Health Issues and Care System for the Elderly by Masakazu Washio & Chikako Kiyohara

Author:Masakazu Washio & Chikako Kiyohara
Language: eng
Format: epub
ISBN: 9789811317620
Publisher: Springer Singapore

Model 1

Model 2

Model 3

Non-elderly (<65 years)

3.67 (95% CI, 1.67–8.27)

3.72 (95% CI, 1.59–8.67)

2.68 (95% CI, 1.05–6.90)

Elderly (≥65 years)

1.47 (95% CI, 0.47–4.59)

1.60 (95% CI, 0.49–5.19)

0.67 (95% CI, 0.16–2.84)

Model 1: Adjusted for age and gender

Model 2: Model 1 + total cholesterol, systolic blood pressure, smoking, and family history of diabetes mellitus

Model 3: Model 2 + fasting plasma glucose ≥110 mg/dL at baseline

To clarify the association between waist circumference and risk of all-cause or cardiovascular mortality in the Japanese population, we conducted pooled analysis of data from Japanese community-based studies including our cohort data [7]. A total of 3554 men and 4472 women who had no history of CVD were registered from 3 cohorts, and their waist circumferences were measured at baseline during the period from 1988 to 1996. Endpoints were all-cause death and CVD death, and the participants were followed up for 14.7 years. Hazard ratios (HRs) were calculated using the Cox proportional hazards model and a penalized spline method, after adjustment for the study cohort, age, smoking, alcohol drinking, hypertension, dyslipidemia, and diabetes. The highest quintile of waist circumference in men was associated with a linear reduction in all-cause mortality risk compared with the lowest quintile (HR, 0.73; 95% CI, 0.60–0.89; P for trend = 0.001). When stratifying participants according to age, CVD mortality risk was increased in men aged ≤65 years with a larger waist circumference. This relationship was U-shaped. On the other hand, in men aged >65 years, waist circumference was associated with all-cause mortality rather than CVD mortality (Fig. 7.1). In women, waist circumference was not associated with all-cause or CVD mortality risk.

Fig. 7.1P-spline fitting curves of hazard ratios and 95% confidence intervals for all-cause and cardiovascular disease deaths vs. waist circumference in men <65 years and ≥65 years of age. (a) All-cause death, age <65 years (nonlinear trend, P = 0.089); (b) all-cause death, age ≥65 years (P = 0.11); (c) CVD death, age <65 years (P < 0.001); (d) CVD death, age ≥65 years (P = 0.31).The hazard ratios were adjusted for age, study community, smoking habits, alcohol consumption, hypertension, hyperlipidemia, and diabetes mellitus. Actual waist circumference used in the present analysis is marked on the x-axis [7]

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