Prevalence of Chronic Pain, Especially Headache, and Relationship with Health-Related Quality of Life in Middle-Aged Japanese Residents

The aim of this study was to evaluate the prevalence of chronic pain (CP) and the relationship between CP, especially headache adjusted for CP at other sites, and health-related quality of life (HRQoL) in middle-aged Japanese residents. We examined the prevalence of CP (defined as pain persisting for 3 months or more) and HRQoL (SF-36) in 1117 middle-aged residents of Japan. We assessed the eight dimensions of health status and the 3 component SF-36 summary score to evaluate HRQoL. The prevalence of CP was 15.3% among men and 15.1% among women. Multiple linear regression analysis demonstrated that lumbar pain (p β = -0.132), knee pain (p β = -0.115), foot pain (p = 0.042, β = -0.065), and age (p β = -0.154) were independently correlated with a lower physical component score (PCS). Older age (ppβ = -0.096), knee pain (p β = -0.109), upper limb pain (p β = -0.098), and lumbar pain (p = 0.022, β = -0.077) all showed a significant negative correlation with MCS. The presence of chronic headache (p = 0.011, β = -0.082) was the only factor significantly correlated with a lower role component score (RCS). We identified a negative correlation between chronic headache and RCS, unlike the relation between musculoskeletal pain and PCS or MCS, suggesting that RCS was an independently influenced by CP differently from PCS or MCS in Japanese residents.

The Association between Activity of Daily Living and the Combination of Alzheimer’s Disease and Cataract in Elderly Requiring Nursing Care

Some clinical and epidemiological studies have suggested that Alzheimer’s Disease (AD) and cataract, may share common pathogenetic mechanisms, subsequently a positive association between the prevalence of AD and cataract, although other studies found no significant relationship between dementia and visual impairment including cataract in the elderly. Little is known about the association between Activity of Daily Living (ADL) and the combination of AD and cataract. To examine the association between ADL and the combination of AD and cataract, we performed a national survey in nursing care institutions in Japan, examining the decreased ADL in elderly with and without AD and cataract for 453 elderly aged 85.0 ± 8.13 years. The proportion, 43.5% of AD in subjects without cataract was significantly higher than that, 23.5% with cataract. Almost all ADL in AD with cataract was significantly lower than that without cataract, although all ADL in cataract patients receiving surgery in AD was significantly (all p < 0.002) higher than that in cataract patients without surgery in AD, as was confirmed by the multiple regression analysis incorporating into the relevant factors as independent variables. These results showed that ADL scores including cognitive functions decreased by cataract were increased by the surgery in the patients with AD. A significantly negative association between AD and cataract seen in our data, which was inconsistent with the previous result, might lead to the necessities of the clinical diagnosis for slight severity of cataract for patients with AD.

Sex- and Age-Specific Associations of Social Status and Health-Related Behaviors with Health Check Attendance: Findings from the Cross-Sectional Kanazawa Study

Health checks are key features of primary and secondary disease prevention. The aim of this study was to examine the sex- and age-specific association of social status and health-related behaviors with health check attendance in eligible persons. Data were derived from the Kanazawa Study 2011 (n = 12,781), a cross-sectional study which investigated all the residents in model areas of Kanazawa City, Ishikawa Prefecture, Japan. We selected participants aged 23 years or older with National Health Insurance (n = 4920). Attendance at health checks was the outcome. We used social status and health-related behaviors as predictor variables. We analyzed them by sex and applied stratified analyses by age groups for each sex. The bivariate analyses were conducted by means of cross-tabs. We calculated health check attendance rates by each variable. We used Pearson’s χ2-test to examine statistically significant differences. We fitted logistic regression models to estimate adjusted odds ratios (ORs) of attendance in the past one year. We computed ORs in a logistic regression model containing all variables described above. Workingmen and women aged 23 to 39 years and aged 40 to 64 years had significantly increased ORs for health check attendance compared with non-working persons. Men, men aged 23 to 39 years and men aged 65 years or older with more physical activity had significantly increased ORs for health check attendance. Male ex-smokers, female ex- and non-smokers, male ex-smokers aged 65 years or older, and female non-smokers aged 40 to 64 years had significantly increased ORs. The findings suggest that population groups with lower social status or increased risks of adverse health effects are less likely to attend health checks than those with higher social status or decreased risks in particular sex and age groups. It indicates that diverse approaches are required to realize the full benefit of health checks.