name of person : Kozo Matsubayashi
address: Center for Southeast Asian Studies, Kyoto University,
46 Shimoadachi-cho, Yoshida, Sakyo-ku, 606-8501 Kyoto.
Email : kmatsu@cseas.kyoto-u.ac.jp
tel and fax Tel: 075-753-7368, Fax: 075-753-7168
counterpart: Ministry of Health
number of researchers: 5 Japanese medical researchers
disciplines: Medicine (Geriatrics, Cardiology, Neurology, Psychiatry)
areas (please be specific): several villages surrounding around Savanaket
Background and problem identification
The elderly population in Japan is rapidly growing at the fastest rate in the world.. In response to the increasing population of the elderly, how to provide efficient and effective health care to older persons has been an intense debate. In 21st centuries, rapid growing of the elderly population in each country in Southeast Asia will follow to Japan. In Laos, the projected percentage of elderly people aged 65 years or more will increase into 14% in 2050 from 4% in 2000. Our medical team have carried out assessing the comprehensive medical functions of the community-dwelling elderly and providing efficient education to promote health state of the elderly population in Japan. Adding to the longitudinal geriatric intervention study in Japan, we also investigated older subjects living in Singapore, Korea and west Java. These countries have second and third leading aging population in Asia. As the results , diseases and frailty in community-dwelling old subjects are revealed to be influenced by the ecological differences such as natural environments, historical backgrounds, the lifestyle, habits, religions and health promotion policies in the area. With longer life span and decreasing birth rate, demographic aging is now an established trend not only in Western country but also in Asian countries. The issue of efficient health-care for the elderly is therefore growing a more urgent issue even in the Southeast Asian countries. To achieve appropriate policies to detect the ecology-related risk factors for frailty in the elderly and to prevent the disabilities of elderly population, and also to provide the useful care services to the frail elderly, we need to further investigate each comprehensive area study in the standpoint of view of health and diseases.
This medicoecological research intends to clarify the medical and geriatric actual conditions of community-dwelling people in the villages in Laos and may contribute to future strategy to promote the health of the elderly in Laos communities as well as in Japanese ones.
Justification and objectives
To clarify the relationship of diseases and disabilities with ecological factors in people living in northern mountainous area in Laos.
Data Collection
Medical data
Socio-ecological data
Methods
Interviewing based on medical and socio-ecological questionnaire
Physical and neurological examination of inhabitants in the villages
Blood chemical examination
Assessment of activities of daily living (ADL) and quality of life (QOL) of the people.
Expected outputs
Based on the results of the prevalence of diseases and disabilities of community-dwelling people, we will clarify the relationship between diseases and ecological or social factors concerned the area, and will contribute to future strategy to promote the health of the people in rural Laos communities.
3. Research team
Kozo Matsubayashi, MD, PhD ( Professor of CSEAS, Kyoto University)
Kiyohito Okumiya, MD, PhD (Associate Professor, NRHN)
Masayuki Ishine, MD (Post Graduate, Faculty of Medicine, Kyoto University)
Naoko Ishine, MD
Matheus Cruz, MD (Post Graduate, Faculty of Medicine, Kyoto University)
Idiane Cruz, Nr (Post Graduate, Faculty of Medicine, Kyoto University)
Teiji Sakagami, MD (Post Graduate, Faculty of Medicine, Kyoto University)
4. Work schedule (2003-2004)
From February 10 to 28 in 2004: medical survey in villages around Savanaket in Laos.
Temporary Staff : 7 translators X 18 days
Domestic Travel Expense : 1000 US$
Overseas Travel Expenses :
Equipment : All medical equipment will be carried out from Japan
Rental (i.e. equipment, vehicle) : vehicles（7 persons +3 plastic containers） X 2 days.
Meetings (i.e. workshops, meetings, training, etc.): attend to plenary meeting.
Purchase of Data, Books : none
Copying Documentation: questionnaire and medical cards : (A4 X 5000 pages)
Communications (i.e. telephone, fax, etc.) : none
Office Supplies :none
Other costs: Kits of blood chemical examination: none
Items of our medical survey are below mentioned.
2004 Health-related interview
2005 Physical examination
2006 Neurobehavioral function tests
2007 Blood chemical analysis from the patients who hope it based on the informed consent
l Blood chemical analysis will be done from only patients who hope it.
l Blood Chemical Analysis will be done on the site and patients will be informed the results of analysis 1 hour after taking blood.
l Items of blood analysis includes; total cholesterol, total protein, albumin, uric acid, blood urea nitrogen, creatinine, GOT, GPT, hemoglobin concentration, all of which are informative to diagnose the health situation of patients.
l We will check-up blood (2ml) of subjects after getting a written informed consent.
l Residual blood will be completely abolished on the site.
l Privacy of personal blood chemical information will be strictly guarded except the publication of statistically mean data which cannot specify the person.
l Above medical surveying method in abroad including Lao has been approved (No. 509, September 22, 2003), at least, in the Ethical Committee in Kyoto University Japan..
Research Title
：Comparative Study of Comprehensive Geriatric Assessment in the Elderly in Asia
Written Agreement
I would agree to be taken my health-related interview and health check based both on the information from Section of the Health Promotion of the Province and Professor K Matsubayashi, Kyoto University, Japan and on the confirmation of each item below mentioned.
１） Purpose of this Comprehensive Geriatric Assessment Research
２） Each item examined
３） Usefulness and side effects of this health-check examination
４） The right I can reject and stop the examination at any time without any disadvantages for me.
５） My private information should be strictly protected.
Name
Date
Sign
Sign (Proxy)
（Family Relationship）
we explained about this geriatric examination to the subject and we have confirmed the subject agreed to join the examination of his/her own free will.
Kozo Matsubayashi, MD
Professor, Center for Southeast Asian Studies, Kyoto University, Japan
Leader, International Geriatric Medical Research Team