Older Japanese Women Research Articles

Alcohol consumption and female urinary incontinence: A community‐based study in Japan

To investigate the association between alcohol consumption and urinary incontinence among Japanese women. A total of 300 women aged 40-75 years were recruited from the community in middle and southern Japan. A validated food frequency questionnaire was given face-to-face to obtain information on dietary intake and habitual alcohol consumption. Urinary incontinence status was ascertained using the International Consultation on Incontinence Questionnaire-Short Form. Among the 298 eligible participants, 82 women (27.5%) experienced urine leakage. The prevalence of alcohol drinking and mean ethanol intake were slightly higher among the incontinent women (39%; 7.1, standard deviation 24.1 g/day) than others without the condition (35.6%; 4.3, standard deviation 10.7 g/day). Relative to non-drinkers, the adjusted odds ratios of urinary incontinence were 1.31 (95% confidence interval 0.74-2.33) for alcohol drinking and 1.69 (95% confidence interval 0.42-6.81) for ethanol intake over 32 g/day, though the increases in risk did not reach statistical significance. Little association is evident between alcohol consumption and urinary incontinence in middle-aged and older Japanese women. Further studies are required to define the role of alcohol as a contributing factor of this distressing condition.

Painful to playful: Quotidian frames in the conversational discourse of older Japanese women

AbstractConversations about serious life changes in old age may be expected to sound painful, but data of conversational narratives by elderly Japanese women even on topics related to illnesses or the death of a husband show highly engaging, lively exchanges, frequently accompanied by humor and laughter among the participants. The common feature in the conversations recounting psychologically intense experiences is a shift to detailed depictions of specific scenes from the quotidian perspective. This phenomenon, which I call quotidian reframing, is signaled by linguistic and paralinguistic quotidian framing cues. Quotidian reframing can function as a useful discourse strategy to relieve tension and let the participants regain the feeling or stance of quotidian self, the identity that they consider “normal.” A detailed account of the quotidian frame draws on such ideas as frame, footing, lamination, and positioning. (Discourse analysis, frame, identity, humor and laughter, older Japanese women)*

Validity of Equation to Estimate the Physical Fitness Age in Community-Dwelling Older Japanese Women

In Japan, people over 65 years old exist approximately 23 %. Therefore, maintaining physical fitness is important for healthy aging in older adults. The performance tests have the merit of providing objective, quantifiable information on physical fitness in older adults. PURPOSE: To assess the validity of equation to estimate the physical fitness age (FFA) in community-dwelling older Japanese women. METHODS: Subjects were 267 Japanese female volunteers aged 61 to 88 years (73.4 +/- 5.2 years), living independently in community. Subjects participated in 6 physical performance tests (grip strength (X1), sit-ups (X2), sit and reach (X3), one leg balance with eyes open (X4), 10 m hurdle walking (X5) and 6 minute walking (X6)), named 'new physical fitness test' proposed by Ministry of Education, Culture, Sports, Science and Technology of Japan. The physical fitness score was calculated by the method of guidelines. The single regression analysis, multiple regression analysis and principal component analysis ware used to obtain the equation estimating the physical fitness age. RESULTS: The decision coefficients of 0.18, 0.39 and 0.54 were obtained by the single regression analysis, multiple regression analysis and principal component analysis, respectively. The results showed that the following equation of FFA obtain by the principal component analysis would be a most accurate method: FFA=0.304 X1+0.176 X2+0.118 X3+0.025 X4-1.087 X5 +0.018 X6+1.366 CA-42.35 (CA: chronological age). CONCLUSION: The proposed test equation could be a useful instrument for providing a comprehensive measure of physical fitness.

Is Upper Extremity Performance Associated With Frailty In Community-dwelling Older Women?

Although a standardized test battery for assessing lower extremity performance (LEP) can reflect health-related outcomes, it has yet to be determined whether upper extremity performance (UEP) is associated with frailty. PURPOSE: To define a summary score of UEP, and to determine the association between UEP and frailty in older women. METHODS: Cross-sectional analysis was conducted on the data from 502 community-dwelling older Japanese women, aged 65-92 years (74.3 ± 6.5 yr). The participants were classified as non-frail, pre-frail, and frail based on the definition of Fried et al. (2001). Trained testers assessed UEP using standardized measures of hand-grip strength (HG), functional reach (FR), and hands working with pegboard (PB). A summary UEP score (UEPS) equation was developed by principal component analysis. Participants were divided into quartile levels according to UEPS (Q1 to Q4) and multiple logistic regression was used to evaluate whether UEPS was independently associated with frailty, adjusting for potential confounders. The cut-off points for pre-frail and frail were determined by receiver-operating characteristic curves. RESULTS: The following equation was developed to estimate UEPS based on the first principal component coefficient of each variable: UEPS = 0.086HG + 0.060FR + 0.063PB - 5.793. In the logistic regression models, the odds ratios (95% confidence interval) of frailty compared with Q1 were 0.37 (0.19-0.70), 0.20 (0.10-0.40), and 0.21 (0.10-0.45) in Q2, Q3, and Q4, respectively, after controlling age, gait speed, vascular risk burden, joint pain, activities of daily living, and instrumental activities daily living (P for trend < 0.05). From the sensitivity and specificity curves, UEPSs of 0.23 (AUC 0.74, sensitivity and specificity 69%, for pre-frail) and -1.24 (AUC 0.89, sensitivity and specificity 83%, for frail) were defined as optimal cut-off points that maximize sensitivity and specificity. CONCLUSION: Among community-dwelling older women, UEP is significantly associated with frailty. Current results suggest that not only LEP but also UEP may be useful items for assessing frailty and other adverse-health outcomes. Supported by a Grant-in-Aid for Scientific Research (A) #19200047.

Mothers and daughters-in-law: a prospective study of informal care-giving arrangements and survival in Japan

BackgroundDaughters-in-law have played an important role in informal care-giving arrangements within East Asian traditional norms. The aim of this study was to measure the impact of daughter-in-law care-giving on the survival of care recipients. We prospectively examined the associations between different types of kinship relationship between the main family caregiver and the care recipient in relation to survival among care recipients.MethodsA questionnaire was administered to Japanese community-dwelling seniors who were eligible to receive national long-term care insurance (LTCI) community-based services. Among 191 individuals whose informal care-giving arrangement was definitively determined, we observed 58 care recipients receiving care from spouses, 58 from daughters-in-law, 27 from biological daughters, 25 from other relatives, and 23 care recipients living alone.ResultsDuring 51 months of follow-up from December 2001, 68 care recipients died, 117 survived, and 6 moved. Hazard ratios of each care-giving arrangement were estimated by Cox proportional hazard models adjusted for care recipients' demographic factors, their care needs level based on their physical and cognitive functioning and their service use, caregivers' demographic factors, and household size. The highest risk of mortality was found for female elders receiving care from daughters-in-law (HR 4.15, 95% CI 1.02-16.90) followed by those receiving care from biological daughters (HR 1.64, 95% CI 0.37-7.21), compared to women receiving spousal care. By contrast, male elders receiving care from daughters-in-law tended to live longer than those receiving care from their spouses.ConclusionsOur finding suggests that there may be a survival "penalty" for older Japanese women who are cared for by their daughters-in-law.

Development A New Physical Performance Test Battery Assessing Functional Fitness In Community-dwelling Older Japanese Women

Development A New Physical Performance Test Battery Assessing Functional Fitness In Community-dwelling Older Japanese Women

Small dose high leucine essential amino acids supplementation ameliorates sarcopenia in sarcopenic older Japanese women

Sarcopenia, skeletal muscle loss with advancing age, leads to muscular weakness and reduced physical functions. It was reported that the high‐leucine essential amino acid mixture (HLEAA, 11 g twice a day) supplementation increased lean body mass (LBM) and physical functions in non‐sarcopenic elderly subjects. We conducted the randomized‐controlled trial to determine if HLEAA reverses sarcopenia in older subjects who actually have sarcopenic characteristics, i.e. reduced muscle mass and strength. The sarcopenic subjects were selected from 1,399 female participants, living at home in Tokyo and aged over 75 years, who had attended a comprehensive geriatric health check. The inclusion criteria were relative muscle mass (muscle mass/height2) ≤ 30th percentile, muscle strength (maximum knee extension power) ≤30th percentile, and BMI ≤ 25. 78 subjects were randomly allocated to a HLEAA group or a control group. The subjects assigned to the HLEAA group ingested 3 g of HLEAA two times a day for 3 months. The control group subjects only received a general health promoting lecture every month. 23 and 27 subjects completed the trial in the HLEAA group and the control group respectively. LBM was significantly increased in the HLEAA group (1.39 ± 0.22 kg, p &lt; 0.001), and no change was observed in the control group (0.42 ± 0.41 kg). Maximum knee extension power was unchanged in both groups, but usual walking speed and maximum walking speed were significantly increased only in the HLEAA group. We conclude that relatively smaller dose (3 g twice a day) HLEAA ingestion for 3 months increases LBM and physical functions in apparent sarcopenic elderly women.

Usual Walking Speed Predicts Decline of Functional Capacity among Community-Dwelling Older Japanese Women: a 4-year Longitudinal Study

[Purpose] In this study, we examined the physical predictors of the decline of functional capacity among community-dwelling older Japanese individuals. [Methods] A total of 265 Japanese individuals aged 68-96 years participated in a baseline survey and a follow-up 4 years later. In this survey, participants performed tests for grip strength, one-legged standing, and 5-m walking. At baseline and the follow-up survey, we measured functional capacity using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), which consists of the instrumental self-maintenance scale, the intellectual activity scale, and the social role scale. [Results] There was only a weak association between physical performance and the decline of functional status in men. The 5-m walking time was most sensitive at predicting the future decline of the instrumental self-maintenance scale in women. Even after controlling for age, body mass index, grip strength, and one-legged standing, a slower 5-m walking time (greater than 4.6 sec) indicated an increased risk of future decline in instrumental self-maintenance in women (odds ratio = 5.31, p<0.01). [Conclusions] The usual walking speed is the best performance measure for predicting the decline of instrumental self-maintenance among Japanese older women.

経年的体力調査に対する脱落高齢者および継続高齢者の特徴

PURPOSE: The aim of this study was to examine the differences in physical fitness level between those who continued to participate and those who dropped out during a 5-year longitudinal study. METHODS: The subjects were 254 older Japanese men and women, aged 60 y and over (69.6±5.6 y), who lived independently and were able to participate in physical fitness testing only at the baseline (drop-out group: n=163, 70.1±5.5 y) or every year from 2000 to 2005 (follow-up group: n=91, 68.7±4.5 y). Seven physical-performance test items related to activities of daily living were measured. In addition, a questionnaire was used to collect information regarding self-reported exercise habituation, joint pain, health-related quality of life and health condition. Significance of differences between the drop-out group and follow-up group were tested using Student's t test and analysis of covariance (ANCOVA). Logistic regression analysis was performed to explain characteristics of physical fitness status in the two groups. The level of statistical significance was set at P<0.05 for all analyses. RESULTS: At the baseline, those in the drop-out group were older, had lower levels of physical fitness and more joint pains, and were physically less active than the follow-up subjects. However, health-related quality of life and health condition did not differ significantly between the two groups. In a multivariate logistic regression analysis adjusted for age and sex, those in the drop-out group had a slower walking speed around the two cones in a figure 8 (odds ratio 1.23, 95% confidence interval 1.12 to 1.35), and were non-habituated to exercise (odds ratio 1.72, 95% confidence interval 0.97 to 3.06). CONCLUSION: These results suggest that older adults who drop out after the baseline in physical fitness tests are older, have lower physical fitness, and are physically sedentary.

ACTN3Polymorphism Affects Thigh Muscle Area

Muscle mass is an important factor influencing the activity of daily living in older adults. We aimed to investigate whether alpha-actinin-3 (ACTN3) gene R577X polymorphism affects muscle mass in older Japanese women. A total of 109 women (mean+/-SD, 64.1+/-6.0 years) were genotyped for the R/X variant of ACTN3. Mid-thigh muscle cross-sectional area (CSA) was assessed using MRI and compared using analysis of covariance models adjusted for body weight. In addition, physical activity and protein intake were measured as the living environmental factors affecting muscle mass. The ACTN3 R577X genotype distributions of the subjects were 19, 63 and 27 for the RR, RX, and XX genotypes, respectively. No differences in physical activity and protein intake were observed among the genotypes. The XX genotype showed lower thigh muscle CSA compared with RR&RX genotype (mean+/-SEM; XX: 69.1+/-1.8 cm(2), RR&RX: 73.6+/-1.1 cm(2); p<0.05). The results of the present study suggest that ACTN3 R577X polymorphism influences muscle mass in older Japanese women.

Five-year alendronate treatment outcome in older postmenopausal Japanese women with osteoporosis or osteopenia and clinical risk factors for fractures.

A retrospective study was conducted to evaluate the outcome of treatment with alendronate (ALN) for 5 years in postmenopausal Japanese women with an increased risk of fractures. Forty postmenopausal Japanese women with osteoporosis or osteopenia and clinical risk factors for fractures (mean age: 75.4 years) were analyzed; 33 patients were treated with alendronate and 7 were treated with alfacalcidol (ALF, controls) in an outpatient clinic run by general practitioners. The metacarpal bone mineral density (BMD) measured using a computed X-ray densitometer, urinary levels of cross-linked N-terminal telopeptides of type I collagen (NTX), and serum levels of alkaline phosphatase (ALP) were monitored during the 5-year treatment period. The urinary NTX and serum ALP levels decreased significantly in the ALN group, compared with the ALF group. The metacarpal BMD was sustained in the ALN group but decreased significantly in the ALF group; the difference between these two groups was also significant. The present study evaluated the outcome of treatment with ALN for 5 years in postmenopausal Japanese women with osteoporosis or osteopenia and clinical risk factors for fractures. ALN successfully suppressed bone turnover and sustained the metacarpal BMD over the 5-year period of treatment in postmenopausal Japanese women with an increased risk of fractures.

Relationship between the abdominal wall fat index and blood pressure in elderly women: a comparison with the body mass index

Several studies have examined the associations between measurements used to assess obesity, such as the body mass index (BMI), waist circumference (WC) and intra-abdominal fat area, and cardiometabolic abnormalities. However, the application of these measures in clinical practice requires more detailed examination in older individuals. The abdominal wall fat index (AFI) is ultrasonographically determined via a vertical scan along the upper abdominal median, to measure the maximum thickness of pre-peritoneal fat at the liver surface and the minimum thickness of subcutaneous fat. Few studies, however, have compared the AFI with the BMI as a measure of obesity. Older women were examined to determine the associations among BMI, AFI and cardiometabolic variables. In 86 asymptomatic women with BMIs of 18.5-29 kg/m2 (mean age+/-SD 77+/-6 years; mean BMI+/-SD 22.7+/-2.5 kg/m2), we measured the following cardiometabolic variables: systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), plasma glucose, serum total cholesterol, triglycerides, and high-density lipoprotein cholesterol. In a multiple regression analysis adjusted for all the above cardiometabolic variables, BMI showed a significant negative correlation with age alone, whereas AFI showed a significant positive correlation with DBP and PP. Our results suggest that, compared with BMI, AFI may be useful in identifying blood pressure-related abnormalities, which represent an atherosclerotic risk in older Japanese women.

Wrapping and Unwrapping Emotions: Clinical Practice with East Asian Immigrant Elders

Using the cultural norm of the way gifts are wrapped, unwrapped, and exchanged as a metaphor for interpersonal connections, this paper presents the way therapists can establish therapeutic relationships with East Asian clients who do not express emotions openly. We first discuss the ways in which emotions are conceptualized, experienced, and expressed in East Asian cultures. We then present vignettes of our work with older Chinese and Japanese immigrant women to illustrate the importance of therapist authenticity and co-construction of the therapeutic relationship. Using the framework of relational/cultural theory, which posits that healing takes place in the context of mutually empathic growth-fostering relationships, we illustrate the importance of establishing mutuality between therapist and client as a form of cultural empathy.

Differences In Functional Fitness And Fear Of Falling Among Older Japanese Women

PURPOSE: Declines in functional ability and the prevalence of falling are problems in older adults. In the elderly, the fear of falling (FOF) may be as limiting as falling itself in terms of restricting daily physical activity. Therefore, measures of functional fitness may be related to FOF. METHODS: A total of 537 women (68.9±5.7 y; range=60-94 y) were recruited from the community and divided into three groups: no fear of falling (NF, n=163), low fear of falling (LF, n=311), and high fear of falling (HF, n=63). FOF was assessed using a single question survey. Functional fitness was assessed by seven measures: 1) Chair Stand (CS); 2) Arm Curl (AC), 3) 8-foot up & go (UPGO); 4) Sit & Reach (SR); 5) Back Scratch (BS), 6) Functional reach, and 7) 12min-walk (12W). Balance was assessed using static postural sway (CTSIB) and limits of stability. Group comparisons were made using analysis of variance. RESULTS: All parameters of functional fitness except BS (upper body flexibility) were significantly lower in HF compared to other groups. Differences in CTSIB with foam-open-eyes were observed between all three groups with HF having lower balance than NF and LF groups.TABLECONCLUSIONS: Results suggest that fear of falling may have negative consequences with respect to older adults' functional fitness and balance. Further study is needed to determine if cause and effect relationships exist. It would also be interesting to examine if an exercise program for persons with FOF would increase functional fitness and balance while reducing FOF. Supported by the Grants-in-for Scientific Research of MEXT Japan.

Functional Fitness Differences In Japanese Older Women Who Walk 10,000 At Different Intensities.

Regular physical activity (PA) plays an important role in maintaining and promoting health, physical fitness, and functional independence in older adults. However, research is less clear when examining the impact of recommended levels of PA accumulation versus PA intensity on health, fitness and functional independence. PURPOSE: To determine if functional fitness (FF) differences exist between community-dwelling older women who accumulate 10,000 steps/day and engage in 30 minutes/day or more of MI versus those who accumulate 10,000 steps/day and engage in less than 30 minutes/day of MI. METHOD: Subjects (Ss) underwent a FF test and received a Lifecorder (Suzuken Co, Japan) accelerometer (LC) to record 2 consecutive weeks of steps and PA intensity (0=low intensity to 9=high intensity). PA intensity was defined as MI corresponding to LC levels 4-6 (3-6 METS). FF was assessed using Arm Curl, Chair Stand, Up & Go, Sit and Reach, Back Scratch, Functional Reach, and 12-min Walk. 603 Ss completed PA and FF assessments; of those 132 Ss (age: 68 ± 5, daily average step: 12370 ± 2087) accumulated 10,000+ steps/day and were selected for analysis. Ss were assigned to one of two groups: 30 or more minutes/day of MI PA (30MMI) or less than 30 minutes (30LMI). RESULTS: in table.TABLECONCLUSION: There appears to be a relationship between MI and FF even for individuals accumulating the recommended PA levels. Individuals who accumulate 10,000 steps/day and engage in 30 minutes/day or more of MI appear to have greater lower body strength, mobility, and cardio-respiratory fitness compared to those who accumulate 10,000 steps/day and engage in less than 30 minutes/day of MI. Future research should examine the impact of increasing MI to recommended levels on FF.

Relative deprivation and incident functional disability among older Japanese women and men: prospective cohort study

Background:A prospective observational study was conducted to test the hypothesis that relative deprivation was associated with incident physical or cognitive disability, independent of absolute income.Methods:Study subjects consist of 9463 non-disabled...

Reliability Of Fat-free Mass And Body Mass By Bioelectrical Impedance Analysis In Older Japanese Women

Reliability Of Fat-free Mass And Body Mass By Bioelectrical Impedance Analysis In Older Japanese Women

Association Between Static And Dynamic Balance With Age In Japanese Older Women

Association Between Static And Dynamic Balance With Age In Japanese Older Women

Development Of A Functional Fitness Index Score In Older Japanese Women

Several assessments of functional fitness in older adults have shown consistent declines in performance with advancing age. However, the variety of assessments available tend to measure single components of functional fitness while not providing an overall evaluation encompassing the multiple domains of function. PURPOSE: The purpose of the present study was to utilize tests representing four components (endurance, flexibility, muscle strength, balance) of functional fitness to develop an index score representative of overall functional fitness in older adults Method: Seven performance tests {30-sec arm curl (AC), 30-sec chair stand (CS), sit and reach (SR), back scratch (BS), up & go (UPGO), functional reach (FR), 12-min distance walk (12W)} chosen to address four domains of functional fitness were administered to 1,234 older Japanese women aged 70.0 ±7.1 yrs. RESULTS: Principal component analysis yielded a single component accounting for 47.8% of the total variance. Variables with a factor-loading score of at least 0.4 were selected, the remaining 6 variables (X1=AC, X2=CS, X3=BS, X4=UPGO, X5=FR, X6=12W) accounted for 53.8% of the total variance. Based on these variables, the following equation was developed: Functional Fitness Index score = (0.049 X1) + (0.043 X2) + (0.141 X3) + (0.016 X4) + (0.035 X5) + (0.001 X6) − 3.285. The average Functional Fitness Index score for this sample was 0.18 ±0.83. Further analysis denoted a moderate association between the Functional Fitness Index score and age (r= −0.53). CONCLUSIONS: These results suggest that the Functional Fitness Index score may be a useful measure of overall functional fitness in older adults. However, further research is needed to determine if additional measures would enhance the comprehensiveness of the score. Moreover, additional research should evaluate the ability of the score to predict performance on instrumental activities of daily living.

Socio-Geographic Factors and the Habitual Physical Activity of Older Japanese Women: The Nakanojo Study

Socio-Geographic Factors and the Habitual Physical Activity of Older Japanese Women: The Nakanojo Study