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The global rise in the aging driving population has heightened concerns about traffic incidents involving this demographic. Beyond transportation, automobiles represent a vital lifeline for older adults, fostering social activities and influencing their health-related quality of life. This study explores improving and sustaining driving ability among older adults with anticipated declines through health-conscious exercises. Sixty-eight participants were randomly allocated into two groups. The exercise-oriented group (E-group) engaged in twelve 90 min health and exercise sessions over twelve weeks, while the control group (C-group) maintained their regular daily routines and did not receive any specific interventions during this period. The focal point of assessment was driving ability, as evaluated by a person using a real car on public roads without using a simulator. Driving ability and physical fitness were assessed before the intervention in both groups. Post-intervention measurements occurred twelve weeks after the initial gauging, encompassing both cohorts. Comparative analysis of pre- and post-intervention changes was executed between the two groups. The E-group demonstrated improved overall driving ability compared to the C-group. The results suggest that healthy exercise and physical activity may maintain and enhance driving ability for older adults.

This study aimed to investigate the link between prolonged sedentary bouts and health-related quality of life (QOL) in patients on chronic hemodialysis (CHD). A total of 84 outpatients on CHD, aged 71.6±11.8 years, were enrolled in this cross-sectional study. Parameters for prolonged sedentary bouts [i.e., ≧ 30 min (% and bout) and ≧ 60 min (% and bout)] were measured using a triaxial accelerometer. Health-related QOL (HRQOL) was evaluated by the Euro-QOL (EQ-5D). Clinical parameters were obtained from medical records. Relatively prolonged sedentary bouts (%) were 44.0±18.2 (≧ 30 min) and 29.8±16.5 (≧ 60 min) for total days. Prolonged sedentary bouts (bouts) were 6.2±2.7 (≧ 30 min) and 2.7±1.6 (≧ 60 min) for total days. EQ-5D scores were 0.728±0.220. All prolonged sedentary bout parameters were negatively correlated with EQ-5D scores, except for prolonged sedentary bouts (≧ 60 min) (min) and relatively prolonged sedentary bouts (%) on hemodialysis days. Multiple regression analysis showed that prolonged sedentary bout parameters were an important factor in EQ-5D scores even after adjusting for confounding factors for total and non-hemodialysis days. Our results suggested that prolonged sedentary bouts were closely associated with HRQOL in patients on CHD, especially on non-hemodialysis days., Competing Interests: No potential conflict of interest relevant to this article was reported.

Purpose: To evaluate the health-related quality of life (HRQoL) of Japanese men on active surveillance (AS) in the Prostate cancer Research International Active Surveillance study in Japan (PRIAS-JAPAN)., Methods: Participants were included in the PRIAS-JAPAN HRQoL study between January 2010 and March 2016. Their general HRQoL was assessed using a validated Japanese version of the Short-Form 8 Health Survey (SF-8) at enrolment and annually thereafter until discontinuation of AS. The SF-8 mental component summary (MCS) and physical component summary (PCS) of men on AS were compared with scores of the general population (norm-based score [NBS]: 50) and MCS and PCS scores for men following AS were analysed over time. We tested whether MCS and PCS scores over time explained discontinuation of AS., Results: Five hundred and twenty-five patients enrolled, and the median age at baseline was 68 years. At enrolment and after 1-, 2-, and 3-year follow-ups, the PCS and MCS scores were significantly higher than the NBS of the general Japanese population except for the median PCS at 3 years. We found that age at diagnosis and time on AS negatively affected the PCS score of men on AS, while every additional year on AS led to a 0.27 point increase in MCS scores. Neither PCS nor MCS were predictors for discontinuation of AS., Conclusion: Japanese men following an AS strategy for 3 years reported better HRQoL compared with the general population, indicating that monitoring Japanese low-risk prostate cancer patients can be an effective treatment strategy., Study Registration: Clinical trial registry-UMIN (University Hospital Medical Information Network); UMIN000002874 (2009/12/11)., (© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.)

Background and Objectives : Both disaster prevention and health promotion have become public health challenges in Japan. Maintaining physical fitness from the perspective of disaster prevention and maintaining physical fitness from the perspective of health are basically covering similar issues, they are seen as different from one another because of differences in administrative jurisdiction in Japan. In the case of disaster prevention education, physical fitness is not mentioned. In and outside Japan, partial integration of disaster prevention education and health education is required. This study compares and examines the effects of disaster prevention education and traditional exercise education, as well as exercise practice. A randomized controlled trial alongside an evacuation behavior model during the event of a disaster were used in this research. Materials and Methods : A total of 97 community-dwelling participants were randomly allocated to two groups, a disaster prevention education group (Group D) and a traditional exercise education group (Group E). Group D received disaster prevention education with weekly exercise. Group E received traditional exercise education with weekly exercise. After ten weeks of intervention, the total evacuation time of the disaster evacuation model course, physical fitness, self-efficacy (General Self-Efficacy Scale: GSES), and health-related quality of life (QOL) were compared between the two groups. Results : No differences were observed between the two groups regarding the changes in the parameters of total evacuation time, physical fitness, and health-related QOL. However, the changes in GSES scores were significantly higher in Group D (1.4 ± 3.9) than in Group E (-1.1 ± 7.5). Conclusions : Disaster prevention education with weekly exercise significantly increased participants' self-efficacy compared to traditional exercise education. The combination of disaster prevention education and exercise practice may have a positive effect not only on disaster prevention behavior but also on self-efficacy in health promotion. Disaster prevention education does not directly influence health promotion, but it may be a very effective method for indirectly promoting health.

We explored the relationship between sedentary behavior and the health-related quality of life (HRQOL) in patients on chronic hemodialysis. A total of 60 outpatients, aged 71.1±12.0 years, were enrolled in this cross-sectional study. Sedentary behavior was measured using a tri-accelerometer and HRQOL was evaluated by the Euro-QOL questionnaire (EQ-5D). The relationship between the patients' sedentary behavior and HRQOL was evaluated by simple and multiple correlation analyses. The relative sedentary behavior (%) for total days was 73.7±12.9% and the EQ-5D scores were 0.688±0.233. Relative sedentary behavior (%) was negatively correlated with EQ-5D scores for total days, hemodialysis days and non-hemodialysis days. The relative light-intensity physical activity (LPA) (%) and relative moderately vigorous-intensity physical activity (MVPA) (%) were correlated with EQ-5D scores. Multiple regression showed that the relative sedentary behavior (%) had a clinical impact on EQ-5D scores after adjusting for confounding factors for total, hemodialysis and non-hemodialysis days. Sedentary behavior is closely linked to HRQOL, and reducing sedentary behavior may be beneficial to improve the HRQOL of patients on chronic hemodialysis., Competing Interests: No potential conflict of interest relevant to this article was reported.

In a longitudinal study, we examined the link between changes in physical activity and changes in health-related quality of life (HRQOL) in patients on chronic hemodialysis. Seventy-one patients (43 males, 28 females; aged 70.9±10.6 years) on chronic hemodialysis in September 2013 were enrolled. The data of the 43 patients whose complete measurements were taken again in September 2014 were used for the longitudinal analysis. Clinical parameters including age, height, dry weight, duration of hemodialysis, blood pressure (BP), blood triglyceride and HDL cholesterol levels, physical activity, and HRQOL were evaluated. Physical activity was measured by a tri-accelerometer, and HRQOL was evaluated by the EuroQol questionnaire (EQ-5D). In the first cross-sectional analysis, EQ-5D scores were significantly correlated with daily step counts (steps per day) on all days and non-hemodialysis days. In the second longitudinal analysis, in the women, changes in EQ-5D scores were positively correlated with changes in daily step counts on all days. In all patients, changes in EQ-5D were weakly and negatively correlated with changes in physical activity (1-3 METs: min per day) on hemodialysis days. Promoting daily physical activity may improve the HRQOL in patients on chronic hemodialysis, especially in women.

Objective: The aim of this study was to compare health-related quality of life (HRQOL) between type 2 diabetic patients with and without locomotive syndrome, which is a risk for becoming bedridden because of deteriorating locomotive organs., Subjects and Methods: A total of 135 patients with type 2 diabetes mellitus (69.2 ± 10.2 years) were enrolled in this cross-sectional study. HRQOL was evaluated by the Euro-QOL-5 (EQ-5D), and locomotive syndrome was evaluated by "loco-check," established the Japanese Orthopedic Association. Clinical data, such as anthropometric parameters, blood and urine examination results, blood pressure (BP), drug usage, and psychological distress, were analyzed., Results: Average HbA1c in all patients was 7.2 ± 1.0 %, and 74 patients (54.8 %) were identified as having the locomotive syndrome. EQ-5D scores were significantly lower in type 2 diabetic patients with locomotive syndrome than in those without locomotive syndrome, even after adjusting for age, sex, body mass index (BMI), and HbA1c. By the multiple regression analysis, locomotive syndrome and age were identified as determinant factors of HRQOL in type 2 diabetic patients., Conclusion: In type 2 diabetic patients, lower HRQOL was a characteristic feature of subjects with locomotive syndrome, even after adjusting for confounding factors. Prevention or management of locomotive syndrome may be beneficial for improving HRQOL in type 2 diabetic patients., Competing Interests: The authors declare that there were no conflicts of interest in this study.

Objective: The aim of this study was to evaluate psychological distress in patients on chronic hemodialysis., Subjects and Methods: A total of 72 patients on chronic hemodialysis were enrolled in this study. We evaluated psychological distress by using the K6 questionnaire, health-related quality of life (HRQOL) by using the EQ-5D questionnaire, and clinical parameters. Among the 72 patients, we also evaluated changes in K6 scores in 58 patients at 1-year follow-up., Results: The mean K6 score was 3.7 ± 3.7 and 2 subjects (2.8%) were defined as having psychological distress. K6 scores were significantly correlated with body fat percentage, albumin level, and EQ-5D scores in total subjects. K6 scores were also significantly and negatively correlated with EQ-5D scores in men and women. In the 1-year follow-up group, changes in K6 scores were weakly and negatively correlated with changes in EQ-5D scores., Conclusion: Psychological distress was closely associated with HRQOL in patients on chronic hemodialysis. Coping strategies for psychological distress might be useful in improving HRQOL in patients on hemodialysis.

Objective: The aim of this study was to investigate the relationship between physical activity and health-related quality of life (HRQOL) in patients on chronic hemodialysis., Methods: A total of 31 men (69.0 ± 11.1 years) and 17 women (66.9 ± 10.0 years) among 61 male and 30 female patients on chronic hemodialysis at Innoshima General Hospital, Onomichi, Japan, were enrolled in this cross-sectional study. Physical activity was evaluated using tri-axial accelerometers. HRQOL and psychological distress were also evaluated using the EuroQol questionnaire (EQ-5D) and the K6 questionnaire, respectively., Results: Physical activity evaluated by Σ[metabolic equivalents × h per week (METs·h/w)] was 8.1 ± 6.0 METs·h/w, and EQ-5D score was 0.754 ± 0.177. Among all patients, EQ-5D scores were significantly correlated with physical activity over 4 METs on non-hemodialysis treatment days (r = 0.426, p = 0.003). In women, EQ-5D scores were also correlated with physical activity over 4 METs on hemodialysis treatment days and non-hemodialysis treatment days. By stepwise multiple regression analysis, physical activity over 4 METs on non-hemodialysis treatment days was a determinant factor of EQ-5D even after adjusting for age and K6 scores., Conclusion: Physical activity over 4 METs on non-hemodialysis treatment days might be associated with EQ-5D in patients on chronic hemodialysis, especially in women.

The present study investigated the use of complementary and alternative medicine (CAM) and its relationship with health-related quality of life (HRQOL) in patients with type 2 diabetes mellitus. A total of 421 patients with type 2 diabetes mellitus who completely met the inclusion criteria, aged 67.3 ± 12.8 years, among 622 outpatients were recruited in this cross-sectional study. We examined the use of CAM, such as supplements, Kampo, acupuncture, and yoga. HRQOL was assessed by EuroQOL. A total of 161 patients (38.2%) with type 2 diabetes mellitus used some type of CAM. The use of supplements and/or health foods was the highest among CAM users (112 subjects, 26.6%). HRQOL was significantly lower in patients who used some CAM (0.829 ± 0.221) than in those without any CAM use (0.881 ± 0.189), even after adjustments for confounding factors [F(1, 414) = 2.530, p = 0.014]. Proper information on CAM is needed for patients with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the prevalence of locomotive syndrome (LS) in patients with obstructive sleep apnea syndrome (OSAS), and to compare the health-related quality of life (HRQOL) among patients with and without LS as classified by age and sex. A total of 1173 patients with OSAS (1013 males and 160 females) who were treated with continuous positive airway pressure (CPAP) therapy were enrolled in this cross-sectional study. Male participants were divided into 6 groups (30-39 years, 40-49 years, 50-59 years, 60-69 years, 70-79 years, and 80-89 years) and female participants were divided into 5 groups (40-49 years, 50-59 years, 60-69 years, 70-79 years, and 80-89 years). LS was evaluated using a "loco-check" established by the Japanese Orthopedic Association. HRQOL was evaluated using the EuroQol 5-dimensional questionnaire (EQ-5D). The prevalence of LS among the different age and sex groups was 19.6-79.4% in males and 27.0-95.5% in females and increased with age. In males aged 30-39 and 70-79 years, and in females aged 50-59 years, the EQ-5D scores were significantly lower in OSAS patients with LS than in OSAS patients without LS, even after adjusting for confounding factors. In OSAS patients, LS was closely linked to HRQOL. Preventing and improving the outcomes of LS would be beneficial for improving the HRQOL in OSAS patients. [ABSTRACT FROM AUTHOR]