analysis examined T2DM in nine-category combinations of oral health status (each of the three categories in NT and MF) and skeletal status (each of the three categories in SMI and HGS).Results: T2DM was prevalent in 83 participants (16.4%) and was significantly associated with low NT and SMI (odds ratio [OR] = 5.93, 95% confidence interval [CI]: 1.37–25.73) and low MF and SMI (OR = 4.48, 95% CI: 1.23–16.35) compared to high NT and SMI and high MF and SMI, respectively.Conclusion: Our findings indicate that low muscle mass with tooth loss or masticatory dysfunction is associated with T2DM among community-dwelling older adults. This suggests that maintaining oral health and muscle mass may be an effective strategy for the prevention of T2DM.