Determination of phytase labile organic phosphate in organic manure

Poster Sessio

Non-financial social determinants of diabetes among public assistance recipients in Japan: A cohort study

Aims/Introduction: Poverty is an important social determinant of diabetes. Poverty is a multidimensional concept including non-financial difficulties, such as social isolation and exclusion from communities. Many countries provide financial social assistance programs for those in need. This study aimed to explore non-financial social determinants of diabetes among public assistance recipients in Japan, by using linkage data of two municipal public assistance databases and medical assistance claim data. Materials and Methods: We carried out a retrospective cohort study. Public assistance is provided to households below the poverty line to ensure their income security. We extracted recipients’ sociodemographic factors of January 2016 (household number and employment status as non-financial social determinants of diabetes) and identified the incidence of diabetes diagnosis until December 2016 as the outcome. Results: We included the data of 2, 698 younger individuals (aged 65 years). A multivariable Poisson regression, with a robust standard error estimator, showed that among 2, 144 younger recipients at risk, unemployment and living alone were slightly associated with 1-year cumulative incidence of diabetes diagnosis (adjusted incidence ratio 1.20, 95% confidence interval 0.93–1.54 and adjusted incidence ratio 1.15, 95% confidence interval 0.89–1.48, respectively). Among 2, 181 older recipients at risk, there was no strong association between their sociodemographic factors and incidence of diabetes diagnosis. Conclusions: Unemployment and living alone might be additional risk factors for diabetes among younger public assistance recipients. Multidimensional supports assuring financial and non-financial securities are required to prevent diabetes among people living in poverty

Functional disability trajectories at the end of life among Japanese older adults: findings from the Japan Gerontological Evaluation Study (JAGES)

BACKGROUND: this study aimed to identify distinct subgroups of trajectories of disability over time before 3 years of death and examine the factors associated with trajectory group membership probabilities among community-dwelling Japanese older adults aged 65 years and above. METHODS: participants included 4, 875 decedents from among community-dwelling Japanese older adults, aged ≥ 65 years at baseline (men: 3, 020; women: 1, 855). The certified long-term care levels of the national long-term care insurance (LTCI) system were used as an index of functional disability. We combined data from the 2010 Japan Gerontological Evaluation Study and data from the 2010 to 2016 LTCI system. Group-based mixture models and multinominal logistic regression models were used for data analysis. RESULTS: five distinct trajectories of functional disability in the last 3 years of life were identified: 'persistently severe disability' (10.3%), 'persistently mild disability' (13.0%), 'accelerated disability' (12.6%), 'catastrophic disability' (18.8%) and 'minimum disability' (45.2%). Multinominal logistic regression analysis found several factors associated with trajectory membership; self-rated health was a common predictor regardless of age and gender. The analysis also showed a paradoxical association; higher education was associated with trajectory group membership probabilities of more severe functional decline in men over 85 years at death. CONCLUSIONS: individual perception of health was a strong predictor of trajectories, independent of demographic factors and socio-economic status. Our findings contribute to the development of policies for the long-term care system, particularly for end-of-life care, in Asian countries