title: [Psychosocial risk factors involved in progressive dementia-associated senility among the elderly residing at home. AGES project--three year cohort longitudinal study].
abstract: OBJECTIVE
  This study aimed to identify psychosocial risk factors involved in the progression of senility associated with dementia, and clarify activities that may prevent such progression.
  
  
  METHODS
  In 2003, as a part of the Aichi Gerontological Evaluation Study Project, a self-completion postal questionnaire survey was conducted among elderly persons aged 65 years or older not under the Certification of Eligibility for Long-Term Care (hereafter, Certification); (response rate: 49.4%). Among the respondents, 9,720 subjects (4,614 males, 5,106 females; average age 72.8 years, range +/- 6.0), whose gender and age were confirmed and who could handle all ADLs independently, were selected for the three-year longitudinal study. The end point of the study was Certification in the second appraisal, through categorization under the ADL Independence Assessment Criteria for the Elderly with Dementia Rank II. Predictive variables used in the study were: health behavior, psychological/ cognitive factors, recreational/social activities, TMIG Index of Competence, and social class. Recreational activities were divided into eight types: sports, culture, music, creative activities, gardening, radio and TV, sightseeing, and investment/gambling. The Cox proportional-hazards regression model was used to determine an age-adjusted hazard ratio (HR) for each in both males and females. Subsequently, those factors with a significant HR were used as predictive variables in stepwise regression for further clarification.
  
  
  RESULTS
  At the end of the 3-year study, the number of subjects who received Certification associated with dementia was 330 (139 males, 191 females); 9,390 were otherwise categorized. The percentage of Certified subjects was 1.13 per year. The following predictive factors showed significant HRs: in both the male and female groups, self-awareness of forgetfulness (male 1.69, female 2.59) and 4 points or less in instrumental independence scores (male 1.80, female 2.23); in the males, living alone (2.39), subjective poor health (2.04), no work (1.80) 3 points or less in intellectual activity score (2.13), and no gardening (1.99); and in the female group, no sports (1.92)
  
  
  CONCLUSIONS
  The study found that the occurrence of Certification associated with dementia is less in those who are enjoying good psychosocial/daily life conditions, in males involved in gardening, and in females involved in sports. Thus the study suggests the importance of focusing on these factors, more so than health behavior, in terms of progressive dementia prevention.
authors.affiliation: Division of Occupational Therapy Faculty of Rehabilitation, Seijoh University.
authors.forename: Tokunori
authors.initials: T
authors.lastname: Takeda
authors.forename: Katsunori
authors.initials: K
authors.lastname: Kondo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hirai
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000209:etiology / Q000523:psychology*; D015331:Cohort Studies; D005260:Female; D006686:Hobbies; D006801:Humans; D057187:Independent Living; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors