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Association between Tub Bathing Frequency and Onset of Depression in Older Adults: A Six-Year Cohort Study from the JAGES Project

Shinya HAYASAKA ; Toshiyuki OJIMA ; Akio YAGI ; Katsunori KONDO

The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine.2024;87(2):49-55. doi:10.11390/onki.2359

Background: The traditional Japanese style of soaking in a hot bath is a lifestyle custom for many citizens, no study had ever investigated the association between bathing as a lifestyle practice and the onset of long-term depression. Through a large-scale six-year longitudinal study, we aimed to determine whether tub bathing as a lifestyle custom plays a role in preventing the onset of long-term depression. Methods: Of 11,882 individuals who responded to surveys conducted in 2010 and 2016 as part of the Japan Gerontological Evaluation Study (the JAGES) project, we analyzed 6,452 and 6,465 individuals for whom information was available regarding summer bathing frequency and winter bathing frequency, respectively; all of these individuals were independent, had a Geriatric Depression Scale (hereafter, “GDS”) score of ≤4, and did not suffer from depression. The cohort study involved dividing participants into a group of those who bathed 0-6 times a week and a group of those who bathed ≥7 times a week and determining the percentages of individuals who developed depression based on their GDS scores six years later. Multiple logistic regression analysis was performed to determine odds ratios for the association between depression onset and tub bathing. Results: For individuals who tub bathed ≥7 times a week, the odds ratios for depression onset versus individuals who bathed 0-6 times a week in summer and winter were 0.84 (95% confidence interval, 0.64-1.10) and 0.76 (95% confidence interval, 0.59-0.98), respectively. Tub bathing ≥7 times a week in winter significantly reduced the risk of depression onset. Conclusions: New-onset depression was shown to be infrequent in older adults who bathe in a tub frequently. Tub bathing was suggested to potentially contribute to the prevention of depression in the elderly.

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Usefulness of the STarT Back Screening Tool to Predict the Effect of Acupuncture Treatment: Evaluation of Its Risk Classification Focusing on the Changes in the Lumbar Pain Visual Analog Scale

Erika MATSUDA ; Hiroshi KONDO

The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine.2024;87(2):56-65. doi:10.11390/onki.2360

Background: The STarT (Subgrouping for Targeted Treatment) Back Screening Tool (SBST) is an established clinical evaluation tool that easily assesses the risk of chronic or refractory low back pain. This study aimed to examine the usefulness of acupuncture in patients with low back pain. Methods: A total of 71 outpatients with low back pain who underwent acupuncture and moxibustion at the Center for Integrative Medicine, Tsukuba University of Technology, between 2019 and 2022 were included in this study, regardless of the specific medical condition causing the pain. Survey items included the SBST and lumbar pain intensity visual analog scale (VAS). Demographic factors and contents of acupuncture treatment were collected from the medical charts. The VAS score 4 weeks after the start of treatment was used as an index of clinical outcome and was analyzed using repeated measures analysis of variance (ANOVA) and hierarchical multiple regression analysis. Results: Classification using the SBST at the first visit resulted in 36, 30, and 15 patients in the low-, medium-, and high-risk groups, respectively. Repeated-measures ANOVA showed statistically significant differences in the mean VAS values with respect to differences in time point (P < 0.01), group (P < 0.01), and interaction (P < 0.05). The VAS values after 4 weeks in the high-risk group were significantly higher than those in the other two groups (both P < 0.01). In the hierarchical multiple regression analysis, with VAS as the dependent variable, the relationship between SBST classification and VAS maintained a significant positive relationship in all models, including adjustments for interaction terms and patients’ background items. A simple slope analysis indicated that this relationship was more evident in patients with lower limb symptoms than in those without symptoms. Conclusion: The SBST could be a simple and useful tool for predicting the clinical outcomes of acupuncture.

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Sustained Effects of Underwater Walking on Respiratory Muscle Strength of the Elderly

Yoshihiro YAMASHINA ; Sho KUMABE ; Kazuyuki TABIRA

The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine.2024;87(2):66-72. doi:10.11390/onki.2362

Purpose: This study aimed to investigate the effects of underwater walking for 6 weeks at 60% of the predicted maximum heart rate on respiratory muscle strength of elderly people as well as its sustained effects on respiratory muscle strength. Methods: The participants were 43 healthy elderly men, who were randomly divided into the continuous group (n=21) and the non-continuous group (n=22). Initially, both groups performed 30 min of underwater walking four times a week for 6 weeks, after which the continuous group continued the same for another 6 weeks, whereas the non-continuous group was prohibited from performing any exercise, except for daily activities. The walking speed during underwater walking was adjusted such that the exercise intensity was 60% of the predicted maximum heart rate, with the water depth up to the fourth intercostal space or higher. Outcome Measures: The maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), and vital capacity (VC) were measured before exercise and 6, 8, 10, and 12 weeks after exercise. Results: The PImax and PEmax were significantly higher after 6 weeks of exercise than those before exercise. In the continuation group, PEmax increased significantly at 12 weeks of exercise compared to that at 6 weeks, whereas PImax did not show a significant increase. In the non-continuous group, PEmax decreased significantly from the 10th week onwards as compared to that at 6 weeks and showed a significantly lower value than that of the continuous group. The PImax of the non-continuous group decreased significantly at 12 weeks compared to that at 6 weeks. The VC after the 6-week underwater walking program did not differ from the pre-exercise value, with no significant difference observed between the two groups. Moreover, the VC in both groups showed no significant changes after 12 weeks of underwater walking compared to that after 6 weeks. Conclusions: Because underwater walking involves moving forward while resisting water pressure, it is necessary to activate the expiratory abdominal muscles to stabilize the trunk. Notably, the respiratory muscle strength in the non-continuous group decreased 4-6 weeks after the underwater walking program was terminated.

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Serum BDNF Changes during Bicycle Ergometer Exercise Combined with Hot Bath in Young Healthy Men

Hiroshi OHKO ; Yasunori UMEMOTO ; Fumihiro TAJIMA

The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine.2023;86(2):33-40. doi:10.11390/onki.2353

[Objectives] The aim of this study was to evaluate the changes in serum brain-derived neurotrophic factor (BDNF) concentrations during 15 min of combined hot bath and bicycle ergometer endurance exercise in healthy young men. [Methods] The experiment was conducted in a parallel design. The subjects were 10 healthy men (aged 23.7±0.8 years). The experimental group performed a combination of head-out water immersion (HOI) at 40°C and bicycle ergometer exercise (40°C HOI-ex), while the control group performed only HOI at 40°C (40°C HOI). After 30 min of rest, 40°C HOI-ex or 40°C HOI was performed for 15 min, followed by a 30 min recovery period. During the experiment, heart rate, blood pressure, and core temperature (esophageal temperature) were continuously measured. Blood samples were collected at four time points: after rest, immediately after intervention, 15 min after recovery, and 30 min after recovery. Serum BDNF, P-selectin, platelet count, hemoglobin, hematocrit, plasma cortisol, and lactic acid were then measured. [Results] A significant increase in serum BDNF concentrations was observed immediately after intervention and 15 min after recovery in the 40°C HOI-ex group compared with the values taken after resting. No changes in serum BDNF concentrations were observed in the 40°C HOI group. Core temperatures significantly increased immediately after intervention, 15 min after recovery, and 30 min after recovery compared with resting for both 40°C HOI-ex and 40°C HOI groups, with between-group differences. Platelet counts were unchanged in both 40°C HOI and 40°C HOI-ex groups. A significant increase in P-selectin was observed immediately after intervention and 15 min after recovery in the 40°C HOI-ex group compared with when at rest. No changes in P-selectin were observed in 40°C HOI. [Discussion] The combination of hyperthermia and exercise can increase serum BDNF in a short time of 15 min by an additive effect, and the increase in serum BDNF in this study may be platelet-derived.

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The Apparent Increase in Diabetes Mellitus in Habitual Spa-Bathers Is due to the Cancer Survival Effect of Spa-Bathing: A Cross-Sectional Study in Beppu

Toyoki MAEDA

The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine.2023;86(2):41-47. doi:10.11390/onki.2354

In 2018, we reported an epidemiological study on disease-preventive effects of habitual hot spa-bathing in the elderly in Beppu city, which has the highest number of hot spring sources in the world. In this analysis, women with diabetes mellitus were observed more often as hot spa-bathers than non-spa-bathers [odds ratio (OR): 1.238, confidence interval (CI): 1.011-1.517]. To see whether there is an apparent harmful effect of spa-bathing, complicated background diseases of women with diabetes mellitus were investigated in this study. We compared background diseases of women complicated with diabetes mellitus in spa-bathers and non-spa-bathers. Compared with non-spa-bathers, female spa-bathers with diabetes mellitus revealed a higher occurrence of cancer history (OR: 2.626, CI 1.517-4.545). The occurrence of diabetes mellitus in women with no cancer history was not significantly different between habitual spa-bathers and non-spa-bathers (OR:1.041, CI 0.837-1.293). The observed odds ratios suggest that spa-bathing associated cancer surviving promotion leads to an increasing number of diabetic women with a past history of cancer and contributes to more women with diabetes mellitus in spa-bathers rather than habitual spa-bathing promoting the pathogenesis of diabetes mellitus.

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Impact of Culture Temperature Changes on the Efficacy of Growth Inhibitory Manipulation of Cancer Cell Lines

Toyoki MAEDA

The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine.2023;86(2):48-61. doi:10.11390/onki.2355

We have previously reported that high-temperature (42°C) culture inhibited the proliferation of human umbilical endothelial cells (HUVECs). We described how the proliferative capacity and telomere length (TL)-related parameters of HUVECs, one of somatic cells, change with culture temperature. It was speculated that a combination of cytostatic manipulations, such as anticancer treatments, and high-temperature conditions would more effectively suppress the growth of somatic cells. Therefore, we hypothesized that increasing the core body temperature (BT) as a pretreatment for cancer treatment enhances the effectiveness of cancer treatment. In the present study, various cells (HUVECs, Jurkat cells, and SLVL) were cultured under different temperature conditions (35°C, 37°C or 39°C) combined with anticancer manipulations (X-ray irradiation or addition of 1-β-D-Arabinofuranosylcytosine [Ara-C]), which resulted in changes in the proliferation rate and TL. The degree of cell proliferation inhibitory effect depended on the combination of cell type, anticancer procedure, and temperature condition. Therefore, the best therapeutic condition might be selected in advance by checking the proliferation rate of biopsied cancer cells being cultured under combinations of anticancer manipulations at altered temperature conditions.

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