Gender difference in the relationships between vision and hearing impairments and negative well-being.

OBJECTIVES: To evaluate the association of hearing impairment, vision impairment and their combination (dual sensory impairment) with negative well-being such as depression, subjective poor health and the reduced functional ability in community-dwelling older adults, and to determine whether any association varies by gender. METHODS: Between 2005 and 2006, we objectively examined vision and hearing impairment (using best-corrected visual acuity and pure-tone audiometric test) in 843 people aged 65 years and older (351 males, 492 females) in a rural Japanese town. Through a home visit interview survey using a structured questionnaire, we also collected information on depression (the five-item Geriatric Depression Scale), subjective poor health, and reduced functional activity (the Tokyo Metropolitan Institute of Gerontology's Index of Competence). RESULTS: We observed gender differences in the association between sensory impairment and depression. Multiple logistic regression analysis revealed that hearing impairment in males (adjusted odds ratio: 2.22, 95% confidence interval; 1.07-4.61) and vision impairment in females (1.91, 1.14-3.21) were related to depression. Vision impairment and dual sensory impairment were also associated with subjective poor health and reduced functional activity in both sexes. CONCLUSIONS: Sensory impairment is significantly associated with negative well-being in older persons, and its association with depression may differ between males and females

Serum levels of retinol and other antioxidants for hearing impairment among Japanese older adults.

BACKGROUND: The objective of this study was to assess the relation between serum levels of retinol and other antioxidants and hearing impairment in Japanese older adults. METHODS: This is a community-based cross-sectional study comprising 762 residents aged 65 years or older in Kurabuchi, Gumma, Japan. We measured serum retinol and other antioxidants (alpha- and gamma-tocopherols, and carotenoids including beta-cryptoxanthin, alpha- and beta-carotenes, lycopene, and lutein plus zeaxanthin) by high-performance liquid chromatography and divided each measurement into quartiles. Hearing impairment was defined as a failure to hear a 30-dB hearing level (HL) signal at 1 kHz and a 40-dB HL signal at 4 kHz in the better ear in pure-tone audiometric tests. The odds ratios (OR) for hearing impairment were calculated for each of the upper three quartiles of retinol and other antioxidant levels relative to the lowest quartile. RESULTS: Crude analysis showed that serum levels of retinol and provitamin A carotenoids (beta-cryptoxanthin, and alpha- and beta-carotenes) were inversely related to the prevalence of hearing impairment. The multiadjusted ORs (95% confidence intervals) for the highest quartile of retinol and the provitamin A family (combinations of provitamin A carotenoids) compared with the lowest were 0.51 (0.26-1.00) and 0.53 (0.27-1.02), respectively. A dose-response relationship was observed for retinol (p = .03) and provitamin A (p = .09). CONCLUSION: Increased serum levels of retinol and provitamin A carotenoids were clearly associated with a decreased prevalence of hearing impairment

Health impact assessment of PM2.5-related mitigation scenarios using local risk coefficient estimates in 9 Japanese cities

Previous studies have highlighted the negative effects of PM2.5 on mortality, expressed in terms of attributable deaths and life years lost. However, there are very few studies assessing the health impacts of air pollution in terms of economic burden/benefits. This study assessed the health impact of two hypothetical interventions among sex- and age-specific risk populations using a robust risk estimation and economic valuation process. We utilized the sex- and age-stratified daily all-cause mortality together with the daily PM2.5 of the 9 Japanese cities from 2002 to 2008 in estimating the relative risks. The estimated risks were then utilized for the economic valuation of co-benefits/burden with respect to the two hypothetical PM2.5-related mitigation scenarios, in comparison to status quo, namely: i) decrease to Japanese standards, and ii) decrease to WHO standards. Impact of these interventions on health were assessed using the following HIA metrics: attributable mortality, attributable years life lost, and environmental health impact. A 10-μg/m3 increase in PM2.5 would increase the risk by 0.52% (95% CI: −0.91% to 1.99%) for all-cause mortality, with varying risk estimates per subgroup. High economic burdens were estimated at status quo, with particularly distinct burden difference for age-specific mortality; 0.40 trillion yen (0–64 y.o.) and 1.50 trillion yen (>64 y.o.). If stricter standards, relative to status quo, were to be enforced, i.e. WHO standard, there is a potential to yield economic benefits in the same risk population; 0.26 trillion yen (0–64 y.o.) and 0.98 trillion yen (>64 y.o.). We did not observe any substantial difference with the burden and benefit related to sex-specific mortality. Using the estimated local risk coefficients complemented with the valuation of the risks, policymaking entities will have the opportunity to operate their own HIA to assess the relevant air pollution-related health impacts

Lifestyle factors and visible skin aging in a population of Japanese elders.

BACKGROUND: The number of studies that use objective and quantitative methods to evaluate facial skin aging in elderly people is extremely limited, especially in Japan. Therefore, in this cross-sectional study we attempted to characterize the condition of facial skin (hyperpigmentation, pores, texture, and wrinkling) in Japanese adults aged 65 years or older by using objective and quantitative imaging methods. In addition, we aimed to identify lifestyle factors significantly associated with these visible signs of aging. METHODS: The study subjects were 802 community-dwelling Japanese men and women aged at least 65 years and living in the town of Kurabuchi (Takasaki City, Gunma Prefecture, Japan), a mountain community with a population of approximately 4800. The facial skin condition of subjects was assessed quantitatively using a standardized facial imaging system and subsequent computer image analysis. Lifestyle information was collected using a structured questionnaire. The association between skin condition and lifestyle factors was examined using multivariable regression analysis. RESULTS: Among women, the mean values for facial texture, hyperpigmentation, and pores were generally lower than those among age-matched men. There was no significant difference between sexes in the severity of facial wrinkling. Older age was associated with worse skin condition among women only. After adjusting for age, smoking status and topical sun protection were significantly associated with skin condition among both men and women. CONCLUSIONS: Our study revealed significant differences between sexes in the severity of hyperpigmentation, texture, and pores, but not wrinkling. Smoking status and topical sun protection were significantly associated with signs of visible skin aging in this study population

Gender-specific associations of vision and hearing impairments with adverse health outcomes in older Japanese: a population-based cohort study

BACKGROUND: Several epidemiological studies have shown that self-reported vision and hearing impairments are associated with adverse health outcomes (AHOs) in older populations; however, few studies have used objective sensory measurements or investigated the role of gender in this association. Therefore, we examined the association of vision and hearing impairments (as measured by objective methods) with AHOs (dependence in activities of daily living or death), and whether this association differed by gender. METHODS: From 2005 to 2006, a total of 801 residents (337 men and 464 women) aged 65 years or older of Kurabuchi Town, Gunma, Japan, participated in a baseline examination that included vision and hearing assessments; they were followed up through September 2008. Vision impairment was defined as a corrected visual acuity of worse than 0.5 (logMAR = 0.3) in the better eye, and hearing impairment was defined as a failure to hear a 30 dB hearing level signal at 1 kHz in the better ear. Information on outcomes was obtained from the town hall and through face-to-face home visit interviews. We calculated the risk ratios (RRs) of AHOs for vision and hearing impairments according to gender. RESULTS: During a mean follow-up period of 3 years, 34 men (10.1%) and 52 women (11.3%) had AHOs. In both genders, vision impairment was related to an elevated risk of AHOs (multi-adjusted RR for men and women together = 1.60, 95% CI = 1.05-2.44), with no statistically significant interaction between the genders. In contrast, a significant association between hearing impairment and AHOs (multi-adjusted RR = 3.10, 95% CI = 1.43-6.72) was found only in the men. CONCLUSION: In this older Japanese population, sensory impairments were clearly associated with AHOs, and the association appeared to vary according to gender. Gender-specific associations between sensory impairments and AHOs warrant further investigation

Association between high and low ambient temperature and out-of-hospital cardiac arrest with cardiac etiology in Japan: a case-crossover study

Abstract Objective The objective of the study was to examine the association between high and low temperature and out-of-hospital cardiac arrest (OHCA) with cardiac etiology. Methods The study was conducted under a case-crossover design. Subjects were 97,500 patients aged 40 years or older with OHCA having a cardiac etiology in Tokyo, Osaka, and Fukuoka Prefecture from 2005 to 2012. We used national data with an Utstein-style resuscitation registration. Temperature was categorized into five categories with cut points of 5, 10, 24, and 30 °C. The reference category was 10–23.9 °C. Conditional logistic regression was used with adjustment for daily means of relative humidity, atmospheric pressure, and wind speed and daily amount of precipitation and hours of daylight. Results Exposure to high temperature (≥30 °C) increased the risk of OHCA (OR = 1.11, 95% confidence interval (CI) 1.04–1.18). Further, low temperature (<5 °C) and relatively low temperature (5–9.9 °C) were also associated with OHCA (OR = 1.20, 95% CI 1.16–1.25; OR = 1.10, 95% CI 1.07–1.13, respectively). The temperature-OHCA association curves were U-shaped or J-shaped, and the association was more prominent among those aged 80 years or older. Conclusion This study shows that the occurrence of OHCA with cardiac etiology is associated with low temperature. In addition, the occurrence is also associated with high temperature in those aged 80 years or older

Three-year follow-up of the impact of Kumamoto Earthquake on acute myocardial infarctions: An interrupted time series analysis

Study objective: This study aimed to investigate whether the incidence of acute myocardial infarction (AMI) and subsequent outcomes over the three years after the Kumamoto earthquake differed from the underlying trend before the earthquake. Design: Quasi-experimental design. Setting: Twenty-one institutions participating from the Kumamoto Prefecture and capable of receiving AMI patients and performing coronary angiography and interventions. Participants: In total 6553 consecutive patients with AMI between 2013 and 2019 were included in this study. Interventions: Interrupted time series analysis. Main outcome measure(s): AMI incidence and following cardiac events after the earthquake. Results: The rate ratio (RR) for AMI incidence after the earthquake was 1.12 (95 % confidence interval [CI]: 1.00–1.25) with reference to that before the earthquake. AMI rates increased among people with diabetes mellitus (RR: 1.20, 95 % CI: 1.01–1.44), those with current smoking (RR: 1.27, 95 % CI: 1.03–1.56), and those with a body mass index >25 kg/m2 (RR: 1.27, 95 % CI: 1.06–1.52). Increased number of AMI patients with onset-to-door time >12 h (RR: 1.46, 95 % CI: 1.02–2.08), a high Killip class on hospital admission (RR: 1.37, 95 % CI: 1.13–1.67), and unperformed emergent coronary angiography (RR: 1.40, 95 % CI: 1.02–1.91) were frequently observed after the earthquake, which may affect following in-hospital cardiac events (RR: 1.49, 95 % CI: 1.03–2.15). Conclusions: The Kumamoto earthquake had an impact on the increase in the incidence of AMI and the following in-hospital cardiac outcomes. Emergency medical care should be ensured in such a way that high-risk patients are managed as usual, especially immediately after earthquake

Serum antioxidants and age-related macular degeneration among older Japanese.

From the perspective of human nutrition, the prevention of age-related macular degeneration (AMD) through diet control is feasible and desirable. We investigated the relationship between serum antioxidants and AMD in the community-dwelling older Japanese eating a typical Japanese diet. In this study, 722 subjects aged 65 years or older (297 males and 425 females) who had gradable fundus photographs were included. The subjects were divided into three groups of early or late AMD or non-maculopathy. Serum antioxidants (alpha-, gamma-tocopherols, retinol, beta-cryptoxanthin, alpha-, beta-carotenes, lycopene, and lutein and zeaxanthin) were measured with high-performance liquid chromatography. To clarify the combined effect as the group of the antioxidants, we defined the carotene family (alpha-, beta-carotenes and lycopene) and carotenoid family (beta-cryptoxanthin, alpha-, beta-carotenes, lycopene, lutein and zeaxanthin). Tertiles of each serum antioxidant were obtained and the prevalence of early or late AMD was compared with univariate or multivariate analysis. The overall prevalence of early AMD was 4.4% (95% confidence interval: 3.1-6.2) and late AMD was 1.1% (0.5-2.2). Only alpha-tocopherol and beta-cryptoxanthin were related to late AMD as single antioxidants. On the other hand, the carotene and carotenoid families as a combination of antioxidants were protectively associated with late AMD. No relationship was found between serum antioxidants and early AMD. Our findings support the hypothesis that a combination of serum antioxidants obtained from the traditional Japanese diet is protective for late AMD, but not for early AMD