Biomedical subjects

Hajime Iwasa

Publications and source records attributed to Hajime Iwasa.

7 recordsLinked to original sources

PubMed2006

[Correlates of change in cognitive function during a two-year follow-up period in a comprehensive health examination for the community-dwelling elderly for the prevention of geriatric syndromes and bed-ridden state].

PURPOSE: We explored correlates of change in cognitive function during a two-year follow-up period among the community-dwelling elderly in Japan, using a population-based prospective approach. METHOD: The participants analyzed in the present study were 260 men and 222 women aged 70 to 84 years at baseline, living in an urban Japanese community. Data such as change in cognitive function during two years (calculated by subtracting baseline Mini-Mental State Examination [MMSE] score from follow-up MMSE score: a negative value means a decrease in MMSE scores during the two-year period) as an outcome variable, age, education, hearing and vision problems, IADL deficit (measured by the Tokyo Metropolitan Institute of Gerontology of Index of Competence), problems related to memory complaint, living alone, hemoglobin level, as explanatory variables, and the baseline MMSE score, depressive status (measured by the Mini-International Neuropsychiatric Interview), chronic conditions (hypertension, stroke, and diabetes mellitus) as covariates, were collected during a comprehensive health examination survey for the elderly. RESULTS AND CONCLUSION: We conducted multivariate regression analysis by genders to explore correlates of change in cognitive function. The results showed that higher age (beta = -0.18), presence of hearing problem (beta = -0.21), presence of IADL deficit (beta = -0.15), and memory complaint (beta = -0.20) in men, and higher age (beta = -0.27), low education level (beta = -0.25) and lower hemoglobin level (beta = 0.16) in women, were significantly associated with change in cognitive function when adjusting for the potential confounders. These factors may be reliable predictors for cognitive decline.

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PubMed2005

[Functional status of very old people in urban area: the Itabashi Oldest-Old Study I].

It is predicted that the future increase in the oldest-old (85 years and older) population will have a marked influence on society. However, little is known about the features of various functions in the oldest-old. The purpose of this study was to clarify the functional status of the oldest-old. We surveyed all oldest-old residents in a small area of Itabashi ward in metropolitan Tokyo to clarify their living conditions. The oldest-old themselves and their family members were invited to participate, and 235 out of 311 residents (75.6%) agreed to do so. Forty-two percent of the participants were dependent and needed care from others. The ADL status measured by the Barthel Index showed that 30% of independent participants also had some deterioration of physical function. These results are indicative of increased frailty in the oldest-old. Comparison between independent and dependent (need care from others in daily living) showed that the functional status was lower in dependent group. However, the psychological well-being was the same in this two groups. These results indicate progressive functional deterioation and psychological adaptation to it, in the oldest-old. Further research to elucidate the process of psychological adaptation to frailty is necessary in order to promote the well-being among the oldest-old, in whom functional limitation is evident.

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PubMed2005

[Cognitive function among physically independent very old people in an urban community in Japan: the Itabashi Oldest-Old Study II].

This study was conducted to clarify the characteristics of cognitive function among physically independent very old people dwelling in an urban community in Japan. Five hundred and thirteen Old-Old (aged 75-84 years) and 168 Oldest-Old (aged 85-100 years) adults participated. We carried out the Mini-Mental State Examination (MMSE) for measuring cognitive functions in the elderly. Age-related differences in the total score and sub-scale scores of the MMSE were analyzed by sex using ANCOVA, controlling for education, vision and hearing problems. Mean MMSE scores for Old-Old and Oldest-Old males were 27.53 and 25.88, respectively, and those for Old-Old and Oldest-Old females were 27.77 and 24.98, respectively. Age-related differences in the MMSE total score between the Old-Old and Oldest-Old were observed in both sexes, suggesting that overall cognitive functions continue to decline over time in very old age. Age-related differences between the Old-Old and Oldest-Old in items measuring, registration, calculation and delayed recall were observed in both sexes, and in addition, time orientation, place orientation, delayed recognition, writing sentences, and copying figures were observed in females. These findings suggest that the faculties are those most sensitive to normal aging among very old individuals. There were no age group differences in five items: reverse spelling, naming objects, repeating a sentence, listening and obeying, and reading and obeying.

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PubMed2005

[Subjective well-being and all-cause mortality among middle-aged and elderly people living in an urban Japanese community].

AIM: We examined the relationship between subjective well-being and all-cause mortality among middle-aged and elderly people, using a population-based prospective approach (Tokyo Metropolitan Institute of Gerontology-Longitudinal Interdisciplinary Study on Aging). METHODS: The participants were 1,034 men and 1,413 women aged 52 to 77 years, living in an urban Japanese community. The baseline data on age, gender, number of years of education, hospitalization, lifestyle-related illness, subjective health status, living alone and subjective well-being (measured by Philadelphia Geriatric Center Morale Scale) were collected in 1993. RESULTS: Mean subjective well-being scores for men and women were 12.3 +/- 3.2 and 11.9 +/- 3.5, respectively. Analysis of covariance controlling for age, the number of years of education, hospitalization, lifestyle-related illness and living alone, revealed no inter-gender difference in subjective well-being. Multiple regression analysis to explore factors related to subjective well-being showed that age in men, and the number of years of education in both genders were significantly, independently and positively associated with subjective well-being, and that hospitalization, lifestyle-related illness and living alone in both genders were significantly, independently and negatively related to subjective well-being. From 1993 to 2000, there were 183 deaths and 258 dropouts. In Cox's multivariate hazard model adjusted for age, the number of years of education, hospitalization, lifestyle-related illness and living alone, there was a significant and independent association between a low level of subjective well-being and the risk for all-cause mortality in both genders. CONCLUSION: Satisfaction with life is an important factor affecting longevity among middle-aged and elderly people.

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PubMed2005

[Memory complaints among community-dwelling elderly in Japan: comprehensive health examination for the community elderly for prevention of the geriatric syndrome and a bed-ridden state ("Otasha-kenshin") part III].

PURPOSE: Previous studies have indicated that memory complaints may predict cognitive decline and dementia among the elderly. The present study was therefore conducted to clarify memory complaint characteristics among elderly dwelling in an urban community in Japan. METHOD: The participants analyzed in the present study were 453 men and 385 women aged 70 to 84 years living in an urban Japanese community. Data on problems related to memory complaints, cognitive decline (below 24 points on Mini-Mental State Examination), depression (measured by Mini-International Neuropsychiatric Interview), hearing and vision problems, I-ADL (measured by TMIG Index of Competence), self-rated health, age, sex, and years of education were collected at a comprehensive mass health examination for the elderly ("Otasha-kenshin"). RESULTS AND DISCUSSION: Twenty-seven percent of male respondents and 32% of female respondents reported having current trouble remembering things (reported as "frequently" or "sometimes"). We collected specific descriptions of the memory complaint difficulties the subjects were experiencing. A quarter of the responses indicated problems with forgetting persons' names, a fifth with forgetting where things had been left, 15% with leaving things behind, and a quarter with prospective memory failure. The results of multivariate logistic regression analysis to explore correlates showed that in men self-rated health and cognitive decline, and in women hearing problems and self-rated health were significantly and independently related to the memory complaint. These findings suggest that in addition to cognitive decline, self-rated health and hearing problems may influence memory complaints, and that memory complaints in men may be a reliable, simple indicator of cognitive decline. We now need to carry out a longitudinal study to clarify predictive validity.

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PubMed2003

[Comprehensive health examination ("Otasha-Kenshin") for the prevention of geriatric syndromes and a bed-ridden state in the community elderly. 1. Differences in characteristics between participants and non-participants].

PURPOSE: We conducted a comprehensive mass health examination for elderly subjects aged 70 or above, living in the community, to assess early deterioration to long-term care conditions and promote healthy and successful aging ("Otasha-Kenshin"). In this study, we clarified characteristic differences between participants and non-participants. SUBJECTS & METHODS: A mass health examination was offered in October 2001 to 863 community elderly, including individuals suffering from falls (and fractures), incontinence, malnutrition, depression, mild cognitive impairment and less of functional capacity. Among the total, 438 (50.8%) opted for the "Otasha-Kenshin" examination. Differences in characteristics between the participants and non-participants were examined, parameters including sex and age distribution, self-rated health, functional capacity by the TMIG Index of Competence, depressed status by the General Health Questionnaire (GHQ), subjective well-being by the Philadelphia Geriatric Center Morale Scale: A revision (PGC-MS), frequency of falls, and prevalence of chronic diseases. The comparison was based on the results of measurements from the final survey conducted in 2000. RESULTS: 1) The participation rate in the "Otasha-Kenshin" was 49.0% in males and 51.0% in females. The average age was 75.3 year olds in participants and 76.4 in non-participants, the difference being significant (t = 3.97, P < 0.0001). 2) Non-participants had a significantly lower level of self-rated health than participants. 3) There was no significant difference in hand grip strength between participants and non-participants. 4) Non-participants showed significantly lower level of functional capacity and subjective well-being, and they were more likely to be in a depressed state than participants. 5) There was no significant difference in fall rate between participants and non-participants. 6) The prevalence of hypertension and diabetes (found in more than 5% among the subjects surveyed in 2000) was not significantly different between participants and non-participants. CONCLUSION: With aging of society, new and specialized health maintenance systems for the elderly are essential, both for the prevention of deterioration to a long-term care condition (a bed-ridden status) and for the promotion of successful aging with autonomy. Participants in "Otasha-Kenshin" appear to be healthier and more independent than non-participants who were more frail and at higher risk group of a long-term care condition and a bed-ridden status. The major reason for non-participation in the health examination found in this study was subjective or mental deterioration rather than the presence of chronic illness or any geriatric syndrome per se. Frail elderly people like the non-participants in this study should be encouraged and mentally supported to avoid aggravation of their health status through intensive or specialized health surveillance system such as home-visit nursing.

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PubMed2003

[Cognitive function as the factor determining higher-level competence in community-dwelling elderly: comprehensive health examination for the community elderly for the prevention of the geriatric syndrome and a bed-ridden state ("otasha-kenshin")].

PURPOSE: This study was conducted to examine age-related differences in cognitive function, and their relation to higher-level competence of elderly living in an urban community. METHOD: Participants were 438 individuals (males 168, females 270) aged 70 to 84 years living in an urban community in Tokyo. Three cognitive performance tests, the Wechsler Adult Intelligence Scale-Revised (WAIS-R) Digit Symbol, Word Fluency Test, and the WAIS-R Digit Span, were employed for estimating cognitive function, and the TMIG Index of Competence for measuring higher-level competence. In the Index, three constructions: "Instrumental Self-Maintenance", "Intellectual Activity", and "Social Role" were involved. RESULTS AND CONCLUSIONS: Age-related differences in the cognitive tests were analyzed using ANCOVA controlling for educational year. Age-related differences between younger elderly (70-79 years old) and older elderly (80-84 years old) were observed with the WAIS-R Digit Symbol, Word Fluency Test and the WAIS-R Digit Span. The results indicate that information processing speed, executive function and primary memory in community-dwelling elderly continue to decline in old age, and this trend is salient in the old-old. We carried out partial correlation analysis and multiple regression analysis for exploring the relationships between cognitive function and the sub-scales in the TMIG Index of Competence, controlling for age and educational year. Cognitive function was significantly and positively related with the sub-scales in the Index, this being especially robust for "Intellectual Activity". The results suggest that higher-level competence can be modestly determined with reference to cognitive function, and "Intellectual Activity" may have a stronger relation with cognitive function than the other two sub-scales in the Index.

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