Association between caregivers' health-related quality of life and care recipients' health outcomes.

AIMS: This study aimed to investigate the relationship between family caregivers' health-related quality of life and health outcomes in care recipients. METHODS: A total of 160 female caregivers in Japan were initially assessed using self-reported baseline questionnaires to determine physical and mental aspects of their health-related quality of life. Based on these scores, they were divided into three groups: lower, middle, and higher quality of life. We followed up with the 133 participants (after excluding those that did not respond) 6 years later to assess the health of their care recipients; 36 caregivers continued to provide home care, while 97 reported that their care recipient had died or been admitted into institutionalized care. RESULTS: Statistically, a higher risk for care recipients' health deterioration was strongly associated with the mental component score in the lower caregivers' quality of life group of than for the middle group, after adjusting for the care recipients' age, health status, and caregivers' age at baseline. There was no significant association between deterioration of health of care recipients and physical component scores of the caregivers. CONCLUSION: Caregivers' poor health-related quality of life, particularly poor mental health, may be linked to the deterioration of care recipients' health.

Morphological defects in native Japanese fir trees around the Fukushima Daiichi Nuclear Power Plant.

After the accident at the Fukushima Daiichi Nuclear Power Plant (F1NPP) in March 2011, much attention has been paid to the biological consequences of the released radionuclides into the surrounding area. We investigated the morphological changes in Japanese fir, a Japanese endemic native conifer, at locations near the F1NPP. Japanese fir populations near the F1NPP showed a significantly increased number of morphological defects, involving deletions of leader shoots of the main axis, compared to a control population far from the F1NPP. The frequency of the defects corresponded to the radioactive contamination levels of the observation sites. A significant increase in deletions of the leader shoots became apparent in those that elongated after the spring of 2012, a year after the accident. These results suggest possibility that the contamination by radionuclides contributed to the morphological defects in Japanese fir trees in the area near the F1NPP.

Characteristics of hypertension-related factors in female home caregivers in Japan-comparison with general community non-caregivers.

AIMS AND OBJECTIVES: To examine the characteristics of hypertension-related factors in female family caregivers in Japan who provide care in the home, in comparison with general community non-caregivers. BACKGROUND: Hypertension is more frequently encountered in female caregivers than in non-caregivers. Lifestyle factors including sleep and eating habits differ in Japanese female caregivers and the general population. Therefore, hypertension-related factors in caregivers may also differ from those in the general population. DESIGN: A cross-sectional study. METHODS: The subjects were 150 female caregivers (aged 62·4, SD 12·2 years) who provided home care for persons with physical impairments and/or dementia and 154 female controls (aged 62·7, SD 2·2 years) who did not provide home care. Persons with a history of ischaemic heart disease or cerebral stroke were excluded. Subjects were examined using a self-reporting questionnaire that included a food frequency questionnaire and the tri-axial coping scale. Urine examinations and blood pressure measurements were also done. Logistic regression analysis was conducted for each group with the same variables as explanatory variables. RESULTS: Hypertension was present in 46·7% of caregivers and 34·4% of controls (p<0·05). Menopause was a factor related to hypertension in both the caregivers and controls. In the caregiver group, hypertension was associated with the estimated 24-h Na excretion in urine and the carbohydrate-energy ratio for nutriti. BMI was associated with hypertension in the control group, but not in the caregiver group. CONCLUSIONS: Hypertension was associated with nutritional factors, such as greater Na excretion in urine and higher carbohydrate energy ratio, in Japanese female caregivers and with obesity in non-caregivers. RELEVANCE TO CLINICAL PRACTICE: To prevent hypertension, it is necessary to carefully monitor salt intake and nutritional balance in female caregivers in Japan.

[Subjective physical and mental health characteristics of male family caregivers].

OBJECTIVES: Due to the increased population of elderly people requiring care and assisted living care, as well as changes in the social structure, the number of males playing a role in home care has therefore been increasing each year. The purpose of this study was to clarify characteristics related to subjective mental and physical health of male family caregivers based on a comparison with male non-caregivers. METHODS: The subjects comprised 52 male family caregivers (caregiver group) who provide care for those requiring at-home care at level 3 or above, or who provided care for people with dementia in cases at a level below 3, with an average age and standard deviation of 69.3 +/- 10.9 years old. The comparison group comprised 52 people who underwent regular health checkups in K city, whose gender and ages, by 10-year age group, were matched to the subjects on a 1:1 basis, and whose average age and standard deviation were 69.2 +/- 11.1 years old. The research was conducted over ther period from December 2005 to April 2007. The survey was conducted with a self-answering format, and subjects were asked questions about such matters as lifestyle, QOL, psychosocial stress and coping with stress. RESULTS: The average age of people requiring care was 75.7 +/- 9.5 years old, and it became apparent that elderly caregivers generally provide care for other elderly people. In a health-related QOL (SF-8), care-giver group were significantly low in "General Health" and "Bodily Pain" in the physical health domain. In the mental health domain, "Mental Health" and mental health summary score of the care-giver group were significantly low. Regarding lifestyle, it was apparent that the care-giver group had significantly fewer sleeping hours than the control group and the PSQI score was also lower. Coping scores were significantly low for the caregiver group regarding 2 items, "Evasive Thinking" and "Recreation", and this indicated a tendency toward not adopting an evasive type of coping. CONCLUSION: It became clear that male caregivers have low subjective health and experience problems about sleep and stress. In addition, they tended not to take coping of evasion type and a need of comprehensive support was suggested.

Physical and psychological health problems among Japanese family caregivers.

The authors commenced research in 2005 with the goal of on constructing a health support system for primary caregivers. This ongoing study aims to develop a health support program and construct a system of regional assistance based on examining the health situation of family caregivers. Furthermore, it aims to present proposals that will put the minds of citizens at ease in respect to their ability to live in a super aging society. A survey was conducted with 213 male and female caregivers and a control group of 477 community residents not engaged in care. This paper collates the various research findings reported in journals and conference presentations by the authors. Among both male and female caregivers, blood pressure levels required regulation. Among female caregivers, grip strength and musculoskeletal symptoms were worse than those in the control group, even when participants were matched for age. We attempted to determine the characteristics of caregivers who have strong feelings of responsibility and obligation toward their provision of care. Age was a significantly higher factor in the group with stronger feelings in that regard. The group with weaker feelings of responsibility and obligation was younger. The percentage of participants who were caring for a spouse, living with a spouse, had no secondary caregivers, or were providing all-day care, was significantly higher in the group with stronger feelings of responsibility and obligation. There was no significant difference between the groups in the mean total score on the J-ZBI-8 that measures burden of care. As the aging population of Japan grows larger, support for caregivers with physical and psychological health problems, and at the very least, concern of government administrators and the general public, will assume greater importance.

[Blood pressure control through awareness of hypertension among female in-home caregivers].

OBJECTIVES: Our purpose was to clarify the situation regarding blood pressure control through awareness of hypertension among female groups of in-home caregivers and non-caregivers. METHODS: We used one existing data generated between December 2005 and April 2007. The subjects were females who were suffering from hypertension (66 caregivers were aged 49-84 years; 52 non-caregivers were aged 47-81 years). We defined persons suffering from hypertension on the basis of results of a self-administered questionnaire and blood pressure values. On the question of awareness of hypertension, we defined the persons who replied positively to any one of "I have hypertension," "I have suffered from hypertension," or "I take antihypertensive agents" as belonging to the "awareness group." We categorized the other respondents, who replied to all three questions in the negative as belonging to the "non-awareness group." We used blood pressure values, to build an index of the control with the chi2 test and the t-test for statistical comparisons. Values of P < 0.05 were considered statistically significant. RESULTS: The results showed that blood pressure values of caregivers in both the awareness group and the non-awareness group were high (awareness group vs non-awareness group overall SBP: 148 +/- 20 mmHg vs 154 +/- 9 mmHg, DBP: 79 +/- 13 mmHg vs 82 +/- 10 mmHg, P > 0.05). Furthermore, values were significantly lower for the awareness than non-awareness group with respect to the non-caregivers (SBP: 135 +/- 15 mmHg vs 149 +/- 7 mmHg, DBP: 73 +/- 10 mmHg vs 78 +/- 6 mmHg). Caregivers who took the antihypertensive agent in the awareness group demonstrated high values exceeding SBP 140 mmHg, which was the hypertensive standard value, not different from the values for caregivers not taking such medication. (taking vs non-taking SBP: 148 +/- 21 mmHg vs 149 +/- 8 mmHg). CONCLUSION: Among the caregivers, it was not only the members of the non-awareness group but also those of the awareness group who were found to have high blood pressure values. Though the caregivers took antihypertensive agents, their blood pressure values remained high.

[Physical and mental health characteristics of female caregivers].

OBJECTIVE: In Japan, research into physical conditions or illnesses of female caregivers focusing on biological markers in biological materials such as blood and urine has been limited. Therefore, the present study was conducted to clarify the physical and mental characteristics of female caregivers in comparison with the general population, using biological markers and self-answered questionnaires. METHODS: The subjects were 161 female in-home primary caregivers for persons requiring care at level 3 or more or less than 3 if suffering from dementia (caregiver group). The control group consisted of females matched 1 : 1 in the same decade of life who received medical checkups in K city. The survey period was from December 2005 to April 2007. The methods were self-answered questionnaires, including lifestyle, caregiving conditions, the Pittsburgh Sleep Quality Index (PSQI) and frequency of taking food, and common parameters for lifestyle diseases using blood and urine and blood pressure, taken by trained investigators at the subjects homes. RESULTS: Average age was 62.8 +/- 11.9 years in the caregiver group and 63.2 +/- 12.4 years in the control group. 46.0% had 5 or more years experience in caregiving and 8.7% had less than 1 year. The required care level most common was 5 at 33.8%, with levels 3 and 4 the next most common. 46.0% of the caregiver group had hypertension, significantly higher than the 34.2% in the control group. The prevalence of glucose intolerance and hypo-HDL-cholesterolemia was also high in the caregiver group, but without significant difference. The caregiver group had lower HDL-cholesterol values than the control group. In lifestyle, the two groups differed in exercise, PSQI, proportion of energy from carbohydrates and estimated 24-hour excretion of sodium (Na) in urine. In particular, it was clear that Na was undesirable for caregiver,s even using urine samples for examination. Although more in the caregiver group described themselves as unhealthy, fewer of them received annual health checkups than in the control group. More in the caregiver group felt stress about their health or aging or depression, with few opportunities for diversion. CONCLUSIONS: Hypertension, the most important risk factor for brain and cardiovascular disease, is significantly high in caregivers, suggesting the need for preventive measures. Similar findigns were also obtained with other biological markers and more in the caregiver group felt stress about their health or aging or depression, pointing to a nee for health support.