Background: As we have previously proposed redefining elderly from “65 years and over” to “75 and over” in Japan, many elderly Japanese now keep working beyond the traditional retirement age, around 60–65 years of age, in this rapidly aging society. It is important to assess the influence of working status on health and health‐care utilization among elderly Japanese. Methods: We evaluated a random sample of community‐dwelling Japanese elderly, aged 55–74 years. Data were collected using a health diary strategy. For health‐related quality of life (HRQOL), we used SF‐8 with a physical component summary (PCS8) and a mental component summary (MCS8). Health‐care utilization included visiting physicians as well as using dietary and physical complementary and alternative medicine (CAM). Results: Among 679 participants aged 65–74 years (40.6% men), there were 254 (37.4%) working and 425 (62.6%) non‐working. PCS8 and MCS8 were not significantly different between the working status groups. There were no differences in the rate for visiting physicians and using dietary and physical CAM between the working and non‐working, except for those aged 70–74 years, who exhibited a higher rate for visiting a physician among the non‐working. A higher annual personal income showed a significant association with better PCS8 ( P = 0.031) and a trend towards better MCS8 ( P = 0.055). The older participants were more likely to report better MCS8 than the young regardless of working status ( P = 0.007). Conclusion: Working status itself does not appear to associate with health and health‐care utilization among elderly Japanese. Working with a higher income may potentially improve HRQOL.
BACKGROUND Use of complementary and alternative medicine (CAM) has become popular in Japan. OBJECTIVE To investigate associations of symptom-related CAM use with sociodemographic factors in Japan. DESIGN AND SETTING A prospective cohort study of a nationally representative sample of households in Japan. PARTICIPANTS Community-dwelling adults who developed at least one symptom during a 31-day period. MAIN OUTCOME MEASURES Self-reported, symptom-related use of CAM, either physical CAM or oral CAM. RESULTS Of 2,453 adults, 2,103 participants (86%) developed at least one symptom. Of these symptomatic adults, 156 (7.4%; 95% CI: 6.3–8.5%) used physical CAM therapy. The likelihood of using physical CAM was not significantly influenced by annual household income, employment, or education. Participants living in large cities had an increased likelihood of using physical CAM with an odds ratio (OR) of 2.6 (95% CI: 1.2–5.8), compared to those living in rural areas. Oral CAM therapy was used by 480 participants (22.8%; 95% CI: 21.0–24.6%) among the symptomatic adults. An age of 60 years old and older (OR 2.0; 95% CI: 1.2–3.3) and female gender (OR 1.8; 95% CI: 1.3–2.6) were significantly associated with an increased use of oral CAM. The unemployed participants had a lower likelihood of using oral CAM, with an OR of 0.6 (95% CI: 0.4–0.9), compared to the employed. CONCLUSIONS Oral CAM use is common among Japanese patients and is associated with older age, female gender, and employed status, while physical CAM use is less common and is associated with living in a large city.
Abstract Objective We investigated whether providing participants in an exercise programme with regular feedback on their exercise progress affected their adherence to the programme regimen. Method We conducted a randomized controlled trial. Adult men and women with borderline hypertension and a body mass index ≥ 25.0 were randomized to two intervention groups (groups A and B) and one control group (group C) and were prescribed regular aerobic exercise. During the 12‐week study period, group A was provided with both feedback information on their exercise progress and a health letter, while group B was provided with the health letter only. The main outcome measure was exercise performance, per cent achievement of target exercise level (%) defined as the number of weeks during which the exercise target was reached divided by the number of weeks in the programme. Results were compared using the Kruskal–Wallis test. Results A total of 105 study subjects were randomized into three groups (A, n = 37; B, n = 37 and C, n = 31). Per cent achievement of target exercise level during the 12‐week period was highest in group A (26.5%), followed by groups B (22.9%) and C (17.4%) ( P = 0.36). Subjects who received regular feedback during the exercise programme tended to have higher exercise performance. Conclusions In improving adherence to exercise intervention, the provision of regular feedback to participants in an exercise programme may be an effective intervention.
Our aim was to analyze the incidence of new onset chest symptoms for the period of a month and to evaluate the possible association of these chest symptoms with demographic, socioeconomic or clinical characteristics.Prospective observational cohort study using a self-reported health diary among subjects without baseline chest diseases.A nationally representative sample of households in Japan.Of a total 3,568 subjects from the study recruitment sample, 3,477 participants completed the diary; of these, 127 participants with active chest diseases at baseline were excluded and the remaining 3,350 participants were analyzed.The mean number of episodes of chest symptoms was 1.19 with 95% confidence interval (CI) of 1.0-2.0 and the incidence was 21% (95% CI, 10-30%). Cough was the most frequent chest symptom with the mean number of episodes of 1.14 and the prevalence of 20%. Chest pain, dyspnea, palpitation, and wheezing were identified in less than 1%. Associated factors for cough were younger age, unemployment, and poor physical quality of life. Associated factors for chest pain included older age, living in smaller cities, unemployment, higher educational attainment, and poor physical and mental quality of life.Chest symptoms are common in the Japanese general population. Cough is the most frequent symptom, followed by chest pain. Younger age, unemployment, and poor physical quality of life are significantly associated with cough.
