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A plasma generator for a long pulse H+/D+ ion source has been developed. The plasma generator was designed to produce 65 A H+/D+ beams at an energy of 120 keV from an ion extraction area of 12 cm in width and 45 cm in length. Configuration of the plasma generator is a multi-cusp bucket type with SmCo permanent magnets. Dimension of a plasma chamber is 25 cm in width, 59 cm in length, and 32.5 cm in depth. The plasma generator was designed and fabricated at Japan Atomic Energy Agency. Source plasma generation and beam extraction tests for hydrogen coupling with an accelerator of the KSTAR ion source have been performed at the KSTAR neutral beam test stand under the agreement of Japan-Korea collaborative experiment. Spatial uniformity of the source plasma at the extraction region was measured using Langmuir probes and ±7% of the deviation from an averaged ion saturation current density was obtained. A long pulse test of the plasma generation up to 200 s with an arc discharge power of 70 kW has been successfully demonstrated. The arc discharge power satisfies the requirement of the beam production for the KSTAR NBI. A 70 keV, 41 A, 5 s hydrogen ion beam has been extracted with a high arc efficiency of 0.9 -1.1 A/kW at a beam extraction experiment. A deuteron yield of 77% was measured even at a low beam current density of 73 mA/cm2. [ABSTRACT FROM AUTHOR]

We have developed a new ion source system in the isotope separator on-line at Japan Atomic Energy Agency, for separation of short-lived isotopes produced by proton-induced fission of 238U. The ion source system is a forced electron beam induced arc discharge version E type ion source with a target container. We successfully operated this system at 2000 °C as a result of reductions in volume of the ion source and the target container, introduction of heating method by electron bombardment, and improvement to the heat shield. This new ion source system was tested using 238U of 640 mg/cm2 with a proton primary beam of 30 MeV, 350 nA. Release times were measured for Kr, In, and Xe. The values of release times are 2.6 s for Kr, 1.8 s for In, and 4.6 s for Xe. In this work, the ion source system enabled us to mass-separate short-lived isotopes such as 93Kr(T1/2=1.286 s), 129In(T1/2=0.61 s), and 141Xe(T1/2=1.73 s) with intensity of 103 ions/s. [ABSTRACT FROM AUTHOR]

It is accepted that a donor's predicted total lung capacity (pTLC) can be 75-125% of the recipient's pTLC in lung transplantation; however, 'optimal graft size' is not clearly defined, especially in restricted lung disease (RD) patients. These disagreements exist as it is difficult to accurately measure lung size before and after transplantation and it is also difficult to predict and evaluate the extent of re-expansion of the restricted thoracic cavity after transplantation. This study examined changes in lung volume after lung transplantation using a 3D lung volume measurement from CT scans before and after surgery under the assumption that the patient's thoracic cavity would return to the size of the patient without underlying lung disease after surgery. A total of 113 patients, who underwent lung transplantation between September 2012 and April 2019 in our institute, and met the inclusion criteria were enrolled in the study. This included 88 patients who were diagnosed with RD and 25 patients who were diagnosed with non-RD. Patients were further divided into oversized and undersized groups according to the donor and recipient pTLC ratio, and a total of 4 groups were studied. Preoperative and postoperative lung volume on CT scans were measured using the synapse 3D program (Fuji film, Japan). RD patients showed a significant increase in total lung volume (TLV) after surgery, while non-RD patients showed a decrease in TLV. These changes showed the greatest increase in the RD group within 1 year and continuously increased up to 5 years. In the non-RD group, TLV decreased within 3 months of surgery. These changes were not related to graft size. In lung transplant patients, the thoracic cavity re-expanded in RD patients and reduced in the non-RD patients, returning to healthy values without lung disease status in terms of TLV. [ABSTRACT FROM AUTHOR]

Objectives: Frailty is a significant cause of adverse health events including long-term care and hospitalization. Although information and communication technology (ICT) has become an integral part of modern life, it remains unclear whether ICT use is associated with frailty., Design: A cross-sectional study (Integrated Longitudinal Studies on Aging in Japan, ILSA-J)., Setting and Participants: Aged 75 and older data from the ILSA-J in 2017 (n = 2893)., Methods: ICT use was measured using the technology usage sub-items of the Japan Science and Technology Agency Index of Competence. Specifically, the use of mobile phones, ATMs, DVD players, and sending e-mails were rated as "yes" (able to do) or "no" (unable to do), with the first quintile (≤1 point) defined as ICT non-users. Frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria based on the phenotype model (e.g., weight loss, slowness, weakness, exhaustion, and low activity). Further, multivariate logistic regression analysis analyzed its association with ICT use. Subgroup analyses were stratified according to gender, years of education, and living arrangements., Results: Higher ICT use was not associated with frailty after adjusting for covariates (odds ratio [OR]: 0.53; 95%CI 0.39-0.73). Similar associations were found in the sub-groups of women (OR 0.45, 95%CI 0.30-0.66), <13 years of education (OR 0.48, 95%CI 0.34-0.67), living alone (OR 0.46, 95%CI 0.27-0.79), and living together (OR 0.57, 95%CI 0.38-0.85). No association existed between using ICT and frailty in the sub-groups of men and ≥13 years of education., Conclusions and Implications: Higher ICT use is associated with the absence of frailty in individuals 75 years and older. Such benefits may be particularly pronounced in women, those with lower levels of education, and older adults living alone or with others., (© 2024. The Author(s).)

Aim: This study aimed to examine the relationships between levels of competence and impaired physical and cognitive functions in older adults., Methods: We used a data set of the Integrated Longitudinal Studies on Aging in Japan for 2017 including 5475 community-dwelling older adults. Levels of competence were assessed using the Japan Science and Technology Agency Index of Competence (JST-IC). Grip strength (low grip strength: <28 kg for men and <18 kg for women) and gait speed (slow gait speed: <1.0 m/s for both sexes) were evaluated as physical function measurements, and the Mini-Mental State Examination (cognitive decline: <24 on the Mini-Mental State Examination) was used to assess cognitive function., Results: The JST-IC had areas under the curve estimated from receiver operating characteristic analysis ranging from 0.65 to 0.73 for detecting low function as assessed by these tests. Restricted cubic spline curves showed that the shape of the association between the JST-IC and impaired function depended on sex and the test used. The comparison between perfect and imperfect JST-IC scores showed significant differences in the prevalence of low grip strength in both sexes, slow gait speed in women, and cognitive decline in men., Conclusions: It may be insufficient to identify those with impaired physical or cognitive function using the JST-IC. The shape of the association with the JST-IC varies across their measurements. Our findings can help interpret JST-IC scores in the context of low physical and cognitive functions. Geriatr Gerontol Int 2024; 24: 352-358., (© 2024 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.)

Background: Over the past 5 years, the number of Vietnamese migrant workers in Japan has grown rapidly to become the largest group of migrant workers in the country. They hold various statuses of residence and are subjected to multifactorial stressors., Aims: The current study's aim is to investigate the association between psychological distress experienced by Vietnamese workers and their work environment. Another aim is to discuss issues involving migrant workers by comparing the characteristics of workers in the major statuses of residence., Methods: The study applied a cross-sectional design, and included a nationwide self-administered online questionnaire that was conducted in Vietnamese in 2022. The questionnaire included the Kessler Psychological Distress Scale (K10), workplace interpersonal factors as well as factors related to work and health. A multiple logistic regression analysis was conducted to investigate factors associated with psychological distress., Results: Of 933 Vietnamese workers, 37% were grouped as distressed under the K10 cutoff. Fewer opportunities to speak with Japanese co-workers, lower welfare and workload ratings, and the visa statuses including 'Technical Intern Training' were significantly associated with psychological distress. Unexpectedly, those in 'Engineer/Specialist in Humanities/International Services (ESI)' category who are deemed to hold better conditions demonstrated the highest amounts of distress., Conclusion: Outside of unsatisfactory working environments, differing situations depending on status of residence could produce various sources of distress. The difficult aspects of Japan's distinct culture seem to contribute to their distress, especially for those who have more interactions with Japanese co-workers. A push for a multicultural society, where migrant workers can pursue proactive life designs of their own choosing, is warranted.

Teeth are known to be the most accurate age indicators of human body and are frequently applied in forensic age estimation. We aimed to validate data mining-based dental age estimation, by comparing the accuracy of the estimation and classification performance of 18-year thresholds with conventional methods and with data mining-based age estimation. A total of 2657 panoramic radiographs were collected from Koreans and Japanese populations aged 15 to 23 years. They were subdivided into a training and internal test set of 900 radiographs each from Koreans, and an external test set of 857 radiographs from Japanese. We compared the accuracy and classification performance of the test sets from conventional methods with those from the data mining models. The accuracy of the conventional method with the internal test set was slightly higher than that of the data mining models, with a slight difference (mean absolute error < 0.21 years, root mean square error < 0.24 years). The classification performance of the 18-year threshold was also similar between the conventional method and the data mining models. Thus, conventional methods can be replaced by data mining models in forensic age estimation using second and third molar maturity of Korean juveniles and young adults., (© 2023. The Author(s).)

Background: As the population ages, it is important to consider whether older adults tend to have healthier lives. This study examined temporal trends in cognitive function among community-dwelling Japanese older adults., Methods: The data source for this study was Integrated Longitudinal Studies on Aging in Japan (ILSA-J). We collected representative values for the Mini-Mental State Examination (MMSE) score obtained in 2010 and 2017; mean, standard deviation, and prevalence of ≤23 as cognitive impairment and ≥28 as intact cognitive function. Six cohorts (n=8,575) in 2010 and seven cohorts (n=6,089) in 2017 were included (age range 65-89). One-group meta-analyses were conducted to calculate pooled means of MMSE scores, the pooled prevalence of MMSE scores ≤23 and ≥28, and 95% confidence intervals (CIs)., Results: The mean MMSE score was higher in 2017 than in 2010 for all age groups in both men and women. The prevalence of MMSE ≤23 was lower in 2017 than in 2010 for all age groups for men and was lower in 2017 than in 2010 for all age groups other than for women aged 75-79 years. The prevalence of MMSE ≥28 was higher in 2017 than in 2010 for all age groups in both men and women. In addition, the pooled means of years of education was lower in 2010 than in 2017, which might be an explanatory factor., Conclusions: This study suggests that the cognitive function of community-dwelling Japanese older adults has improved in recent years. Future studies need to identify factors associated with the improvement., (Copyright © 2022. Published by Elsevier B.V.)

Ascertaining progress in building age-friendly cities (AFCs) requires community diagnostic indicators. This study examines the relationship between social participation and happiness at the municipal level. The data from the Japan Gerontological Evaluation Study (JAGES) from 2013, 2016, and 2019, comprising 442,079 older people from 289 municipalities, are used. We also employ linear mixed-effects models to evaluate the association between social participation and happiness. In these models, we adjust for seven variables as potential confounders. This study reveals that the higher the social participation, except for neighborhood association, the higher the state of happiness ( B = 0.14-0.30). Our study suggests that social participation is useful, as a community diagnostic indicator, for monitoring the progress of building AFCs, developing strategies, and creating evidence.

Intending to obtain scientific evidence to use in developing indicators for evaluating the quality of home care, we surveyed doctors, nurses, and other home care professionals to determine the points they consider to be essential in evaluating home care. We investigated all 901 clinics registered to the National Association of Medical Institutions Supporting Home Care and a random sample of 600 Visiting Nurse Service stations registered to the National Association for Visiting Nurse Service in Japan. A total of 539 questionnaire responses were received (response rate: 35.9%). In this study, a factor analysis revealed four factors to be considered when evaluating the quality of home care: (1) patients' and family members' level of satisfaction, (2) home care process, (3) structure of home care, and (4) medical outcomes. The factor of the satisfaction of patients and family members identified in the present study was not considered in previous studies for evaluating the quality of care in Japan. Satisfaction is the point of difference in goals between hospital-based care and home care, and it requires different measurement indicators. Home care professionals expect to help relieve the physical and psychological burden felt by the patient and their family. Thus, on the evaluation indicators of quality of home care, their perspectives from the present study are valuable.

During the last three decades, Japan has become one of the world's top countries for longevity, and the increase in average life expectancy is accompanied by a sharp rise in older population 65 years of age and above to ∼28%. This study aimed to examine the changes in major health-related measures, including a physical constitution, physical function, and functional capacity of community-dwelling Japanese older people in the last decade. From the data of 13 longitudinal cohort studies on aging conducted in Japan with a total of 13,441 older subjects, this study analyzed the changes in six indices that are related to health and functioning of the older people; height, weight, body mass index, walking speed, grip strength, and instrumental activity of daily living, between 2007 (±2 years) and 2017 (±2 years). Comparison of data for the two periods between subjects matched for age group and gender evidently showed better health status and a slower decline in most of the health-related measures in 2017 compared to a decade ago. The results of this study indicate that the phenomenon of "rejuvenation" is occurring among the new generation of Japanese older adults, and the importance of this older population as a social resource in the super-aged society should be reacknowledged.

Objective: To examine whether age-specific prevalence of frailty in Japan changed between 2012 and 2017., Design: This study performed meta-analyses of data collected from 2012 to 2017 using the Integrated Longitudinal Studies on Aging in Japan (ILSA-J), a collection of representative Japanese cohort studies., Setting: The ILSA-J studies were conducted on community-living older adults., Participants: ILSA-J studies were considered eligible for analysis if they assessed physical frailty status and presence of frailty in the sample. Seven studies were analyzed for 2012 (±1 year; n = 10312) and eight studies were analyzed for 2017 (±1 year; n = 7010). Five studies were analyzed for both 2012 and 2017., Measurements: The study assessed the prevalence of frailty and frailty status according to 5 criteria: slowness, weakness, low activity, exhaustion, and weight loss., Results: The overall prevalence of physical frailty was 7.0% in 2012 and 5.3% in 2017. The prevalence of frailty, especially in people 70 years and older, tended to decrease in 2017 compared to 2012. Slight decreases were found in the prevalence of frailty subitems including weight loss, slowness, exhaustion, and low activity between 2012 and 2017, but change in the prevalence of weakness was weaker than other components., Conclusions: The prevalence of physical frailty decreased from 2012 to 2017. There are age- and gender-related variations in the decrease of each component of frailty., Competing Interests: None declared.

Background: This study aimed to investigate whether care capacity for patients following stroke contributes to improved activities of daily living (ADL) at discharge from hospital based on the degree of stroke severity., Design: Retrospective, observational, longitudinal study., Setting: Acute phase hospitals., Participants: From 2005 to 2011, 5006 patients with stroke at acute phase hospitals were registered in a database. There were 2501 individuals from 11 hospitals who met the following four criteria: (1) a pre-stroke modified Rankin Scale (mRS) score of 0-3; (2) admission to hospital within 7 days of suffering a stroke; (3) ischemic or hemorrhagic stroke; and (4) staying in hospital for 8-60 days., Main Outcome Measures: The main outcome measure was the Functional Independence Measure (FIM, version 3.0) score at discharge. The FIM is an internationally used scale, which is used as an ADL outcome assessment scale for after rehabilitation., Results: Among patients with stroke, those with care capacity had higher FIM scores at hospital discharge than did those without care capacity (unstandardized coefficient = 2.3, P = 0.015). Examination of this relationship by stroke severity showed that the FIM score at discharge was only significantly higher in patients who suffered from a moderate to severe stroke (unstandardized coefficient = 7.0, P = 0.040). No associations were observed in patients who suffered from minor, moderate, or severe stroke., Conclusions: These results suggest that care capacity facilitates total recovery of the FIM, especially among patients who suffer from a moderate to severe stroke., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Aim: To examine whether the outcomes of fever treatment through home care differ from those through hospitalized care for older people who regularly receive home care in Japan., Methods: A retrospective survey of medical record-based data for 679 older people who regularly received home care provided by a clinic in Japan. From these data, 61 fever cases (21 cases treated in the hospital and 40 treated at home and assigned to the hospitalized and home-care groups, respectively) were selected for analysis through a matching process. We compared the two groups in terms of mortality rate at 90 days after fever onset, and concerning changes in respective ranks for "Degree of Independent Living for the Elderly with Disability" and "Degree of Independent Living for the Elderly with Dementia" from immediately before fever onset to 90 days after fever onset., Results: The mortality rate tended to be higher in the hospitalized group than in the home-care group (33% vs. 13%, respectively, P = 0.05). The hospitalized group also had a higher proportion of patients whose disability had worsened (43% vs. 23%, respectively, P = 0.16) and a significantly higher proportion of patients whose dementia had worsened (29% vs. 6%, respectively, P = 0.03)., Conclusions: Our findings suggest that home care is more effective than hospitalized care for treating fever in older people who regularly receive home care in Japan, as it leads to lower mortality and better maintenance of activities of daily living capabilities. Geriatr Gerontol Int 2020; 20: 482-487., (© 2020 Japan Geriatrics Society.)

On 11 March 2011, the great earthquake hit Japan, resulting in 15,895 deaths, 6156 serious injuries, and 2539 missing persons. This event affected the health and lives of older residents, and reports showed an increase in the number of people eligible for long-term care afterward. In this study, among the places affected by the 2011 Great East Japan Earthquake and tsunami, we focused on 15 municipalities, including designated municipalities based on the Special Act on Nuclear Evacuation in Fukushima Prefecture, and aimed to clarify the medium-term effects (six years post-disaster) on the long-term care certification rate and expenditure for provision of services. We used the Ministry of Health, Labour, and Welfare Monthly Status Report on Long-Term Care Insurance and the Ministry of Internal Affairs and Communications Population Register for 2011, 2014, and 2017. In 2011, we found no intergroup differences among the 15 Fukushima municipalities and other municipalities in either the long-term care certification rate or the per-person expenditure for use of services. In 2014, after the earthquake, the long-term care certification rate was 5.4% higher in the 15 Fukushima municipalities than in other municipalities for those aged 75 years or older. The rate of 2014-2017 has not increased significantly, partly because of stability after the disaster and change in the population structure. Nevertheless, the long-term care certification rate in the 15 Fukushima municipalities is higher than that of the other two groups even after six years since the earthquake. Similarly, the per-person expenditure for use of services for one month was 11,800 yen higher in the 15 Fukushima municipalities than in other municipalities in 2014, and this trend continued into 2017. Strong, ongoing governmental support is needed, especially for those aged 75 or older, following a disaster., Competing Interests: The author declares no conflict of interest.

This study compared the relationship between social participation, including work, and incidence of functional decline in rural and urban older people in Japan, by focusing on the number and types of organizations older people participated in. The longitudinal data of the Japan Gerontological Evaluation Study (JAGES) that followed 55,243 individuals aged 65 years or older for six years were used. The Cox proportional hazards model was employed to calculate the hazard ratio (HR) of the incidence of functional decline over six years and the stratification of rural and urban settings. In this model, we adjusted 13 variables as behavioral, psychosocial, and functional confounders. The more rural and urban older people participated in various organizations, the more they were protected from functional decline. Participation in sports (HR: rural = 0.79; urban = 0.83), hobby groups (HR: rural = 0.76; urban = 0.90), and work (HR: rural = 0.83; urban = 0.80) significantly protected against the incidence of decline in both rural and urban areas. For both rural and urban older people, promoting social participation, such as sports and hobby groups and employment support, seemed to be an important aspect of public health policies that would prevent functional decline.

Depression is considered the primary risk factor for older people's suicide. When considering suicide measures, it is necessary to clarify the relationship between depressive symptoms, social capital, and suicide rates. Therefore, we aimed to clarify the relationship between community-level social capital, depressive symptoms, and suicide rates among older people in Japan. We analyzed the data gathered from 63,026 men and 72,268 women aged 65 years and older, totaling 135,294 subjects in 81 municipalities with a population of over 100,000 participants in the 2013 Sixth Long-Term Care Needs Survey and another survey conducted by Japan Gerontological Evaluation Study (JAGES) in 2013 including the same question items as the survey in Japan. Multiple regression analysis revealed that the male suicide standardized mortality ratio (SMR) was positively correlated with depressive symptoms (B = 2.318, p = 0.002), and received emotional support (B = -2.622, p = 0.014) had a negative correlation with the male suicide SMR. In older males particularly, the received emotional support in the community was independently associated with the suicide rate. Therefore, fostering social support in a community could act as a countermeasure to suicide among older males in Japan.

Background & Aims: Oral health is an integral part of nutrition and rehabilitation. The purpose of this study was to investigate the impact of impaired oral health status on clinical and functional outcomes in post-acute in-hospital rehabilitation., Methods: We conducted a prospective cohort study of hospitalized patients undergoing rehabilitation at a 225-bed post-acute rehabilitation hospital in Japan. All newly admitted patients were eligible to enroll during the two-year research period. Oral health status was evaluated on admission using the Revised Oral Assessment Guide (ROAG). Nutritional status, assessed using the Mini Nutritional Assessment-Short Form; activities of daily living, assessed by Functional Independence Measure motor scores; home discharge; all-cause in-hospital mortality; and length of hospital stay were measured as clinical and rehabilitation outcomes. Multivariate analyses were used to determine whether the ROAG score on admission was associated with these outcomes at discharge., Results: Of the 1066 patients enrolled, 1056 were included in the final analysis. The mean age was 70 ± 17 years. Fifty-two percent of patients were women. Stroke (21.7%) and musculoskeletal disorders (30.5%) were the most common reasons for admission. Slight or moderate to severe oral health problems were detected in 609 (57.7%) and 163 (15.4%) patients, respectively. Eighteen patients died during hospitalization. The ROAG score at admission was independently associated with Functional Independence Measure motor scores at discharge (P = 0.022), home discharge (P = 0.005), in-hospital mortality (P = 0.039), and length of hospital stay (P = 0.045), after adjusting for potential confounders., Conclusions: Impaired oral health status may be associated with rehabilitation outcomes in hospitalized patients. Early detection of oral health problems and treatment by dental professionals, or through cooperation between medical and dental professionals, should be implemented in these patients., (Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

We analyzed the relationships between forgetfulness and social participation, social contact, and social support by municipality to develop community diagnosing indicators. The analysis subjects included 105 municipalities that agreed to provide data for the 2013 Survey of Needs in Spheres of Daily Life in Japan ( n = 338,659 people). Forgetfulness as a risk factor for dementia was used as the dependent variable. The variables of social environment factors were (1) social participation, (2) social contact, and (3) social support. The ratio of people responding that they experienced forgetfulness differed among municipalities, with a mean of 19.0% (7.1-35.6%). Higher levels of social participation, social contact, and social support were associated with lower levels of forgetfulness, even after adjusting for age and regional variables. The results of the present study suggest that it is appropriate to use forgetfulness and social participation at least a few times a year in any social activity as community diagnosing indicators. Municipalities could encourage their inhabitants to participate by developing and providing engaging social activities.

Information gap in drug labeling among countries create challenges in therapeutic use of drugs. We aimed to evaluate the consistency of drug interaction information in drug labels among five countries. The study drugs were chosen from the commonly approved drug list in the US, UK, China, Japan, and Korea. The degree of agreement of drug interaction data was evaluated by kappa coefficient. Thirty-eight drugs were evaluated, and moderate degree of agreement was observed among all countries' labeling (κ = 0.43, 95% confidence interval (CI) = 0.41-0.46). The degree of agreement was the highest for the UK and Korea (κ = 0.71, 95% CI = 0.67-0.75) and the lowest for the UK and Japan (κ = 0.02, 95% CI = 0.00-0.04). Information regarding drug interactions listed in the studied drug labels was not in high agreement. International standardization of drug labeling is required to ensure safe drug therapy., (© 2018 American Society for Clinical Pharmacology and Therapeutics.)

Objectives:  Promoting social and leisure activity participation in older adults could be effective in preventing their health decline. However, gender or regional differences in those activities remain unclear despite the necessity of gender- or region-specific approaches to their promotion. This study examined gender and urban-rural differences in going-out, social, and leisure activities among community-dwelling older adults., Methods:  Data were obtained from the Japan Gerontological Evaluation Study (JAGES). Those analyzed were 103,621 people aged 65 or older who were functionally independent and lived in one of 31 municipalities. A total of seven activity variables were assessed with weekly going out, engagement in paid work, monthly and any frequency of engagement in group activities, monthly and any frequency of contact with friends, and having hobbies. We additionally assessed the contents of the group activities and hobbies. Gender, age groups (young-old: 65-74; old-old: 75 and over), and region groups, which were categorized as rural, urban, or metropolitan, were assessed along with education, depression, and other covariates. A chi-square test and multivariate logistic regression analysis were conducted to examine the age group-stratified differences in the going-out, social, and leisure activities among gender and region groups (P<.01)., Results:  Multivariate logistic regression analysis showed that men were more likely to engage in weekly going out, paid work, and hobbies but less likely to engage in group activities and contact with friends, either monthly or at any frequency. Most activities were also found to differ significantly among the region groups. For instance, people in metropolitan areas were 2.3 times more likely to engage in weekly going out but were 0.4 (old-old group) or 0.5 times (young-old group) less likely to engage in contact with friends. Percentages of engagement in hobby- or sport-groups were over 20% in all gender and region groups; on the other hand, about 30% differences were found in the percentages of engagement in senior clubs or neighborhood associations between metropolitan and rural men. As for having hobbies, walking/jogging and gardening were popular across all gender and region groups, while the percentages of engagement in a variety of hobbies differed among gender and region groups., Conclusion:  Our findings suggest 1) differences in the levels of social and leisure activities among gender and region groups and 2) both similarities and differences in the popular group activities or hobbies among gender and region groups. Activity promotion for older adults should be targeted considering these gender and region group characteristics.

Background: Studies have reported that the predictive ability of self-rated health (SRH) for mortality varies by sex/gender and socioeconomic group. The purpose of this study is to evaluate this relationship in Japan and explore the potential reasons for differences between the groups., Methodology/principal Findings: The analyses in the study were based on the Aichi Gerontological Evaluation Study's (AGES) 2003 Cohort Study in Chita Peninsula, Japan, which followed the four-year survival status of 14,668 community-dwelling people who were at least 65 years old at the start of the study. We first examined sex/gender and education-level differences in association with fair/poor SRH. We then estimated the sex/gender- and education-specific hazard ratios (HRs) of mortality associated with lower SRH using Cox models. Control variables, including health behaviors (smoking and drinking), symptoms of depression, and chronic co-morbid conditions, were added to sequential regression models. The results showed men and women reported a similar prevalence of lower SRH. However, lower SRH was a stronger predictor of mortality in men (HR = 2.44 [95% confidence interval (CI): 2.14-2.80]) than in women (HR = 1.88 [95% CI: 1.44-2.47]; p for sex/gender interaction = 0.018). The sex/gender difference in the predictive ability of SRH was progressively attenuated with the additional introduction of other co-morbid conditions. The predictive ability among individuals with high school education (HR = 2.39 [95% CI: 1.74-3.30]) was similar to that among individuals with less than a high school education (HR = 2.14 [95% CI: 1.83-2.50]; p for education interaction = 0.549)., Conclusions: The sex/gender difference in the predictive ability of SRH for mortality among this elderly Japanese population may be explained by male/female differences in what goes into an individual's assessment of their SRH, with males apparently weighting depressive symptoms more than females.