Living alone is associated with an increased risk of institutionalization in older men: A follow-up study in Hamanaka Town of Hokkaido, Japan.

AIM: In order to clarify the risks of institutionalization or mortality among older adults living alone compared with those not living alone, we carried out a prospective study on older adults in Hamanaka Town in the far eastern part of Hokkaido, Japan. METHODS: All 978 community-dwelling residents aged 70-85 years in the town were chosen as study candidates between February and May of 2014. Written informed consent was obtained from 562 residents (57.5%), and a self-administered questionnaire, including a question about living arrangements, was mailed to them. They returned the completed questionnaire to us in 2014. A follow-up survey was carried out with a questionnaire mailed to each participant about institutionalization and mortality, three times, in February of 2015 and 2016, and in April of 2017. Hazard ratios and 95% confidence intervals were calculated with the Cox proportional hazards model. RESULTS: Living alone was significantly associated with an increased risk of institutionalization in the male participants, after adjusting for age, sex and having daily support from family around a participant (hazard ratio 5.71, 95% confidence interval 1.17-27.83), although it was not significant in the total participants or the female participants. Additional adjustments for a history of having common diseases did not change the results meaningfully. Living alone was not associated with the risk of mortality in the total participants, the male participants or the female participants. CONCLUSIONS: Poor social support in social networks for older men living alone may be etiologically associated with increased risk of institutionalization in rural area. Further study with a larger sample size is necessary to confirm this finding. Geriatr Gerontol Int 2018; 18: 867-872.

Influence of volunteer-led net step exercise class on older people's self-rated health in a depopulated town: A longitudinal study.

In a depopulated region where population aging is advancing, it is necessary to establish a method so local residents themselves can be actively involved in older people's health promotion. Net Step Exercise, a novel dual-task walking program, introduced residents to opportunities for physical activities and social participation without any health specialist support. In one depopulated town (Ikeda, Nakagawa-gun, Hokkaido, Japan), volunteer residents have held Net Step Exercise classes throughout the town since 2007. We longitudinally examined the influence of volunteer-led Net Step Exercise class participation on subsequent self-rated health in all individuals aged 70-79 years living in Ikeda. A total of 662 people who completed a baseline mail-in questionnaire survey in 2012 were followed until 2014. Logistic regression analysis was performed to examine the association with self-rated health after two years of class participation once a month or more at baseline, after controlling for confounds such as age, sex, years of education, living alone, baseline self-rated health, regular exercise, and other physical activities. The odds ratio of poor self-rated health in older people who participated in classes was 0.53 (95% confidence interval [CI]: 0.34-0.85) compared to older people not participating in classes. Even after confounding factors were adjusted, the odds ratio of class participation was 0.50 (95% CI: 0.29-0.85). This study showed that participation in volunteer-led Net Step Exercise might prevent poor self-rated health. Such Net Step Exercise classes are a feasible method for older people's health promotion in depopulated municipalities.

Effect of a dual-task net-step exercise on cognitive and gait function in older adults.

BACKGROUND AND PURPOSE: Participation in generally recommended aerobics or strength exercises may be challenging for older adults. Therefore, it is necessary to consider the types and levels of physical activities suited for them to improve their cognitive and gait function and adherence to exercise programs. This has prompted efforts to identify exercises that require less physical strength and frequency of performance, while still offering cognitive and health benefits. Here, we aimed to assess the effect of a novel dual-task net-step exercise (NSE) performed once a week for 8 consecutive weeks on improvements in cognitive performance and gait function in an older population. METHODS: In this pretest/posttest experimental case control study, 60 healthy older adults (mean age 76.4 years) were recruited from community-dwelling people and separated randomly into 2 groups: a dual-task NSE group and a control group. The NSE group was asked to walk across a net without stepping on the ropes or being caught in the net. Two computer panel-type cognitive functional assessments, the Touch-M and Touch Panel-Type Dementia Assessment Scale, were administered at baseline and after 8 weeks of intervention to determine the effects of NSE. Improvements in gait function were also evaluated using Timed Up and Go test scores. Mixed-effect models with repeated measures (group × time) (analysis of variance, F test) were used to test the effects of NSE. Adjustments were made for covariates including age and sex (analysis of covariance). RESULTS: The NSE group showed significant improvement in cognitive performance (6.8% change; total Touch-M score 5.4 points; P = .04) and gait performance (11.5% change; Timed Up and Go time -0.98 second; P < .001) over the 8-week period. In the control group, there was no significant improvement. CONCLUSIONS: This study shows that dual-task NSE is capable of improving cognitive and gait performance in healthy older adults. Our results indicate that NSE offers an option for a large segment of the older population who need an easier way to maintain their cognitive health and gait function.

Pneumococcal vaccination reduced the risk of acute otitis media: Cohort study.

BACKGROUND: Seven-valent pneumococcal conjugate vaccine (PCV7) was introduced to Japan in 2009, and after that invasive pneumococcal disease has gradually decreased. There are few data, however, on the effectiveness of PCV7 against acute otitis media (AOM) in Japan. METHODS: From 10 daycare centers in Sapporo, Japan, 614 parents participated in the survey. Each parent reported whether their child subject had received one or more doses of PCV7, and, if so, the exact dates of receiving PCV7 were verified by reviewing their maternal and child health handbooks marked by a pediatrician. AOM was diagnosed by otorhinolaryngologist or pediatrician. Cox's proportional hazard model was used for calculating the hazard ratio (HR) of AOM incidence reduced by PCV7 inoculation. RESULTS: Inoculation of PCV7 significantly reduced the risk of AOM (crude HR, 0.63; 95%CI: 0.50-0.79). Adjusting for potentially confounding variables reduced the risk further (adjusted HR, 0.32; 95%CI: 0.23-0.44). On stratification by subject age on 30 April 2012, PCV7 was significantly associated with a reduced risk of AOM in both infants < 3 years old, and in children ≥ 3 years. CONCLUSION: PCV7 is effectiveness in reducing the risk of AOM both in infants < 3 years old, and in young children ≥ 3 years in Japan.

Effectiveness of influenza vaccine in children in day-care centers of Sapporo.

BACKGROUND: We conducted a retrospective cohort study for evaluating the effectiveness of the trivalent inactivated influenza vaccine (TIV) among children aged 0-6 years in the 2011-2012 season in Sapporo City, Japan, because of scarce evidence. METHODS: From 10 day-care centers in Sapporo City, Japan, 629 parents participated in the study. Each parent of the subjects described whether a subject received TIV once or twice in the 2011-2012 season, as well as the exact dates of receiving TIV from records in a maternal and child health handbook marked by a pediatrician. The incidence of influenza was defined as being affected with influenza as diagnosed by a pediatrician. Cox's proportional model was used for calculating a hazard ratio (HR) and its 95% confidence interval (95%CI) of TIV on an influenza incidence. RESULTS: After adjusting potential confounding variables, such as the day-care center, presence of comorbidity, size of household, number of siblings, and number of smokers in the home in addition to the age and sex of the child, HR was significantly reduced in the subjects aged 1 year (HR = 0.22, 95%CI 0.09-0.54) as well as in the total subjects (HR = 0.72, 95%CI 0.52-0.99). Consequently, the effectiveness of TIV was calculated as 78% for the subjects aged 1 year and 28% for the total subjects. CONCLUSION: Our study suggests that TIV is effective, especially in subjects aged 1 year. Further studies are necessary in different seasons, places, and populations to clarify the effectiveness of the influenza vaccine in children.