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Duijvestijn M, de Wit GA, van Gils PF, Wendel-Vos GCW. Impact of physical activity on healthcare costs: a systematic review. BMC Health Serv Res 2023; 23:572. [PMID: 37268930 DOI: 10.1186/s12913-023-09556-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/16/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND This systematic review aims to describe the relation between physical inactivity and healthcare costs, by taking into account healthcare costs of physical-inactivity-related diseases (common practice), including physical-activity-related injuries (new) and costs in life-years gained due to avoiding diseases (new), whenever available. Moreover, the association between physical inactivity and healthcare costs may both be negatively and positively impacted by increased physical activity. METHODS A systematic review was conducted, including records reporting on physical (in)activity in relation to healthcare costs for a general population. Studies were required to report sufficient information to calculate the percentage of total healthcare costs potentially attributable to physical inactivity. RESULTS Of the 264 records identified, 25 were included in this review. Included studies showed substantial variation in the assessment methods of physical activity and in type of costs included. Overall, studies showed that physical inactivity is related to higher healthcare costs. Only one study included costs of healthcare resources used in prolonged life when physical-inactivity-related diseases were averted, showing net higher healthcare costs. No study included healthcare costs for physical-activity-related injuries. CONCLUSIONS Physical inactivity is associated with higher healthcare costs in the general population in the short-term. However, in the long-term aversion of diseases related with physical inactivity may increase longevity and, as a consequence, healthcare costs in life-years gained. Future studies should use a broad definition of costs, including costs in life-years gained and costs related to physical-activity-related injuries.
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Affiliation(s)
- Marjolein Duijvestijn
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| | - G Ardine de Wit
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paul F van Gils
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - G C Wanda Wendel-Vos
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Amamoto R, Shimamoto K, Suwa T, Park S, Matsumoto H, Shimizu K, Katto M, Makino H, Matsubara S, Aoyagi Y. Relationships between dietary diversity and gut microbial diversity in the elderly. Benef Microbes 2022; 13:453-464. [PMID: 36377581 DOI: 10.3920/bm2022.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Diet is considered as a major driver of gut microbiota composition. However, little is known about the relationship between overall dietary balance and gut microbiota, especially in the elderly. Here, using the Quantitative Index for Dietary Diversity (QUANTIDD), we analysed the relationships between dietary diversity and gut microbiota diversity in 445 Japanese subjects aged 65-90 years. We also examined the effect of age by comparing the young-old group aged 65 to 74 years (<75 years group; n=246) and the old-old group aged 75 years and older (≥75 years group; n=199). QUANTIDD showed significant positive relationships with Pielou's evenness and Shannon indices, two α-diversity indices related to the uniformity of species distribution. This suggests that a more diverse diet is associated with a more uniform abundance of various bacterial groups, rather than a greater variety of gut bacteria. QUANTIDD also showed significant positive associations with the abundance of Anaerostipes, Eubacterium eligens group, and Eubacterium ventriosum group, which produce short-chain fatty acids (SCFAs) and are beneficial to health. Negative association was found with the abundance of Ruminococcus gnavus group, which produces inflammatory polysaccharides. Positive associations between QUANTIDD and α-diversity indices or the abundance of specific bacterial groups were identified among all subjects and in the <75 years group, but not in the ≥75 years group. Our results suggest that dietary diversity contributes to the diversity of the gut microbiota and increases the abundance of SCFAs-producing bacteria, but only up to a certain age. These findings help to understand the complex relationship between diet and gut microbiota, and provide hints for specific dietary interventions to promote beneficial gut microbiota in the elderly.
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Affiliation(s)
- R Amamoto
- Food Research Department, Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - K Shimamoto
- Food Research Department, Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - T Suwa
- Food Research Department, Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - S Park
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi-ku, Tokyo 173-0015, Japan
| | - H Matsumoto
- Microbiological Research Department, Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - K Shimizu
- Basic Research Department, Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - M Katto
- Basic Research Department, Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - H Makino
- Food Research Department, Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - S Matsubara
- Food Research Department, Yakult Central Institute, 5-11 Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - Y Aoyagi
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi-ku, Tokyo 173-0015, Japan
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Okamoto S, Kamimura K, Shiraishi K, Sumita K, Komamura K, Tsukao A, Chijiki S, Kuno S. Daily steps and healthcare costs in Japanese communities. Sci Rep 2021; 11:15095. [PMID: 34301997 PMCID: PMC8302729 DOI: 10.1038/s41598-021-94553-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/09/2021] [Indexed: 11/14/2022] Open
Abstract
Physical inactivity is a pandemic that requires intensive, usually costly efforts for risk reduction of related chronic diseases. Nevertheless, it is challenging to determine the effectiveness of physical activity in healthcare cost reduction based on existing literature. Therefore, this study aimed to investigate the impact of physical activity (daily steps) on healthcare costs utilising the data retrieved from a health promotion project (the e-wellness Project, held in three municipalities in Japan). Evaluating the effects of daily steps, measured by pedometers, on healthcare costs by a quasi-experimental approach among participants aged 40–75 years (about 4000 person-years of observation, between 2009 and 2013), we found that a one-step-increase in the annual average daily step reduced outpatient healthcare costs by 16.26 JPY (≒ 0.11 GBD) in the short run. Based on the assumption of a dynamic relationship between the health statuses in multiple years, the long-run effects of daily steps on healthcare costs were estimated at 28.24 JPY (≒ 0.20 GBD). We determined the health benefits of walking in a sample of middle-aged and older Japanese adults by our findings that an increase in step counts reduced healthcare costs.
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Affiliation(s)
- Shohei Okamoto
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan. .,Institute for Global Health Policy Research, National Centre for Global Health and Medicine, Tokyo, Japan.
| | | | - Kenichi Shiraishi
- Department of Social Welfare, Gunma University of Health and Welfare , Gunma, Japan
| | - Kazuto Sumita
- Department of International Economics, Toyo University , Tokyo, Japan
| | | | | | | | - Shinya Kuno
- R&D Center for Smart Wellness City Policies, University of Tsukuba , Ibaraki, Japan
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Yearly changes in the composition of gut microbiota in the elderly, and the effect of lactobacilli intake on these changes. Sci Rep 2021; 11:12765. [PMID: 34140561 PMCID: PMC8211673 DOI: 10.1038/s41598-021-91917-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 06/02/2021] [Indexed: 01/19/2023] Open
Abstract
The onset and worsening of some diseases are related to the variation and instability of gut microbiota. However, studies examining the personal variation of gut microbiota in detail are limited. Here, we evaluated the yearly variation of individual gut microbiota in 218 Japanese subjects aged 66–91 years, using Jensen-Shannon distance (JSD) metrics. Approximately 9% of the subjects showed a substantial change, as their formerly predominant bacterial families were replaced over the year. These subjects consumed fermented milk products less frequently than their peers. The relationship between the intake frequencies of fermented milk products containing Lacticaseibacillus paracasei strain Shirota (LcS) and JSD values was also investigated. The intra-individual JSD of subjects ingesting LcS products ≥ 3 days/week over the past 10 years was statistically lower than the < 3 days/week group (P = 0.045). Focusing on subjects with substantial gut microbiota changes, only 1.7% of the subjects were included in the LcS intake ≥ 3 days/week group whereas 11.3% were found in the < 3 days/week group (P = 0.029). These results suggest that about one-tenth of the elderly Japanese could experience a substantial change in their gut microbiota during a 1-year period, and that the habitual intake of probiotics may stabilize their gut microbiota.
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Inada S, Yoshiuchi K, Park S, Aoyagi Y. Trajectories of objectively measured physical activity and mood states in older Japanese adults: longitudinal data from the Nakanojo Study. Biopsychosoc Med 2021; 15:5. [PMID: 33622368 PMCID: PMC7903728 DOI: 10.1186/s13030-021-00207-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 02/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background Japan, like many developed countries, now faces fiscal problems from the escalating health-care expenditures associated with an aging population. Mental health problems such as depression contribute as much to these growing demands as physical disease, and measures to prevent depression are important to controlling costs. There are few longitudinal studies examining the relation between objectively measured physical activity and depressive symptoms. Therefore, the aims of our study were to explore the patterns of change of physical activity in older Japanese adults for 5 years through the use of trajectory analysis and to examine the relation between physical activity trajectories and depressive mood states. Main body Ninety-two male and 99 female volunteers aged 65–85 years were asked to equip themselves with an electronic accelerometer with a 60-day storage capacity for at least 5 years. The parameters calculated each July for the 5 years were the average daily step count and the average daily duration of activity > 3 METs (moderate to vigorous physical activity: MVPA). Hospital Anxiety and Depression Scale (HADS) assessed corresponding mood states (HADS-A and HADS-D). Trajectories of the accelerometer data were analyzed and fifth-year HADS-D and HADS-A scores were compared among trajectory groups using an analysis of covariance (ANCOVA) that controlled for baseline scores and for baseline scores and age. Six and five distinct trajectories were identified for daily step count and for daily duration of MVPA, respectively. Using ANCOVA controlling for baseline scores, HADS-D scores differed significantly among trajectory groups classed by daily duration of MVPA (p = 0.04), and Tukey’s multiple comparison tests showed significant differences between group 2, whose pattern was stable with the middle duration of MVPA, and group 1, whose pattern was stable with the lowest duration of MVPA (p = 0.02), while the results were not significant controlling for both baseline scores and age. Conclusions Older people with less MVPA continued to do less MVPA over the 5 years of study, which may be related to a future more depressive mood. Further clinical studies will be necessary to clarify these findings.
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Affiliation(s)
- Shuji Inada
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
| | - Sungjin Park
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, 35-1 Sakecho, Itabashi-ku, Tokyo, Japan
| | - Yukitoshi Aoyagi
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, 35-1 Sakecho, Itabashi-ku, Tokyo, Japan
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A Kinect-Based Interactive System for Home-Assisted Active Aging. SENSORS 2021; 21:s21020417. [PMID: 33435557 PMCID: PMC7827281 DOI: 10.3390/s21020417] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 12/24/2020] [Accepted: 12/30/2020] [Indexed: 11/17/2022]
Abstract
Virtually every country in the world is facing an unprecedented challenge: society is aging. Assistive technologies are expected to play a key role in promoting healthy lifestyles in the elderly. This paper presents a Kinect-based interactive system for home-assisted healthy aging, which guides, supervises, and corrects older users when they perform scheduled physical exercises. Interactions take place in gamified environments with augmented reality. Many graphical user interface elements and workflows have been designed considering the sensory, physical and technological shortcomings of the elderly, adapting accordingly the interaction methods, graphics, exercises, tolerance margins, physical goals, and scoring criteria. Experiments involved 57 participants aged between 65 and 80 who performed the same physical routine six times during 15 days. After each session, participants completed a usability survey. Results provided significant evidence that support (1) the effectiveness of the system in assisting older users of different age ranges, (2) the accuracy of the system in measuring progress in physical achievement of the elderly, and (3) a progressive acceptance of the system as it was used. As a main conclusion, the experiments verified that despite their poor technological skills, older people can adapt positively to the use of an interactive assistance tool for active aging if they experience clear benefits.
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Codogno JS, Monteiro HL, Turi-Lynch BC, Fernandes RA, Pokhrel S, Anokye N. Sports Participation and Health Care Costs in Older Adults Aged 50 Years or Older. J Aging Phys Act 2020; 28:634-640. [PMID: 32053793 DOI: 10.1123/japa.2019-0219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 11/21/2019] [Accepted: 11/24/2019] [Indexed: 11/18/2022]
Abstract
The objective of the study was to analyze the relationship between sports participation and health care costs in older adults. The sample was composed of 556 participants (145 men and 411 women) who were followed from 2010 to 2014. The engagement in sports considered three different components (intensity, volume, and previous time). Health care costs were assessed annually through medical records. Structural equation modeling (longitudinal relationship between sport and costs) and analysis of variance for repeated measures (comparisons over time) were used. Health care costs increased significantly from 2010 to 2014 (analysis of variance; p value = .001). Higher baseline scores for intensity were related to lower health care costs (r = -.223, 95% confidence interval [-.404, -.042]). Similar results were found to volume (r = -.216, 95% confidence interval [-.396, -.036]) and time of engagement (r = -.218, 95% confidence interval [-.402, -.034]). In conclusion, higher sports participation is related to lower health care costs in older adults.
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Yamashita K, Yamashita T, Sato M, Inoue M, Takase Y. The Effects of an 18-Month Walking Habit Intervention on Reducing the Medical Costs of Diabetes, Hypertension, and Hyperlipidemia—A Prospective Study. ADVANCED BIOMEDICAL ENGINEERING 2020. [DOI: 10.14326/abe.9.117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Yamashita T, Yamashita K, Sato M, Takase Y. Effect of walking on depression prevalence for diabetes using information communication technology: Prospective study. Geriatr Gerontol Int 2019; 19:1147-1152. [PMID: 31646729 DOI: 10.1111/ggi.13787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 08/25/2019] [Accepted: 09/10/2019] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to evaluate the prevention of diabetic depression and its impact on medical costs through the implementation of a step count monitoring system using information and communication technology. METHODS This study carried out a longitudinal analysis of a prospective cohort. A total of 296 participants were enrolled in the intervention group and 882 participants in the control group. The participants in the intervention group were provided with pedometers, which each participant was asked to scan using devices stationed throughout the city. Activity data were stored in real time by a cloud system. The experiment lasted 30 months. RESULTS None of the diabetes patients in the intervention group was diagnosed with depression during the study period, compared with 4.09% in the control group. Thus, the intervention suppressed the increase in medical costs for the people who did not develop depression in the diabetic group. CONCLUSIONS The prevalence rate of depression among the participants with diabetes was lowered significantly. The medical costs of the participants who did not have diabetes were also reduced by implementing the step count monitoring system with information and communication technology. This shows that the use of an information and communication technology pedometer system can have favorable effects in terms of preventing depression in diabetes patients and further benefits for non-diabetic people. Geriatr Gerontol Int 2019; 19: 1147-1152.
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Affiliation(s)
| | | | - Mitsuru Sato
- School of Nursing and Rehabilitation Sciences, Showa University, Kanagawa, Japan
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10
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Yuki A, Otsuka R, Tange C, Nishita Y, Tomida M, Ando F, Shimokata H, Arai H. Daily Physical Activity Predicts Frailty Development Among Community-Dwelling Older Japanese Adults. J Am Med Dir Assoc 2019; 20:1032-1036. [DOI: 10.1016/j.jamda.2019.01.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 01/01/2019] [Accepted: 01/03/2019] [Indexed: 01/09/2023]
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Aoyagi Y, Amamoto R, Park S, Honda Y, Shimamoto K, Kushiro A, Tsuji H, Matsumoto H, Shimizu K, Miyazaki K, Matsubara S, Shephard RJ. Independent and Interactive Effects of Habitually Ingesting Fermented Milk Products Containing Lactobacillus casei Strain Shirota and of Engaging in Moderate Habitual Daily Physical Activity on the Intestinal Health of Older People. Front Microbiol 2019; 10:1477. [PMID: 31417501 PMCID: PMC6684969 DOI: 10.3389/fmicb.2019.01477] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 06/13/2019] [Indexed: 12/12/2022] Open
Abstract
Infrequent bowel movements decrease the number of beneficial bacteria in the human intestines, thereby potentially increasing the individual's risk of colorectal cancer. The correction of such bowel problems could therefore make an important contribution to improving population health and quality-adjusted lifespan. We examined independent and interactive effects upon the fecal microbiota of two potentially favorable determinants of intestinal motility: the intake frequency of a fermented milk product containing Lactobacillus casei strain Shirota (LcS) and the quantity/quality of habitual physical activity in 338 community-living Japanese aged 65-92 years. Subjects were arbitrarily grouped on the basis of questionnaire estimates of LcS intake (0-2, 3-5, and 6-7 days/week) and pedometer/accelerometer-determined patterns of physical activity [<7000 and ≥7000 steps/day, or <15 and ≥15 min/day of activity at an intensity >3 metabolic equivalents (METs)]. After adjustment for potential confounders, the respective numbers of various beneficial fecal bacteria tended to be larger in more frequent consumers of LcS-containing products, this trend being statistically significant (mostly P < 0.001) for total Lactobacillus, the Lactobacillus casei subgroup, and the Atopobium cluster; in contrast, there were no statistically significant differences in fecal bacterial counts between the physical activity groups. A multivariate-adjusted logistic regression analysis estimated that the risk of infrequent bowel movements (arbitrarily defined as defecating ≤3 days/week) was significantly lower (P < 0.05) in subjects who ingested LcS-containing products 6-7 rather than 0-2 days/week [odds ratio (95% confidence interval) 0.382 (0.149-0.974)] and was also lower in those who took ≥7000 rather than <7000 steps/day [0.441 (0.201-0.971)] or spent ≥15 rather than <15 min/day of physical activity at an intensity >3 METs [0.412 (0.183-0.929)]. The risk of infrequent bowel movements in subjects who combined 6-7 days/week of LcS with ≥7000 steps/day or ≥15 min/day of activity at >3 METs was only a tenth of that for individuals who combined 0-2 days/week of LcS with <7000 steps/day or <15 min/day at >3 METs. These results suggest that elderly individuals can usefully ingest LcS-containing supplements regularly (≥6 days/week) and also engage in moderate habitual physical activity (≥7000 steps/day and/or ≥15 min/day at >3 METs) in order to enhance their gastrointestinal health.
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Affiliation(s)
- Yukitoshi Aoyagi
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ryuta Amamoto
- Food Research Department, Yakult Central Institute, Tokyo, Japan
| | - Sungjin Park
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yusuke Honda
- Food Research Department, Yakult Central Institute, Tokyo, Japan
| | | | - Akira Kushiro
- Microbiological Research Department, Yakult Central Institute, Tokyo, Japan
| | - Hirokazu Tsuji
- Basic Research Department, Yakult Central Institute, Tokyo, Japan
| | | | - Kensuke Shimizu
- Microbiological Research Department, Yakult Central Institute, Tokyo, Japan
| | - Kouji Miyazaki
- Food Research Department, Yakult Central Institute, Tokyo, Japan
| | | | - Roy J Shephard
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
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Morais LC, Rocha APR, Turi-Lynch BC, Ferro IS, Koyama KAK, Araújo MYC, Codogno JS. Health indicators and costs among outpatients according to physical activity level and obesity. Diabetes Metab Syndr 2019; 13:1375-1379. [PMID: 31336495 DOI: 10.1016/j.dsx.2019.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 02/12/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE How biochemical variables influence the costs of the Brazilian National Healthcare System, according to body composition and physical activity. METHODS Participated in this study 168 patients. Biochemical variables were glucose, triglycerides, total cholesterol, high, low, very low density lipoprotein and C-reactive protein (CRP). For the cost analysis the medical records was analyzed. Physical activity was assessed through questionnaire. Body adiposity was assessed by body mass index. Four groups were defined according body adiposity and physical activity. RESULTS The active obese group had higher values of very low density lipoprotein and triglycerides when compared to the inactive obese. The non-obese inactive group had lower values of non-high density lipoprotein compared to the inactive obese. The non-obese active group presented lower insulin value when compared to the inactive obese. The inactive obese group presented higher values in the CRP when compared to the non-obese active and inactive groups when compared to non-obese and active obese group. There was a positive correlation between insulin, glucose, CRP and drug and total costs. CONCLUSIONS Biochemical variables were different according to body composition and physical activity. Insulin, glucose and CRP were related to cost in drugs and total costs.
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Affiliation(s)
- Luana C Morais
- São Paulo State University Department of Physical Education, School of Sciences and Technology, São Paulo State University-UNESP, 305 Roberto Simonsen, 19060-900, Presidente Prudente, Brazil.
| | - Ana Paula R Rocha
- Department of Physiotherapy, Woman's Health Research Laboratory - LAMU, Federal University of São Carlos - UFSCar, 235 Km Rod. Washington Luis, 13565-905, São Carlos, Brazil.
| | - Bruna C Turi-Lynch
- Department of Physical Education, School of Sciences and Technology, São Paulo State University-UNESP, 305 Roberto Simonsen, 19060-900, Presidente Prudente, Brazil.
| | - Izabela S Ferro
- Department of Physical Education, School of Sciences and Technology, São Paulo State University, 305 Rua Roberto Símonsen, 19060-900, Presidente Prudente, Brazil.
| | - Kelly A K Koyama
- Department of Physiotherapy, Woman's Health Research Laboratory - LAMU, Federal University of São Carlos - UFSCar, 235 Km Rod. Washington Luis, 13565-905, São Carlos, Brazil.
| | - Monique Y C Araújo
- Department of Physiotherapy, Woman's Health Research Laboratory - LAMU, Federal University of São Carlos - UFSCar, 235 Km Rod. Washington Luis, 13565-905, São Carlos, Brazil.
| | - Jamile S Codogno
- Department of Physiotherapy, Woman's Health Research Laboratory - LAMU, Federal University of São Carlos - UFSCar, 235 Km Rod. Washington Luis, 13565-905, São Carlos, Brazil.
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13
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Cho S, Park S, Takahashi S, Yoshiuchi K, Shephard RJ, Aoyagi Y. Changes in and Interactions between Physical and Mental Health in Older Japanese: The Nakanojo Study. Gerontology 2018; 65:340-352. [PMID: 30566936 DOI: 10.1159/000494383] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/10/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND An age-related decrease in functional capacity is consistently reported, but it is not consistently related to a worsening of health-related quality of life (HRQOL) or psychological adjustment. A poor functional capacity and HRQOL have been associated with anxiety or depression, but the possible causal nature and direction of the relationship remain to be explored using long-term longitudinal data. OBJECTIVE The purpose of this study was to examine age-related changes in functional capacity, HRQOL, and scores on the Hospital Anxiety and Depression Scale (HADS), and possible causal interrelationships between these variables. METHODS Study participants were 5,124 Japanese aged ≥65 years. After the baseline study (2003), annual follow-up observations continued for 10 years. Generalized linear mixed models examined age-related changes in Barthel index (BI), Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), HRQOL, and HADS. Cross-lagged effects models tested possible causal interrelationships. RESULTS With age, functional capacity and HRQOL scores showed similar declines in both sexes. Changes in mental health, anxiety, and depression developed more slowly than decreases in physical health (BI, TMIG-IC, and physical functioning scores). Cross-lagged effects models demonstrated that functional capacity had positive effects on psychological adjustment, and that psychological adjustment had positive effects on functional capacity 5 years later. Interactions between functional capacity and psychological adjustment showed no sex differences. A decline in functional capacity negatively affected psychological adjustment, but reduced psychological adjustment had no significant impact on functional capacity 5 and 10 years later. Moreover, functional capacity and poor psychological adjustment showed no interactions in either sex. CONCLUSION Functional capacity and mood state are interrelated. Greater function could sustain vitality and mental health, possibly reducing anxiety and depression.
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Affiliation(s)
- Sunyoung Cho
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Sungjin Park
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shin Takahashi
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Roy J Shephard
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Yukitoshi Aoyagi
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
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Aoyagi Y, Park S, Cho S, Shephard RJ. Objectively measured habitual physical activity and sleep-related phenomena in 1645 people aged 1-91 years: The Nakanojo Community Study. Prev Med Rep 2018; 11:180-186. [PMID: 29992084 PMCID: PMC6037906 DOI: 10.1016/j.pmedr.2018.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/04/2018] [Accepted: 06/24/2018] [Indexed: 11/28/2022] Open
Abstract
Relationships between habitual physical activity and sleep-related phenomena were examined in 623 male and 1022 female Japanese participating in the Nakanojo Community Study, using data collected in 2012–2013. Ages ranged from infancy to very old. Daily step count and daily duration of exercise at an intensity >3 metabolic equivalents (METs) were determined by pedometer/accelerometer, 24 h/day for 1 week. Duplicate axillary temperatures were also taken on rising and when retiring. Total bed time was noted, and the efficiency of sleep determined as hours of actual sleep (from a validated pedometer/accelerometer algorithm) divided by bed time. Step counts and especially duration of activity >3 METs peaked in teenagers and decreased as age advanced (p < 0.001). Both axillary temperatures subsequently showed a gradual age-related decline (p < 0.001). The duration and efficiency of sleep also showed a small age-dependent decrease (p < 0.001). Multivariate-adjusted correlation coefficients indicated a better quality of sleep in individuals who took greater habitual physical activity. In individuals aged ≥40 years, these findings were modified by chronic disease conditions including hypertension, diabetes mellitus and hyperlipemia; after controlling statistically for potential confounders, both physical activity and axillary temperature were lower (p < 0.05 or 0.01), and the time spent lying was longer but the efficiency of sleep was poorer (p < 0.01) in those with chronic conditions. These results suggest that habitual physical activity bears an important relationship to sleep-related phenomena at all ages, with a modification of relationships by chronic disease in people aged ≥40 years. Habitual physical activity is related to body temperature and sleep patterns. Body temperature is higher and sleep quality is better in physically active people. In people aged ≥40 years, these relationships are modified by chronic disease. Physical activity and body temperature are lower in older people with chronic disease. The time spent lying is longer but the quality of sleep is poorer in such people.
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Affiliation(s)
- Yukitoshi Aoyagi
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Itabashi, Tokyo, Japan
| | - Sungjin Park
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Itabashi, Tokyo, Japan
| | - Sunyoung Cho
- Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, Itabashi, Tokyo, Japan
| | - Roy J Shephard
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Sikes EM, Richardson EV, Cederberg KJ, Sasaki JE, Sandroff BM, Motl RW. Use of the Godin leisure-time exercise questionnaire in multiple sclerosis research: a comprehensive narrative review. Disabil Rehabil 2018; 41:1243-1267. [PMID: 29343122 DOI: 10.1080/09638288.2018.1424956] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE The Godin Leisure-Time Exercise Questionnaire has been a commonly applied measure of physical activity in research among persons with multiple sclerosis over the past decade. This paper provides a comprehensive description of its application and inclusion in research on physical activity in multiple sclerosis. METHOD This comprehensive, narrative review included papers that were published between 1985 and 2017, written in English, involved participants with multiple sclerosis as a primary population, measured physical activity, and cited one of the two original Godin papers. RESULTS AND CONCLUSION There is a broad scope of research that has included the Godin Leisure-Time Exercise Questionnaire in persons with multiple sclerosis. Overall, 8 papers evaluated its psychometric properties, 21 evaluated patterns of physical activity, 24 evaluated correlates or determinants of physical activity, 28 evaluated outcomes or consequences of physical activity, and 15 evaluated physical activity interventions. The Godin Leisure-Time Exercise Questionnaire is a valid self-report measure of physical activity in persons with multiple sclerosis, and further is an appropriate, simple, and effective tool for describing patterns of physical activity, examining correlates and outcomes of physical activity, and provides a sensitive outcome for measuring change in physical activity after an intervention. Implications for rehabilitation There is increasing interest in physical activity and its benefits in multiple sclerosis. The study of physical activity requires appropriate and standardized measures. The Godin Leisure-Time Exercise Questionnaire is a common self-report measure of physical activity for persons with multiple sclerosis. Godin Leisure-Time Exercise Questionnaire scores are reliable measures of physical activity in persons with multiple sclerosis. The Godin Leisure-Time Exercise Questionnaire further is an appropriate, simple, and effective tool for describing patterns of physical activity, examining correlates and outcomes of physical activity participation, and is an advantageous primary outcome for measuring change in physical activity in response to an intervention.
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Affiliation(s)
- Elizabeth Morghen Sikes
- a School of Health Professions - Rehabilitation Science , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Emma V Richardson
- b Department of Physical Therapy , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Katie J Cederberg
- a School of Health Professions - Rehabilitation Science , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Jeffer E Sasaki
- b Department of Physical Therapy , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Brian M Sandroff
- b Department of Physical Therapy , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Robert W Motl
- b Department of Physical Therapy , University of Alabama at Birmingham , Birmingham , AL , USA
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Cost-Effectiveness of a Community Exercise and Nutrition Program for Older Adults: Texercise Select. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050545. [PMID: 28531094 PMCID: PMC5451995 DOI: 10.3390/ijerph14050545] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/16/2017] [Accepted: 05/17/2017] [Indexed: 01/20/2023]
Abstract
The wide-spread dissemination of evidence-based programs that can improve health outcomes among older populations often requires an understanding of factors influencing community adoption of such programs. One such program is Texercise Select, a community-based health promotion program previously shown to improve functional health, physical activity, nutritional habits and quality of the life among older adults. This paper assesses the cost-effectiveness of Texercise Select in the context of supportive environments to facilitate its delivery and statewide sustainability. Participants were surveyed using self-reported instruments distributed at program baseline and conclusion. Program costs were based on actual direct costs of program implementation and included costs of recruitment and outreach, personnel costs and participant incentives. Program effectiveness was measured using quality-adjusted life year (QALY) gained, as well as health outcomes, such as healthy days, weekly physical activity and Timed Up-and-Go (TUG) test scores. Preference-based EuroQol (EQ-5D) scores were estimated from the number of healthy days reported by participants and converted into QALYs. There was a significant increase in the number of healthy days (p < 0.05) over the 12-week program. Cost-effectiveness ratios ranged from $1374 to $1452 per QALY gained. The reported cost-effective ratios are well within the common cost-effectiveness threshold of $50,000 for a gained QALY. Some sociodemographic differences were also observed in program impact and cost. Non-Hispanic whites experienced significant improvements in healthy days from baseline to the follow-up period and had higher cost-effectiveness ratios. Results indicate that the Texercise Select program is a cost-effective strategy for increasing physical activity and improving healthy dietary practices among older adults as compared to similar health promotion interventions. In line with the significant improvement in healthy days, physical activity and nutrition-related outcomes among participants, this study supports the use of Texercise Select as an intervention with substantial health and cost benefits.
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Ding D, Kolbe-Alexander T, Nguyen B, Katzmarzyk PT, Pratt M, Lawson KD. The economic burden of physical inactivity: a systematic review and critical appraisal. Br J Sports Med 2017; 51:1392-1409. [PMID: 28446455 DOI: 10.1136/bjsports-2016-097385] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To summarise the literature on the economic burden of physical inactivity in populations, with emphases on appraising the methodologies and providing recommendations for future studies. DESIGN Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number CRD42016047705). DATA SOURCES Electronic databases for peer-reviewed and grey literature were systematically searched, followed by reference searching and consultation with experts. ELIGIBILITY CRITERIA Studies that examined the economic consequences of physical inactivity in a population/population-based sample, with clearly stated methodologies and at least an abstract/summary written in English. RESULTS Of the 40 eligible studies, 27 focused on direct healthcare costs only, 13 also estimated indirect costs and one study additionally estimated household costs. For direct costs, 23 studies used a population attributable fraction (PAF) approach with estimated healthcare costs attributable to physical inactivity ranging from 0.3% to 4.6% of national healthcare expenditure; 17 studies used an econometric approach, which tended to yield higher estimates than those using a PAF approach. For indirect costs, 10 studies used a human capital approach, two used a friction cost approach and one used a value of a statistical life approach. Overall, estimates varied substantially, even within the same country, depending on analytical approaches, time frame and other methodological considerations. CONCLUSION Estimating the economic burden of physical inactivity is an area of increasing importance that requires further development. There is a marked lack of consistency in methodological approaches and transparency of reporting. Future studies could benefit from cross-disciplinary collaborations involving economists and physical activity experts, taking a societal perspective and following best practices in conducting and reporting analysis, including accounting for potential confounding, reverse causality and comorbidity, applying discounting and sensitivity analysis, and reporting assumptions, limitations and justifications for approaches taken. We have adapted the Consolidated Health Economic Evaluation Reporting Standards checklist as a guide for future estimates of the economic burden of physical inactivity and other risk factors.
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Affiliation(s)
- Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia.,Centre for Chronic Disease Prevention, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Australia
| | - Tracy Kolbe-Alexander
- Department of Human Biology, Research Unit for Exercise Science and Sports Medicine (ESSM), Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,School of Health and Wellbeing, University of Southern Queensland, Ipswich, Australia
| | - Binh Nguyen
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Michael Pratt
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
| | - Kenny D Lawson
- Centre for Chronic Disease Prevention, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Australia.,Centre for Health Research, School of Medicine, Western Sydney University, Penrith, Australia
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Kodama A, Kume Y, Tsugaruya M, Ishikawa T. Deriving the reference value from the circadian motor active patterns in the “non-dementia” population, compared to the “dementia” population: What is the amount of physical activity conducive to the good circadian rhythm. Chronobiol Int 2016; 33:1056-63. [DOI: 10.1080/07420528.2016.1196696] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ayuto Kodama
- Doctor Course, Graduate School of Health Sciences, Akita University, Hondo Akitaken, Japan
| | - Yu Kume
- Department of Occupational Therapy, Graduate School of Health Sciences, Akita University, Hondo Akitaken, Japan
| | - Megumi Tsugaruya
- Department of Occupational Therapy, Graduate School of Health Sciences, Akita University, Hondo Akitaken, Japan
| | - Takashi Ishikawa
- Department of Occupational Therapy, Graduate School of Health Sciences, Akita University, Hondo Akitaken, Japan
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Rosa CSC, Bueno DR, Souza GD, Gobbo LA, Freitas IF, Sakkas GK, Monteiro HL. Factors associated with leisure-time physical activity among patients undergoing hemodialysis. BMC Nephrol 2015; 16:192. [PMID: 26613791 PMCID: PMC4662813 DOI: 10.1186/s12882-015-0183-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 11/02/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND End-stage renal disease patients are characterized by low levels of physical activity, especially during leisure time. However, the recognition of variables associated with patterns of physical activity in this population has been little explored. Thus, the objective was to assess factors associated with levels of physical activity during leisure time among patients on haemodialysis. METHODS Ninety-eight patients (51.6 ± 15.7 years, 57 M/41 F) from two dialysis centres in São Paulo, Brazil participated in this cross-sectional study. Participants were divided into those who never exercised during leisure-time (inactive) and those who exercised at least once a week (active). The independent factors assessed were: socio-demographic data, comorbidities, personal barriers to exercise and physical activity records from childhood to adulthood (tracking of physical activity). RESULTS Only 27 % of patients were engaged in PA during their leisure time at least once a week. Patients who engaged in regular physical activity during adulthood before the initiation of the hemodialysis treatment (adjusted OR: 7.24 95 % IC: 1.99; 26.50), those who developed the renal disease through diseases other than diabetes or hypertension (adjusted OR: 4.82; 95 % IC: 1.48; 15.68), and those who had no cardiovascular diseases (adjusted OR: 11.33; 95 % IC: 1.23; 103.8) where more likely to be active during their leisure-time. CONCLUSION Comorbidities such as cardiovascular disease, hypertension and diabetes mellitus as well as the level of physical activity prior to end-stage renal disease could predict leisure-time physical activity among patients receiving hemodialysis therapy.
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Affiliation(s)
- Clara S C Rosa
- Unesp - Instituto de Biociências, Campus de Rio Claro, Seção Técnica de Pós-graduação, Sao Paulo State University, Avenida 24-A n° 1515 - Bairro Bela Vista, 13506-900, Rio Claro/SP, Brazil.
| | - Denise R Bueno
- Department of Public Health and Nutrition, University of Sao Paulo, Sao Paulo, Brazil.
| | - Giovana D Souza
- Department of Medicine, Sao Paulo State University, Botucatu, Brazil.
| | - Luís A Gobbo
- Department of Physical Education, Sao Paulo State University, Presidente Prudente, Brazil.
| | - Ismael F Freitas
- Department of Physical Education, Sao Paulo State University, Presidente Prudente, Brazil.
| | - Giorgos K Sakkas
- School of Physical Education and Sport Science, University of Thessaly, Trikala, Greece.
| | - Henrique L Monteiro
- Department of Physical Education, Sao Paulo State University, Bauru, Brazil.
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Baba T, Hagino H, Nonomiya H, Ikuta T, Shoda E, Mogami A, Sawaguchi T, Kaneko K. Inadequate management for secondary fracture prevention in patients with distal radius fracture by trauma surgeons. Osteoporos Int 2015; 26:1959-63. [PMID: 25792493 DOI: 10.1007/s00198-015-3103-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 03/06/2015] [Indexed: 11/29/2022]
Abstract
UNLABELLED We evaluated the secondary fracture prevention in 1445 patients with distal radius fracture by trauma surgeons. The rate of patients with distal radius fracture who underwent bone mineral density (BMD) examination was low, suggesting that appropriate treatment for osteoporosis by trauma surgeons is not performed at present. INTRODUCTION To clarify the status of osteoporosis interventions after distal radial fractures by trauma surgeons who play the main role in treatment for these fractures, we performed a survey involving multiple institutions in Japan. METHODS We asked 155 board members of the Japanese Society for Fracture Repair for their cooperation and performed a survey in 48 institutions with which members who gave cooperation were affiliated. The subjects consisted of consecutive patients with distal radial fractures occurring between January and December 2012. The presence or absence of a diagnosis of osteoporosis and bone mineral density examination after fracture was investigated. RESULTS A total of 1445 patients with distal radial fractures were evaluated in this study. BMD examination for diagnosis and treatment for osteoporosis after fracture was performed respectively in 126 (8.7 %) and 193 (13.4 %) of 1445 patients. Treatment for osteoporosis was performed in 93 (73.8 %) of 126 patients who underwent BMD examination after fracture and 100 (8.2 %) of 1219 who did not undergo BMD examination. Of the 126 patients who underwent BMD examination after fracture, 89 showed a BMD <80 % of the young adult mean as a criterion for the initiation of drug treatment for osteoporosis in Japan and 77 (86.5 %) of the 89 patients were treated with drugs. CONCLUSIONS The rate of patients with distal radial fractures who underwent BMD examination was low, suggesting that appropriate treatment for osteoporosis by trauma surgeons is not performed at present.
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Affiliation(s)
- T Baba
- Department of Orthopaedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan,
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Physical Activity and the Risk of Cardio-Metabolic Disease in the Elderly: Dose Recommendations as Seen in the Nakanojo Study. CURRENT CARDIOVASCULAR RISK REPORTS 2014. [DOI: 10.1007/s12170-014-0387-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Suh EE, Kim H, Kang J, Kim H, Park KO, Jeong BL, Park SM, Jeong SY, Park KJ, Lee K, Jekal M. Outcomes of a culturally responsive health promotion program for elderly Korean survivors of gastrointestinal cancers: a randomized controlled trial. Geriatr Nurs 2013; 34:445-52. [PMID: 24156925 DOI: 10.1016/j.gerinurse.2013.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 09/13/2013] [Accepted: 09/23/2013] [Indexed: 11/25/2022]
Abstract
This single-blind, prospective, randomized controlled trial was designed to evaluate the effects of a culturally responsive health promotion program for elderly Korean (CHP-K) survivors of gastrointestinal (GI) cancers. The program consisted of 8 weeks of Qi exercise and face-to-face counseling on physical and psychological factors. A total of 63 Korean GI cancer survivors, aged ≥65 years, who had completed their active cancer treatment, were recruited from a cancer center in South Korea. Outcomes included the amount of exercise, body weight, BMI, the Patient Generated Subjective Global Assessment scale, the M.D. Anderson Symptom Inventory, and self-efficacy and self-esteem scales. Repeated measures MANCOVA revealed a significant difference over time between the groups (Wilks' Lambda F1,62 = 5.361, p = 0.007). Univariate RM-ANCOVA for each outcome measure revealed statistically significant differences between groups. These results suggested that the participation in the CHP-K may have enhanced the health of elderly Korean GI cancer survivors.
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Affiliation(s)
- Eunyoung E Suh
- College of Nursing, Research Institute of Nursing Science, Seoul National University, Room 513, 103 Daehak-ro, Jongno-gu, Seoul 110-799, Republic of Korea.
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Abstract
BACKGROUND This study aimed to explore the experiences and challenges of informal caregivers in Singapore with the intent of identifying the multi-dimensional unmet needs from their perspective and generating caregivers' needs checklist based on the findings. METHODS Informal caregivers were relatives of people with dementia and were responsible for organizing care and providing regular physical and/or financial support. Using a qualitative research design, informal caregivers' experiences were explored. A total of ten focus group discussions and 12 semi-structured interviews were conducted with adult caregivers. Caregivers' perceived unmet needs were identified using thematic analysis. Findings from the qualitative study were combined with inputs from professionals to create a checklist of caregivers' needs for dementia. RESULTS The average age of the participants was 52.9 years; the majority of the participants were of Chinese ethnicity (50%), followed by Indian (23%), Malay (22%), and other (3%) ethnic groups. Informal caregivers perceived four categories of unmet needs: (i) emotional and social support, (ii) information, (iii) financial support, and (iv) accessible and appropriate facilities. Caregivers strongly expressed the need for emotional support to overcome the psychological and physical burden of care. Challenges with obtaining adequate information, access to services, and financial barriers were discussed. Based on these findings and expert panel discussions, a checklist of 26 items representing their unmet needs was designed. CONCLUSIONS Informal caregivers face several challenges while caring for their relative with dementia and hence there is a clear demand to address their unmet needs for information, services, respite, and emotional and financial support.
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Kurti AN, Dallery J. Internet-based contingency management increases walking in sedentary adults. J Appl Behav Anal 2013; 46:568-81. [DOI: 10.1002/jaba.58] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 03/04/2013] [Indexed: 11/10/2022]
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Aoyagi Y, Shephard RJ. Sex differences in relationships between habitual physical activity and health in the elderly: Practical implications for epidemiologists based on pedometer/accelerometer data from the Nakanojo Study. Arch Gerontol Geriatr 2013; 56:327-38. [DOI: 10.1016/j.archger.2012.11.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 11/19/2012] [Accepted: 11/20/2012] [Indexed: 10/27/2022]
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Kimura M, Moriyasu A, Kumagai S, Furuna T, Akita S, Kimura S, Suzuki T. Community-based intervention to improve dietary habits and promote physical activity among older adults: a cluster randomized trial. BMC Geriatr 2013; 13:8. [PMID: 23343312 PMCID: PMC3560222 DOI: 10.1186/1471-2318-13-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 01/12/2013] [Indexed: 11/10/2022] Open
Abstract
Background The fastest growing age group globally is older adults, and preventing the need for long-term nursing care in this group is important for social and financial reasons. A population approach to diet and physical activity through the use of social services can play an important role in prevention. This study examined the effectiveness of a social health program for community-dwelling older adults aimed at introducing and promoting physical activity in the home at each individual’s pace, helping participants maintain good dietary habits by keeping self-check sheets, and determining whether long-standing unhealthy or less-than-ideal physical and dietary habits can be changed. Method This cluster randomized trial conducted at 6 community centers in an urban community involved 92 community-dwelling older adults aged 65–90 years. The intervention group (3 community centers; n = 57) participated in the social health program “Sumida TAKE10!” which is an educational program incorporating the “TAKE10!® for Older Adults” program, once every 2 weeks for 3 months. The control group (3 community centers; n=35) was subsequently provided with the same program as a crossover intervention group. The main outcome measures were changes in food intake frequency, food frequency score (FFS), dietary variety score (DVS), and frequency of walking and exercise. The secondary outcome measures were changes in self-rated health, appetite, and the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence score. Results Compared to baseline, post-intervention food intake frequency for 6 of 10 food groups (meat, fish/shellfish, eggs, potatoes, fruits, and seaweed), FFS, and DVS were significantly increased in the intervention group, and interaction effects of FFS and DVS were seen between the two groups. No significant differences were observed between baseline and post-intervention in the control group. Frequency of walking and exercise remained unchanged in both groups, and no significant difference in improvement rate was seen between the groups. Self-rated health was significantly increased in the intervention group. Appetite and TMIG Index of Competence score were unchanged in both groups. Conclusions The social health program resulted in improved dietary habits, as measured by food intake frequency, FFS, and DVS, and may improve self-rated health among community-dwelling older adults. Trial registration number UMIN000007357
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Affiliation(s)
- Mika Kimura
- Center for Health Promotion, International Life Sciences Institute Japan, Nishikawa Bldg, 3-5-19 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan.
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Tudor-Locke C. Walk more (frequently, farther, faster): the perfect preventive medicine. Prev Med 2012; 55:540-1. [PMID: 22819847 DOI: 10.1016/j.ypmed.2012.07.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 07/09/2012] [Accepted: 07/10/2012] [Indexed: 01/12/2023]
Affiliation(s)
- Catrine Tudor-Locke
- Walking Behavior Laboratory, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA.
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Cao Y, Jones G, Cicuttini F, Winzenberg T, Wluka A, Sharman J, Nguo K, Ding C. Vitamin D supplementation in the management of knee osteoarthritis: study protocol for a randomized controlled trial. Trials 2012; 13:131. [PMID: 22867111 PMCID: PMC3503652 DOI: 10.1186/1745-6215-13-131] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 07/18/2012] [Indexed: 01/29/2023] Open
Abstract
Background Osteoarthritis (OA) is a common health issue worldwide in the aging population who are also commonly deficient in vitamin D. Our previous study suggested that higher serum 25-(OH)D levels were associated with reduced knee cartilage loss, implying that vitamin D supplementation may prevent the progression of knee OA. The aim of the VItamin D Effects on OA (VIDEO) study is to compare, over a 2- year period, the effects of vitamin D supplementation versus placebo on knee structural changes, knee pain, and lower limb muscle strength in patients with symptomatic knee OA. Methods/design Randomised, placebo-controlled, and double-blind clinical trial aiming to recruit 400 subjects (200 from Tasmania and 200 from Victoria) with both symptomatic knee OA and vitamin D deficiency (serum [25-(OH)D] level of >12.5 nmol/liter and <60 nmol/liter). Participants will be randomly allocated to vitamin D supplementation (50,000 IU compounded vitamin D3 capsule monthly) or identical inert placebo group for 2 years. The primary endpoint is loss of knee cartilage volume measured by magnetic resonance imaging (MRI) and Western Ontario and McMaster Universities Index of OA (WOMAC) knee pain score. The secondary endpoints will be other knee structural changes, and lower limb muscle strength. Several other outcome measures including core muscle images and central blood pressure will be recorded. Linear and logistic regression will be used to compare changes between groups using univariable and multivariable modeling analyses. Both intention to treat and per protocol analyses will be utilized. Discussion The trial is designed to test if vitamin D supplementation will reduce loss of knee cartilage volume, prevent the progression of other knee structural abnormalities, reduce knee pain and strengthen lower limb muscle strength, thus modify disease progression in knee OA. Trial registration ClinicalTrials.gov identifier: NCT01176344; Australian New Zealand Clinical Trials Registry: ACTRN12610000495022
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Affiliation(s)
- Yuelong Cao
- Menzies Research Institute Tasmania, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
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