Prevalence of Lifestyle-Related Diseases Among Homeless Men in Nagoya, Japan and the Relationship Between Disease Prevalence and Lifestyle Factors

Presentation Number: SUN 283
Date of Presentation: April 2nd, 2017

Mayumi Yamamoto*1, Yuki Isomura1, Ryo Horita1, Tadahiro Sado2, Takahiro Watanabe3, Ryosuke Uehara4 and Akihiro Nishio1
1Gifu University, Gifu, Japan, 2Tokoha University, Hamamatsu, Japan, 3Midori Hospital, Gifu, Japan, 4Yosida Hospital, Nara, Japan

Abstract

[Background] The actual prevalence of lifestyle-related diseases among homeless people has not been elucidated due to limited access to the homeless population. In this study, we conducted a survey to determine the prevalence of diabetes mellitus (DM), hypertension (HT), hyperlipidemia (HL), hyperuricemia (HU), and obesity among homeless individuals living in Nagoya, Japan. The relationship between disease prevalence and lifestyle factors of the homeless individuals, including their mental/intellectual condition, was also analyzed.

[Methods] According to a national survey from 2010 assessing the number of homeless individuals in Japan, 352 men were identified in Nagoya. Of these 352, 106 homeless men, with an average age of 54.2 ± 12.7 years, were recruited in cooperation with the Sasashima Support Center, NGO, as participants for the present study. Medical professionals collected blood samples and conducted interviews. The following blood parameters and cut-off values were used for defining the disease status: HbA1c ≥ 6.5 was diagnosed as DM; 6.4–6.0 was defined as suspicious for pre-diabetes (pre-DM); systolic blood pressure ≥ 140 as HT; total cholesterol ≥ 240, LDL ≥ 140, HDL ˂ 40, and triglycerides (TG) ≥ 250 were diagnosed as HL; uric acid ≥ 7.0 as HU; and body mass index ≥ 25.0 as obesity.. Furthermore, psychiatrists interviewed participants using the Mini-International Neuropsychiatric Interview, which is based on the diagnostic criteria of the DSM-IV-TR. A clinical psychologist assessed the intellectual capacity of homeless individuals using the Wechsler Adult Intelligence Scale-III (WAIS-III). This research protocol was approved by the Ethical Review Committee, Gifu University.

[Results] Of the 106 participants, 7 (6.6%) were diagnosed with DM, 12 (11.3%) with pre-DM, 51 (48.1%) with HT, 14 (13.2%) with hypercholesterolemia, 23 (21.7%) with hyper-LDL, 29 (27.4%) with hyper-TG, 13 (12.3%) with HU, and 28 (26.4%) with obesity. Furthermore, 45 (42.5%) were diagnosed with mental illness, 34 (32.1%) with cognitive disability, and 15 (14.2%) with both mental illness and cognitive disability. There was no correlation between the incidence of DM, pre-DM, HT, HL, HU, or obesity and the mental/intellectual condition. There was also no significant relationship between the prevalence of these lifestyle-related diseases and the participants’ life background, including living place (e.g., road, park, and shelter), duration of homeless life, and life habits (e.g. smoking and alcohol consumption).

[Conclusion] The prevalence of lifestyle-related diseases in the Japanese homeless population was almost the same as the one reported among 20–70-year-olds in the national data by the Ministry of Health and Welfare. For homeless people, early detection and prevention of lifestyle-related diseases might be as important as social support, especially in developed countries like Japan.

 

Nothing to Disclose: MY, YI, RH, TS, TW, RU, AN