Health Issues and Care System for the Elderly (Current Topics in Environmental Health and Preventive Medicine)

This book sheds new light on health issues that concern both aging patients and their caregivers, and provides practical and in-depth insights. The respective chapters address various topics including locomotive organ disease, cardiovascular disease, diabetes mellitus, chronic kidney disease and more. Japan is currently experiencing a massive growth in its elderly population, and at a speed unmatched elsewhere in the world. As such, this edited volume offers a valuable guide for countries that are likely to experience an increase in their elderly population, especially with regard to the epidemiological findings and cohort studies in Japan that it presents. Health Issues and Care System for the Elderly offers a valuable resource for both new and established researchers, doctors, healthcare workers, and students who are seeking information on health problems involving the elderly in the field of public health and gerontology. Preface 6 Contents 7 Chapter 1: Population Aging and Health of Older People in Japan: Introduction of Health Issues and Care System for the Elderly 9 1.1 Introduction 10 1.2 Population Aging in Japan: Demographics, Projections, and Causes 11 1.3 Measures to the Declining Labor Force 13 1.3.1 Population Aging and the Labor Force 13 1.3.2 Support for Women Not to Lose Gainful Employment Outside of the Home After the Delivery 14 1.3.3 Ensuring Employment Until Age 65 and Supporting Reemployment 14 1.3.4 Health Promotion and Prevention of Chronic Disease for Working Ages 15 1.4 Health Problems of Older People 16 1.4.1 High Prevalence of Chronic Disease and Multiple Diagnoses 16 1.4.2 Hypoalbuminemia and Frailty 16 1.4.3 Prevalence and Number of Dementia Among the Older People in Japan 17 1.5 Speed of Population Aging 18 1.6 Discussion 19 References 22 Chapter 2: Burden Among Family Caregivers of Older People Who Need Care in Japan 25 2.1 Introduction 26 2.2 Public Long-Term Care Insurance System for Older People in Japan 27 2.3 Burden Among Family Caregivers of Older People 30 2.3.1 Factors Related to a Heavy Burden/Depression Among Family Caregivers of Older Persons with Disabilities 30 2.3.1.1 The Characteristics of the Older Persons Who Are Cared by Their Family Caregivers 30 2.3.1.2 The Characteristics of Family Caregivers 31 2.3.1.3 The Care Setting 31 2.3.2 Factors Related to Ill Health Among Family Caregivers of Older Persons in Japan 32 2.3.3 Depressive Rates Among Family Caregivers of the Older People Around the Introduction of Public Long-Term Care Insurance System for the Older People in Japan 33 2.3.4 The Characteristics of the Home-Visiting Nursing Service Users Under the Public Long-Term Care Insurance System 33 2.3.5 Caring for Cancer Patients at Home 35 2.4 Discussion 35 References 37 Chapter 3: Health Promotion and Long-Term Care for the Elderly in Rural Areas of Hokkaido, Japan 41 3.1 Recommendation of the Net-Step Exercise (NSE) for Health Promotion Among the Elderly in Rural Areas of Hokkaido 42 3.2 Time-Series Study on Reduction in Physical Activity in the Snowfall Season Among the Elderly in Chitose, Hokkaido 43 3.2.1 Introduction 43 3.2.2 Methods 43 3.2.3 Results 44 3.2.4 Discussion 45 3.2.5 Conclusion 45 3.3 Longitudinal Study on the Influence of Participation in Net-Step Exercise (NSE) Class for Elderly in Ikeda, Hokkaido 46 3.3.1 Introduction 46 3.3.2 Methods 46 3.3.3 Results 46 3.3.4 Discussion 47 3.3.5 Conclusion 47 3.4 Intervention Study on Effects of the Net-Step Exercise (NSE) for Elderly in Kushiro, Hokkaido 48 3.4.1 Introduction 48 3.4.2 Methods 48 3.4.3 Results 49 3.4.4 Discussion 49 3.4.5 Conclusion 50 3.5 Future Study Planning 50 References 50 Chapter 4: Prevention Strategy for Frailty 53 4.1 Introduction 53 4.2 Risk Factors 56 4.3 Prevention Strategy 56 4.3.1 Nutritional Supplementation 57 4.3.2 Exercise 58 4.3.3 Combination 58 4.4 Treatment Strategy 58 4.4.1 Intervention Characteristics 59 4.4.2 Changes in the Components of the Frailty Phenotype 62 4.4.2.1 Change in Muscle Mass (Unintentional Weight Loss) 62 4.4.2.2 Change in Muscle Strength (Weakness) 64 4.4.2.3 Change in Exhaustion 67 4.4.2.4 Change in Gait Speed 67 4.4.2.5 Change in Physical Activity Level 69 Change in Frailty Status 69 4.5 Conclusion 73 References 74 Chapter 5: Epidemiology of the Locomotive Organ Diseases 77 5.1 Introduction 78 5.2 Prevalence of Locomotive Organ Diseases 79 5.2.1 Prevalence of Knee Osteoarthritis (KOA), Lumbar Spondylosis (LS), and Hip Osteoarthritis (OA), and Their Coexistence 79 5.2.2 Prevalence of OP and SP and Their Coexistence 81 5.2.3 Mutual Associations Between Locomotive Organ Diseases, Such as KOA, LS, and OP 83 5.3 Prevalence of Symptom of Locomotive Organ Diseases, Such as Knee Pain and Lumbar Pain 84 5.4 Prevalence and Number of Patients with Locomotive Syndrome at Stages 1 and 2 86 5.5 Conclusion 88 References 89 Chapter 6: Epidemiology of Dementia in a Community: The Hisayama Study 90 6.1 Introduction 91 6.2 The Burden of Dementia in Japan 91 6.3 Risk Factors of Dementia 94 6.3.1 Hypertension 94 6.3.2 Diabetes Mellitus 95 6.3.3 Smoking 97 6.3.4 Physical Activity 98 6.3.5 Diet 98 6.4 Conclusions 99 References 100 Chapter 7: Obesity and Diabetes Mellitus as Risk Factors for Cardiovascular Disease in the Elderly 103 7.1 Obesity in the Elderly and Lifestyle-Related Diseases or Cardiovascular Disease 104 7.2 Diabetes Mellitus as a Risk Factor for Cardiovascular Disease in the Elderly 107 References 111 Chapter 8: Blood Pressure and Cardiovascular Disease in the Elderly 113 8.1 Introduction 114 8.2 Blood Pressure and Its Control in Relation to Aging 114 8.3 The Impact of Blood Pressure Reduction in Clinical Trials 116 8.4 Recent Findings from the EPOCH-JAPAN Observational Study 117 8.5 Out-of-Office Blood Pressure: Self-Measurement at Home 119 8.6 Perspectives 121 References 122 Chapter 9: Stroke in the Elderly Population 126 9.1 Epidemiology 127 9.1.1 Stroke Incidence 127 9.1.2 Stroke Mortality 128 9.2 Stroke Risk Factors and Prevention in the Elderly Population 129 9.2.1 Hypertension 129 9.2.1.1 Antihypertensive Treatment 129 9.2.1.2 Target Blood Pressure Levels 129 9.2.2 Diabetes Mellitus 130 9.2.2.1 Glycemic Control 130 9.2.2.2 Multifactorial Intervention 131 9.2.3 Atrial Fibrillation 131 9.2.3.1 Anticoagulation Therapy 131 9.2.3.2 Hemorrhagic Risk During Anticoagulation Therapy 132 9.2.4 Hypercholesterolemia 132 9.2.4.1 Lipid-Lowering Treatment 133 9.3 Stroke Treatment for Elderly Patients 133 9.3.1 Stroke Care Unit 133 9.3.2 Intravenous Thrombolytic Therapy 134 9.3.3 Carotid Endarterectomy and Stenting 134 9.4 Conclusions 135 References 136 Chapter 10: Chronic Kidney Disease (CKD) as an Emerging Risk Factor in the Elderly 141 10.1 Introduction 142 10.2 Clinical Topics 142 10.2.1 Aging and CKD 142 10.2.2 Factors of CKD 143 10.2.3 Causes of CKD Common in Elderly People 144 10.3 Outcomes of CKD 144 10.3.1 End-Stage Renal Disease (ESRD) 144 10.3.2 Mortality Rate 145 10.4 Management of CKD 147 10.4.1 Non-dialysis-Dependent Patients 147 10.4.2 Dialysis-Dependent Patients 149 10.4.3 Transplant Patients 149 10.5 Perspectives 149 10.5.1 Paucity of Trials in Nephrology 149 10.5.2 Specific Health Check Program (SHCP) 150 10.5.3 KDIGO 150 10.5.4 Dementia 151 10.6 Conclusion 151 References 152 Chapter 11: Lung Cancer in the Elderly: The Most Dominant Cause of Cancer Death in Japan 155 11.1 Introduction 156 11.2 Case-Control Study to Investigate Association Between Genetic Polymorphism and Lung Cancer Risk 158 11.2.1 Background 158 11.2.2 Materials and Methods 159 11.2.2.1 Study Subjects and Data Collection 159 11.2.2.2 Genetic Analysis 160 11.2.2.3 Statistical Analysis 160 11.2.3 Results 161 11.2.3.1 Characteristics of Study Subjects 161 11.2.3.2 Association Between Genetic Polymorphisms Involved in Xenobiotic Metabolism and Lung Cancer Risk 161 11.2.3.3 Association Between Genetic Polymorphisms Involved in DNA Repair and Lung Cancer Risk 165 11.2.3.4 Association Between Genetic Polymorphisms Involved in Inflammation and Lung Cancer Risk 165 11.2.4 Discussion 165 11.3 Conclusion 170 References 171 Chapter 12: Influenza and Influenza Vaccination in Japanese Elderly 175 12.1 Influenza Virus 175 12.2 History of Influenza 176 12.3 Influenza Disease Burden in the Elderly 177 12.4 Clinical Symptoms and Treatment of Influenza 179 12.5 Influenza Vaccine 179 12.5.1 Influenza Vaccine Efficacy and Effectiveness 180 12.5.2 Influenza Vaccine Effectiveness in Japanese Elderly 181 12.5.3 Influenza Vaccine Effectiveness in Elderly Persons Living in the Community 183 12.6 Immunogenicity of Influenza Vaccination 184 12.7 Safety of Influenza Vaccine 185 12.8 Influenza and Pneumococcal Combination Vaccine 185 12.9 Conclusions 186 References 186 Chapter 13: The Great East Japan Earthquake, the Fukushima Daiichi Nuclear Power Plant Accident, and Elderly Health 188 13.1 Introduction 188 13.1.1 Demographic Characteristics of Japan: Aging Society 188 13.1.2 Life Expectancy at Birth and Healthy Life Expectancy at Birth in Japan 190 13.1.3 Increasing survivorship in the elderly population in Japan 190 13.1.4 Physical, Psychological, and Social Aspects of the Elderly Population in Japan 192 13.2 The Great East Japan Earthquake, the Fukushima Daiichi Nuclear Power Plant Accident, and the Health of the Elderly 193 13.2.1 The Elderly in a Disaster Situation 193 13.2.2 Evacuation Support Plan 194 13.2.3 Life and Health Control Guidelines for Evacuation [14] 194 13.2.4 Great East Japan Earthquake 195 13.2.4.1 Disaster-Related Deaths 196 13.2.4.2 Evacuation Stress in Disasters 196 13.2.4.3 Suicide after the Great East Japan Earthquake 196 13.3 Conclusion 197 References 198 Front Matter ....Pages i-viii Population Aging and Health of Older People in Japan: Introduction of Health Issues and Care System for the Elderly (Ikuko Miyabayashi, Masakazu Washio, Tomoko Yanagimoto, Eric Fortin, Seiji Yasumura)....Pages 1-16 Burden Among Family Caregivers of Older People Who Need Care in Japan (Masakazu Washio, Yasuko Toyoshima, Ikuko Miyabayashi, Yumiko Arai)....Pages 17-32 Health Promotion and Long-Term Care for the Elderly in Rural Areas of Hokkaido, Japan (Mitsuru Mori, Kazutoshi Kitazawa, Satoko Showa, Miki Takeuchi, Toshiaki Seko, Shunichi Ogawa)....Pages 33-44 Prevention Strategy for Frailty (Hunkyung Kim, Tatsuro Ishizaki)....Pages 45-68 Epidemiology of the Locomotive Organ Diseases (Noriko Yoshimura, Kozo Nakamura, Sakae Tanaka)....Pages 69-81 Epidemiology of Dementia in a Community: The Hisayama Study (Toshiharu Ninomiya)....Pages 83-95 Obesity and Diabetes Mellitus as Risk Factors for Cardiovascular Disease in the Elderly (Hirofumi Ohnishi, Shigeyuki Saitoh)....Pages 97-106 Blood Pressure and Cardiovascular Disease in the Elderly (Kei Asayama, Takayoshi Ohkubo)....Pages 107-119 Stroke in the Elderly Population (Masahiro Kamouchi)....Pages 121-135 Chronic Kidney Disease (CKD) as an Emerging Risk Factor in the Elderly (Kunitoshi Iseki)....Pages 137-150 Lung Cancer in the Elderly: The Most Dominant Cause of Cancer Death in Japan (Chikako Kiyohara, Yoichi Nakanishi, Masakazu Washio)....Pages 151-170 Influenza and Influenza Vaccination in Japanese Elderly (Megumi Hara)....Pages 171-183 The Great East Japan Earthquake, the Fukushima Daiichi Nuclear Power Plant Accident, and Elderly Health (Seiji Yasumura)....Pages 185-196