老年病の縦断的研究 Longitudinal Studies in Geriatric Medicine
-
- 上田 一雄 UEDA Kazuo
- 九州大学医療技術短期大学部 School of Health Science, Kyushu University
この論文にアクセスする
この論文をさがす
著者
-
- 上田 一雄 UEDA Kazuo
- 九州大学医療技術短期大学部 School of Health Science, Kyushu University
抄録
老年病学における縦断研究の成果を, 老年者の生命予後と循環器病に関する知見に限定して, 最近の内外の文献を参照しながら述べた. 広義に解釈すると縦断研究にはコホート研究のみならず, 前向き症例-対照研究も含まれる. こうした手法を用いる場合には, 疫学研究のみならず, 臨床的研究でも多数の交絡因子を調整して, 得られた結果の独立性を確認することが常道になりつつある. 老年者の生命予後に関しては, 単に平均余命の延長を評価するのみでは不十分で, QOLが保持されねばならない. 健康度の自己評価度が高く, 栄養状態のパラメターとしてBMIや血清アルブミン値が低値を示さず, 適度な身体活動を保つ群の生命予後が良いことが示されている. 認知能力の低下は老年者のQOLを著しく阻害するが, 痴呆でない状態での平均余命が検討されている. 老年者循環器疾患の危険因子として左室肥大が再び注目を集めている. 頭蓋外アテローム硬化とも関係が深く, アテローム血栓性脳梗塞の危険因子となりうる. 血清脂質は加齢とともに減少するので, 老年者冠状動脈疾患の危険因子としての意義は低いが, 老年者でもインスリン抵抗性の介在する可能性は否定できない. 脳血管障害や冠状動脈疾患の死亡率は先進国では近年減少するが, 地域研究でも発症率の低下が認められている. しかし, 1980年代後半から減少幅が鈍化する傾向にある. 大規模症例-対照研究の結果からは, 血清脂質の改善により冠状動脈疾患を減少させ得ることが示されたが, 老年者での成績は乏しい. 老年者の収縮期性あるいは拡張期性高血圧でも, 管理により脳卒中を中心とする心血管病のリスクを減じうる. 老年者高血圧に対する降圧薬としてACE阻害薬の適性が論じられている.
The results of longitudinal studies in geriatric medicine were reviewed by referring to relatively recent publications. "Longidufinal studies" comprised not only cohort studies but also prospective case-control studies in the broad sense. Poor self-rated health, weight loss, hypoalbuminemia, inability to perform activities of daily living, low levels of physical activity, and cognitive dysfunction, all of which could be manifestations of chronic diseases, might shorten longevity. Cardiomegaly or left ventricular hypertrophy on ECG were again found to be important risk factors for cardiovascular disease in the aged, because of their relation to atherosclerosis. There is no evidence regarding the contribution of hyperlipidemia to the risk of cardiovascular disease in the aged, although insulin resistance can increase serum triglyceride levels and reduced level of high-density lipoprotein cholesterol even in the aged. Mortality due to stroke and heart disease have been decreasing in most developed countries, and several recent community-based studies have also shown decreases in the incidence of cerebral stroke. Large-scale case-control studies on the pharmacological treatment of hyperlipidemia have resulted in both primary and secondary prevention of coronary heart disease. However, information concerning the effects of treatment for hyperlipidemia on coronary heart disease in the aged is limited. Results of large-scale case-control studies indicate that pharmacological treatment of elderly hypertensive patients can reduce cardiovascular morbidity and mortality, and angiotensin-converting enzyme inhibitors have recently been shown ot be useful.
収録刊行物
-
- 日本老年医学会雑誌
-
日本老年医学会雑誌 35(5), 343-352, 1998-05-25
The Japan Geriatrics Society
参考文献: 98件中 1-98件 を表示
-
1
- Physiological and biochemical changes in ageing-based on a population survey in a Japanese community, Hisayama
-
UEDA K.
Ann Acad Med 16, 35-41, 1987
被引用文献1件
-
2
- Self-rated health : a predictor of mortality among the elderly
-
MOSSEY JM.
Am J Public health 72, 800-808, 1982
被引用文献4件
-
3
- Perceived health and mortality : a nine-year follow-up of the Human Population Laboratory Cohort
-
KAPLAN GA.
Am J Epidemiol 117, 292-304, 1983
被引用文献3件
-
4
- Self-rated health and mortality among the elderly in New Haven, Connecticut and Iowa and Washington Counties, Iowa, 1982-1986
-
IDLER EI.
Am J Epidemiol 131, 91-103, 1990
被引用文献1件
-
5
- Perceived health status and mortality among older men and women
-
WOLINSKY ED.
J Gerontol Social Sci 46, s304-s312, 1992
被引用文献1件
-
6
- Serf-rated health and mortality in the high-functioning elderly-a closer look at healthy individuals : MacArthur Field Study of Successful Aging
-
SCHOENFELD DE.
J Gerontol 49, M109-M115, 1994
被引用文献1件
-
7
- Dementia-free life expectancy in France
-
RITCHIE K.
Am J Public Health 84, 232-236, 1994
被引用文献1件
-
8
- Dementia-free life expectancy in Australia
-
RITCHIE K.
Aust J Public Health 18, 149-152, 1994
被引用文献1件
-
9
- Dementia-free life expectancy : Preliminary calculation for France and the United Kingdam
-
RITCHIE K.
Colloques INSERM 226, 233-244, 1993
被引用文献1件
-
10
- Dementia-free life expectancy in Belgium
-
ROELANDS M.
Eur J Public Health 3, 33-37, 1994
被引用文献1件
-
11
- Demen-tia-free life expectancy among elderly Japanese
-
SAUVAGET C.
Gerontology 43, 168-175, 1997
被引用文献1件
-
12
- Incidence and risk factors of vascular dementia and Alzheimer's disease in a defined elderly Japanese population : the Hisayama study
-
YOSHITAKE T.
Neurology 45, 1161-1168, 1995
被引用文献3件
-
13
- Albumin levels as a predictor of mortality in the healthy elderly
-
KLONHOFF-COHEN H.
J Clin Epidemiol 45, 207-212, 1992
被引用文献1件
-
14
- A longitudinal study of functional change and mortality in the United States
-
MANTON KG.
J Gerontol 43, s153-s161, 1988
被引用文献3件
-
15
- Thinness and mortality
-
SIDENEY S.
Am J Public Health 77, 317-322, 1987
被引用文献1件
-
16
- Risk factor change in older persons, a perspective from Hong Kong : weight change and mortality
-
HO SC.
J Geront 49, M269-M272, 1994
被引用文献1件
-
17
- Changes in body weight in relation to mortality in 6441 European middle-aged men : The Seven Countries Study
-
PETERS EThJ
Int J Obesity 19, 862-868, 1995
被引用文献1件
-
18
- Physical activity, all-cause mortality and longevity of college alumni
-
PAFFENBARGER R. S. Jr.
N Engl J Med 314, 605-613, 1986
被引用文献8件
-
19
- Self-report of physical activity and patterns of mortality in Seventh-Day Adventist men
-
LINDSTED KD.
J Clin Epidemiol 44, 355-364, 1991
被引用文献1件
-
20
- Mortality among the elderly in the Alameda County Study ; behavioral and demographic risk factors
-
KAPLAN GA.
Am J Publ Health 77, 307-312, 1987
被引用文献1件
-
21
- Cognitive performance and three-year mortality in the PAQUID elderly study
-
BERR C.
Revue d Epidemiol et de Sante Publique 42, 277-284, 1994
被引用文献1件
-
22
- Causes of death in the elderly and their changing pattern in Hisayama, a Japanese community results from a long term and autopsy-based study
-
UEDA K.
J Am Geriatr Soc 38, 1332-1338, 1990
被引用文献2件
-
23
- Left ventricular hypertrophy on electrocardiogram : Prognostic implications from a 10-year cohort study of old subjects : A report from the Bronx Longitudinal Aging Study
-
KAHN S.
J Am Geriatr Soc 44, 524-529, 1996
被引用文献1件
-
24
- Prognosis implications of baseline electrocardiographic features and their serial changes in subjects with left ventricular hypertrophy
-
LEVY D.
Circulation 90, 1786-1793, 1994
被引用文献1件
-
25
- Pathophysiologic assessment of left ventricular hypertrophy and strain in asymptomatic patients with essential hypertension
-
PRINGLE SD.
J Am Coll Cardiol 1, 1371-1381, 1989
被引用文献1件
-
26
- Effects of left ventricular hypertrophy on the coronary circulation
-
DELLSPERGER KC.
Am J Cardiol 90(suppl), 555-559, 1990
被引用文献1件
-
27
- Association of carotid atherosclerosis and left ventricular hypertrophy
-
ROMAN MJ.
J Am Coll Cardiol 25, 83-90, 1995
被引用文献1件
-
28
- Association of silent myocardial ischemia with new atherothrombotic brain infarction in older patients with extracranial internal or common carotid arterial disease with and without previous atherothrombotic brain infarction
-
ARONOW WS.
J Am Geriatr Soc 43, 1272-1274, 1995
被引用文献1件
-
29
- Evaluation of the association between carotid artery atherosclerosis and coronary artery stenosis
-
CRAVAN TE.
Circulation 82, 1230-1242, 1990
被引用文献1件
-
30
- Relationship between insulin and carotid atherosclerosis in the general population. The Bruneck Study
-
BONOVA E.
Stroke 28, 1147-1152, 1997
被引用文献1件
-
31
- Lipoprotein (a) and asymptomatic carotid artery disease. Evidence of prominent role in the evaluation of advanced carotid plaques : The Bruneck Study
-
WILLEIT J.
Stroke 26, 1582-1587, 1995
被引用文献1件
-
32
- Blood lipid distribution in older persons : prevalence and correlates to hyperlipidemia
-
WALLACE RB.
Ann Epidemiol 2, 15-22, 1992
被引用文献1件
-
33
- Longitudinal changes in serum cholesterol in men : an epidemiologic search for an etiology
-
HERSHCOPF RJ.
J Chron Dis 321, 641-646, 1990
被引用文献1件
-
34
- Determinants of change in total cholesterol and HDL-C with age : The Framingham Study
-
WILSON PWF.
J Gerontol 49, M252-M257, 1994
被引用文献1件
-
35
- Joint effects of serum triglyceride and LDL cholesterol and HDL cholesterol concentrations on coronary heart desease risk in the Helsinki Heart Study
-
MANNINEN V.
Circulation 85, 37-45, 1992
被引用文献1件
-
36
- Higt density lipoprotein cholesterol as a predictor of cardiovascular disease mortality in men and women : the follow-up study of the Lipid Research Clinics Prevalence Study
-
JACOBS DR.
Am J Epidemiol 131, 32-47, 1990
被引用文献1件
-
37
- Is the level of serum triglyceride a significant predictor of coronary death in normocholesterolemic subjects? The Paris Prospective Study.
-
CAMBIEN F.
Am J Epidemiol 124, 624-632, 1986
被引用文献4件
-
38
- Combined effects of HDL cholesterol, triglyceride, and total cholesterol concentration on 18-year risk of atherosclerotic disease
-
BURCHFIEL CM.
Circulation 92, 1430-1436, 1995
被引用文献1件
-
39
- Relation of fasting plasma insulin concentration to high density lipoprotein cholesterol and triglyceride concentrations in men
-
LAWS A.
Arterioscler Thromb 11, 1636-1642, 1991
被引用文献1件
-
40
- Metabolic heterogenecity associated with high plasma triglyceride or low HDL cholesterol levels in men
-
LAMARCHE B.
Arterioscler Thromb 13, 33-40, 1993
被引用文献1件
-
41
- The association of the insulin resistance syndrome with impaired glucose tolerance and NIDDM in the Japanese general population : the Hisayama study
-
OHMURA T.
Diabetologia 37, 897-904, 1994
被引用文献3件
-
42
- Longitudinal relation between endogenous teststerone and cardiovascular risk factors in middle-aged men. A 13-year follow-up of former Multiple Risk Factor Intervention Trial participants
-
ZMUDA JM.
Am J Epidemiol 146, 609-617, 1997
被引用文献1件
-
43
- A prospective study of sex hormone-binding globulin and fatal cardiovascular disease in Rancho Bernardo men and women
-
GOODMAN-GRUEN D.
J Clin Endocrinol & Metabol 81, 2999-3003, 1996
被引用文献1件
-
44
- A prospective study of angar and coronary heart disease. The Normative Aging Study
-
KAWACHI I.
Circulation 94, 2090-2095, 1996
被引用文献1件
-
45
- International trends in stroke mortality : 1970-1985
-
BONITA R.
Stroke 21, 989-992, 1990
被引用文献2件
-
46
- Impact of high blood pressure on morbidity and mortality
-
UEDA K.
Handbook of Hypertension 12, 174-185, 1989
被引用文献1件
-
47
- Trends for coronary heart disease and stroke and their risk factors in Japan
-
SHIMAMOTO T.
Circulation 79, 503-515, 1989
被引用文献18件
-
48
- 久山町における脳血管障害の変貌
-
上田一雄
脳卒中 16, 464-469, 1991
被引用文献1件
-
49
- Trends in stroke incidence and mortality in Hawaii Japanese men
-
KAGAN A.
Stroke 25, 1170-1175, 1994
被引用文献1件
-
50
- Secular trends in stroke incidence : The Framingham study
-
WOLF PA.
Stroke 23, 1551-1555, 1992
被引用文献1件
-
51
- Incidence rates of stroke in eighties : The end of the decline in stroke?
-
BRODERICK JP.
Stroke 20, 577-582, 1989
被引用文献1件
-
52
- Marked increase of stroke incidence in men between 1972 and 1990 in Frederisberg, Denmark
-
J0RGENSEN HS.
Stroke 23, 1701-1704, 1992
被引用文献1件
-
53
- Stroke incidence were unchanged, while fatality rates declined, during 1971-1987 in Goteborg, Sweden
-
HARMSEN P.
Stroke 23, 1410-1415, 1992
被引用文献1件
-
54
- Changing rates of stroke in the providence of Ouebec, Canada : 1981-1988
-
MAYO NE.
Stroke 22, 590-595, 1991
被引用文献1件
-
55
- Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia.
-
SHEPHERD J.
N.Engl.J.Med. 333, 1301-1307, 1995
被引用文献36件
-
56
- Regression of coronary artery disease as a results of intensive lipid-lowering therapy in men with high level of apolipoprotein B
-
BROWN G.
N Engl J Med 323, 1289-1298, 1990
被引用文献1件
-
58
- Coronary angiographic changes with lovastatin therapy. The Monitored Atherosclerosis Regression Study (MARS)
-
BLANKENHORN DH.
Ann Intern Med 119, 969-976, 1993
被引用文献4件
-
59
- Mortality and morbidity results from European Working Party on High Blood Pressure in the Elderly Trial
-
AMERY A.
Lancet i, 1349-1355, 1985
被引用文献1件
-
60
- A randomized controlled trial of the effects of three antihypertensive agents on blood pressure control and quality of life in old women
-
APPLEGATE WB.
Arch Intern Med 151, 1817-1823, 1991
被引用文献1件
-
61
- Hypertension in the elderly with a special focus on treatment with angiotensin-converting enzyme inhibitors and calcium antagonists
-
HALL WD.
Am J Cardiol 69, 33E-42E, 1992
被引用文献1件
-
62
- Effect of enalapril on survival in patients with reduced left ventricular ejection fraction and congestive heart failure
-
SOLVD Investigations
N Engl J Med 325, 293-302, 1991
被引用文献1件
-
63
- Effects of captopril on blood pressure and left ventricular myocardial mass of elderly hypertensive patients
-
CANONICO V.
Geriatr Cardiovas Med 1, 159-163, 1988
被引用文献1件
-
64
- Diabetic nephropathy. The basis for dietary and converting enzyme inhibitor therapy
-
NARIS RG.
Am J Hypertens 1, 215-220, 1988
被引用文献1件
-
65
- Nifedipine. Dose-related increased in mortality in patients with coronary heart disease
-
FURBERG CD.
Circulation, 1326-1331, 1995
被引用文献1件
-
66
- 老年者の疾病と死因--久山町の成績から (第26回日本老年医学会総会)
-
尾前 照雄 , 上田 一雄
日本老年医学会雑誌 22(3), p207-217, 1985-05
医中誌Web 被引用文献1件
-
67
- 高齢者死亡例の血液生化学値--久山町における高齢者死亡例と生存例との5年間の血液生化学値変化の比較
-
蓮尾 裕
日本老年医学会雑誌 23(1), p65-72, 1986-01
医中誌Web 被引用文献3件
-
68
- Serum albumin level and physical disability as apredictors of mortality in older persons
-
CORTI MC.
JAMA 272, 1036-1042, 1994
DOI 被引用文献44件
-
69
- 一般住民における肥満に伴う合併症と生命予後 : 久山町研究
-
中山 敬三 , 清原 裕 , 加藤 功 , 岩本 廣満 , 上田 一雄 , 藤島 正敏
日本老年医学会雑誌 34(11), 935-941, 1997-11-25
医中誌Web 参考文献13件 被引用文献2件
-
70
- Body weight and longevity : A reassessment
-
MANSON JE
JAMA 257, 353-358, 1987
DOI 被引用文献24件
-
71
- Body mass index and mortality among nonsmoking older persons. The Framingham Heart Study
-
HARIS T.
JAMA 259, 1520-1524, 1988
DOI 被引用文献6件
-
72
- Body weight as a risk factor in the elderly
-
TAYBACK M.
Arch Intern Med 150, 1065-1072, 1990
DOI 被引用文献4件
-
73
- Weight change, survival time and cause of death in Dutch elderly
-
DEEG DJH.
Arch Gerontol Geriatr 10, 97-111, 1990
DOI 被引用文献1件
-
74
- Physical activity and the incidence of coronary heart disease
-
POWELL K. E.
Ann Rev Public Health 8, 253-287, 1987
DOI 被引用文献13件
-
75
- The association of changes in physical-activity level and other lifestyle characteristics with mortality among men
-
R. S Paffenbarger
N Engl J Med. 328, 538-545, 1993
DOI 被引用文献46件
-
76
- Does exercise reduce mortality rates in the elderly? Experience from the Framingham Heart Study
-
SHERMAN SE.
Am Heart J 128, 965-972, 1994
DOI 被引用文献2件
-
77
- Physical-strength tests and mortality among visitors to health-promotion centers in Japan
-
FUJITA Y.
J. Clin. Epidemiol. 48(11), 1349-1359, 1995
DOI 被引用文献6件
-
78
- Malignant neoplasms in the Japanese community of Hisayama : mortality and changing pattern during a 30-year observation period based on a consecutive autopsy series
-
NOMIYAMA K.
J Clin Epidemiol 49, 45-50, 1996
DOI 被引用文献3件
-
79
- Cardiomegaly on chest x-ray: Prognostic implications from a ten-year cohort study of elderly subjects : A report from Bronx Longitudinal Aging Study
-
FRISHMAN WH.
Am Heart J 124, 1026-1030, 1992
DOI 被引用文献1件
-
80
- Major electrocardiographic abnormalities in persons aged 65 years and older (the Cardiovascular Health Study). Cardiovascular Health Study Collaborative Study Research Group
-
FURBERG CD.
Am J Cardiol 69, 1329-1335, 1992
DOI 被引用文献2件
-
81
- 久山町における高齢者の生命予後とその危険因子--26年間の追跡調査
-
岩本 広満
日本老年医学会雑誌 31(9), p671-676, 1994-09
医中誌Web 被引用文献1件
-
82
- Association of extracranial carotid arterial disease, prior atherothrombotic brain infarction, systemic hypertension, and left ventricular hypertrophy with the incidence of new atherothrombotic brain infarction at 45-month follow-up in 1,482 older patients
-
ARONOW WS.
Am J Cardiol 79, 991-993, 1997
DOI 被引用文献1件
-
83
- Atherosclerotic disease of the aortic arch and the risk of ischemic stroke
-
AMARENCO P.
N Engl J Med 331, 1474-1479, 1994
DOI 被引用文献28件
-
84
- Predictors of stroke pattern in hypertensive patients
-
HENRIQUES IL.
J Neurol Sci 144, 142-146, 1996
DOI 被引用文献2件
-
85
- <no title>
-
CASTELLI W. P.
JAMA 256, 2835-2838, 1986
DOI 被引用文献59件
-
86
- Is elevated serum cholesterol level a risk factor for coronary heart disease in the elderly?
-
BENFANTE R.
JAMA 263, 393-396, 1990
被引用文献14件
-
87
- The relation of documented coronary artery disease to levels of total cholesterol and high-density lipoprotein cholesterol
-
FREEDMAN DS.
Epidemiology 5, 80-87, 1994
DOI 被引用文献1件
-
88
- Plasma triglyceride level and mortality from coronary heart disease
-
CRIQUI M. H.
N Engl J Med 328, 1220-1225, 1993
DOI 被引用文献6件
-
89
- 高齢者高血圧に及ぼす血清インスリン値の意義--久山町研究
-
大森 将
日本老年医学会雑誌 30(7), p595-601, 1993-07
医中誌Web 被引用文献4件
-
90
- The changing pattern of hypertension and the declining incidence of stroke
-
GARRAWAY WM.
JAMA 258, 214-217, 1987
DOI 被引用文献4件
-
91
- The Lipid Research Clinics Coronary Primary Prevention Trial results. I. Reduction in incidence of coronary heart disease
-
The Lipid Research Clinics Program investigators
JAMA 251, 351-364, 1984
DOI 被引用文献52件
-
92
- The Lipid Research. Clinics
-
The Lipid Research Clinics Program investigators
JAMA 251, 365, 1984
DOI 被引用文献30件
-
93
- Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease : The Scandinavian Simvastatin Survival Study (4S)
-
SCANDINAVIAN SIMVASTAIN SURVIVAL STUDY GROUP
Lancet 344, 1383-1389, 1994
DOI 被引用文献314件
-
94
- Effect of simvastatin on coronary atheroma: The Multicentre Anti-Atheroma Study (MAAS).
-
MAAS Investigations.
Lancet 344, 633-638, 1994
被引用文献30件
-
95
- Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension
-
SHEP Cooprative Research Group
JAMA 265, 3255-3264, 1991
被引用文献93件
-
96
- Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension)
-
DAHLOF B.
Lancet 338, 1281-1285, 1991
被引用文献45件
-
97
- Effects of captopril on survival in patients with heart failure
-
NEWMAN TJ.
Am J Med 84(suppl 3A), 140-144, 1988
DOI 被引用文献1件
-
98
- The risk of myocardial infarction associated with antihypertensive drug therapies
-
PSATY B. M.
JAMA 274, 620-625, 1995
DOI 被引用文献30件
被引用文献: 3件中 1-3件 を表示
-
1
- 老年症候群 : 要介護への原因
-
鈴木 隆雄
理学療法科学 18(4), 183-186, 2003-11-20
医中誌Web 参考文献6件 被引用文献5件
-
2
- 地域高齢者の包括的健康維持に対する新しい健診システム
-
鈴木 隆雄
日本老年医学会雑誌 42(3), 294-297, 2005-05-25
-
3
- 地域高齢者の包括的健康維持のための新しい健診システム
-
鈴木 隆雄
日本保健科学学会誌 7(3), 133-138, 2004