1
|
Osawa E, Sasaki Y, Hsu HC, Miura H. Attitudes toward active aging and their association with social determinants and views on older adults in Japan: a cross-sectional study. BMC Geriatr 2024; 24:140. [PMID: 38326743 PMCID: PMC10851495 DOI: 10.1186/s12877-024-04711-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Globally, the population of older adults has greatly increased, and active aging-whereby older adults can live healthy and fulfilling lives-is considered crucial for a sustainable society. However, the concept and practice of active aging are highly debated because it is unclear how people perceive active aging. This study explored Japanese people's attitudes toward active aging (ATAA) and examined the associations between ATAA scores and sociodemographic variables, views on older adults, and self-rated life and health. METHODS This study used data obtained from an online survey that originally targeted adults of all generations in Taiwan, South Korea, and Japan. In this study, we used only data from Japanese participants to elaborate on factors associated with ATAA in Japan. We conducted a one-way analysis of variance test and multiple linear regression analysis to evaluate the associations between the ATAA scores of 506 Japanese individuals and sociodemographic variables, views on older adults, and self-rated life and health. RESULTS The sample comprised 171 females and 335 males. The mean (± SD) ATAA score of the 506 respondents was 138.8 (± 20.80). Females had a significantly higher ATAA score than males (144.02 versus 136.13, F = 26.29, p < 0.001). The respondents with higher education attainment, religious beliefs, better views on older adults, and better self-rated health were more likely to have a positive ATAA score (B: 3.83, 95% CI: 0.11, 7.56; B: 4.31, 95% CI: 0.93, 7.69; B: 2.07, 95% CI: 1.61, 2.53; B: 2.87, 95% CI: 0.92, 4.82, respectively). Being male, single (i.e., never married, divorced, or widowed) and other non-married marital statuses, and satisfied with one's financial condition were negatively associated with ATAA (B: -8.73, 95% CI: -12.49, -4.96; B: -5.47, 95% CI: -9.07, -1.86; B: -2.04, 95% CI: -3.99, -0.09, respectively). CONCLUSIONS This study identified that females have more positive ATAA than males. Better views on older adults are a possible contributing factor that promotes ATAA among Japanese people. Our findings provide useful evidence that an approach towards those who are male, single, and economically satisfied is needed so that they have a positive attitude toward aging in Japan. It is necessary to address ageism and develop an environment in which individuals can expect to age actively.
Collapse
Affiliation(s)
- Eri Osawa
- Department of Public Health Policy, National Institute of Public Health, 351-0197, Saitama, Japan.
| | - Yuri Sasaki
- Department of Public Health Policy, National Institute of Public Health, 351-0197, Saitama, Japan
| | - Hui-Chuan Hsu
- School of Public Health, Research Centre of Health Equity, College of Public Health, Taipei Medical University, 11031, Taipei, Taiwan
| | - Hiroko Miura
- Division of Disease Control and Epidemiology, School of Dentistry, Health Sciences University of Hokkaido, 061-0293, Tobetsu, Hokkaido, Japan
| |
Collapse
|
2
|
Silva JDPD, Martins IV, Braga LHR, Oliveira CMD, Lima-Costa MF, Braga LDS, Torres JL. Differences in determinants of active aging between older Brazilian and English adults: ELSI-Brazil and ELSA. CAD SAUDE PUBLICA 2023; 39:e00076823. [PMID: 37851723 PMCID: PMC10599105 DOI: 10.1590/0102-311xen076823] [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] [Received: 04/26/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 10/20/2023] Open
Abstract
This study aimed to investigate differences in determinants of active aging between older Brazilian and English adults and to verify the association of behavioral, personal, and social determinants with physical health. This cross-sectional study was based on the ELSI-Brazil (2015-2016) and ELSA (2016-2017) cohorts. Active aging determinants included behavior (smoking, sedentary lifestyle, and poor sleep quality), personal (cognitive function and life satisfaction), and social determinants (education, loneliness, and volunteering), according to the World Health Organization. Physical health included activities limitation and multimorbidity. We estimated age- and sex-adjusted prevalence for each indicator and mean score, and used the negative binomial regression for statistical analysis. We included 16,642 participants, 9,409 from Brazil and 7,233 from England. Overall, all active aging determinants were worse in Brazil than in England, except for life satisfaction (no difference). The most remarkable difference was found for social determinants score in Brazil (mean difference of 0.18; p < 0.05), mainly due to a significantly lower education level in Brazil (70.6%; 95% confidence interval - 95%CI: 69.7-71.5) than England (37.1%; 95%CI: 35.1-39.1). All determinants (behavioral, personal, and social) were associated with health in Brazil and in England. However, the behavioral domain was stronger associated with health in England (coefficient = 2.76; 95%CI: 2.46-3.10) than in Brazil (coefficient = 1.38; 95%CI: 1.26-1.50; p < 0.001). Older English adults beneficiate more from healthier behaviors than Brazilians, which depend more on social policies.
Collapse
Affiliation(s)
| | | | | | | | - Maria Fernanda Lima-Costa
- Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
| | | | | |
Collapse
|
3
|
Tani Y, Fujiwara T, Kondo K. Associations of Cooking Skill with Social Relationships and Social Capital among Older Men and Women in Japan: Results from the JAGES. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054633. [PMID: 36901644 PMCID: PMC10002414 DOI: 10.3390/ijerph20054633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 05/13/2023]
Abstract
The health benefits of social relationships and social capital are well known. However, little research has examined the determinants of social relationships and social capital. We examined whether cooking skill was associated with social relationships and social capital in older Japanese people. We used 2016 Japan Gerontological Evaluation Study data on a population-based sample of men and women aged ≥ 65 years (n = 21,061). Cooking skill was assessed using a scale with good validity. Social relationships were evaluated by assessing neighborhood ties, frequency and number of meetings with friends, and frequent meals with friends. Individual-level social capital was evaluated by assessing civic participation, social cohesion, and reciprocity. Among women, high-level cooking skill was positively associated with all components of social relationships and social capital. Women with high-level cooking skill were 2.27 times (95% CI: 1.77-2.91) more likely to have high levels of neighborhood ties and 1.65 (95% CI: 1.20-2.27) times more likely to eat with friends, compared with those with middle/low-level cooking skill. Cooking skills explained 26.2% of the gender difference in social relationships. Improving cooking skills may be key to boosting social relationships and social capital, which would prevent social isolation.
Collapse
Affiliation(s)
- Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
- Correspondence: ; Tel.: +81-3-5803-5189
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi 260-8672, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morikoka-cho, Obu-shi 474-8511, Japan
| |
Collapse
|
4
|
Yoshida N, Arai Y, Takayama M, Abe Y, Oguma Y. The impact pathways of environmental, social, and behavioural factors on healthy ageing for urban dwellers aged 85+: Longitudinal study of the Tokyo Oldest Old Survey on Total Health (TOOTH). SSM Popul Health 2022; 18:101089. [PMID: 35493406 PMCID: PMC9046878 DOI: 10.1016/j.ssmph.2022.101089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 11/05/2022] Open
Abstract
In the context of global population ageing and concentration in cities, the population aged 80 and over (80+) is growing rapidly. Japan has the fastest ageing population and longest healthy average life expectancy, while health decline becomes pronounced and care needs increase in the 85+ age group post the ‘average life expectancy’. The healthy ageing of older urban community dwellers is a pressing issue in world initiatives for sustainable urbanisation. However, for the 85+ age group, less is known about how promoting/inhibiting factors and their pathways influence healthy ageing, and related longitudinal studies remain insufficient. Using data from a longitudinal cohort study conducted from 2008–2009 to 2014–2015 among independent dwellers aged 85+ in central Tokyo (men = 203, women = 232), this study analysed the impact pathways of environmental, social, and behavioural factors on health and survival to explore promoters and potential risks on healthy ageing by gender, with multi-group structural equation modelling (SEM) and Bayesian SEM. For both genders, there was a positive chained pathway starting from friends as facilitators through positive interactions between 'social participation’ and 'active behaviour' to 'ageing-related health'. Additionally, their personal networks were small, suggesting that men with family-centred networks and women with non-family-centred networks require different approaches and supports. Implications of the results are discussed, and an organised social watch and support system, which becomes more important in the ‘new normal’ for urban dwellers aged 85+, is recommended. A 6-year longitudinal cohort study for independent urban dwellers aged 85+. SEM analysis among environmental, social, and behavioural factors on health. Friends can facilitate positive chained path through activities to health. Gender-differences in nature of personal networks affect healthy ageing. Social watching, support are necessary for this group in sustainable urbanisation.
Collapse
|
5
|
Sato K, Kondo N, Kondo K. Pre-pandemic individual- and community-level social capital and depressive symptoms during COVID-19: A longitudinal study of Japanese older adults in 2019-21. Health Place 2022; 74:102772. [PMID: 35228058 PMCID: PMC8872828 DOI: 10.1016/j.healthplace.2022.102772] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/12/2021] [Accepted: 02/15/2022] [Indexed: 12/12/2022]
Abstract
During a pandemic, it is important to know whether social capital can mitigate the risk of mental disorders, given the restrictions on social interactions. However, evidence using longitudinal data is scarce. This study examined the association between pre-pandemic social capital and depressive symptoms during COVID-19 among older adults. We used longitudinal data from the Japan Gerontological Evaluation Study (JAGES), including 8291 participants aged 65 or older who were physically and cognitively independent and not depressed at baseline. We conducted baseline and follow-up mail surveys in ten municipalities in Japan from November 2019 to January 2020 (pre-pandemic period) and from November 2020 to February 2021 (pandemic period), respectively. We measured depressive symptoms using the 15-item Geriatric Depression Scale. Social capital was measured with three validated subscales, namely, civic participation, social cohesion, and reciprocity. We performed a multilevel logistic regression analysis to examine the association. A total of 1089 (13.1%) participants newly developed depressive symptoms during the pandemic. The logistic regression showed that pre-pandemic individual-level social cohesion (odds ratio = 0.79, 95% confidence interval: 0.73 to 0.86) and reciprocity (0.89, 0.82 to 0.96) and community-level reciprocity (0.93, 0.88 to 0.98) were negatively associated with the odds of depressive symptoms. Even after adjusting for declines in social capital during the pandemic, the observed associations of pre-pandemic social capital remained. Fostering social cohesion and reciprocity may increase resilience to mental disorders during a pandemic of infectious disease.
Collapse
Affiliation(s)
- Koryu Sato
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan; Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| |
Collapse
|
6
|
Ikeda T, Cable N, Saito M, Koyama S, Tsuji T, Noguchi T, Kondo K, Osaka K, Aida J. Association Between Social Isolation and Smoking in Japan and England. J Epidemiol 2021; 31:523-529. [PMID: 32779628 PMCID: PMC8421201 DOI: 10.2188/jea.je20200138] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/16/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Existing evidence suggest that those who are socially isolated are at risk for taking up or continuing smoking. This study investigated country-based differences in social isolation and smoking status. METHODS We performed a repeated cross-sectional study using two waves of data from two ongoing aging studies: the English Longitudinal Study of Ageing and the Japan Gerontological Evaluation Study. Participants from both studies aged ≥65 years were included. We applied a multilevel Poisson regression model to examine the association between social isolation and smoking status and adjusted for individual sociodemographic characteristics. We used the social isolation index which comprises the following domains: marital status; frequency of contact with friends, family, and children; and participation in social activities. Interaction terms between each country and social isolation were also entered into the mode. RESULTS After exclusion of never smokers, we analyzed 75,905 participants (7,092 for ELSA and 68,813 for JAGES, respectively). Taking ex-smokers as the reference, social isolation was significantly associated with current smoking; the prevalence ratios (PRs) were 1.06 (95% credible interval [CrI], 1.05-1.08) for men and 1.08 (95% CrI, 1.04-1.11) for women. Taking Japan as a reference, the interaction term between country and social isolation was significant for both sexes, with increased PRs of 1.32 (95% CrI, 1.14-1.50) for men and 1.30 (95% CrI, 1.11-1.49) for women in England. CONCLUSIONS Older people who were less socially isolated were more likely to quit smoking in England than in Japan, possibly explained by the strict tobacco control policies in England.
Collapse
Affiliation(s)
- Takaaki Ikeda
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Masashige Saito
- Department of Social Welfare, Nihon Fukushi University, Aichi, Japan
| | - Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan
| | - Taiji Noguchi
- Department of Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| |
Collapse
|
7
|
Noguchi T, Saito M, Aida J, Cable N, Tsuji T, Koyama S, Ikeda T, Osaka K, Kondo K. Association between social isolation and depression onset among older adults: a cross-national longitudinal study in England and Japan. BMJ Open 2021; 11:e045834. [PMID: 33737442 PMCID: PMC7978252 DOI: 10.1136/bmjopen-2020-045834] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Social isolation is a risk factor for depression in older age. However, little is known regarding whether its impact varies depending on country-specific cultural contexts regarding social relationships. The present study examined the association of social isolation with depression onset among older adults in England, which has taken advanced measures against social isolation, and Japan, a super-aged society with a rapidly increasing number of socially isolated people. DESIGN Prospective longitudinal study. SETTING We used data from two ongoing studies: the English Longitudinal Study of Ageing (ELSA) and the Japan Gerontological Evaluation Study (JAGES). PARTICIPANTS Older adults aged ≥65 years without depression at baseline were followed up regarding depression onset for 2 years (2010/2011-2012/2013) for the ELSA and 2.5 years (2010/2011-2013) for the JAGES. PRIMARY OUTCOME MEASURE Depression was assessed with eight items from the Centre for Epidemiologic Studies Depression Scale for the ELSA and Geriatric Depression Scale for the JAGES. Multivariable logistic regression analysis was performed to evaluate social isolation using multiple parameters (marital status; interaction with children, relatives and friends; and social participation). RESULTS The data of 3331 respondents from the ELSA and 33 127 from the JAGES were analysed. Multivariable logistic regression analysis demonstrated that social isolation was significantly associated with depression onset in both countries. In the ELSA, poor interaction with children was marginally associated with depression onset, while in the JAGES, poor interaction with children and no social participation significantly affected depression onset. CONCLUSIONS Despite variations in cultural background, social isolation was associated with depression onset in both England and Japan. Addressing social isolation to safeguard older adults' mental health must be globally prioritised.
Collapse
Affiliation(s)
- Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Bunkyo-ku, Japan
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University, Sendai, Japan
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Takaaki Ikeda
- Department of Health Policy Science, Yamagata University Faculty of Medicine Graduate School of Medical Science, Yamagata, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry School of Dentistry, Sendai, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry School of Dentistry, Sendai, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| |
Collapse
|
8
|
Saito M, Aida J, Cable N, Zaninotto P, Ikeda T, Tsuji T, Koyama S, Noguchi T, Osaka K, Kondo K. Cross-national comparison of social isolation and mortality among older adults: A 10-year follow-up study in Japan and England. Geriatr Gerontol Int 2020; 21:209-214. [PMID: 33350047 PMCID: PMC7898799 DOI: 10.1111/ggi.14118] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 11/11/2020] [Accepted: 11/27/2020] [Indexed: 01/03/2023]
Abstract
AIM Existing evidence links social isolation with poor health. To examine differences in the mortality risk by social isolation, and in socio-economic correlates of social isolation, we analyzed large-scale cohort studies in Japan and England. METHODS Participants were drawn from the Japan Gerontological Evaluation Study (JAGES) and the English Longitudinal Study of Ageing (ELSA). We analyzed the 10-year mortality among 15 313 JAGES participants and 5124 ELSA respondents. Social isolation was measured by two scales, i.e., scoring the frequency of contact with close ties, and a composite measurement of social isolation risk. We calculated the population attributable fraction, and Cox regression models with multiple imputations were used to estimate hazard ratios (HRs) for mortality due to social isolation. RESULTS The proportion of those with contact frequency of less than once a month was 8.5% in JAGES and 1.3% in ELSA. Males, older people, those with poor self-rated health, and unmarried people were significantly associated with social isolation in both countries. Both scales showed that social isolation among older adults had a remarkably higher risk for premature death (less frequent contact with others in JAGES: hazard ratio [HR] = 1.18, 95% confidence interval [CI]: 1.05-1.33, in ELSA: HR = 1.27, 95% CI: 0.85-1.89; and high isolation risk score in JAGES: HR = 1.30, 95% CI: 1.12-1.50, in ELSA: HR = 2.05, 95% CI: 1.52-2.73). The population attributable fraction showed less frequent contact with close ties was attributed to about 18 000 premature deaths annually in Japan, in contrast with about 1800 in England. CONCLUSIONS Negative health impacts of social isolation were higher among older Japanese compared with those in England. Geriatr Gerontol Int 2021; 21: 209-214.
Collapse
Affiliation(s)
- Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Mihama, Japan.,Center for Well-being and Society, Nihon Fukushi University, Mihama, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Takaaki Ikeda
- Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata, Japan.,Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Taishi Tsuji
- Faculty of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan
| | - Shihoko Koyama
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Taiji Noguchi
- Department of Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Katsunori Kondo
- Center for Well-being and Society, Nihon Fukushi University, Mihama, Japan.,Department of Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.,Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| |
Collapse
|
9
|
Matsuda Y, Masuda M, Asai M, Iida O, Okamoto S, Ishihara T, Nanto K, Kanda T, Tsujimura T, Okuno S, Hata Y, Uematsu H, Mano T. Comparison of prognosis and safety of pacemaker implantation in patients aged less than or 85 years and older. J Interv Card Electrophysiol 2020; 61:171-179. [PMID: 32533276 DOI: 10.1007/s10840-020-00797-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 06/05/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Cardiac conduction disturbance necessitating pacemaker implantation is common among elderly patients. However, patients often have comorbidities and increased frailty which may result in limited life prognosis and a high rate of procedure-related complications. We evaluated pacemaker implantation in older patients by comparing life prognosis and complication rate in patients aged ≥ and < 85 years. METHODS We retrospectively enrolled 262 consecutive patients who underwent initial pacemaker implantation for bradycardia (age, 77 ± 10 years old; male, 132 (50%); dual chamber pacemaker, 222 (85%) patients). Acute and long-term outcomes were compared between patients aged ≥ 85 and < 85 years. Primary outcome was a composite of all-cause death and severe procedure-related complications. RESULTS Seven (14%) patients aged ≥ 85 years (n = 50; 19%) were non-ambulatory. During 2-year follow-up, primary outcome (death or severe complication) occurred in 47 (18%). Freedom from primary outcome was similar between age groups (81.6% versus 80.8%; p = 0.98). Freedom from all-cause death and from severe complication in the study period were also similar (all-cause death, 91.6% versus 88.7%, p = 0.70; severe complication, 89.7% versus 91.5%, p = 0.75). On multivariate analysis, sick sinus syndrome (hazard ratio (HR) 2.7, 95% confidence interval (CI) 1.1-6.4, p = 0.03), immunosuppressant use (HR 21 (95% CI 3.3-134), p < 0.01), and high C-reactive protein (HR 1.5 (95% CI 1.2-1.9), p < 0.01) were independent predictors of primary outcome. CONCLUSIONS Life prognosis and severe complication rates after pacemaker implantation were similar between patients aged ≥ and < 85 years.
Collapse
Affiliation(s)
- Yasuhiro Matsuda
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Masaharu Masuda
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan.
| | - Mitsutoshi Asai
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Osamu Iida
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Shin Okamoto
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Takayuki Ishihara
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Kiyonori Nanto
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Takashi Kanda
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Takuya Tsujimura
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Shota Okuno
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Yosuke Hata
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Hiroyuki Uematsu
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| | - Toshiaki Mano
- Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan
| |
Collapse
|
10
|
Arroyo-Quiroz C, Brunauer R, Alavez S. Factors associated with healthy aging in septuagenarian and nonagenarian Mexican adults. Maturitas 2019; 131:21-27. [PMID: 31787143 DOI: 10.1016/j.maturitas.2019.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/31/2019] [Accepted: 10/12/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To examine the factors associated with healthy aging in a cohort of Mexican adults after a follow-up of 14 years. STUDY DESIGN Participants were part of a prospective cohort of the Mexican Healthy Aging Study (MHAS), from which we included 5142 individuals aged 63 years or more. MAIN OUTCOME Healthy aging, defined as reaching age 77 or 90 without major chronic conditions or physical limitations. MEASURES Information on age, education, marital status, smoking, alcohol consumption, physical activity, self-perceived depression, health conditions and history of age-related diseases was collected at baseline and follow-up. RESULTS Among the overall cohort, 57.8% experienced healthy survival to age 77 and 42.2% had died before age 77 or were undergoing normal aging. Participants with long-lived parents and who exercised had a lower risk of being non-healthy agers. Being overweight, obese or a smoker increased the risk of being a non-healthy ager. Physically active participants had increased odds of healthy aging at age 77 (OR: 1.17; 95% CI: 1.01-1.46) and at age 90 (OR: 1.5; 95% CI: 1.01-2.24). Depression had a negative relationship with healthy aging at age 90 (OR: 0.66; 95% CI: 0.45- 0.97). Maternal longevity was associated with healthy aging only at age 77 (OR = 1.34; 95% CI: 1.04-1.72). CONCLUSIONS Our findings support the view that a combination of genetic and behavioral factors is associated with healthy aging. In accordance with findings in Caucasian populations, our data suggest for the first time that there might also be a genetic determinant for healthy ageing in Latin Americans.
Collapse
Affiliation(s)
- Carmen Arroyo-Quiroz
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana, Unidad Lerma, Estado de México, México. Av. de las Garzas No. 10 Lerma, Edo. Mex. 52005, Mexico.
| | - Regina Brunauer
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, 1197 VMR Building, College Station, TX 77843-4466, USA.
| | - Silvestre Alavez
- Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana, Unidad Lerma, Estado de México, México. Av. de las Garzas No. 10 Lerma, Edo. Mex. 52005, Mexico; Centro de Ciencias de la Complejidad (C3), Universidad Nacional Autónoma de México, México City, Mexico.
| |
Collapse
|