著者

Takaaki Ikeda Upul Cooray Toshifumi Yodoshi Makoto Kaneko Ken Osaka Masayasu Murakami

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.8, pp.20230033, 2023 (Released:2023-09-27)

参考文献数

41

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Objectives : There has been no analysis of the effects of in-hospital rehabilitation on adult patients with Down’s Syndrome (DS) after hospitalization for community-acquired pneumonia (CAP). Medical claims data retrospectively collected nationwide were used to examine outcomes at discharge.Methods : Hospitalization data were obtained from 440 Japanese hospitals for DS patients with CAP that were discharged between 1 June 2009 and 31 January 2022 (n=2897). After the exclusion of 2478 patients, mainly on the basis of age or type of admission, the records of 419 patients were extracted. The following were used as outcomes: (1) 30-day readmission, (2) 45-day readmission, (3) discharge Barthel Index (BI), (4) BI score gain, and (5) length of hospital stay. The targeted minimum loss-based estimator was used to examine effects of the average daily times of rehabilitation on outcomes at discharge.Results : Most patients had no in-hospital rehabilitation (73.5%). Provided that the average daily time of rehabilitation therapy was at least 20 min, BI scores were lower at discharge (coefficient, −15.91; 95% confidence interval, −30.07 to −1.75) and BI gain was lower (coefficient, −12.56; 95% confidence interval, −25.60 to 0.47) when compared with the use of no rehabilitation therapy.Conclusions : In-hospital rehabilitation medicine in DS patients with CAP provided by a therapist was not associated with improved activities of daily living at discharge. Future studies are warranted to develop systematic, efficient, and comprehensive rehabilitation medicine for DS patients suffering from CAP.

著者

Taiji Noguchi Takaaki Ikeda Takao Kanai Masashige Saito Katsunori Kondo Tami Saito

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20230127, (Released:2023-09-09)

参考文献数

58

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Background: Per the biopsychosocial model, pain, especially chronic low back pain, which often presents with nonspecific pain, requires a comprehensive approach involving social factors. However, the association of social factors, including social isolation and loneliness, with this condition remains unclear. This study examined the cross-sectional association of social isolation and loneliness with chronic low back pain among older adults.Methods: We recruited functionally independent older adults through a mail survey in 2019 from the Japan Gerontological Evaluation Study (JAGES). Chronic low back pain was defined as low back pain lasting more than three months. Social isolation was identified based on face-to-face and non-face-to-face interactions (“not isolated,” “isolated tendency,” and “isolated”). Loneliness was assessed using the UCLA Loneliness Scale (“not lonely,” “lonely tendency,” and “lonely”).Results: Consequently, 21,463 participants were analyzed (mean age: 74.4 years; 51.5% females); 12.6% reported chronic low back pain. Multivariable Poisson regression analysis revealed that loneliness was significantly associated with the likelihood of chronic low back pain; compared with “not lonely”, the prevalence ratio (PR) was 1.14 (95% confidence interval [CI]: 1.05–1.25) for “lonely tendency” and 1.40 (1.27–1.54) for “lonely.” Social isolation was not associated; compared with “not isolated,” the PR (95% CI) was 0.96 (0.88–1.05) for “isolated tendency” and 0.99 (0.89–1.10) for “isolated.” A positive multiplicative interaction between social isolation and loneliness for chronic low back pain was found.Conclusions: Lonelier individuals were more likely to experience chronic low back pain, and those with loneliness and social isolation were synergistically more likely for this condition.

著者

Takaaki Ikeda Tomoto Suzuki Michiaki Takagi Masayasu Murakami

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.6, pp.20210049, 2021 (Released:2021-12-09)

参考文献数

36

被引用文献数

3

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Objectives : Vertebral compression fractures are common among older people. Currently, knowledge of the effects of early rehabilitation treatment on the recovery of activities of daily living (ADL) in older patients who receive conservative treatment for these fractures is limited. Using the instrumental variable (IV) method, we examined the effects on ADL at discharge of a delay in initiating rehabilitation treatment.Methods: In this retrospective cohort study, data from the Japanese Diagnosis Procedure Combination database were analyzed. The subjects were patients with vertebral compression fracture who had undergone rehabilitation treatment during their hospitalization between 2014 and 2019 in one of the 29 acute-care hospitals in Yamagata Prefecture. We analyzed data from 1706 patients (mean age, 82.1 years). The independent variable was the number of days between hospital admission and the start of rehabilitation treatment, and the outcome was the Barthel index (BI) score at discharge. An IV method was applied, with adjustments for covariates, including demographics and functional status at admission.Results: Most patients started rehabilitation treatment within 3 days of hospital admission. Our IV method showed that the interval between hospital admission and the start of rehabilitation treatment was significantly associated with the BI score at discharge. The coefficient was −2.71 (95% confidence interval [CI]: −5.06 to −0.35).Conclusions: A delay in initiating rehabilitation treatment had a negative effect on ADL at discharge. This result emphasizes the importance of including early rehabilitation treatment in acute care, as recommended by several existing guidelines for the treatment of orthopedic diseases.

著者

Takaaki Ikeda Noriko Cable Masashige Saito Shihoko Koyama Taishi Tsuji Taiji Noguchi Katsunori Kondo Ken Osaka Jun Aida

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.10, pp.523-529, 2021-10-05 (Released:2021-10-05)

参考文献数

39

被引用文献数

3 14

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Background: Existing evidence suggest that those who are socially isolated are at risk for taking up or continuing smoking. This study investigated country-based differences in social isolation and smoking status.Methods: We performed a repeated cross-sectional study using two waves of data from two ongoing aging studies: the English Longitudinal Study of Ageing and the Japan Gerontological Evaluation Study. Participants from both studies aged ≥65 years were included. We applied a multilevel Poisson regression model to examine the association between social isolation and smoking status and adjusted for individual sociodemographic characteristics. We used the social isolation index which comprises the following domains: marital status; frequency of contact with friends, family, and children; and participation in social activities. Interaction terms between each country and social isolation were also entered into the mode.Results: After exclusion of never smokers, we analyzed 75,905 participants (7,092 for ELSA and 68,813 for JAGES, respectively). Taking ex-smokers as the reference, social isolation was significantly associated with current smoking; the prevalence ratios (PRs) were 1.06 (95% credible interval [CrI], 1.05–1.08) for men and 1.08 (95% CrI, 1.04–1.11) for women. Taking Japan as a reference, the interaction term between country and social isolation was significant for both sexes, with increased PRs of 1.32 (95% CrI, 1.14–1.50) for men and 1.30 (95% CrI, 1.11–1.49) for women in England.Conclusions: Older people who were less socially isolated were more likely to quit smoking in England than in Japan, possibly explained by the strict tobacco control policies in England.

著者

Takaaki Ikeda Noriko Cable Masashige Saito Shihoko Koyama Taishi Tsuji Taiji Noguchi Katsunori Kondo Ken Osaka Jun Aida

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200138, (Released:2020-08-08)

参考文献数

39

被引用文献数

14

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Background: Existing evidence suggest that those who are socially isolated are at risk for taking up or continuing smoking. This study investigated country-based differences in social isolation and smoking status.Methods: We performed a repeated cross-sectional study using two waves of data from two ongoing aging studies: the English Longitudinal Study of Ageing and the Japan Gerontological Evaluation Study. Participants from both studies aged ≥65 years old were included. We applied a multilevel Poisson regression model to examine the association between social isolation and smoking status and adjusted for individual sociodemographic characteristics. We used the social isolation index which comprises the following domains: marital status; frequency of contact with friends, family, and children; and participation in social activities. Interaction terms between each country and social isolation were also entered into the mode.Results: After exclusion of never smokers, we analyzed 75,905 participants (7,092 for ELSA and 68,813 for JAGES, respectively). Taking ex-smokers as the reference, social isolation was significantly associated with current smoking; the prevalence ratios (PRs; 95% credible intervals [CrIs]) were 1.06 (1.05–1.08) for men and 1.08 (1.04–1.11) for women. Taking Japan as a reference, the interaction term between country and social isolation was significant for both sexes, with increased PRs (95% CrIs) of 1.32 (1.14–1.50) for men and 1.30 (1.11–1.49) for women in England.Conclusions: Older people who were less socially isolated were more likely to quit smoking in England than in Japan, possibly explained by the strict tobacco control policies in England.