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Nishijima C, Harada K, Katayama O, Kurita S, Morikawa M, Yamaguchi R, Fujii K, Misu Y, Kakita D, Shimada H. Association between perceived value of adopting new behaviors and incident disability among Japanese community-dwelling older adults. Prev Med 2024; 183:107976. [PMID: 38688347 DOI: 10.1016/j.ypmed.2024.107976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVES This longitudinal observational cohort study aimed to clarify the relationship between perceived value (PV) to adopt new behaviors and incident disability in community-dwelling older adults. METHOD Participants were 5073 community-dwelling older adults aged ≥65 years in Japan (Mage = 74.0 ± 5.6 years; female = 55.1%). The mean follow-up time was 34.5 months. Baseline data were collected during health checkups in a prospective cohort study. Measurements included engagement in physical activity (PA), cognitive activity (CA), and social activity (SA), PV, health and physical conditions, and demographic characteristics. PV was assessed by asking whether participants thought it was valuable to adopt new behaviors related to PA, CA, and SA. Participants were classified as having higher/lower PV, PA, CA, and SA. Cox proportional hazard models were used to analyze the association between PV and incident disability. PV was examined both as an independent variable and in combination as follows: higher PV and higher PA/CA/SA (high/high); lower PV and higher PA/CA/SA (low/high); higher PV and lower PA/CA/SA (high/low); and lower PV and lower PA/CA/SA (low/low). RESULTS Higher PV was significantly associated with a lower hazard ratio (HR) for incident disability. The low/high, high/low, and low/low significantly increased the HR compared to high/high in the analyses of PV & PA and CA. The analysis of PV & SA showed that only low/low increased the HR compared to high/high. CONCLUSION Having both higher PV and higher activity engagement may contribute to preventing disability development. Both support for activities and value education in older adults may be needed.
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Affiliation(s)
- Chiharu Nishijima
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan.
| | - Kenji Harada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Osamu Katayama
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo 102-0083, Japan
| | - Satoshi Kurita
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Masanori Morikawa
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Ryo Yamaguchi
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Kazuya Fujii
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Yuka Misu
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Daisuke Kakita
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Hiroyuki Shimada
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
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Jones CH, Dolsten M. Healthcare on the brink: navigating the challenges of an aging society in the United States. NPJ AGING 2024; 10:22. [PMID: 38582901 PMCID: PMC10998868 DOI: 10.1038/s41514-024-00148-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/21/2024] [Indexed: 04/08/2024]
Abstract
The US healthcare system is at a crossroads. With an aging population requiring more care and a strained system facing workforce shortages, capacity issues, and fragmentation, innovative solutions and policy reforms are needed. This paper aims to spark dialogue and collaboration among healthcare stakeholders and inspire action to meet the needs of the aging population. Through a comprehensive analysis of the impact of an aging society, this work highlights the urgency of addressing this issue and the importance of restructuring the healthcare system to be more efficient, equitable, and responsive.
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Affiliation(s)
- Charles H Jones
- Pfizer, 66 Hudson Boulevard, New York, New York, 10018, USA.
| | - Mikael Dolsten
- Pfizer, 66 Hudson Boulevard, New York, New York, 10018, USA.
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Goto Y, Miura H. Validation and Clinical Application of the Japanese Version of the Patient-Reported Experience Measures for Intermediate Care Services: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:743. [PMID: 38610167 PMCID: PMC11012065 DOI: 10.3390/healthcare12070743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Older adult patients account for 70% of all hospitalized patients in Japan, and intermediate care based on patient-centered care (PCC) that ensures continuity and quality of care at the interface between home services and acute care services and restores patient's independence and confidence is necessary for them to continue living independently. At present, no concept of intermediate care is established in Japan, and the implementation of PCC has been delayed. Thus, in this study, a Japanese version of the intermediate care evaluation index (patient-reported experience measure (PREM)) was created on the basis of the original PREM developed in the UK, and data in wards with intermediate care functions in Japan were collected to confirm internal consistency and validity from 2020 to 2022. The Japanese version of PREM was found to have a factor structure with two potential factors. Given the clear correlation with the shared decision-making evaluation index, which is the pinnacle of PCC, the theoretical validity of the Japanese version of PREM, which is based on PCC as a theoretical basis, was confirmed.
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Affiliation(s)
- Yuko Goto
- Department of Home Care and Regional Liaison Promotion, Hospital, National Center for Geriatrics and Gerontology, Obu 474-8511, Aichi, Japan;
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Jain N, Kourampi I, Umar TP, Almansoor ZR, Anand A, Ur Rehman ME, Jain S, Reinis A. Global population surpasses eight billion: Are we ready for the next billion? AIMS Public Health 2023; 10:849-866. [PMID: 38187896 PMCID: PMC10764969 DOI: 10.3934/publichealth.2023056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/10/2023] [Accepted: 10/15/2023] [Indexed: 01/09/2024] Open
Abstract
In November 2022, the global population had officially crossed eight billion. It has long been recognized that socioeconomic or health-related problems in the community always accompany an uncontrolled population expansion. International calls have been made regarding lack of universal health coverage, an insufficient supply of healthcare providers, the burden of noncommunicable disease, population aging and the difficulty in obtaining safe drinking water and food. The present health policy paper discusses how to conquer these crowded world issues, including (1) promoting government and international organization participation in providing appropriate infrastructure, funding and distribution to assist people's health and well-being; (2) shifting health program towards a more preventive approach and (3) reducing inequalities, particularly for the marginalized, isolated and underrepresented population. These fundamental principles of health policy delivery as a response to an increasingly crowded world and its challenges are crucial for reducing the burden associated with excessive healthcare costs, decreased productivity and deteriorating environmental quality.
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Affiliation(s)
- Nityanand Jain
- Faculty of Medicine, Riga Stradinš University, 16 Dzirciema street, Riga, Latvia, LV-1007
| | - Islam Kourampi
- Department of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, Athens, Greece, 11527
| | - Tungki Pratama Umar
- UCL Centre for Nanotechnology and Regenerative Medicine, Division of Surgery and Interventional Science, University College London, London, United Kingdom
- Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia 30128
| | - Zahra Rose Almansoor
- Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom
| | - Ayush Anand
- BP Koirala Institute of Health Sciences, Buddha Road, Dharan 56700, Nepal
| | | | - Shivani Jain
- Department of Oral and Maxillofacial Surgery, Genesis Institute of Dental Sciences & Research, Ferozepur-Moga Road, Ferozepur, Punjab, India 152002
| | - Aigars Reinis
- Department of Biology and Microbiology, Riga Stradinš University, 16 Dzirciema street, Riga, Latvia, LV-1007
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Sorimachi K, Moriyama N, Hatashita S, Miyajima H, Shigemoto S, Takagi K, Hirano H, Ito M, Iseki K, Yasumura S. Association of the Number of Teeth With Physical Function and Length of Hospital Stay After Hip Fracture Surgery: A Prospective Observational Study at a Tertiary Hospital in Japan. Cureus 2023; 15:e47297. [PMID: 38022003 PMCID: PMC10656494 DOI: 10.7759/cureus.47297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVES Although lower-extremity muscle strength is associated with physical function, there are challenges in assessing the muscle strength of patients after hip surgery due to pain or limited cognitive function. The number of teeth is a characteristic that can be easily examined. Although the relationship between the number of teeth and physical function has been reported in recent years, there are no reports examining the relationship with prognosis in patients with hip fractures. Therefore, this study aimed to investigate the relationship between the number of teeth and physical function and length of hospital stay after hip fracture surgery and to evaluate the predictive efficacy of the number of teeth on postoperative prognosis. METHODS This prospective cohort study was conducted in a tertiary clinical care facility. Patients aged ≥65 years who underwent hip surgery were included. A total of 101 patients (mean age: 85.1±8.0 years) were included. The factor analyzed was the number of teeth at admission. Patients were divided into two groups according to the number of teeth: those with ≥20 and those with ≤19 teeth. The outcomes were knee extension muscle strength-to-weight ratio at two weeks postoperatively and the length of hospital stay. A multiple regression analysis was performed to determine the association between the two groups. RESULTS Of 101 patients, 79 (78.2%) had ≤19 teeth, whereas 22 (21.8%) had ≥20 teeth. The mean muscle strength-to-weight ratio and length of hospital stay were 0.26±0.11 kgf/kg and 57.5±31.4 days, respectively. Multiple regression analysis revealed that the number of teeth was significantly associated with the muscle strength-to-weight ratio (β=-0.26, p=0.04) but not with the duration of hospitalization (β=0.17, p=0.09). CONCLUSIONS We suggest that assessment of the number of teeth at admission may be a useful predictor of patient physical function.
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Affiliation(s)
- Kotaro Sorimachi
- Department of Public Health/Department of Emergency and Critical Care Medicine, Fukushima Medical University School of Medicine, Fukushima, JPN
- Department of Traumatology and Reconstructive Surgery, Aizu Chuo Hospital, Aizuwakamatsu, JPN
| | - Nobuaki Moriyama
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, JPN
| | - Satoshi Hatashita
- Department of Traumatology and Reconstructive Surgery, Aizu Chuo Hospital, Aizuwakamatsu, JPN
- Department of Traumatology and Reconstructive Surgery, Fukushima Medical University, Fukushima, JPN
| | - Hisashi Miyajima
- Clinical Unit of Dentistry and Oral Surgery, Aizu Chuo Hospital, Aizuwakamatsu, JPN
| | - Shimpei Shigemoto
- Clinical Unit of Dentistry and Oral Surgery, Aizu Chuo Hospital, Aizuwakamatsu, JPN
| | - Kaori Takagi
- Rehabilitation Center, Aizu Chuo Hospital, Aizuwakamatsu, JPN
| | - Hiroko Hirano
- Department of Nursing, Aizu Chuo Hospital, Aizuwakamatsu, JPN
| | - Masayuki Ito
- Department of Traumatology and Reconstructive Surgery, Aizu Chuo Hospital, Aizuwakamatsu, JPN
- Department of Traumatology and Reconstructive Surgery, Fukushima Medical University, Fukushima, JPN
| | - Ken Iseki
- Department of Emergency and Critical Care Medicine, Fukushima Medical University School of Medicine, Fukushima, JPN
| | - Seiji Yasumura
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, JPN
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Sano J, Hirazawa Y, Komamura K, Okamoto S. An overview of systems for providing integrated and comprehensive care for older people in Japan. Arch Public Health 2023; 81:81. [PMID: 37143140 PMCID: PMC10158362 DOI: 10.1186/s13690-023-01076-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/27/2023] [Indexed: 05/06/2023] Open
Abstract
As longevity occurs, people encounter various risks associated with ageing, including economic uncertainty and health issues. Therefore, in addition to extending healthy life expectancy, it is crucial to create an environment where older people can live better even when their intrinsic capacity declines. Additionally, integrated and comprehensive care for older adults is needed to maintain their functional ability and well-being at higher levels. This review provides an overview of the systems and initiatives in Japan, a forerunner of population ageing that supports the quality of life of older people and summarises their remaining challenges. In Japan, with support for access to necessary care available from social welfare councils and community comprehensive support centres, various health and welfare services are provided to respond to the needs of people with different levels of intrinsic capacity, including medical care, preventive care, long-term care, adult guardianship systems, pensions, and social assistance. Nevertheless, there are challenges for the systems, including the gap between life and healthy life expectancy, moderate accumulation and decumulation of retirement assets, lack of human and financial resources for care, and user-unfriendliness and non-covered needs of the current system. Therefore, integrated and comprehensive care beyond health and long-term care is needed to maintain the well-being of older adults, even with their intrinsic capacity declining.
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Affiliation(s)
- Junko Sano
- Research Center for Financial Gerontology, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, Japan
| | - Yuzuki Hirazawa
- Faculty of Economics, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, Tokyo, Japan
| | - Kohei Komamura
- Research Center for Financial Gerontology, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, Japan
- Faculty of Economics, Keio University, 2-15-45 Mita, Minato-ku, Tokyo, Tokyo, Japan
| | - Shohei Okamoto
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, Japan.
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Akada K, Koyama N, Miura Y, Takahashi K, Aoshima K. Nationwide Database Analysis of Risk Factors Associated with Decreased Activities of Daily Living in Patients with Alzheimer's Disease. J Alzheimers Dis 2023; 94:1465-1475. [PMID: 37393499 DOI: 10.3233/jad-230106] [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: 07/03/2023]
Abstract
BACKGROUND Preserving activities of daily living (ADL) is the key issue for Alzheimer's disease (AD) patients and their caregivers. OBJECTIVE To clarify the ADL level of AD patients at diagnosis and the risk factors associated with decreased ADL during long-term care (≤3 years). METHODS Medical records of AD patients in a Japanese health insurance claims database were analyzed retrospectively to determine ADL using the Barthel Index (BI) and identify the risk factors associated with decreased ADL. RESULTS A total of 16,799 AD patients (mean age at diagnosis: 83.6 years, 61.5% female) were analyzed. Female patients were older (84.6 versus 81.9 years; p < 0.001) and had lower BI (46.8 versus 57.6; p < 0.001) and body mass index (BMI) (21.0 versus 21.7 kg/m2; p < 0.001) than male patients at diagnosis. Disability (BI≤60) increased at age≥80 years and was significantly higher in females. Complete disability was most frequent for bathing and grooming. Risk factors for decreased ADL were determined separately by sex through comparing the ADL-preserved and ADL-decreased groups using propensity score matching by age and BI and multivariable logistic regression analysis. In males, decreased ADL was significantly associated with BMI < 21.5 kg/m2, stroke, and hip fracture, and inversely associated with hyperlipidemia. In females, decreased ADL was significantly associated with BMI < 21.5 kg/m2 and vertebral and hip fractures, and inversely associated with lower back pain. CONCLUSION AD patients with low BMI, stroke, and fractures had increased risks of decreased ADL; such patients should be identified early and managed appropriately, including rehabilitation to preserve ADL.
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Affiliation(s)
- Keishi Akada
- Human Biology Integration Foundation, Deep Human Biology Learning, Eisai Co. Ltd., Tokyo, Japan
| | - Noriyuki Koyama
- Government Relations Strategy Department, Eisai Co. Ltd., Tokyo, Japan
| | - Yuji Miura
- Human Biology Integration Foundation, Deep Human Biology Learning, Eisai Co. Ltd., Tokyo, Japan
| | - Kentaro Takahashi
- Human Biology Integration Foundation, Deep Human Biology Learning, Eisai Co. Ltd., Ibaraki, Japan
| | - Ken Aoshima
- Microbes & Host Defense Domain, Deep Human Biology Learning, Eisai Co. Ltd., Ibaraki, Japan
- School of Integrative and Global Majors, University of Tsukuba, Ibaraki, Japan
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