Relationship between 5-Year Decline in Instrumental Activity of Daily Living and Accumulation of Cardiovascular Risk Factors: NIPPON DATA90

Hayakawa, Takehito; Okamura, Tomonori; Okayama, Akira; Kanda, Hideyuki; Watanabe, Makoto; Kita, Yoshikuni; Miura, Katsuyuki; Ueshima, Hirotsugu

doi:10.5551/jat.1727

Cited by 21 publications

(20 citation statements)

References 19 publications

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“…Okamura et al 24 reported that elderly residents with systolic hypertension (X160 mm Hg) in two communities located in Akita and Kochi Prefectures showed a 3.41 times higher odds ratio for having low IADL scores than those with normal BP. Hayakawa et al 25 reported a significant relationship between decrease in IADL score and cardiovascular risk factors including hypertension, dyslipidemia, diabetes mellitus and smoking, in a cohort in Japan. The present observation of an association between decline in IADL score and untreated hypertension is, at least in part, compatible with the reports of Okamura et al 24 and Hayakawa et al 25 Therefore, active treatment of hypertension in elderly community-dwelling subjects may be linked to prevention of future decline in IADL in Japanese elderly, allowing them to live a healthy and active life.…”

Section: Discussionmentioning

confidence: 98%

Association between hypertension status and the screening test for frailty in elderly community-dwelling Japanese

et al. 2013

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To clarify the possible association of frailty with hypertension prevalence, treatment and blood pressure (BP) control in the elderly, we conducted a screening survey of 1091 elderly community-dwelling subjects aged ≥65 years, using data from public health check-ups and frailty was determined by a 25-item questionnaire, the Basic Checklist for Frailty (BCF). The significance of differences in the association of BCF categories or BCF items with each hypertension status was analyzed using multiple logistic regression analysis after adjusting for age, sex and possible confounding underlying chronic conditions. A total of 63% of subjects were hypertensive (BP≥140/90 mm Hg), and of those, 85% were receiving antihypertensive treatment, and 56.0% of those receiving treatment had controlled BP (<140/90 mm Hg). BCF categories that showed an independent association with hypertension status were 'impaired walking status' and absence of 'impaired nutritional status' for prevalence of hypertension, 'impaired instrumental activity of daily living status' and 'impaired nutritional status' for untreated hypertension among hypertensives and 'impaired oral function' for BP-uncontrolled hypertension among treated hypertensives. In addition, BCF items that showed an independent association were 'inability to walk for more than 15 min without rest' and absence of 'Body mass index (BMI) <18.5 kg m(-2') for prevalence of hypertension, 'weight loss of more than 2-3 kg in the past 6 months' for untreated hypertension, and 'difficulty eating hard food' for BP-uncontrolled hypertension. These observations indicate that assessment of these specified frailty categories and/or items may be useful for evaluating hypertension status in elderly community-dwelling subjects.

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Section: Discussionmentioning

confidence: 98%

Association between hypertension status and the screening test for frailty in elderly community-dwelling Japanese

et al. 2013

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“…Association between the accumulation of risk factors and the estimated risk of CVD has often been a subject of interest as prophylactic strategies directed against these risk factors may contribute to reduce the burden of atherosclerosis, leading to a healthy life for people at increased risk [1][2][3][4][5] . In fact, the ability to reflect upstream inflammatory activity, steady levels without any significant circadian variation in persons of differing sexes, ages and ethnicities, and high stability with a long half-life of the actual substance are additional important criteria for an ideal biomarker in CVD.…”

Section: Introductionmentioning

confidence: 99%

Gamma-glutamyltransferase to Determine Cardiovascular Risk: Shifting the Paradigm Forward

Turgut

Tandoğan

2011

JAT

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Gamma-glutamyltransferase (GGT), regarded as a marker of excessive alcohol consumption or liver disturbances, is an enzyme catalyzing the first step in the extracellular degradation of the antioxidant glutathione (GSH) and may take part in atherogenesis. The marked relationship between GGT and the atherosclerotic process has shifted attention to the issue of whether its serum levels can aid in the detection of individuals at high risk for incident cardiovascular events. It is likely that the process entails the oxidation of low-density lipoprotein through GSH/GGT-dependent iron reduction within the plaque. In this context, oxidative stress is a probable mediator. Recent insights into the pathophysiological background of GGT in the precipitation and progression of atherosclerosis appear to be supported by relevant epidemiological observations as a cardiovascular risk predictor. Further understanding is, nevertheless, warranted to ameliorate the prognostic stratification of patients through GGT.

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“…15 Among those who are thought to be representative of the Japanese population in the NIPPON DATA90, the accumulation of cardiovascular risk factors was associated with IADL. 19 In the present study, the association between impaired higherlevel functional capacity and stroke incidence remained even after adjustment for these risk factors, which suggests that the observed associations were not fully explained by these traditional risk factors. However, some risk factors, such as dietary habits or suboptimal health care utilization, were not considered, and these need to be examined in future studies.…”

Section: Discussionmentioning

confidence: 57%

Impaired Higher-Level Functional Capacity as a Predictor of Stroke in Community-Dwelling Older Adults

Murakami

Tsubota‐Utsugi

Satoh

et al. 2016

Stroke

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S troke continues to be a major public health concern worldwide. As with other developed countries, it is the leading cause of death and a major neurological cause of long-term disability in Japan.1 Therefore, stroke prevention is a public health priority.Limitations in functional capacity after stroke are prevalent 2 because strokes often affect the memory and physical capabilities required to perform activities of daily living. A small but growing number of studies have challenged the conventional view that disability emerges after acute onset conditions, including stroke; that is, what is often thought of as stroke-related disability actually precedes stroke incidence.3-5 These studies measured disability by assessing basic activities of daily living (BADL), such as feeding, bathing, dressing, toileting, transferring, and continence 3,4 or cognitive function. 5Background and Purpose-Functional capacity is a predictor, as well as a consequence, of stroke. However, little research has been done to examine whether higher-level functional capacity above basic activities of daily living is a predictor of stroke. Methods-We followed 1493 Japanese community-dwelling adults aged ≥60 years (mean age, 70.1 years) who were independent in basic activities of daily living and had no history of stroke. Baseline data were collected using a selfadministered questionnaire. Higher-level functional capacity was measured using the total score and 3 subscales (instrumental activities of daily living, intellectual activity, and social role) derived from the Tokyo Metropolitan Institute of Gerontology Index of Competence. Adjusted hazard ratios and 95% confidence intervals were calculated by the Cox proportional hazards model. Results-During a mean follow-up of 10.4 years, 191 participants developed a first stroke. Impaired higher-level functional capacity based on total score of the Tokyo Metropolitan Institute of Gerontology Index of Competence was significantly associated with stroke (hazard ratio, 1.64; 95% confidence interval, 1.15-2.33). Among the 3 subscales, only intellectual activity was significantly associated with stroke (hazard ratio, 1.64; 95% confidence interval, 1.21-2.22). Social role was significantly associated with stroke only among those aged ≥75 years (hazard ratio, 1.78; 95% confidence interval, 1.07-2.98). Conclusions-Impaired higher-level functional capacity, especially in the domain of intellectual activity, was a predictor of stroke, even among community-dwelling older adults with independent basic activities of daily living at baseline. Lawton defined and systematized 7 stages of competence (ie, functional capacity) from the lowest and most basic function to the highest. 6 The stages were, in ascending order of complexity, life maintenance, functional health, perception and cognition, physical self-maintenance (corresponding to BADL), instrumental self-maintenance (instrumental activities of daily living [IADL]), effectance, and social role.6 Of these stages, the complex capacity to cover the last 3 stag...

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Relationship between 5-Year Decline in Instrumental Activity of Daily Living and Accumulation of Cardiovascular Risk Factors: NIPPON DATA90

Cited by 21 publications

References 19 publications

Association between hypertension status and the screening test for frailty in elderly community-dwelling Japanese

Association between hypertension status and the screening test for frailty in elderly community-dwelling Japanese

Gamma-glutamyltransferase to Determine Cardiovascular Risk: Shifting the Paradigm Forward

Impaired Higher-Level Functional Capacity as a Predictor of Stroke in Community-Dwelling Older Adults

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