Older Japanese Women Research Articles

Exercise and/or Dietary Varieties and Incidence of Frailty in Community-Dwelling Older Women: A 2-Year Cohort Study.

Exercise and dietary habits rich in variety may reduce the risk of frailty incident, but such association remains unexamined. This study aimed to examine the longitudinal associations between exercise and/or dietary varieties and incidence of frailty in older women. A 2-year population-based prospective cohort study. Six hundred and four community-dwelling older Japanese women aged ≥75 years with non-frailty at baseline survey. Frailty was assessed using Fried's frailty criteria composed of shrinking, weakness, slowness, low activity, and exhaustion at both baseline and follow-up surveys. Frailty incident was defined as the presence of ≥3 components at the follow-up survey. At baseline, information about exercise and dietary habits were obtained from all participants through a face-to-face interview. Participants were grouped into two categories, high (≥2) and low (<2) exercise varieties, assessed by the number of participations in 17 exercise types. By dietary variety, assessed using Dietary Variety Score (range, 0 to 10), participants were grouped into two, high (≥4 points) and low (<4 points) dietary varieties. Binary logistic regression analyses were applied to obtain adjusted odds ratios (ORs) and 95% confident intervals (CIs) of the incidence of frailty in the 4 groups (low-exercise and low-dietary varieties [low EV + low DV] as reference; low-exercise and high-dietary varieties [low EV + high DV]; high-exercise and low-dietary varieties [high EV + low DV]; and high-exercise and high-dietary varieties [high EV + high DV]). Frailty incidence rate was 9.3% over the 2-year follow-up period. Incidence rates of frailty in the 4 groups were as follows: 23.7%, 10.1%, 6.5%, and 7.7% in the low EV + low DV, low EV + high DV, high EV + low DV, and high EV + high DV groups, respectively. After adjustment for covariates, only the high EV + high DV group was associated with a significantly lower OR (0.38; 95% CI 0.15-0.92) of frailty incidence compared with the low EV + low DV group. Higher variety of exercise and diet was significantly associated with lower incidence of frailty. Thus, the combination of variety-rich exercise and dietary program may be useful in preventing the incidence of frailty in older women.

Association of Oral Function With Long-Term Participation in Community-Based Oral Exercise Programs in Older Japanese Women: A Cross-Sectional Study.

BackgroundThere are several researches demonstrating that community-based educational and exercise programs can improve oral function in older people. However, the relationship between oral function and long-term participation in health programs has not been fully elucidated. The objective of this study was to clarify the oral health status and oral function of older people (≥ 65 years) who had been participating in community-based exercise programs at community salons.MethodsWe enrolled 108 women (mean age: 77.6 ± 5.7 years) who participated in oral and physical exercise programs once a week at community salons in Takehara throughout May 2017. This cross-sectional pilot study was approved by the Ethical Committee of Hiroshima University and informed consent was obtained from all participants. To assess oral function, the following tests were performed: tongue pressure test, oral diadochokinesis (ODK) measurement, repetitive saliva swallowing test (RSST) and oral wetness measurement.ResultsA significant negative correlation was found between age and ODK or RSST (Spearman’s rank correlation; P = 0.007 and P = 0.01, respectively). The duration of participation ranged widely from 1 month to 7 years (median: 2.3 years). Although there was no significant difference between participation period and oral function, individuals who had been participating for 3 years or longer did not demonstrate a negative relationship between age and oral wetness. Furthermore, they exhibited a weaker negative relationship between age and oral function (i.e. tongue pressure, ODK and RSST) when compared with individuals who had been participating for less than 3 years.ConclusionsOur results suggest that long-term participation in community salon exercise programs may suppress the deterioration of oral function in older people. Further study will be necessary to clarify the significant correlation between oral function and community-based social activities such as oral exercise.

Improvement of salivary flow and oral wetness by a lip trainer device and sonic toothbrush in older Japanese men and women with dry mouth.

Dry mouth, caused by decreased salivary gland function and/or weak salivary stimulation, can severely affect oral health in older individuals. Therefore, the aim of this study is to evaluate whether a lip trainer device and sonic toothbrush can improve salivary flow and oral wetness in older patients complaining of dry mouth. Overall, 39 subjects aged ≥60 years who had at least 20 natural teeth were randomly assigned to use a lip trainer device (group P, n = 13) or a sonic toothbrush (group S, n = 13). The subjects who did not experience oral dryness were included as controls (group C; n = 13). The unstimulated and stimulated salivary flow rates and oral wetness were measured at baseline, 1 and 6 months. The unstimulated salivary flow significantly increased in both groups at 1 and 6 months (P < 0.05). The stimulated salivary flow was also significantly increased in group P (P < 0.01) compared with the level at baseline. However, no significant difference was observed over time in group S. Oral wetness of the tongue and buccal mucosa in group P had significantly improved at 1 and 6 months (P < 0.05). Dry mouth in older individuals may be improved by using a lip trainer device or a sonic toothbrush.

Combined aerobic and resistance training, and incidence of diabetes: A retrospective cohort study in Japanese older women.

Aims/IntroductionTo investigate the relationship between combined aerobic and resistance training, and the incidence of type 2 diabetes mellitus.Materials and MethodsThe present study included 10,680 Japanese women. Participants enrolled between 2005 and 2010, and were followed up until 2014. The frequency of combined training was counted for the first 3 months, the 6th month and the 9th month. In 2014, women reported whether or not they had diabetes, as well as the year of developing diabetes. Hazard ratios and 95% confidence intervals (CI) for the incidence of type 2 diabetes were obtained using Cox proportional hazard models.ResultsThe median duration of follow up was 5 years, with 166 women developing type 2 diabetes. Using the lowest frequency of training group (1st quartile) as the reference, the hazard ratios for the second through fourth quartiles was as follows: 0.95 (95% CI 0.64–1.41), 0.73 (95% CI 0.48–1.13) and 0.69 (95% CI 0.44–1.07), respectively (P for trend = 0.116). After adjustment for age, body mass index and thigh circumference, the hazard ratios were: 0.84 (95% CI 0.56–1.26), 0.69 (95% CI 0.45–1.06) and 0.61 (95% CI 0.39–0.95), respectively (P for trend = 0.040).ConclusionsA higher frequency of combined aerobic and resistance training is associated with a lower risk of developing type 2 diabetes in Japanese women.

Exercise type and activities of daily living disability in older women: An 8-year population-based cohort study.

Exercise may reduce the risk of disability for activities of daily living (ADL), but the degree of associations between specific exercise types and such a risk remains unclear. This study aimed to examine the longitudinal associations between exercise types and the incidence of ADL disability in older women. This 8-year population-based prospective cohort study enrolled 1003 community-dwelling older Japanese women without ADL disability in the baseline surveys. In the baseline surveys, all participants were asked whether or not they participated in any of 16 exercise types through a face-to-face interview. ADL were assessed using a modified form of the Katz index that comprised five ADL tasks. ADL disability was defined as dependence in at least one ADL task during the 8-year follow-up period. Binary logistic regression analyses were applied to obtain adjusted odds ratios (ORs) and 95% confident intervals (CIs) for the incidence of ADL disability based on participation or non-participation in each exercise type. Activities of daily living disability was noted in 130 participants (13.0%) over the 8-year follow-up period. After adjustment for confounders and other exercise types, participation in dancing, compared to non-participation, was associated with a significantly lower OR (0.27; 95% CI: 0.09-0.75) for incident ADL disability. There were no significant associations between other exercise types and incident ADL disability. Dancing was significantly and independently associated with a lower incidence of ADL disability. Thus, dancing may solely contribute to a reduced risk of ADL disability in older women.

Plasma Amino Acid Concentrations Are Associated with Muscle Function in Older Japanese Women.

Although several previous studies have found benefits for amino acid supplementation in terms of muscle function, the role of plasma amino acid concentrations on sarcopenia are not well addressed yet. The aim of this study was to compare the amino acid concentrations at each stage of sarcopenia (normal, pre-sarcopenia, dynapenia, and sarcopenia) in community-dwelling older Japanese adults. Community-dwelling older Japanese women (n=232, 79.4±7.0 years) participated in this study. We measured plasma amino acid concentrations, 5-m walking speed, grip strength, and skeletal muscle mass using a bioelectrical impedance data acquisition system and compared them among participants at each stage of sarcopenia. The proportions of normal, pre-sarcopenia, dynapenia, and sarcopenia patients were 40.5% (n=94), 12.1% (n=28), 26.3% (n=61), and 21.1% (n=49), respectively. Significant differences were observed for concentrations of leucine, branched-chain amino acid (BCAAs), and essential amino acid (EAAs) among the four groups (p<0.05), and the dynapenia and sarcopenia groups showed significantly lower concentrations of leucine than the normal group (p<0.05). This study indicated a positive relationship between plasma leucine, BCAA and EAA concentrations and muscle function. A longitudinal study is needed to determine the causal relationship between leucine/BCAA concentrations and muscle function.

Relationship between visceral fat areas at the different levels and metabolic syndrome risk factors in middle-aged and older Japanese women

Relationship between visceral fat areas at the different levels and metabolic syndrome risk factors in middle-aged and older Japanese women

Nutritional correlates of monetary diet cost in young, middle-aged and older Japanese women.

Studies in many Western countries have consistently shown that monetary diet cost is positively associated with diet quality, but this may not necessarily be the case in Japan. This cross-sectional study examined the nutritional correlates of monetary diet cost among 3963 young (all 18 years old), 3800 middle-aged (mean age 48 years) and 2211 older (mean age 74 years) Japanese women. Dietary intakes were assessed using a comprehensive self-administered diet history questionnaire for young and middle-aged women and a brief self-administered diet history questionnaire for older women. Monetary diet cost was estimated using retail food prices. Total vegetables, fish and shellfish, green and black tea, white rice, meat, fruit and alcoholic beverages contributed most (79-89 %) to inter-individual variation in monetary diet cost. Multiple regression analyses showed that monetary diet cost was negatively associated with carbohydrate intake, but positively with intakes of all other nutrients examined (including not only dietary fibre and key vitamins and minerals but also saturated fat and Na) in all generations. For food group intakes, irrespective of age, monetary diet cost was associated inversely with white rice and bread but positively with pulses, potatoes, fruit, total vegetables, fruit and vegetable juice, green and black tea, fish and shellfish, and meat. In conclusion, in all three generations of Japanese women and contrary to Western populations, monetary diet cost was positively associated with not only healthy dietary components (including fruits, vegetables, fish and shellfish, dietary fibre, and key vitamins and minerals), but also less healthy components (including saturated fat and Na).

Associations of sit-up ability with sarcopenia classification measures in Japanese older women.

To test the hypothesis that sit-up performance is associated with sarcopenia classification measures, 93 older women aged 53–78 years were divided into three groups based on achieved repetitions (30 s) for the sit-up performance test: Group 0 (G 0, n = 33) performed 0 repetitions, Group 1–9 (G 1–9, n = 30) performed between 1 and 9 repetitions, and Group 10+ (G 10+, n = 30) performed over 10 repetitions. Dual-energy X-ray absorptiometry-derived appendicular lean soft tissue mass (aLM), handgrip strength (HGS), usual walking speed, and chair stand were measured, and low muscle mass (aLM index) and poor physical function were defined according to previous studies. Age and body mass index were similar among the three groups. HGS was higher in G 10+ compared with G 0. The prevalence rate of low muscle mass was 30% for G 0, 20% for G 1–9, and 3% for G 10+. Low HGS was observed in both G 0 (24%) and G 1–9 (20%), but not in G 10+. Only two persons in G 0 were classified as slow walking speed. Our results suggest that sit-up performance may be a useful indicator to determine the extent of sarcopenia because low muscle mass and poor function were almost non-existent in individuals who could perform over 10 sit-ups.

Is osteoporosis a predictor for future sarcopenia or vice versa? Four-year observations between the second and third ROAD study surveys.

The present 4-year follow-up study was performed to clarify the prevalence, incidence, and relationships between sarcopenia (SP) and osteoporosis (OP) in older Japanese men and women. We enrolled 1099 participants (aged, ≥60years; 377 men) from the second survey of the Research on Osteoarthritis/Osteoporosis against Disability (ROAD) study (2008-2010) and followed them up for 4years. Handgrip strength, gait speed, skeletal muscle mass, and bone mineral density were assessed. SP was defined according to the Asian Working Group for Sarcopenia. OP was defined based on the World Health Organization criteria. SP prevalence was 8.2% (men, 8.5%; women, 8.0%) in the second survey. In those with SP, 57.8% (21.9%; 77.6%) had OP at the lumbar spine L2-4 and/or femoral neck. SP cumulative incidence was 2.0%/year (2.2%/year; 1.9%/year). Multivariate regression analysis revealed that OP was significantly associated with SP occurrence within 4years (odds ratio, 2.99; 95% confidence interval, 1.46-6.12; p<0.01), but the reciprocal relationship was not significantly observed (2.11; 0.59-7.59; p=0.25). OP might raise the short-term risk of SP incidence. Therefore, OP would not only increase the risk for osteoporotic fracture but may also increase the risk for SP occurrence.

A Japanese diet with low glycaemic index and glycaemic load is associated with both favourable and unfavourable aspects of dietary intake patterns in three generations of women.

Western studies have suggested cultural differences in food and nutrient intake patterns associated with dietary glycaemic index (GI) and glycaemic load (GL). Here, we conducted a cross-sectional study to examine the GI and GL of Japanese diets in relation to food and nutrient intakes. Dietary intake was assessed using a validated, self-administered, diet history questionnaire. A total of thirty-five of forty-seven prefectures in Japan. Young (age 18 years), middle-aged (mean age 48 years) and older (mean age 74 years) Japanese women (n 3961, 3800 and 2202, respectively). Irrespective of age, a positive association with dietary GI was seen for white rice only, which contributed most (37-42 %) to the variation in dietary GI. Conversely, all other food groups (such as fruit and vegetable juice, dairy products, noodles and fruit) were negative predictors of dietary GI. For dietary GL, 95-96 % of variation was explained by carbohydrate-rich food groups, all of which were positive predictors of GL. After adjustment for potential confounding factors, only carbohydrate intake was positively associated with dietary GI and GL, irrespective of age. Conversely, dietary GI and GL were inversely associated with intakes of all other nutrients examined (including SFA and Na). A low-GI and -GL diet, which was characterized principally by a low intake of white rice, was associated with both favourable (higher intakes of dietary fibre and key vitamins and minerals) and unfavourable (higher intakes of SFA and Na) aspects of dietary intake patterns in three generations of Japanese women.

Bidirectional relationship between renal function and periodontal disease in older Japanese women.

The purpose of this study was to evaluate the reciprocal effects of chronic kidney disease (CKD) and periodontal disease. A total of 332 postmenopausal never smoking women were enrolled, and their serum high-sensitivity C-reactive protein, serum osteocalcin and serum cystatin C levels were measured. Poor renal function was defined as serum cystatin C>0.91mg/l. Periodontal disease markers, including clinical attachment level and the periodontal inflamed surface area (PISA), were also evaluated. Logistic regression analysis was conducted to evaluate the relationships between renal function and periodontal disease markers, serum osteocalcin level and hsCRP level. The prevalence-rate ratios (PRRs) on multiple Poisson regression analyses were determined to evaluate the relationships between periodontal disease markers and serum osteocalcin, serum cystatin C and serum hsCRP levels. On logistic regression analysis, PISA was significantly associated with serum cystatin C level. The odds ratio for serum cystatin C level was 2.44 (p=0.011). The PRR between serum cystatin C level and periodontal disease markers such as number of sites with clinical attachment level ≥6mm was significantly positive (3.12, p<0.001). Similar tendencies were shown for serum osteocalcin level. This study suggests that CKD and periodontal disease can have reciprocal effects.

Frequency of Combined Aerobic and Resistance Training and Incidence of Diabetes

Some papers report that there is an inverse dose-response relationship between the frequency of exercise and the incidence of type 2 diabetes. However, limited data are available on the relationship between training frequency of combined resistance and aerobic training and the incidence of type 2 diabetes among women. PURPOSE: To investigate the relationship between training frequency of combined aerobic and resistance training and the incidence of type 2 diabetes among older Japanese women. METHODS: This cohort study was conducted in 10,764 nondiabetic Japanese women [median (IQR) age 59 (52-65) years] who are members of a private fitness club which provides a 30 minute circuit program combining aerobic and resistance training. Participants enrolled between 2005 to 2010 with follow-up until August 2014. The frequency of combined aerobic and resistance training was counted using the check-in system of the fitness club from entry day to 9 months after the enrolment year. Age, height and weight were collected via a self-administered questionnaire on enrolment day at the fitness club. In 2014, women reported whether or not they had diabetes, as well as the year of developing diabetes in a questionnaire. Hazard ratios and 95% confidence intervals for the incidence of type 2 diabetes were obtained using Cox proportional hazard models to assess the relationship between training frequency of combined aerobic and resistance training and the incidence of type 2 diabetes. RESULTS: The average duration of follow-up was 5.6 years, with 160 women developing type 2 diabetes during this period. Using the lowest frequency of exercise (quartile I) group as the reference category, the hazard ratios for quartiles II through IV were: 0.95 (0.64-1.41), 0.75 (0.49-1.16), 0.72 (0.46-1.11), respectively (p for trend = 0.079). After adjustment for age and body mass index, the hazard ratios were: 0.88 (0.59-1.30), 0.66 (0.43-1.02), 0.59 (0.37-0.92), respectively (p for trend = 0.008). CONCLUSIONS: Although we did not adjust for other potential confounding factors, such as alcohol consumption or family history of diabetes, these results suggest that a higher frequency of combined aerobic and resistance training was associated with a lower risk of developing type 2 diabetes among older Japanese women.

Relationship between advanced glycation end-product accumulation and low skeletal muscle mass in Japanese men and women.

The present study aimed to investigate the relationship between advanced glycation end-product accumulation and skeletal muscle mass among middle-aged and older Japanese men and women. A total of 132 participants enrolled in this cross-sectional study. Skin autofluorescence was assessed as a measure of advanced glycation-end products. Appendicular skeletal muscle mass was measured using dual-energy X-ray absorptiometry, and skeletal muscle index was calculated by dividing appendicular skeletal muscle mass by height squared. Participants were divided into two groups (low skeletal muscle index and normal skeletal muscle index) using the Asian Working Group for Sarcopenia's skeletal muscle index criteria for diagnosing sarcopenia. Multivariate logistic regression analysis and the area under the receiver operating characteristic curve were used to determine significant factors associated with low skeletal muscle index. Participants consisted of 70 men (mean age 57 ± 10 years) and 62 women (mean age 60 ± 11 years). There were 31 and 101 participants in the low and normal skeletal muscle index groups, respectively. Skin autofluorescence was significantly higher in the low skeletal muscle index group compared with the normal skeletal muscle index group (P < 0.01). Skin autofluorescence was a significant independent factor associated with low skeletal muscle index based on multivariate logistic regression analysis (odds ratio 15.7, 95% confidence interval 1.85-133.01; P = 0.012). The cut-off for skin autofluorescence was 2.45 arbitrary units, with a sensitivity of 0.75 and specificity of 0.91. Skin autofluorescence was an independent factor associated with low skeletal muscle index among middle-aged and older Japanese men and women. Geriatr Gerontol Int 2017; 17: 785-790.

A comparison of Geriatric Depression Scale scores in older Australian and Japanese women.

The aim of this study was to compare the prevalence of depressive symptoms in Australian and Japanese populations of community-dwelling older women using the Geriatric Depression Scale (GDS-15). In addition, the relationship between lifestyle and health factors and higher ratings of depressive symptoms was also examined to determine if there were culturally consistent risk factors associated with higher depressive symptom scores. A total of 444 community based women aged between 65 and 77 years completed a depressive symptom measure (GDS-15) and provided information on common lifestyle factors. The Australian sample (n = 222) were drawn from the Women's Healthy Ageing Project and the age-matched, Japanese sample from the Kumamoto Ageing Study of Mental Health (n = 222). The GDS was chosen to; (1) reduce the impact of physical symptoms associated with old age and, (2) reduce the inflation in scores that may result from the Japanese tendency to endorse somatic items more often than Western adults. Mean GDS total scores were significantly higher for the Japanese population 3.97 ± 3.69 compared with 1.73 ± 2.7 for Australian women. The percentages of women scoring in the normal; mild and moderate ranges for depression were 91, 7 and 2% for Australia and 67, 24 and 9% for Japan. Scores remained significantly higher for the Japanese cohort when controlling for lifestyle and health factors associated with depression. The analysis of lifestyle and health characteristics showed that the greatest difference between cohorts was in the area of living status, with more Australian women living with their partner and more than three times as many Japanese women living with their children. When the data for the countries was considered independently employment status affected the likelihood of higher depression scores in the Australian sample while heart disease and poor sleep impacted the risk for the Japanese population. Significantly more Japanese women scored within the mild and moderate ranges on the GDS compared with their Australian peers, even when controlling for possible confounding factors. Of the lifestyle and health factors assessed in this analysis no single variable was a common risk factor for higher depressive scores for both countries. The presence of cultural influences that may impact the risk of experiencing depressive symptoms, and culture specific patterns of item endorsement on depressive symptom measures, needs to be explored in more detail.

Obesity and Muscle Weakness as Risk Factors for Mobility Limitation in Community-Dwelling Older Japanese Women: A Two-Year Follow-Up Investigation.

To examine the combined association of obesity and low muscle strength with mobility limitation in older adults. This two-year follow-up longitudinal study included pooled data from 283 older community-dwelling Japanese women without mobility limitations who were 65 to 87 years of age (mean age 72.2 ± 5.0 years). Muscle strength was measured by hand-grip strength (HGS). The participants were categorized by HGS (high muscle strength: HGS ≥19.6 kg, low muscle strength: HGS <19.6 kg) and body mass index (BMI) (obese: BMI ≥25 kg/m2, normal weight: BMI <25 kg/m2). The main outcome was mobility limitation, assessed by a self-reported questionnaire (difficulty walking one-half mile or climbing 10 steps without resting). Multivariate logistic regression analysis was performed to determine the combined effect of HGS and BMI on mobility limitation, adjusting for age, exercise habits, medications, and knee pain. During the follow-up period, 82 of 283 participants (29.0%) developed mobility limitation. The adjusted odds ratios (95% confidence interval) for the incidence of mobility limitation were 1.53 (0.86-2.73) and 2.05 (1.08-3.91) in the obese and low muscle strength groups, respectively. Obesity combined with low muscle strength exhibited a significant and strong association with mobility limitation (odds ratio: 3.88, 1.08-13.91) compared with participants with normal weight and high muscle strength. Among community-dwelling older Japanese women, obesity alone was not associated with the incidence of mobility limitation, but when combined with low muscle weakness, the risk of developing mobility limitation was 3.9-fold greater than for the reference group.

Development of a food-based diet quality score for Japanese: associations of the score with nutrient intakes in young, middle-aged and older Japanese women.

Several previous studies have shown that a diet score based on the Japanese food guide Spinning Top (the original score) is associated with both favourable and unfavourable dietary intake patterns. We developed a food-based diet quality score (the modified score) and examined associations with nutrient intakes. Subjects were 3963 young (all aged 18 years), 3800 middle-aged (mean age 47·7 (sd 3·9) years) and 2211 older (mean age 74·4 (sd 5·2) years) Japanese women. Dietary intakes were assessed using comprehensive (for the young and middle-aged) and brief-type (for the older) diet history questionnaires. The original score was calculated based on intakes of grains, vegetables, fish/meat, milk, fruits, and snacks/alcoholic beverages. The modified score was similarly calculated, but included Na from seasonings and without applying the upper cut-off values for dietary components where increased consumption is advocated for Japanese women (grains, vegetables, fish/meat, milk, and fruits). The original score was positively associated with intakes of carbohydrate, dietary fibre, and all the vitamins and minerals examined including Na and inversely with intakes of fats and alcohol in young and middle-aged women. In older women, the original score was inversely associated with intakes of all nutrients except for carbohydrate and vitamin C. However, the modified score was associated positively with intakes of protein, carbohydrate, dietary fibre, K, Ca, Mg, Fe, vitamins A, C and E, and folate and inversely with intakes of fats, alcohol and Na in all generations. In conclusion, the modified diet score was positively associated with favourable nutrient intake patterns in Japanese women.

Laughter is the Best Medicine? A Cross-Sectional Study of Cardiovascular Disease Among Older Japanese Adults.

BackgroundWe sought to evaluate the associations between frequency of daily laughter with heart disease and stroke among community-dwelling older Japanese women and men.MethodsWe analyzed cross-sectional data in 20 934 individuals (10 206 men and 10 728 women) aged 65 years or older, who participated in the Japan Gerontological Evaluation Study in 2013. In the mail-in survey, participants provided information on daily frequency of laughter, as well as body mass index, demographic and lifestyle factors, and diagnoses of cardiovascular disease, hyperlipidemia, hypertension, and depression.ResultsEven after adjustment for hyperlipidemia, hypertension, depression, body mass index, and other risk factors, the prevalence of heart diseases among those who never or almost never laughed was 1.21 (95% CI, −1.03–1.41) times higher than those who reported laughing every day. The adjusted prevalence ratio for stroke was 1.60 (95% CI, 1.24–2.06).ConclusionsDaily frequency of laughter is associated with lower prevalence of cardiovascular diseases. The association could not be explained by confounding factors, such as depressive symptoms.

Physical Performance Measures Associated With Locomotive Syndrome in Middle-Aged and Older Japanese Women.

The Japanese Orthopaedic Association proposed a concept called locomotive syndrome (LS) to identify middle-aged and older adults at high risk of requiring health care services because of problems with locomotion. It is important to identify factors associated with the development of LS. Physical performance measures such as walking speed and standing balance are highly predictive of subsequent disability and mortality in older adults. However, there is little evidence about the relationship between physical performance measures and LS. To determine the physical performance measures associated with LS, the threshold values for discriminating individuals with and without LS, and the odds ratio of LS according to performance greater than or less than these thresholds in middle-aged and older Japanese women. Participants were 126 Japanese women (mean age = 61.8 years). Locomotive syndrome was defined as a score of 16 or more on the 25-question Geriatric Locomotive Function Scale. Physical performance was evaluated using grip strength, unipedal stance time with eyes open, seated toe-touch, and normal and fast 6-m walk time (6 MWT). Variables were compared between LS and non-LS groups. Fourteen participants (11.1%) were classed as having LS. Unipedal stance time, normal 6 MWT, and fast 6 MWT were significantly different between the 2 groups. The LS group had a shorter unipedal stance time and a longer normal and fast 6 MWT than the non-LS group. For these 3 variables, the area under the receiver operating characteristic curve was greater than 0.7, and the threshold for discriminating the non-LS and LS groups was 15 s for unipedal stance time, 4.8 s for normal 6 MWT and 3.6 s for fast 6 MWT. These variables were entered into a multiple logistic regression analysis, which indicated that unipedal stance time less than 15 s was significantly related to LS (odds ratio = 8.46; P < .01). Unipedal stance time was the physical performance measure that was most strongly associated with LS. This measure may be useful for early detection of LS.

The power of the ordinary: Quotidian framing as a narrative strategy

In examining various conversations and narratives associated with contents and contexts of psychologically heightened situations, we often find segments that are told from an incongruous perspective, specifically from a perspective of ordinary life, and accompanied by laughter and other signs of animated engagement. This phenomenon, quotidian (re)framing, can function as a discourse strategy to decrease psychological intensity and to reground participants’ sense of self in the quotidian (quotidian self). The paper discusses uses and interactional functions of quotidian (re)framing based on examples in a range of linguistic and social contexts from older Japanese women's conversations to a talk show and to two American presidents’ interactions at public events. In contrast to many studies of discourse and in sociolinguistics that have focused on how participants of interactions appropriate or are given various identities, this study illustrates the importance of investigating how people agentively cast away the assumed identities to gain a better sense of self.