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Zhou L, Ju P, Li Y, Liu B, Wang Y, Zhang X, Yin H. Preventive health behaviors among the middle-aged and elderly in China: Does social capital matter? Prev Med Rep 2023; 35:102329. [PMID: 37554353 PMCID: PMC10404801 DOI: 10.1016/j.pmedr.2023.102329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 08/10/2023] Open
Abstract
This study explores the status quo of preventive care use and social capital among middle-aged and elderly people (≥45 years old) in China, and employs a multi-level model to analyze whether social capital at different levels is associated with preventive care use. The data are derived from the 2018 China Health and Retirement Longitudinal Study (CHARLS), which includes 11,503 respondents and 450 communities. Preventive care use covers the utilization of routine physical examination services. Individual social capital is measured by the level of social network and social activities participation. Social network includes contacting with children or other people, for example, by phone, text message. Social activities participation is measured by the involvement in social activities, for example, playing mahjong, going to community club. Community social capital is evaluated by the richness of community facilities. Results reveals that the utilization of preventive care is 48.94% among middle-aged and elderly in China. The most used preventive service is routine blood test. The intra-class correlation (ICC) coefficient indicates that preventive health behaviors of the respondents are clustered at communities where they live. Multi-level regression shows that influence of social network is not significant to preventive care use (p > 0.05). Community facilities and individual social activities participation are significantly associated with preventive care use (p < 0.05). The association between social capital and preventive care use could be considered as an important factor when making policies to promote preventive care use.
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Affiliation(s)
- Liangru Zhou
- School of Health Management, Harbin Medical University, Harbin, China
| | - Peiyan Ju
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yi Li
- School of Health Management, Harbin Medical University, Harbin, China
| | - Bingjie Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yan Wang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Xin Zhang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Hui Yin
- School of Health Management, Harbin Medical University, Harbin, China
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Iwai-Saito K, Sato K, Aida J, Kondo K. Association of frailty with influenza and hospitalization due to influenza among independent older adults: a longitudinal study of Japan Gerontological Evaluation Study (JAGES). BMC Geriatr 2023; 23:249. [PMID: 37101153 PMCID: PMC10131426 DOI: 10.1186/s12877-023-03979-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/17/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND It is unknown that whether frailty is a risk factor of influenza and the hospitalization among older adults, although it has been shown that frailty was associated with poor recovery from the hospitalization among those. We examined the association of frailty with influenza and the hospitalization and the effect by sex among independent older adults. METHODS We used the longitudinal data from the Japan Gerontological Evaluation Study (JAGES), performed in 2016 and 2019 and conducted in 28 municipalities in Japan. The target population comprised 77,103 persons aged ≥ 65 years who did not need assistance from the public long-term care insurance. Primary outcome measures were influenza and hospitalization due to influenza. Frailty was evaluated with the Kihon check list. We estimated the risk of influenza, the hospitalization, those risks by sex, and the interaction for frailty and sex using Poisson regression adjusting for covariates. RESULTS Frailty was associated with both influenza and the hospitalization among the older adults compared with nonfrail individuals after adjusting for covariates (influenza, frail: risk ratio {RR}: 1.36, 95% confidence interval {95% CI}: 1.20 - 1.53, and prefrail: RR: 1.16, 95% CI: 1.09 - 1.23; the hospitalization, frail: RR: 3.18, 95% CI: 1.84 - 5.57, and prefrail: RR: 2.13, 95% CI: 1.44 - 3.16). Male was associated with the hospitalization, but not associated with influenza compared to female (the hospitalization: RR: 1.70, 95% CI: 1.15 - 2.52 and influenza: RR: 1.01, 95% CI: 0.95 - 1.08). The interaction for frailty and sex was significant neither in influenza nor in the hospitalization. CONCLUSION These results suggest that frailty is a risk of influenza and the hospitalization, that risks of the hospitalization are different by sex, but that the sex difference does not cause the effect heterogeneity of frailty on the susceptibility and severity among independent older adults.
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Affiliation(s)
- Kousuke Iwai-Saito
- Division of International Health, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-Dori, Chuo-ku, Niigata City, 951-8510, Japan.
| | - Koryu Sato
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo City, Tokyo, 113-8549, Japan
- Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-Machi, Aoba Ward, 980-8574, Sendai City, Miyagi, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chuo-Ku, Chiba, 260-8670, Japan
- Department of Gerontology and Evaluation Study, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, 7-430 Morioka-Cho, Obu, 474-8511, Japan
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Komada MT, Lee JS, Watanabe E, Nakazawa E, Mori K, Akabayashi A. Factors of influenza vaccine inoculation and non-inoculation behavior of community-dwelling residents in Japan: suggestions for vaccine policy and public health ethics after COVID-19. Vaccine X 2022; 13:100245. [PMCID: PMC9744486 DOI: 10.1016/j.jvacx.2022.100245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022] Open
Abstract
The aim of this study is to provide basic information that contributes to vaccine inoculation policy after COVID-19. We used the secondary data of the influenza vaccine inoculation behavior survey for community-dwelling adults conducted in 2011, before the COVID-19 pandemic, but after the 2009 novel influenza A (H1N1) pdm 09 pandemic. All factors such as socio-demographic characteristics, health-related behaviors, family environment, physical and social environment, and area of residence were adjusted, and factors related to vaccine inoculation behavior were analyzed. Those living with pregnant women had a significantly higher odds ratio of inoculation; this was self-evident in that those people considered infection to their family. Regarding the social environment, those aged 20–64 years with a significantly higher adjusted odds ratio of inoculation were those with “at least five people with which they interacted in the neighborhood”. This result can be interpreted in two ways relating to altruism in Japan. Finally, we indicated the importance of learning from the past, including the case of 2009.
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Affiliation(s)
- Mayuko T. Komada
- Division of Nursing, Higashigaoka Faculty of Nursing, Tokyo Healthcare University, 2-5-1, Higashigaoka, Meguro-ku, Tokyo 152-8558, Japan
| | - Jung Su Lee
- Postgraduate School of Healthcare, Tokyo Healthcare University 4-1-17 Higashigotanda, Shinagawa-ku, Tokyo 141-8648, Japan
| | - Etsuko Watanabe
- Postgraduate School of Healthcare, Tokyo Healthcare University 4-1-17 Higashigotanda, Shinagawa-ku, Tokyo 141-8648, Japan
| | - Eisuke Nakazawa
- Department of Biomedical Ethics, University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Katsumi Mori
- Department of Biomedical Ethics, University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Akira Akabayashi
- Department of Biomedical Ethics, University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Division of Medical Ethics, New York University School of Medicine, 227 East 30th Street, New York, NY 10016, USA
- Corresponding author at: Department of Biomedical Ethics, University of Tokyo Faculty of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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4
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Iwai-Saito K, Sato K, Kondo K. Association of functional competencies with vaccination among older adults: a JAGES cross-sectional study. Sci Rep 2022; 12:17247. [PMID: 36241910 PMCID: PMC9568573 DOI: 10.1038/s41598-022-22192-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/11/2022] [Indexed: 01/06/2023] Open
Abstract
It is unknown whether higher functions in sublevels of competence other than instrumental activities of daily living (IADL) are associated with vaccinations. This study examined whether higher functions, including intellectual activity (IA) and social role (SR), were associated with vaccinations among 26,177 older adults. Older adults with incapable activities in IA and SR had increased risks for non-receipt of influenza vaccinations (IA: for one incapable task/activity: incident rate ratio (IRR) = 1.05, 95% confidence interval (CI) = 1.02-1.09; SR: for two incapable tasks: IRR = 1.12, 95% CI = 1.08-1.16). Those with incapable activities in IADL and IA had increased risks for non-receipt of pneumococcal vaccination (IADL: for two incapable tasks: IRR = 1.13, 95% CI = 1.05-1.23; IA: for two incapable tasks: IRR = 1.10, 95% CI = 1.08-1.12). Those with incapable activities in IADL, IA, and SR had increased risks for non-receipt of both of the two vaccinations (IADL: for two incapable tasks: IRR = 1.17, 95% CI = 1.03-1.33; IA: for two incapable tasks: IRR = 1.18, 95% CI = 1.11-1.25; SR: for two incapable tasks: IRR = 1.13, 95% CI = 1.07-1.20). Having a family physician mitigated associations for non-receipt, regardless of competency. Our results suggest-maintaining the higher functions are important for older adults to undergo recommended vaccinations as scheduled; also, having a family physician to promote vaccinations is beneficial even for older adults with limited functions.
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Affiliation(s)
- Kousuke Iwai-Saito
- grid.260975.f0000 0001 0671 5144Division of International Health, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Koryu Sato
- grid.258799.80000 0004 0372 2033Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Katsunori Kondo
- grid.136304.30000 0004 0370 1101Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-8-1, Inohana, Chuo-Ku, Chiba 360-0856 Japan ,grid.419257.c0000 0004 1791 9005Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institution, National Center for Geriatrics and Gerontology, Aichi, Japan
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Wu D, Jin C, Bessame K, Tang FFY, Ong JJ, Wang Z, Xie Y, Jit M, Larson HJ, Chantler T, Lin L, Gong W, Yang F, Jing F, Wei S, Cheng W, Zhou Y, Ren N, Qiu S, Bao J, Wen L, Yang Q, Tian J, Tang W, Tucker JD. Effectiveness of a pay-it-forward intervention compared with user-paid vaccination to improve influenza vaccine uptake and community engagement among children and older adults in China: a quasi-experimental pragmatic trial. THE LANCET INFECTIOUS DISEASES 2022; 22:1484-1492. [PMID: 35868342 PMCID: PMC9492551 DOI: 10.1016/s1473-3099(22)00346-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 01/04/2023]
Abstract
Background China has low seasonal influenza vaccination rates among priority populations. In this study, we aimed to evaluate a pay-it-forward strategy to increase influenza vaccine uptake in rural, suburban, and urban settings in China. Methods We performed a quasi-experimental pragmatic trial to examine the effectiveness of a pay-it-forward intervention (a free influenza vaccine and an opportunity to donate financially to support vaccination of other individuals) to increase influenza vaccine uptake compared with standard-of-care user-paid vaccination among children (aged between 6 months and 8 years) and older people (≥60 years) in China. Recruitment took place in the standard-of-care group until the expected sample size was reached and then in the pay-it-forward group in primary care clinics from a rural site (Yangshan), a suburban site (Zengcheng), and an urban site (Tianhe). Participants were introduced to the influenza vaccine by project staff using a pamphlet about influenza vaccination and were either asked to pay out-of-pocket at the standard market price (US$8·5–23·2; standard-of-care group) or to donate any amount anonymously (pay-it-forward group). Participants had to be eligible to receive an influenza vaccine and to have not received an influenza vaccine in the past year. The primary outcome was vaccine uptake. Secondary outcomes were vaccine confidence and costs (from the health-care provider perspective). Regression methods compared influenza vaccine uptake and vaccine confidence between the two groups. This trial is registered with ChiCTR, ChiCTR2000040048. Findings From Sept 21, 2020, to March 3, 2021, 300 enrolees were recruited from patients visiting three primary care clinics. 55 (37%) of 150 people in the standard-of-care group (40 [53%] of 75 children and 15 [20%] of 75 older adults) and 111 (74%) of 150 in the pay-it-forward group (66 [88%] of 75 children and 45 [60%] of 75 older adults) received an influenza vaccine. People in the pay-it-forward group were more likely to receive an influenza vaccine compared with those in the standard-of-care group (adjusted odds ratio [aOR] 6·7 [95% CI 2·7–16·6] among children and 5·0 [2·3–10·8] among older adults). People in the pay-it-forward group had greater confidence in vaccine safety (aOR 2·2 [95% CI 1·2–3·9]), importance (3·1 [1·6–5·9]), and effectiveness (3·1 [1·7–5·7]). In the pay-it-forward group, 107 (96%) of 111 participants donated money for subsequent vaccinations. The pay-it-forward group had a lower economic cost (calculated as the cost without subtraction of donations) per person vaccinated (US$45·60) than did the standard-of-care group ($64·67). Interpretation The pay-it-forward intervention seemed to be effective in improving influenza vaccine uptake and community engagement. Our data have implications for prosocial interventions to enhance influenza vaccine uptake in countries where influenza vaccines are available for a fee. Funding Bill & Melinda Gates Foundation and the UK National Institute for Health Research.
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Kinoshita K, Ozato N, Yamaguchi T, Mori K, Katsuragi Y, Yasukawa T, Murashita K, Nakaji S, Ihara K. Association between visceral fat and influenza infection in Japanese adults: A population-based cross-sectional study. PLoS One 2022; 17:e0272059. [PMID: 35881591 PMCID: PMC9321422 DOI: 10.1371/journal.pone.0272059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 07/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background Several studies have reported that obesity is associated with influenza infection; however, the role of visceral fat remains unclear. The aim of this study was to investigate the association between visceral fat and influenza infection in community-dwelling Japanese adults. Methods A cross-sectional study was performed using data from an annual community-based health check-up conducted from May to June in 2019. In total, 1,040 Japanese adults aged 20–89 years were enrolled in this study. Influenza infection status was determined by participants’ responses to a self-administered questionnaire. The visceral fat area (VFA) was measured using a bioimpedance-type visceral fat meter. Participants were classified into four groups using the following cut-off points: VFA < 100 cm2 was set as the reference category according to the Japanese criteria, 100 ≤ VFA < 150 cm2, 150 ≤ VFA < 200 cm2, and 200 cm2 ≤ VFA. Logistic regression models were used to assess the association between VFA and influenza infection. Results In total, 119 participants had influenza infections in the past year. In the multivariate adjusted model, a higher VFA was significantly associated with increased influenza infection; the adjusted odds ratio for 200 cm2 ≤ VFA was 5.03 [95% confidence interval (CI): 1.07–23.6], that for 150 ≤ VFA < 200 cm2 was 1.97 (95% CI: 0.71–5.45), and that for 100 ≤ VFA < 150 cm2 was 1.62 (95% CI: 0.84–3.12), compared with that for VFA < 100 cm2 (p for trend = 0.049). These findings were confirmed in the same cohort the following year. Conclusions Our results suggest that visceral fat accumulation is associated with influenza infection. Large-scale prospective studies using diagnostic information for influenza infection are required to confirm this association.
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Affiliation(s)
- Keita Kinoshita
- Department of Active Life Promotion Sciences, Graduate School of Medicine, Hirosaki University, Aomori, Japan
- Health & Wellness Products Research Laboratories, Kao Corporation, Tokyo, Japan
- Department of Social Medicine, Graduate School of Medicine, Hirosaki University, Aomori, Japan
| | - Naoki Ozato
- Department of Active Life Promotion Sciences, Graduate School of Medicine, Hirosaki University, Aomori, Japan
- Health & Wellness Products Research Laboratories, Kao Corporation, Tokyo, Japan
| | - Tohru Yamaguchi
- Health & Wellness Products Research Laboratories, Kao Corporation, Tokyo, Japan
| | - Kenta Mori
- Health & Wellness Products Research Laboratories, Kao Corporation, Tokyo, Japan
| | - Yoshihisa Katsuragi
- Department of Active Life Promotion Sciences, Graduate School of Medicine, Hirosaki University, Aomori, Japan
- Health & Wellness Products Research Laboratories, Kao Corporation, Tokyo, Japan
| | - Takuji Yasukawa
- Department of Preemptive Medicine, Innovation Center of Health Promotion, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Koichi Murashita
- COI Research Initiatives Organization, Graduate School of Medicine, Hirosaki University, Aomori, Japan
| | - Shigeyuki Nakaji
- Department of Social Medicine, Graduate School of Medicine, Hirosaki University, Aomori, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Graduate School of Medicine, Hirosaki University, Aomori, Japan
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Kawaharada R, Sugimoto T, Uchida K, Murata S, Tsuboi Y, Isa T, Nakatsuka K, Horibe K, Ono R. Indirect effects of social activity on appetite via depressive symptoms in community-dwelling older adults: A cross-sectional study. Appetite 2021; 168:105705. [PMID: 34547348 DOI: 10.1016/j.appet.2021.105705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 09/12/2021] [Accepted: 09/17/2021] [Indexed: 11/18/2022]
Abstract
Depressive symptoms have a strong effect on appetite decline in older adults. There is also an association between social activity and decreased depressive symptoms, but the mechanism between appetite and social activity with respect to depressive symptoms is unclear. This cross-sectional study examined the direct and indirect effects of social activity on appetite, via depressive symptoms. A total of 259 community-dwelling older adults (mean age 75.1 ± 5.3 years; 55% female) completed the Council on Nutrition Appetite Questionnaire (CNAQ) and the 15-item version of the Geriatric Depression Scale (GDS). We used a cutoff score of 6 on the GDS-15 to determine whether participants displayed depressive symptoms. Social activity was assessed based on the number of activities participated in at least 1-3 times per month. The types of social activity consisted of local community, hobby, sports, citizen, industry, religion, volunteer, and others. Other assessed factors included age, sex, education, financial status, living situation, and comorbidities. To examine the relationships among social activity, depressive symptoms, and appetite, structural equation modeling (SEM) was used, adjusting for variables associated with depressive symptoms or appetite in multivariate analyses. SEM revealed that participation in more types of social activity had a significant indirect effect on higher appetite score via less having depressive symptoms (β = 0.04, p = 0.018). Our findings suggest that active participation in social activities may have a positive effect on good appetite via not having depressive symptoms among older adults. Further longitudinal or intervention studies are needed to confirm our findings.
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Affiliation(s)
- Rika Kawaharada
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Taiki Sugimoto
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kazuaki Uchida
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Shunsuke Murata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Yamato Tsuboi
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan; Japan Society for the Promotion of Science, Chiyoda, Tokyo, Japan
| | - Tsunenori Isa
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Kiyomasa Nakatsuka
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Kana Horibe
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan.
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Iwai-Saito K, Shobugawa Y, Aida J, Kondo K. Frailty is associated with susceptibility and severity of pneumonia in older adults (A JAGES multilevel cross-sectional study). Sci Rep 2021; 11:7966. [PMID: 33846416 PMCID: PMC8041848 DOI: 10.1038/s41598-021-86854-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/19/2021] [Indexed: 12/17/2022] Open
Abstract
Pneumonia is a leading cause of mortality among older adults worldwide. Recently, several studies reported that frailty was associated with mortality among older adults hospitalized due to respiratory infectious diseases, including pneumonia. However, it is unknown whether frailty is associated with susceptibility to and severity of pneumonia in functionally-independent community-dwelling older adults. In this study, we examined whether frailty increased the susceptibility to pneumonia and hospitalization in older adults. We used cross-sectional data from the Japan Gerontological Evaluation Study; the data was collected by using mail-based, self-reported questionnaires from 177,991 functionally-independent community-dwelling older adults aged ≥ 65 years. Our results showed that frailty was significantly associated with both occurrence of and hospitalization due to pneumonia after adjustments with covariates; (Preference ratio {PR} 1.92, 95% confidence interval {95% CI} [1.66-2.22] and PR 1.80, 95% CI [1.42-2.28], respectively, p < 0.001 for the both). Pre-frailty was associated only with the occurrence of pneumonia. Besides, the instrumental activity of daily living, physical strength, nutrition status, oral function, homeboundness, and depression status in frail older adults were associated with either or both occurrence of and hospitalization due to pneumonia. Our results suggest that frailty influenced the susceptibility to and severity of pneumonia in older adults.
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Affiliation(s)
- Kousuke Iwai-Saito
- Division of International Health, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo Ward, Niigata, 951-8510, Japan.
| | - Yugo Shobugawa
- Department of Active Aging (Donated By Tokamachi City, Niigata Japan), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo City, Tokyo, 113-8549, Japan.,Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba Ward, Sendai City, Miyagi, 980-8574, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chuo-ku, Chiba, 260-8670, Japan.,Department of Gerontology and Evaluation Study, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi, 474-8511, Japan
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9
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Iwai-Saito K, Shobugawa Y, Aida J, Kondo K. Frailty is associated with susceptibility and severity of pneumonia in older adults (A JAGES multilevel cross-sectional study). Sci Rep 2021. [PMID: 33846416 DOI: 10.1038/s41598-021-86854-3[publishedonlinefirst:2021/04/14]] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
Pneumonia is a leading cause of mortality among older adults worldwide. Recently, several studies reported that frailty was associated with mortality among older adults hospitalized due to respiratory infectious diseases, including pneumonia. However, it is unknown whether frailty is associated with susceptibility to and severity of pneumonia in functionally-independent community-dwelling older adults. In this study, we examined whether frailty increased the susceptibility to pneumonia and hospitalization in older adults. We used cross-sectional data from the Japan Gerontological Evaluation Study; the data was collected by using mail-based, self-reported questionnaires from 177,991 functionally-independent community-dwelling older adults aged ≥ 65 years. Our results showed that frailty was significantly associated with both occurrence of and hospitalization due to pneumonia after adjustments with covariates; (Preference ratio {PR} 1.92, 95% confidence interval {95% CI} [1.66-2.22] and PR 1.80, 95% CI [1.42-2.28], respectively, p < 0.001 for the both). Pre-frailty was associated only with the occurrence of pneumonia. Besides, the instrumental activity of daily living, physical strength, nutrition status, oral function, homeboundness, and depression status in frail older adults were associated with either or both occurrence of and hospitalization due to pneumonia. Our results suggest that frailty influenced the susceptibility to and severity of pneumonia in older adults.
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Affiliation(s)
- Kousuke Iwai-Saito
- Division of International Health, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori, Chuo Ward, Niigata, 951-8510, Japan.
| | - Yugo Shobugawa
- Department of Active Aging (Donated By Tokamachi City, Niigata Japan), Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo City, Tokyo, 113-8549, Japan
- Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba Ward, Sendai City, Miyagi, 980-8574, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chuo-ku, Chiba, 260-8670, Japan
- Department of Gerontology and Evaluation Study, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi, 474-8511, Japan
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Lumjeaksuwan M, Patcharasopit S, Seksanpanit C, Sritharo N, Aeampuck A, Wittayachamnankul B. The trend of emergency department visits among the elderly in Thailand. WHO South East Asia J Public Health 2021; 10:25-28. [PMID: 35046154 DOI: 10.4103/who-seajph.who-seajph_67_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Emergency department (ED) usage by older adults tends to be a major health issue due to increase in aging population and their health fragility. Currently, there is no study comparing ED data of older adults with those of younger population in Southeast Asia. The aim of this study was to explore the epidemiologic data of elderly who visited the ED from 2016 to 2018 and compare them with data from younger group. Data on ED visits from 2016 to 2018 were extracted from the electronic medical database. Descriptive statistics were used for analyzing the collected data and compared with the data of the age group of 15-59 years. A total of 27,871 elderly patients were found eligible and included. The mean age was 72.69 years (95% confidence interval 72.6-72.8). Patients aged 60-69 years have the highest ED visits rate (45.4%). From the total visits, 58.06% were discharged from ED, while 40.82% were admitted to hospital with 11.22% death rate after the admission. The most diagnosed condition was injury, poisoning, or other consequence from an external cause, with a head injury as the leading cause (20.74%). Compared with patients aged 15-59 years, elderly patients had a higher visit rate per 1000 population (21.99 vs. 30.91; P < 0.001), more admissions (15% vs. 40.8%; P < 0.001), and more re-visits within 7 days (1.81% vs. 4.07%; P < 0.001). These results showed that older adult patients tend to have higher ED visits rate, ED re-visits rate, and admissions rate compared to younger age groups.
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Affiliation(s)
- Methasit Lumjeaksuwan
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Suparada Patcharasopit
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chanatip Seksanpanit
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Natchaya Sritharo
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Apichat Aeampuck
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Borwon Wittayachamnankul
- Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Hayward AC, Beale S, Johnson AM, Fragaszy EB. Public activities preceding the onset of acute respiratory infection syndromes in adults in England - implications for the use of social distancing to control pandemic respiratory infections. Wellcome Open Res 2020; 5:54. [PMID: 32399501 PMCID: PMC7194223 DOI: 10.12688/wellcomeopenres.15795.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2020] [Indexed: 01/08/2023] Open
Abstract
Background: Social distancing measures may reduce the spread of emerging respiratory infections however, there is little empirical data on how exposure to crowded places affects risk of acute respiratory infection. Methods: We used a case-crossover design nested in a community cohort to compare self-reported measures of activities during the week before infection onset and baseline periods. The design eliminates the effect of non-time-varying confounders. Time-varying confounders were addressed by exclusion of illnesses around the Christmas period and seasonal adjustment. Results: 626 participants had paired data from the week before 1005 illnesses and the week before baseline. Each additional day of undertaking the following activities in the prior week was associated with illness onset: Spending more than five minutes in a room with someone (other than a household member) who has a cold (Seasonally adjusted OR 1·15, p=0·003); use of underground trains (1·31, p=0·036); use of supermarkets (1·32, p<0·001); attending a theatre, cinema or concert (1·26, p=0·032); eating out at a café, restaurant or canteen (1·25, p=0·003); and attending parties (1·47, p<0·001). Undertaking the following activities at least once in the previous week was associated with illness onset: using a bus, (aOR 1.48, p=0.049), shopping at small shops (1.9, p<0.002) attending a place of worship (1.81, p=0.005). Conclusions: Exposure to potentially crowded places, public transport and to individuals with a cold increases risk of acquiring circulating acute respiratory infections. This suggests social distancing measures can have an important impact on slowing transmission of emerging respiratory infections.
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Affiliation(s)
- Andrew C. Hayward
- UCL Research Department of Epidemiology & Public Health, UCL, London, WC1E 7HB, UK
| | - Sarah Beale
- UCL Public Health Data Science Research Group, Institute of Health Informatics, UCL, London, NW1 2DA, UK
| | | | - Ellen B. Fragaszy
- UCL Public Health Data Science Research Group, Institute of Health Informatics, UCL, London, NW1 2DA, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Flu Watch Group
- UCL Research Department of Epidemiology & Public Health, UCL, London, WC1E 7HB, UK
- UCL Public Health Data Science Research Group, Institute of Health Informatics, UCL, London, NW1 2DA, UK
- UCL Institute of Global Health, UCL, London, WC1E 6JB, UK
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
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