Health expectancies in Japan: Gender differences and policy implications for women

SUMMARY. Based on prospective observation of elderly people in the community in Japan, we compared the time-course of development and progression of physical disability between women and men. Men experienced disability at a younger age and at a faster rate than did women. The duration of time spent with disability in women was twice as long as in men. Consequently, women consume about two-thirds of the total resources of formal caregiving services in Japan. Women in Japan are increasingly educated, postponing marriage to higher ages, and less likely to care for parents in the home. Given these changes in family structure and social norms, the capacit

2002-183.april

ABSTRACT. Objective. To investigate the associations of dietary factors with the occurrences of active disease and vascular damage in female patients with systemic lupus erythematosus (SLE). Methods. Clinical and questionnaire data were collected from 279 female patients with SLE in a 1995 baseline survey. Dietary nutrients were estimated by a semiquantitative food frequency questionnaire and disease activity was evaluated based on the Lupus Activity Criteria Count. Patients were followed over 4 years and changes in disease activity and occurrences of major organ damage were determined. Using data from 216 patients with inactive disease whose dietary data were complete at baseline, the association of each nutrient intake with occurrence of active disease was evaluated. The relation of diet with the development of 3 types of vascular injury (ischemic heart disease, cerebrovascular accident, thrombotic events) was examined in 196 patients who had been inactive with no history of these injuries. Patients who developed these vascular events were put in one category and nutrient intakes at baseline were compared between patients who did or did not develop vascular events. Results. A total of 9966 person-months were accumulated from the 216 inactive patients, among whom 43 patients developed active disease. The proportional hazard model including indicator variables for tertiles of each nutrient, total energy, and confounding variables revealed an inverse association of intake of vitamin C (p for trend = 0.005) and crude fiber (p for trend = 0.06) with the risk of active disease. The inverse association with vitamin C intake was also significant after Bonferroni adjustment. Patients who developed vascular events (n = 7) consumed a greater amount of vegetable fat at baseline than patients who did not (p = 0.04). Conclusio