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Aim: We aimed to identify the factors contributing to subjective well‐being in community‐dwelling older adults in rural Japan. This study explored the relationship among physical and mental health, socioeconomic status, and activity levels with regard to the subjective well‐being of older adults. Methods: In the Frail Elderly in the Sasayama‐Tamba Area study, a cohort investigation of independent older adults in a rural Japanese community, 541 of 844 participants completed a 2‐year follow‐up survey. Subjective well‐being was assessed as a binary based on three factors – "happiness," "satisfaction with life" and "meaning in life" – using a subset of the World Health Organization's Quality of Life questionnaire. The improvement group transitioned from not having subjective well‐being during the baseline survey to having subjective well‐being during the follow‐up survey. Furthermore, we used multivariable log‐Poisson regression models to calculate the prevalence ratios of subjective well‐being. Results: The cross‐sectional study showed that sleep satisfaction, health services access satisfaction and having a higher‐level functional capacity were positively associated with having "happiness" and "satisfaction with life." Furthermore, being aged ≥80 years and having financial leeway were positively associated with having "meaning in life." The longitudinal study showed that having a higher‐level functional capacity was positively associated with improving "happiness" and "satisfaction with life." Being female was positively associated with improving "happiness" and "meaning in life," and health services access satisfaction and alcohol drinking were positively associated with improving "satisfaction with life" and "meaning in life," respectively. Conclusions: These findings offer promising avenues for enhancing the subjective well‐being of older adults. Geriatr Gerontol Int 2024; 24: 311–319. [ABSTRACT FROM AUTHOR]

The authors propose several estimation methods for the confidence interval of the percentile of the power-normal distribution, which specifies the distribution of the observed values before Box-Cox transformation and assumes that transformed distribution is the truncated normal distribution. Their approaches are based on the delta method and the inverse transformation method. Then the finite sample performance of each estimation method is compared through a simulation, and it is shown that the performance of the inverse transformation method is superior to the delta method. A reparametrization method of the power-normal distribution, which is useful parameter setting tool in simulations, is suggested. The authors also investigate the asymptotic behavior of the coverage probability of the confidence interval of the percentile of the power-normal distribution in the case wherein the variance inflation of the MLE associated with the estimation of the transformation parameter of the power-normal distribution is ignored. [ABSTRACT FROM AUTHOR]

Objective: Recent large-scale observational studies have shown better outcomes after coronary artery bypass grafting than after angioplasty or stenting in patients with multiple-vessel disease. The time frames of these studies, however, include periods of varying behavior with respect to patient selection, stent technique and design, and medical therapy. Our objective was to examine long-term outcomes of coronary stenting and coronary artery bypass grafting, including those performed in the contemporary era of aggressive medical therapy. Methods: We examined in-hospital and long-term follow-up data from consecutive patients with multivessel coronary artery disease who underwent isolated initial revascularization by coronary stenting or coronary artery bypass grafting between 1995 and 2003. Cox proportional hazards modeling with propensity scoring and propensity-based case matching were used to compare long-term survival and correct for baseline differences between the populations. Results: A total of 6847 patients were studied (stenting 3917, coronary artery bypass grafting 2930). Each patient had 1 to 9 years of follow-up (median 3.5 years). Unadjusted long-term mortalities were similar for coronary artery bypass grafting and stenting (hazard ratio 1.1, 95% confidence interval 0.9–1.2, P = .21). Matched comparison of 3488 patients (1856 in each group) with similar likelihoods of undergoing coronary stenting or coronary artery bypass grafting, however, suggested that coronary artery bypass grafting provided better long-term survival (hazard ratio 0.7, 95% confidence interval 0.6–0.9; P = .004). Conclusion: During a 9-year period, in physician-selected patients with favorable demographic characteristics for both revascularization procedures, coronary artery bypass grafting was associated with better long-term survival than stent-assisted angioplasty. [Copyright &y& Elsevier]