bluuebunny/crossref_metadata_2025 huggingface dataset:
Glucose metabolism, advanced glycation endproducts, and cognition
Authors: Araki Atsushi , Ito Hideki
Published: September 2004

The accumulation of advanced glycation endproducts (AGEs) has been implicated in the pathogenesis of diabetic complications and aging. Diabetes mellitus is associated with moderate cognitive deficit. The AGEs may exert several actions on central nervous system. To explore a possible role of AGEs for cognitive impairment, we have examined the association between serum AGEs and cognitive function in diabetic patients.

We studied 198 diabetic patients with a mean age of 74 years. Serum AGE (N‐epsilon‐ carboxymethyllysine, CML) was measured with the enzyme immunoassay. The several domains of cognitive function were assessed using the WAIS‐R, Stroop test, and Benton test. Diabetic patients had more impairment of complex pychomotor skill and visual memory as assessed with the digit symbol substitution test and Benton test than non‐diabetic subjects. Among the diabetic patients, a marker of hyperglycemia, HbA1c level was associated with the cognitive impairment, while short‐term glucose control partially improved the cognitive impairment. Serum AGE levels correlated with age, duration of diabetes, and HbA1c. Serum AGE levels were significantly associated with the impairment of complex psychomotor skills independent of HbA1c. In conclusion, hyperglycemia and increased AGE accumulation were associated with the cognitive impairment in patients with diabetes mellitus as a model of accelerated aging.
Preventive effects of traditional Chinese medicine on senile osteoporosis using the murine model
Authors: Chen Huayue , Shoumura Shizuko , Isono Hideo
Published: September 2004

In this study, the preventive effects of the traditional Chinese medicine, Hachimi‐jio‐gan, Juzen‐taiho‐to and Unkei‐to were investigated, on bone loss in the murine model of senile osteoporosis, senescence‐accelerated mouse P6 (SAMP6). The experimental animals were given 0.05% solution of the Chinese medicines for 3 months. Bone mineral density and bone morphology were studied together with serum parathyroid hormone and estradiol levels. After the treatment with Unkei‐to, the serum estradiol level was increased without any marked change in the bone. Bone mass was significantly increased after the treatment with Hachimi‐jio‐gan or Juzen‐taiho‐to. These findings suggest that Hachimi‐jio‐gan and Juzen‐taiho‐are effective in preventing bone loss in SAMP6.
Immunopharmacological effect of a Japanese herbal medicine (Hochu‐ekki‐to) on the elderly
Authors: Liou Shin’yu , Kuroiwa Ataru , Yan Hong , Eshita Akihiko
Published: September 2004

Hochu‐ekki‐to (HOT) has long been used for treatment of the elderly complaining of severe weakness. In this study, we examined its immunopharmacological effect on 16 elderly patients, aged 76.5 years on average and complaining of general fatigue. They were administered orally 7.5 g of HOT every day for at least 120 days (4 months), which provided them with a noticeable improvement of their physical condition. From the immunological point of view, during the observation period, the total number of circulating leukocytes remained unchanged, as well as the ratios between CD3+T‐ and CD20+B‐cells and between CD4+T‐ and CD8+T‐cells. However, as verified on day 30 as well as on day 120 after the administration of HOT, the activity of NK against K562 target cells was significantly enhanced. Also, on days 30 and 120, there was a significant increase in serum IFN‐γ level which is thought to be associated with NK activity. From these results, it may be concluded that the oral administration of HOT to the elderly may help them ameliorate, at least partially, their immunological capacity as well as their physical condition.
Electrophysiological assessment of Choto‐san treatment for stroke patients with mild cognitive impairments
Authors: Yamaguchi Shuhei , Matsubara Miwa , Kobayashi Shotai
Published: September 2004

In this study, P3 event‐related brain potentials (ERPs) were measured to assess the effect of Choto‐san administration on stroke patients with mild cognitive impairments. Before and after 12‐week drug administration, P3 ERPs were recorded in a modified auditory oddball paradigm, including occasional novel sounds. Cognitive functions were also assessed with the Mini Mental State Examination (MMSE) and verbal fluency test. The drug administration improved significantly the MMSE and verbal fluency test scores. P3 latency to target sounds was shortened in association with reduced reaction time to the sounds, after the drug administration. Furthermore, P3 amplitude to novel sounds was enlarged and its topography shifted from central to frontal sites. These results indicate that Choto‐san improves electrophysiological indices related to higher cognitive function in addition to neuropsychological test scores in stroke patients with mild cognitive impairments.
Effects of the Chinese herbal medicine ‘Ba Wei Di Huang Wan’ in the treatment of dementia: A SPECT cerebral blood flow examination and a randomized, double‐blind, placebo‐controlled clinical trial for cognitive function and ADL
Authors: Iwasaki Koh , Kobayashi Seiichi , Chimura Yuri , Taguchi Mayumi , Inoue Kazumi , Akiba Tetsuo , Arai Hiroyuki , Cyong Jong‐Chol , Sasaki Hidetada
Published: September 2004

Context:  Traditional Chinese herbal medicine has a long history as a remedy for dementia among East Asian countries. This study clarifies its benefits through current scientific designs.

Objective:  Study 1: To evaluate the effects of Ba Wei Di Huang Wan (BDW), a Chinese herbal drug on cerebral blood flow (CBF) by tecnetium‐99 m‐ethyl cysteinate dimer brain single photon emission computed tomography (99mTc ECD SPECT).

Study 2: To evaluate whether BDW improves cognitive and physical functioning in dementia patients.

Design:  Study 1: An 8‐week case series for the SPECT examination.

Study 2: An 8‐week randomized, double‐blind, placebo‐controlled trial for cognitive and physical functioning in dementia patients.

Setting and Participants:  Study 1: Ten patients with multiple brain infarctions (5 men and 5 women; mean age 73 years) were recruited.

Study 2: Thirty‐three patients with mild‐to‐severe dementia (7 men and 26 women; age 84.4 ± 7.8 [mean ± SD] years) admitted to a long‐term care facility in Japan, were recruited and enrolled from May 2002 through September 2002.

Interventions:  Study 1: Participants took BDW extract 7.5 g/day for 8 weeks, and CBF in whole brain and regional CBFs were compared before and after the administration.

Study 2: Participants were randomly assigned to the active drug (BDW) group (n = 16) or the placebo group (n = 17), and treated by BDW or placebo for 8 weeks.

Main outcome measures:  Study 1: CBF in whole brain and rCBF in each Regions of interest (ROIs)

Study 2: Cognitive function and the activities of daily living (ADL)

Results:  Study 1: CBF in whole brain were increased from 38.2 ± 3.0 mL/100 mg/min to 40.5 ± 3.1 mL/100 mg/min (P = 0.007). rCBFs in bilateral temporal lobes, area Broca, and lt. thalamus were also increased significantly (P < 0.05).

Study 2: After the trial, cognitive function as assessed by Mini‐Mental State Examination (MMSE) significantly improved from 13.5 ± 8.5 to 16.3 ± 7.7 (mean  ±  SD, P < 0.01, − 4.1 < 95% C.I. < −1.4) in the BDW group. The ADL score in the Barthel index also significantly went from 61.8 ± 34.6 to 78.9 ± 21.1 (P < 0.01, − 26.2 < 95% C.I. < −7.9). Eight weeks after the end of the administration, both MMSE and Barthel index score of the BDW group declined to the baseline level.

Conclusions:  Our results argue the benefits of BDW in the treatment of dementia.
Disability‐adjusted life expectancy: Is it useful?
Authors: Hirao Tomohiro
Published: September 2004

In this study, Japanese disability‐adjusted life expectancy (DALE) in two methods, was estimated to evaluate the possibilities of the indicator as a policy tool. It was specified that both methods had merits and demerits regarding data collection, calculation, accuracy, and significance. DALE is a summary measure of health outcome for policy evaluation and might be useful for turning policy makers’ eyes and capturing public awareness on health. The concept is appropriate and acceptable but more efforts are required to improve its quality and methodology. DALE is still a developing tool.
Active life expectancy and predictors for maintaining functional independence among older Japanese
Authors: Ishizaki Tatsuro
Published: September 2004

Independence of functioning has been used as a health index among the older population. This paper introduces a few of recent studies which examined the effect of aging on functional decline during a 5‐year follow up, which estimated active life expectancy, and which examined predictors for functional independence during a 3‐year follow up among older Japanese. It is believed that these studies are useful not only to estimate needs for long‐term care services among the older population, but also to develop programs that aim to prevent functional decline and to maintain functional independence among the older population in an aging society.
An actuarial analysis of long‐term care demand in Hong Kong
Authors: Chan Wai Sum , Li Siu Hang , Fong Pak Wing
Published: September 2004

Hong Kong is a fast‐aging society. More than 775 000 citizens (around 11% of the total population) in Hong Kong were aged 65 or above in 2002, and it is expected the figure will increase to 2.2 million (or 24% of the total) in 2031. In this paper, an actuarial projection of the demand of long‐term care (LTC) services in Hong Kong using the US National Long‐Term Care Surveys (NLTCS) data, is provided. The need for LTC in Hong Kong will be growing drastically for older ages in the next few years; around 10% for elderly aged between 65 and 74 and the proportion would mount to 60% for the elderly at age 85 or above. Using a Markov Chain model, an individual's (age–gender specific) future LTC expenditures in Hong Kong have been projected. The net actuarial present values of total future LTC costs are expected to be HK$83 000 and HK$160 000 for males aged 65 and females aged 65, respectively. Alternative funding strategies for these liabilities are discussed. A simple private insurance scheme is chosen to illustrate the actuarial calculations. The results could be useful for funding and planning LTC services in Hong Kong.
Dietary restriction initiated late in life can restore age‐related changes in protein metabolism
Authors: Takahashi Ryoya , Goto Sataro
Published: September 2004

Dietary restriction (DR) from weaning or young adult stages in laboratory animals throughout their usual life span extends maximum lifespan and retards the development of a broad spectrum of pathophysiological changes. However, the effects of DR when performed at middle age or later have not been well investigated. We previously reported that short‐term (about 2.5 months) DR in early senescence reduced the amount of altered proteins and shortened the half‐life of proteins. Furthermore, our previous studies in rats demonstrated DR initiated later in life reduces the content of oxidatively modified proteins, measured as protein carbonyls, in mitochondria from old rats. In addition, we recently found that the age‐related decline in the activities of proteasomes that have been implicated in removal of altered proteins was restored by DR. Thus, our findings suggest that DR initiated even relatively late in life can restore an animal's youthful condition, reducing the accumulation of altered proteins.
Oral health care for elderly in Korea
Authors: Paik Dai‐Il , Bae Kwang‐Hak , Chung Sung‐Chang
Published: September 2004

The aged population has increased rapidly in Korea. The proportion of senior persons aged over 65 surpassed 7% of the population in 2000, and it is expected to reach 14% by 2020. A total of 96.4% experienced dental caries and an average decayed, missing and filled teeth score was 12 in the age of 65–74. Another 21.7% of those aged 65–74 and 33.4% aged over 75 had upper full dentures, and 14.8% of those aged 65–74 and 24.7% aged over 65 had lower full dentures. With aging, the prevalence of ‘difficulty in chewing’, ‘trouble in pronouncing’ and ‘food catching’, had increased. With ‘headaches’, prevalence was 2.3 times higher for females than for males. For ‘painful gum’, prevalence was 1.4 times higher for females than for males and 1.8 times for removable denture wearers than for dentate persons. A highlight is that Koreans (96.5%) are benefited primary and secondary dental care by National Health Insurance, and 3.5% among 48 million Koreans have been supplied free health care, except prosthetic and esthetic dental care.
Oral health care system for elderly in India
Authors: Shah Naseem
Published: September 2004

The elderly population of India at present is over 77 million, constituting 7.7% of the total population and is expected to rise to 100 million in 2013. The two striking features regarding the elderly population of India are: (i) the rate of growth of the elderly population is much faster than the growth of the total population; and (ii) the feminization of the elderly population. Also, 80% of the elderly population reside in rural India, 30% live below the poverty line, 73% are not literate, 75% are economically dependant, 45% suffer from chronic diseases, and 5.4% are immobile. Oral cancers, which commonly manifest in older age groups, constitute 13–16% of all body cancers. India has 185 recognized dental schools from which 12 000 dental graduates qualify each year. The total dentist population ratio is 1 : 23 000. However, the distribution in urban and rural areas is very uneven; in urban areas, the dentist: population ratio is 1 : 15 000, whereas in rural areas, it is 1 : 150 000. There are several challenges for geriatric oral health care delivery in India. Education in geriatric dentistry is as not yet a recognized specialty in India. The dental manpower tends to segregate in urban areas; only 20% serve 80% of the rural elderly. The primary health centers, the basic unit of primary health care, does not have the provision for dental care. Except those in organized sectors like in government jobs, railways, defense services and public sector companies, the majority of the elderly population have no health security. Health insurance companies do not reimburse expenses on dental treatment. Dental treatment is expensive in the private sector and considered optional by the majority of elderly and their care providers. This paper provides an overview of the oral health care system for the elderly in India in the context of socio‐demographic profile, social and income security for the elderly, and the health insurance system.
Oral care reduces pneumonia in older patients
Authors: Yoneyama Takeyoshi
Published: September 2004

The present study was performed with older patients in 11 nursing homes in Japan. In total, 417 patients were randomly assigned to an ‘oral care’ group or a ‘no oral care’ group and were investigated for 2 years. Patients receiving oral care had fewer febrile days than did patients not receiving oral care. It was also found that the risk of pneumonia in patients in a long‐term care facility, followed up for 2 years, was significantly reduced in patients receiving oral care. The removal of latent oral infection and potential problems might be a way to reduce the incidence of lower respiratory tract infection. In light of the central importance of oral health to an older patient's overall well‐being, it is essential that all health providers support and advocate the expansion of oral health benefits for older adults, dentate or edentate.
An experience of social work case management for frail elders in Hong Kong
Authors: Liu Chi‐pun , Leung Chi‐tat Antony , Li Sau‐yee , Chi Iris , Chow Wing‐sun Nelson
Published: September 2004

Eighty‐three hospital‐discharged elders were served by a social work case manager in our 18‐month case management project in July 2000. Results indicate that elderly care‐recipients utilized less hospital services without sacrificing the quality‐of‐life of their informal carers. This paper shares the experience in the process of case management interventions and suggests strategies to implement case management interventions successfully.
The emergence of centenarians and supercentenarians in Australia
Authors: McCormack John
Published: September 2004

This paper explores the changing prevalence and socio‐health status of centenarians in Australia over the last 100 years. The aims of the source study were (1) To identify and describe sociodemographic characteristics of Australian centenarians, and compare them with centenarians from other countries; (2) to investigate whether there is social and health heterogeneity among Australian centenarians; (3) to investigate whether there are social and health differences between centenarians and younger aged cohorts in Australia; and (4) to report on preliminary quality‐of‐life measures. Findings confirming the aims are reported and the author concludes by arguing for the establishment of a multidisciplinary Australian Centenarian Study.
Tokyo Centenarian Study: Aging inflammation hypothesis
Authors: Hirose Nobuyoshi , Arai Yasumichi , Gondoh Yasuyuki , Nakazawa Susumu , Takayama Michiyo , Ebihara Yoshinori , Shimizu Kenichiro , Inagaki Hiroki , Masui Yukie , Kitagawa Kohji , Kojima Toshio
Published: September 2004

The biomedical characteristics of centenarians are (1) low level of albumin, cholesterol, and HDL‐cholesterol; (2) high level of CRP and Il‐6; (3) high level of thrombin‐antithrombin complex, suggesting centenarians are malnourished, in proinflammatory status and prothrombotic conditions. The score of ADL and MMSE is also low. The nutritional status is associated with inflammation, the level of ADL and MMSE. Since proinflammatory cytokines, such as IL‐6 and TNFα are known to cause malnutrition, we think that inflammation is partly responsible for the malnutrition. We proposed an ‘aging‐inflammation ‘hypothesis. Aging causes excessive inflammatory response, resulting in malnutrition, which in turn contributes to the low level of ADL and cognitive function in centenarians.

The suppression of excessive inflammatory reaction may ameliorate the low objective QOL.
An outbreak of Severe Acute Respiratory Syndrome in a nursing home: Lessons to learn
Authors: Ho Wency W , Hui Elsie , Kwok Timothy , Woo Jean
Published: September 2004

Hong Kong experienced an epidemic of Severe Acute Respiratory Syndrome (SARS) from March to June 2003. Nursing homes were a potential area of cross‐infection because of the crowded living space, substandard environmental hygiene, inadequate ventilation, low working staff to resident ratio, and staff who lacked knowledge of infection control. The mortality in elderly SARS patients was high because of their atypical presentations, their multiple comorbidities, and that they are more susceptible to the side‐effects of treatment. The community geriatric assessment team need to work closely with the hospitals and the primary health care system to provide surveillance of the disease, infection control, and management of sub‐acute clinical problems, in order to reduce unnecessary hospital admissions in nursing home residents during an epidemic outbreak.
Work and retirement in the Asia–Oceania region: Perspectives on longer employment and flexible retirement
Authors: Taylor Philip , Oka Masato , Rolland Louise
Published: September 2004

This paper considers the situation of older workers in developed economies generally, and the specific cases of Australia and Japan. It examines trends in the employment of older people, the development of public policies, and identifies measures for promoting longer employment, re‐employment, and gradual retirement.
Resistance of mitochondrial DNA‐depleted cells against cell death: Potential relevance to aging
Authors: Park Sun Young , Lee Myung‐Shik
Published: September 2004

We studied the changes of gene expression in SK‐Hep1 hepatoma ρ° cells to study the mechanism of their resistance to cell death. The expression of MnSOD and glutathione peroxidases was increased in ρ° cells. ρ° cells were resistant to ROS. ρ° cells were also resistant to p53. These results suggest that an increase in the expression of antioxidant enzymes renders cancer cells or aged cells with frequent mitochondrial DNA mutations to resist against oxidative stress or host surveillance.
Epidemiology of cerebrovascular disease in the elderly in East Asia
Authors: Jeng Jiann‐Shing , Yip Ping‐Keung
Published: September 2004

Cerebrovascular disease (CVD) is one of the leading causes of mortality, and is also the most common cause of physical and mental disability in the elderly worldwide, particularly East Asian populations. CVD mortality accounts for 10–16% of total deaths and has declined moderately since the mid‐1960s in East Asia. However, with increased aging populations, no alteration of age‐specific stroke incidence, Westernization of lifestyle, and socioeconomic alteration, the burden of CVD in the elderly in East Asia may still escalate in the forthcoming decades. There are prominent race–ethnic differences in stroke types between East Asian and Caucasian populations. The proportions of cerebral hemorrhage, small artery lacunar infarct, and intracranial atherosclerosis are more common in East Asian populations than Caucasians. Environmental and genetic factors may account for the race–ethnic differences and trends of stroke types. Hypertension is still the major risk factor for CVD in East Asia. Control of blood pressure in the population level should be the important strategy for the prevention of CVD. With aging populations, CVD‐related dementia becomes more and more critical, particularly in East Asia. Urbanization, industrialization, and lifestyle are altering in this area, thus, monitoring the impact of these changes on CVD risks is essential to enable the implementation of appropriate strategies towards better prevention of CVD.
The effect of heel elevation in Parkinsonian gait
Authors: Eto Fumio , Wada Naoki , Maeno Takashi , Miyake Naoyuki , Saotome Ikuko
Published: September 2004

The effect of heel elevation of shoes in Parkinson's disease was analyzed by using two gait measurement systems. The heel elevation brought about some improvement of walking in the patients with Parkinson's disease with shortening of a stride period, a step period and the transition time of the plantar pressure peak from heel contact to toe off. After measurement study of the gait, all the patients answered the best heel height of shoes was higher than that of their casual footwear or the same. This simple treatment method may be also effective for fall prevention in patients with Parkinson's disease, and further investigation with follow‐up observations should be necessary to verify the effect.
Locomotor training with partial body weight support in patients with Parkinson's disease and stroke: Its efficacy and neural mechanisms
Authors: Miyai Ichiro
Published: September 2004

Locomotor training with partial bodyweight support on the treadmill is applicable to neuro‐rehabilitation for various gait disorders caused by neurological diseases. Although neural mechanisms for the efficacy remain unclear, recent optical neuroimaging studies using near infra‐red spectroscopy have suggested that this training might modify the hierarchical locomotor control system, including several cortical motor areas and the central pattern generator in the spinal cord.
Housing problems and policy for older Koreans
Authors: Kim Tae‐Il
Published: September 2004

Korea is becoming an aging society with the aging population currently at 7% of the population at July 2001. It is predicted that the percentage of the aged in 25 years will rise from 7% to 14% (this is even faster than that of Japan). Traditionally, the aged of Korea were supported by their family and the neighbors, but they can’t be supported in this way any longer. The aging of Korea have changed and their residential problems are becoming more serious. In relation to the quality and function of welfare facilities, as well as for residential problems, it is necessary to improve functional facilities such as the home rather than hospitals. In this paper, we propose improvements of residential welfare for the aged of Korea faced with rapid aging society.
Housing policy towards a super aging society: From building specifications to special needs measures
Authors: Ohara Kazuoki
Published: September 2004

Japan is becoming a ‘super‐aging society’ beyond an ‘aged society’. During last decade, considerable political measures on the housing for the elderly have been launched, but the turning point is coming. There are many private detached houses in Japan. In order to upgrade the quality of ordinary houses, ‘guidelines of housing design devised to cope with aged society’ was announced by the ministry. From April 2000, under the Long‐term Care Insurance Law, house adaptation system for the frail elderly was institutionalized and the needs of it have been increasing wider and wider. Most elderly people feel anxious for the future when they need personal care that includes home help services and nursing care. Elderly residents of collective housings want to reserve the service facility in the same building. New types of dwellings have also been developed (such as senior housing, care house, group home) Recently, the old peoples homes began to consider a high value to the comfortable atmosphere as a house. Even the nursing homes are changing into houses that contain small scale homes. Group living is not an institution, but a house that must have a possibility to suit the all categories of elderly people. The scheme will become one of the mainstreams of housing for the elderly as a new type of dwelling.
Life guidelines of the Sasang constitutional medicine in the management of ‘Mibyou’ in Korea
Authors: Cho Ki‐ho , Jung Woo‐sang , Moon Sang‐kwan , Park Seong‐uk , Ko Chang‐nam
Published: September 2004

‘Mibyou’ is taken as a presymptomatic clinical stage between the healthy and ill status. In Korea, Sasang Constitutional Medicine (SCM) provides life guidelines for each of the constitutional types, and these guidelines have been adopted in the management of ‘Mibyou.’ The SCM claims that human constitutions are classified into four constitutional types and those are Tae‐yang, Tae‐eum, So‐yang, and So‐eum type. Tae‐yang type is recommended to be diligent, calm down, and be gentle. Fresh and plain foods such as marine products and vegetables are desirable for this type. Tae‐eum type is recommended to try to be outgoing. Foods with animal and bean protein are recommended for Tae‐eum type. So‐yang type is recommended to be patient. Fresh and cold foods such as vegetables and marine products are good for this type. So‐eum type is recommended to be positive and active. The suitable foods for So‐eum type are warm ‘Qi’ foods or foods which are easy to digest. In conclusion, there is a recent trend to manage ‘Mibyou’ by controlling the individual's behaviors, exercise, and diet according to the life guidelines suggested by the SCM in Korea. This has proven highly effective in preventing the diseases each constitution type can easily suffer.
Physical check‐up and blood data analysis in the Thai elderly of Chaingmai Province, Thailand
Authors: Uttawichai Kasem , Takahashi Masakazu , Kiyoshi Sukuma , Hirai Kazuto , Kasempitakpong Boonsong , Matanasarawoot Anuchart , Sermpanich Nipon
Published: September 2004

Introduction:  Chiangmai is one of the provinces in Northern Thailand. The Aging population has increased rapidly since family planning commenced in 1972. For the surveillance of aging, we started a health investigation of the elderly over 60 years of age in the suburban area of Chiangmai since 1997 with the Nippon Medical School Team.

Materials and Method:  Medical examination was carried out for the elderly (male = 34, female = 73) at Department of Family Medicine, Chiangmai University, Chiangmai Thailand in August 2002. Chula Mental Test (CMT) was used for cognitive function and Geriatric Depression Scale was used for evaluation of depressive condition.

Results:  The major health problems of this group of elderly in Chiangmai Province were visual acuity abnormality (98.1%), anemia (66.4%), hypertension (37.4%), dental caries (29%), bone and joint disease (23.4%), cardiovascular disease (11.2%), gingivitis (11.2%), diabetes mellitus (9.3%), digestive system disease (8.4%), and presbycrusis (8.4%). The prevalence of cognitive impairment and depression were 0.9 and 2.8%, respectively. The prevalence of high cholesterol, triglyceride, and LDL cholesterol were 43.9, 29.0, and 15.9%, respectively. The prevalence of high BUN, creatinine, and uric acid were 17.8, 11.2, and 29.9%, respectively. The prevalence of high GOT, GPT, gamma GT, ZTT, and TTT were 4.7, 1.9, 53.3, 35.5, and 21.5%, respectively. The prevalence of low hemoglobin was 66.4%.

Conclusion:  There was a high prevalence of anemia and hyperlipidemia in this group of elderly in Chiangmai Province. The analysis of background factors and further investigation should be carried out continuously.
Changing family structure and elder abuse issues in Japan
Authors: Kasuga Kisuyo
Published: September 2004

Families are now changing; contemporary Japanese women are threatened by loss of their right to care by their family members, and as a result, they are clearly placed in danger of poverty. Elder abuse exhibits different phases, from child abuse or domestic violence, in terms of the power relationship between the abuser and the abused. This leads to incidences of abuse cover‐up, creating difficult situations where it cannot be determined who is the abuser and who is the abused. Although the definition of elder abuse by the National Center on Elder Abuse in America (NCEA), namely, physical abuse, emotional/psychological abuse, neglect, financial/material exploitation, sexual abuse, and self‐neglect, is used in many parts of the world, a quantitative analysis based on this definition alone does not clarify the relationship between abuse and women in a sexually discriminative society.
Women's Association for a Better Aging Society
Authors: Higuchi Keiko
Published: September 2004

The Women's Association for a Better Aging Society was established in 1983 to study and take action to address problems of aging, and to promote the well‐being of women in their later life. With the ultimate goal of building a better aging society for both men and women, the Association intended to put forward proposals from the viewpoint of women who are living a longer elderly life and who are taking greater responsibility in giving care to elderly family members. At present, the Association is a nationwide network embracing 1500 individual members and 150 group members. In the early 1980s, due to population aging, giving care to elderly parents was becoming more demanding and requiring a longer period of time, and the heavy burden was concentrated on daughters‐in‐law (mainly the first son's wife). Women's social and economic status was lower than men's due to discriminatory employment practices and wage and social security systems, resulting in their economically weak old‐age life. There were only a very small number of women involved in the decision‐making process for social welfare policies, even though women were the main caregivers and recipients. The main activities of the Association are research and advocacy to national and local governments. The Association's efforts culminated in the creation of the Public Long‐term Care Insurance that was adopted by the Diet in 1997 and was applied in April 2000. The Association, as a member of the ‘One Million Citizens’ Committee to Promote the Socialization of Elderly Care’ together with trade unions, NGO, scholars and concerned individuals, had acted to raise public opinion toward the creation of the insurance scheme. In 2050, it is expected that nearly 40% of the population will be people over 65 years of age, of whom 60% will be women. The Association will continue its efforts to improve women's lives and to increase women's participation in policy‐making structures so that the future society will not consist only of impoverished elderly women.
Social security pensions re‐examined: incomes and contributions in Japan
Authors: Maya Yoshio
Published: September 2004

The social security pension system can be regarded as a social income redistribution system governed by the state. On that hypothesis, an effort based on social solidarity must be exerted in order to realize substantial social equality by granting equally to all members of society their basic needs, and also by optimizing income redistribution effects.
Pain control in Asia: Foreword of the round table discussion of pain control
Authors: Hanaoka Kazuo , Arita Hideko , Hayashida Masakazu , Yajima Choku , Lee Sang Chul
Published: September 2004

In the near future, the population of elderly people will increase tremendously. Therefore, in the 21st century, pain control for elderly patients who have chronic and intractable pain is one of the most important medical fields. In this round table discussion, pain clinicians from Japan, Taiwan, China, Korea, and Philippines discussed the problems and useful methods for pain control of chronic and intractable pain in patients in Asia. We were able to understand the differences of pain control among the Asian countries, and also, we introduced the classification of pain patient's sex, age, chronic non‐cancer pain, and treatments of non‐cancer pain patients in the Department of Anesthesiology and Pain Relief Center, University of Tokyo Hospital. This round table discussion gave us valuable hints for the application to chronic pain patients.
Pain control for elderly patients in Japan
Authors: Arita Hideko , Hayashida Masakazu , Hanaoka Kazuo
Published: September 2004

Today, approximately 25% of the Japanese population is over 60 years of age, and about 70% of patients who visit the Pain Relief Center, the University of Tokyo Hospital, are elderly (≥ 60 years). The main diseases causing pain in elderly patients include lower back pain and leg pain, post‐herpetic neuralgia, trigeminal neuralgia, and cancer. At our pain clinic, these painful conditions are treated with a variety of treatment modalities, including nerve block, sympathetic blockade, phototherapy, acupuncture, epiduroscopy, and pharmacologic treatment such as systemic and/or topical NSAIDs, opioids, antidepressants, anticonvulsants, vasoactive drugs, and local as well as general anesthetics. This paper briefly describes methods of pain control for these diseases, especially focusing on recently developed treatment modalities.
Acute pain in the elderly: Management options
Authors: Nuevo Florian R
Published: September 2004

In the last decade, we have seen an increasing number of elderly surgical patients. Most of them are in‐hospital patients, but, we also find a trend towards ambulatory cases, particularly for short procedures such as cataract extraction, herniorrhapy, and other minor procedures. For major surgeries, the successful outcome is much influenced by the adequacy of postoperative pain control. Good pain control leads to fast recovery and resumption of mobility of patients. The multimodal analgesic therapy has been advocated, using combinations of opioids and non‐opioid analgesics. Patient‐controlled analgesia (PCA) and the use of epidural anesthesia techniques facilitate optimum postoperative pain relief with less adverse effects and risks. Several management options for acute pain in the elderly are presented in this brief discourse.
Estrogen intervention in aging and longevity: Problems and prospectives
Authors: Thakur MK , Sharma PK , Ghosh Soumi , Mani ST
Published: September 2004

Estrogen  exerts  multitude  of  functions.  It  regulates  its  own  receptor  and  genes  involved in Alzheimer's disease. Such action is helpful for estrogenic intervention in aging and longevity.
A study of elder abuse and risk factors in Japanese families: Focused on the Social Affiliation Model
Authors: Anme Tokie
Published: September 2004

The aim of this study was to clarify the risk factors for elder abuse in Japanese families, and so 3600 mail surveys and 78 home visits were conducted. People who had strong social affiliation tended to force the elderly to obey a caregiver's opinion. Three items were found to be the key predictors of elder abuse by logistic analysis: the elderly who wander due to senility, the caregiver's health problems and the caregiver's misunderstanding of the elder's conditions.
Application of Resident Assessment Instrument – Home Care to assess the functional status of Korean older people
Authors: June Kyung Ja
Published: September 2004

The purpose of this study is to assess the functional status of the Korean elderly using the Resident Assessment Instrument – Home Care (RAI‐HC). According to the results, problematic conditions were significantly different for older adults by sex, age groups, and geographical areas. Most of the subjects were assessed at the independent level of activities of daily living (ADL) self‐performance, while more dependent older adults exhibited more problematic conditions. Conclusively, the use of RAI‐HC was recommended to develop long‐term care services at the community or national level.
Policy‐oriented cross‐cultural study in Japan
Authors: Maeda Daisaku
Published: September 2004

Cross‐cultural research in the field of social gerontology is very useful for the development of aging policies and programs especially in the beginning stage of population aging. This is because the aging of population brings about the decline of family care and other social changes that society has not experienced so far. There are three types of cross‐cultural research in this field. The simplest type of cross‐cultural policy‐oriented study is the observation tour to advanced countries. The comparatively fast development of health and social services for the elderly in Japan between 1950 and the mid‐1970s owes greatly to this type of study. As the level of services is improved, the comparison of numerical data on the levels of basic health and social services for the elderly is gradually taken up. This type of study was once frequently used in Japan by policy‐makers and academicians. The third type of policy‐oriented cross‐cultural study is the one for the improvement of quality of services. It is to be noted that the methods to be used in this type of study is very different from those used in the comparative study of numerical data. It is a new challenge worthy of being defied, with their full strength, by contemporary and future Japanese social gerontologists.
Cross‐national comparison of the profiles of nursing home residents
Authors: Chi Iris
Published: September 2004

Given the diverse roles the residential facilities for elderly play in long term care service delivery in different countries, the objective of this paper was to compare the long term care policies and the residents’ profile of residential facilities in four countries or region including Finland, Sweden, Israel, and Hong Kong by using a standardized assessment tool which provides a unique opportunity arouses the international interest on comparing clinical and functional characteristics of residential facilities residents.
Interactions between health and psychological changes in Japanese: the NILS‐LSA
Authors: Shimokata Hiroshi , Ando Fujiko , Fukukawa Yasuyuki
Published: September 2004

A comprehensive longitudinal study would be essential in the analyses of psychological changes. At the National Institute for Longevity Sciences (NILS), a comprehensive longitudinal study of aging in Japan, the NILS Longitudinal Study of Aging (NILS‐LSA) started in November 1997. The participants of this study were 2300 residents aged 40–79 years who were random samples selected from the neighborhood area of the NILS. They were examined every 2 years at the NILS‐LSA Examination Center. From the recent results of the NILS‐LSA, interactions between health and psychological changes including mental effects of disease, relationship between physical health and cognitive function, and association of depression with nutrition and physical activity were shown.
Effects of age on relationship of alcohol drinking and obesity to atherosclerotic risks
Authors: Wakabayashi Ichiro
Published: September 2004

Atherosclerosis is a chronic pathological process in the arteries, in which a variety of its risk factors, such as hypertension, dyslipidemia, smoking, diabetes mellitus and obesity, are involved. Atherosclerotic progress is also closely linked with aging. We investigated effects of age on the relationships of alcohol drinking and obesity to atherosclerotic risks. Elevating effects of light drinking on blood pressure were significant in middle‐aged and relatively old subjects but not in young subjects. The decreasing effects of light drinking on blood LDL cholesterol were significant in relatively young and middle‐aged subjects, but not in elderly subjects, while increasing effects of light drinking on blood HDL cholesterol were significant in young, middle‐aged, and elderly groups. In patients with type 2 diabetes, light drinking significantly decreased aortic pulse‐wave velocity, which reflects atherosclerotic progress, without significant changes in blood HDL and fibrinogen levels, and this tendency was also found in elderly diabetes patients. Body mass index (BMI) was significantly correlated with arterial pressure and serum tryglyceride, HDL cholesterol, uric acid, and sialic acid levels in elderly patients with type 2 diabetes. Thus, age may be an important factor that affects the relations of some atherosclerotic risk factors to atherosclerotic progress.
Cardiovascular disease in later life in Taiwan
Authors: Liau Chiau‐Suong
Published: September 2004

In Taiwan, the percentage of the population 65 years of age or older increased regularly, from 3.08% in 1972 to 8.8% in 2001. Taiwan started the national health insurance system in 1995. The aged population utilized a large share of the medical resources, for example 28.73% of the total national medical expenditures in 2000. Cardiovascular diseases are common causes of mortality in Taiwan. Cerebrovascular diseases, heart diseases and hypertensive diseases, held the second, third and 10th positions, respectively, among the 10 leading causes of mortality in 2002, in Taiwan. The mortality rates of cerebrovascular diseases and heart diseases are decreasing, while that of malignant neoplasms and diabetes mellitus are increasing, as evidenced over the past 2 decades. Cerebral hemorrhage is relatively common in Taiwan. As demonstrated in a series, of the 10 772 hospitalized acute stroke cases, 35.4% were diagnosed as cerebral hemorrhage. Hypertension is highly prevalent in the elderly population in Taiwan, more than 55% for both sexes, as indicated by some epidemiologic studies. There are few studies on the prevalence of heart diseases in the elderly population in Taiwan. One large‐scale epidemiologic study demonstrated that the prevalence rates of coronary artery disease (CAD) among the elderly population, were 12.3% for males and 10.2% for females. The biostatistic data indicated that, in Taiwan, the mortality due to CAD was rapidly increasing in the 1970s and 1980s and reached a plateau in the 1990s. It is concluded that cardiovascular diseases are common causes of morbidity and mortality in elderly people in Taiwan. Although mortality due to cerebrovascular diseases and heart diseases have decreased over past decades, the mortality due to coronary artery disease is still at the peak level.
Childhood lifestyle influence coronary risk factors and pre‐clinical atherosclerosis in the elderly: Results from Hiroshima–Hawaii–Los Angeles study
Authors: Egusa Genshi
Published: September 2004

To investigate whether childhood lifestyle affects coronary risk factors and progression of preclinical atherosclerosis in the elderly, we surveyed second generation Japanese–‐American men (JA) who were educated in Japan for more than 10 years during childhood and still use Japanese language more than English (Kibei, n= 256) and JA born and raised in US (non‐Kibei, n= 157).
We have two strategies to attain healthy aging
Authors: Ohno Hideki , Kizaki Takako , Hitomi Yoshiaki , Watanabe Sumiko , Ishibashi Yoshinaga , Izawa Tetsuya , Saitoh Daizoh , Kinugasa Takashi , Haga Shukoh
Published: September 2004

To attain healthy and successful aging, we emphasized the importance in making the most of easily available, rather traditional ways, such as swimming, as well as in developing a new strategy, such as the ‘working‐high sleeping‐low body temperature’ strategy.
Oral health care systems for elderly in Asia and Japan
Authors: Maki Yoshinobu
Published: September 2004

More than one‐third of the world population live in Asian countries, and Aging causes the health problems of not only systemic diseases but also oral health in these countries. The purpose of this symposium was to grasp the oral health care systems for aged people in Asian countries. I had already asked to check the percentage of elderly population over 65‐years‐old and their oral health care systems (e.g. oral health status, dental visit and dental care delivery systems, insurance systems, dental manpower, and institutional care for the elderly).

Oral health care compromised for the elderly should not be solely based on the activity of dentists, but also interdisciplinary health care teams including dental hygienists, nurses, health workers, and medical doctors. However, these team care systems are not satisfactory at present.

Speakers from five countries (China, India, Korea, Thailand, and Japan) presented their systems of oral health care for healthy and compromised elder people. We discussed suitable oral health care systems for each country and the integration of oral health to general health promotion.
The Teacher's Career and Life
Authors: Williams Raymond B. , Massaro Thomas J. , Airhart Phyllis D. , Zikmund Barbara Brown
Published: September 2004

Abstract.  Participants in a Wabash Center consultation on vocation discussed the variety of expectations, opportunities, and challenges that create contexts for teaching as they move through careers. These essays emerge from the experiences and reflections of four participants about different stages of careers in diverse contexts. Tom Massaro writes from the perspective of one who recently navigated the challenges leading up to the tenure review in a Jesuit theological school and notes common patterns amidst the diversity of challenges. Phyllis Airhart ponders vocational fidelity in the transitions to new roles and responsibilities at mid‐career in a Canadian university. Barbara Brown Zikmund deals with what she calls the ‘mature years’ and traces a major shift in her career from administration in an American school to teaching in Japan. Raymond Williams reflects on vocation during the process of preparing for retirement from teaching in a liberal arts college, attempting to respond faithfully to the inevitable question, ‘What are you going to do when you retire?’ Vocation is a thread that runs through each essay as reflection on the integrity and continuity of careers. The authors raise issues and make suggestions that may help others reflect on their vocation as teacher.
Handling Doubt in Teaching Religion: A Turkish Case Study
Authors: Ok Uzeyir
Published: September 2004

Abstract.  This study ventures to sketch the dimensions of stress in religious thinking among young Muslims studying theology in Turkish universities and the ways in which these tensions are handled in educational institutions. As a result of a review of related literature, together with the use of a questionnaire with 382 respondents and interviews with 15 participants, the extent of experienced intense religious stress, the source, the content, the ways of resolution, the duration, and the period of religious stress were identified. Finally, the cognitive, educational, theological, and socio‐cultural challenges to which young Muslims were exposed were delineated and possible ways to overcome these problems were outlined, with some suggestions for educational settings. (The questionnaire mentioned in this essay can be found on the Wabash Center Web site .)