Relationship between Chronic Low Back Pain, Social Participation, and Psychological Distress in Elderly People : A Pilot Mediation Analysis

Several studies indicated that chronic low back pain (CLBP) worsened psychological distress (PD) and social participation (SP) improved PD. The relationships among CLBP, SP and PD have not been established. Here we investigate whether SP mediates the relationship between CLBP and PD in 96 elderly people. We evaluated CLBP and SP by a self-administered questionnaire and PD by K6 questionnaires. We used simple correlation analyses, the unpaired t-test, and a mediation analysis following the approach outlined by Structural Equation Modeling (SEM) to clarify the relationships among CLBP, SP and PD. Using SEM, was observed a significant relationship between CLBP and SP (β=−0.321, p=0.003), a significant negative correlation between SP and K6 scores (β=−0.357, p=0.001), and a significant positive correlation between CLBP and K6 scores (β=0.333, p=0.002). By including SP as a parameter, the coefficient of correlation between CLBP and K6 scores varied from 0.333 (p=0.002) to 0.218 (p=0.035). After bootstrapping, 0 was not included in the 95% confidence interval (0.119, 1.913). SP as a mediator may reduce PD in elderly people with CLBP

Relationship between Social Participation, Physical Activity and Psychological Distress in Apparently Healthy Elderly People: A Pilot Study

Few studies examined the relationship between social participation, physical activity and psychological distress in elderly people. Here we examined these relationships in apparently healthy elderly people. After exclusion of subjects who dropped out or did not meet enrollment criteria, the data of 86 subjects (apparently healthy elderly embers at a college health club; 25 males, 61 females) from July 20 to September 10, 2016 were used. We evaluated each subject’s psychological distress using the K6 questionnaire, social participation by a self-completed questionnaire, and physical activity level by a triaxial accelerometer (7 consecutive days). The K6 scores were significantly correlated with social participation in the total series and the women. The K6 scores of the subjects who had engaged in social participation (1.847±2.231) were significantly lower (better) than those of the subjects who had not (6.714±5.014). Both exercise limitation and social participation were significant predictors of the K6 scores. Our findings indicate that psychological distress in apparently healthy elderly people is not associated with physical activity, but is associated with social participation. Our results demonstrate that in healthy elderly people, participating in a social activity can help improve psychological distress

Influence of epoch length on measurement of light physical activity in the elderly: A technical analysis

Aims: To clarify how epoch lengths of accelerometers affect measurement of physical activity in elderly people. Methods: The data was based on 70 elderly people (72.6 ± 5.4 years) living in Japan between 2017 and 2018. Furthermore, we used data obtained from triaxial accelerometers that the subjects wore for more than 10 hours every day for 7 days. We evaluated light physical activity (2.9 Mets or less) and further grouped it into sedentary behaviour (SB, 1.5 Mets or less) and Light Intensity Physical Activity (LIPA, between 1.6 and 2.9 Mets). We also compared 10-second epoch lengths (ELs) to 60-second ELs (%) by Bayesian estimation. Results: In 2017 and 2018, SB at 10-second ELs was longer than at 60-second ELs (55.5 vs. 50.4% in 2017; 55.7 vs. 48.9% in 2018); however, LIPA at 10-second ELs was shorter than at 60-second ELs (35.0 vs. 42.3% in 2017; 35.0 vs. 44.5% in 2018). The Bayesian factor varied between 3.0x1012 and 3.2x1024. The robustness of the Bayesian factor was confirmed by the robustness check. Furthermore, effect sizes were between |1.68| and |3.00|. Conclusion: ELs of the accelerometer may affect measurement of physical activity in elderly people. Thus, SB at 10-second ELs may be longer than at 60-second ELs and may be the reverse for LIPA.This research was supported in part by research grants from the Ministry of Education, Culture, Sports, Science and Technology, Japan (JSPS KAKENHI grant no. JP17K01851)

Examination of the Causality Relationship between Psychological Distress and Social Participation in Elderly People: A Pilot Study

Few studies have considered the causal relationship between psychological distress and social participation in elderly people. Here we investigated this relationship based on an initial survey and a follow-up survey. In 2016, a survey was distributed to 86 participants. A follow-up survey of 80 of those participants was performed in 2017. We adopted the following variables: psychological distress and social participation as represented by the Kessler psychological distress scale and social participation scores, respectively. By using cross-lagged and synchronous effects models, we found that the 2016 Kessler psychological distress scale had a significant influence on the 2017 social participation scores (standardization factor=−0.221, p=0.020) and the 2017 Kessler psychological distress scale significantly influenced the 2017 social participation scores (standardization factor=−0.345, p=0.039). The results suggest that psychological distress may affect social participation one year later

“Active Guide” Brochure Reduces Sedentary Behavior of Elderly People: A Randomized Controlled Trial

The aim of this study was to examine in a randomized controlled trial how much the sedentary behavior (sitting time) of community-dwelling elderly Japanese subjects decreased as a result of using the “Active Guide” brochure published by the Ministry of Health, Labour and Welfare (2013) and additional documents related to the benefits of reducing sedentary behavior. A total of 86 elderly people who participated in health-club activities for one year were randomly allocated to two groups. Subjects in the intervention group received explanations of the importance of physical activity using the “Active Guide” brochure (n=42) and additional documents, while subjects in the control group did not (n=44). Physical activity was measured using a triaxial accelerometer for two weeks at baseline and again after one year. After one year of intervention, the difference in the sedentary behavior rate from baseline was −2.2% for the intervention group (n=40) and +2.5% for controls (n=40) (Welch’s t-test, p=0.007). Use of the “Active Guide” brochure and additional documents may reduce the sedentary behavior of community dwelling elderly people in Japan

Factors that Decrease Sedentary Behavior in Community-Dwelling Elderly People: A Longitudinal Study

Background and objectives: This study was to clarify how the frequency of participation in a health class affected the reduction in sedentary behavior after two years, and whether decreases in sedentary behavior in elderly people who participated in a health class persisted two years after the end of an intervention. Materials and Methods: This study was longitudinal, and the results of a previous study conducted in 2017 were added to the findings of a different year. The participants were elderly health class members at a community dwelling in Japan who participated between 2016 and 2018. Of the 86 participants that were enrolled, the data of 80 were collected in 2016. A year later, in a 2017 follow-up, the number of participants was 80, and two years later, in a 2018 follow-up, there were 71 participants. Results: There was a significant difference with regards to the reduction of the sedentary behavior rate between two different groups (a health class participation rate of more than 75% and the other with less than 75%) two years later. However, no difference in sedentary behavior rate was found between the two groups (intervention group and control group) at a two-year follow-up, despite observing differences after one year. Conclusions: Continuous participation in a health class may help reduce sedentary behavior. After two years, “Active Guide” brochures and documents may not help in reducing sedentary behavior, despite seeing improvements after one year. Persistent social participation may have a more lasting effect than one-off interventions in reducing the sedentary behavior ratio

Prediction of Chronic Lower Back Pain Using the Hierarchical Neural Network: Comparison with Logistic Regression—A Pilot Study

Background: Many studies have reported on the causes of chronic lower back pain (CLBP). The aim of this study is to identify if the hierarchical neural network (HNN) is superior to a conventional statistical model for CLBP prediction. Linear models, which included multiple regression analysis, were executed for the analysis of the survey data because of the ease of interpretation. The problem with such linear models was that we could not fully consider the influence of interactions caused by a combination of nonlinear relationships and independent variables. Materials and Methods: The subjects in our study were 96 people (30 men aged 72.3 ± 5.6 years and 66 women aged 71.9 ± 5.4 years) who participated at a college health club from 20 July 2016 to 20 March 2017. The HNN and the logistic regression analysis (LR) were used for the prediction of CLBP and the accuracy of each analysis was compared and examined by using our previously reported data. The LR verified the fit using the Hosmer–Lemeshow test. The efficiencies of the two models were compared using receiver performance analysis (ROC), the root mean square error (RMSE), and the deviance (−2 log likelihood). Results: The area under the ROC curve, the RMSE, and the −2 log likelihood for the LR were 0.7163, 0.2581, and 105.065, respectively. The area under the ROC curve, the RMSE, and the log likelihood for the HNN were 0.7650, 0.2483, and 102.787, respectively (the correct answer rates were HNN = 73.3% and LR = 70.8%). Conclusions: On the basis of the ROC curve, the RMSE, and the −2 log likelihood, the performance of the HNN for the prediction probability of CLBP is equal to or higher than the LR. In the future, the HNN may be useful as an index to judge the risk of CLBP for individual patients

Long-Term Relationship between Psychological Distress and Continuous Sedentary Behavior in Healthy Older Adults: A Three Panel Study

Background and objectives: Psychological distress (PD) is associated with continuous sedentary behaviors (CSB; based on the ratio of 1.5 metabolic equivalents (METs) sessions or more continuing for over 30 min) in older adults, but the long-term relation is not sufficiently clarified. This study aims to clarify the long-term relationship between PD and the rate of CSB. Materials and Methods: In this secondary analysis, a sample population of 72 healthy elderly people aged 65 years or older participated in a health club of college A from 2016 to 2018. We conducted structural equation modeling (SEM) using the cross-lagged and synchronous effects models. We adopted the following as proxy variables: CSB and PD (based on the Kessler 6 scale (K6) scores). Results: “2016 K6” to“2017 CSB” (standardization factor (β = 0.141, p = 0.025), “2017 K6” to “2018 CSB” (β = 0.187, p < 0.001) and “2016 CSB” to “2018 CSB” (β = 0.188, p < 0.001) were all statistically significant using the cross-lagged effects models. Fit indices were adjusted goodness of fit index (AGFI) = 0.961, comparative fit index (CFI) = 1.000, and root mean square error of approximation (RMSEA) = 0.000. Conclusion: The results suggest that PD may affect the ratio of CSB one year later, and CSB may affect the ratio of PD two year later

Relationship between Food Dependence and Nicotine Dependence in Smokers: A Cross-Sectional Study of Staff and Students at Medical Colleges

Background and objectives: The aim of this study was to examine the relationship between nicotine dependence and food dependence in smokers. Smoking and obesity are both serious public health problems that give rise to diseases and increased medical expenses. Nicotine dependence is one of the sources of difficulty in smoking cessation, while food dependence is one of the causes of obesity. Materials and Methods: We examined the data of 72 (smoking vs. nonsmoking) and 62 (nicotine dependence vs. no nicotine dependence) subjects among 321 staff and students at medical colleges in Kagawa and Okayama prefectures in Japan. Results: There was a significant difference in food dependence (except women) between the smoking and nonsmoking groups (total: smoking 4.7 ± 6.1, nonsmoking 2.1 ± 2.0, p = 0.0411; men: smoking 4.0 ± 4.7, nonsmoking 2.0 ± 2.1, p = 0.0490). There was also a significant difference in food dependence (except women) between the nicotine dependence and no nicotine dependence groups (total: nicotine dependence 4.6 ± 6.3, no nicotine dependence 2.0 ± 2.1, p = 0.0370; men: nicotine dependence 3.6 ± 4.8, no nicotine dependence 1.6 ± 1.8, p = 0.0489). Conclusion: The findings showed that the smoking group (and nicotine dependence group) had higher food dependence than the nonsmoking group (and no nicotine dependence group). Our results indicate an interdependence between nicotine and food dependences