I. INTRODUCTION

Based on the Health Promotion Law, health Japan 21 was issued as Ministry of Health, Labor and Welfare No.430 in 2012.Public health centers of local governments are conducting Health Japan 21 according to local conditions in accordance with the policy set out by the Japanese government. Currently, Health Japan ${212}^{\mathrm{nd}}$ plan is being carried out.

The Healthy Japan 21 $2^{\text{nd}}$ plan includes nine different types of content (nutrition and diet, physical activity and exercise, rest and mental health, tobacco, health care, dental health, diabetes, cardiovascular disease, and cancer), In addition, each basic plan and goals are shown in it.

Currently, health management aimed at improving productivity has begun to be implemented with the goal to maintain the health of workers in Japan. This is because it is essential to raise the health condition of each employee and improve productivity due to the social background of a declining working population, an aging workforce, and an increase in national medical expenses in Japan. A feeling of dizziness, a headache, or a minor discomfort can significantly affect productivity. Therefore, in this study, we report the results of a self-administered questionnaire survey conducted in 2019 on subjective dizziness, tinnitus, and headache at resident health checkups in Yakumo Town, Hokkaido, Japan, where there is little population movement. From 2027 to 2019, we have continuously conducted taste and smell test results at the time of the Yakumo town resident health checkups. Using these results, we will report a comparison by age group. Although many sensory organs have been reported to deteriorate with age, there have been few reports on the interrelationships among taste, smell, hearing and vision.

In recent years, many reports have revealed that reduced sense of smell and decreased sense of taste occur as precursors of cognitive decline.

In recent years, there have been many reports that cognitive function declines when hearing declines. Therefore, this study also reports on the relationship between taste and smell test results and other test results in residents aged 40 and over in Yakumo Town, Hokkaido, Japan resident health checkups.

II. MATERIAL AND METHOD

A total of 297 participants, 128 male and 169 female aged 40 and over, participated in the health checkup for residents of Yakumo Town, Hokkaido, Japan, in August 2019. The subjects of the self-reported questionnaire survey were subjective dizziness, subjective tinnitus, subjective headache, subjective taste, and subjective sense of smell.

A simple salty taste test kit (salsave: manufactured by Advantech) was used for the taste test. A simple olfactory test kit (smell stick: manufactured by Daiichi Kogyo Co., Ltd.) was used for the olfactory test.

The obtained data were compared using statistical methods. A binomial logistic regression analysis was used. The objective variable was subjective dizziness, and the explanatory variables were subjective tinnitus, headache, taste, smell, taste test results, and smell test results. The statistical software used was Excel Statistics 2020 (SSRI Co.,).

A quick saltiness test recorded perceptible concentrations within six concentrations (0.6%, 0.8%, 1.0%, 1.2%, 1.4%, 1.6%). The salty taste was categorized into three categories: 0.6% to 1.0% salty taste is the normal range, 1.2% to 1.6% requires observation, and 1.6% or more requires consultation.

A simple olfactory test using 12 different odors (Japanese ink, wood, perfume, menthol, mandarin orange, curry, household gas, rose, cypress, stuffy socks, condensed milk, and fried garlic) and recorded the number of smells. Of the 12 types of odors, if six or more classes were recognized, they were classified as normal range; if 5 to 3 classes observation was required; and if two classes or less, consultation was required.

III. RESULTS

As shown in Table 1, the participants were 33 in their 40s, 63 in their 50s, 116 in their 60s, 76 in their 70s, and eight in their 80s.

Table 1 Age distribution of participants (n=297) Table 2 shows subjective dizziness by age group. Among participants in their 50s, 50s, and 60s, more male participants than female participants answered that they did not feel subjective dizziness. In addition, it was found that many females in their 50shas a personal feeling of dizziness.

Table 2 Subjective dizziness in each age group numbetr $(\mathrm{\%})$

Table 3 shows subjective tinnitus for each age group. The proportion of males and females in their 40s, 50s, and 60s who did not experience subjective tinnitus was about the same (60-66%).

Table3 Subjective tinnitus in each age group numbetr $(\mathrm{\%})$

Table 4 shows the results of the dizziness questionnaire. It is found that female participants were feeling headaches more than males in each age group.

Table 4 Subjective headache in each age group numbetr $(\mathrm{\%})$

Table 5 Subjective sense of smell in each age group numbetr $(\mathrm{\%})$

Table 6 shows the subjective sense of taste for each age group. Compared to males, females answered that they could appreciate the taste of each age group. However, the effect of aging was small in both males and females.

Table 6 Subjective sense of taste in each age group numbetr $(\mathrm{\%})$

Table 7 shows the results of the 12 odor tests more males in their 50s to 80s who had less recognition on the odor sticks. It has been found that the sense of of odor than females. smell declines with aging. It was found that there was

Table 7 Olfactory test results in each age group numbetr $(\mathrm{\%})$

Table 8 shows the salty taste test results by Salsave. There was no difference in the results of the salty taste test between males and females. However, there were more males than females who required consultation.

Table 8 Taste test results in each age group numbetr $(\mathrm{\%})$

Table 9 shows the olfactory test results. The number of recognizable odors among 12 types of odors was recorded. It was shown that the number of perceived odors decreased as the age of the participants increased.

Table 9 Actual measurment results of the number of cognitions of twelve types of olfactory tests

Table 10 shows the salty taste test results. There was no age-related difference in saltiness perceived by the participants in both males and females.

Table 10 Cognitive resultsof salt concentration in a salty taste test (number:%)

A binomial logistic regression analysis was used. The objective variable was subjective dizziness, and the explanatory variables were subjective tinnitus, headache, taste, smell, taste test results, and smell test results.

Table 11 shows the relationship with diseases that can be understood from the questionnaire results.

As for items related to dizziness, the results of obesity, urinalysis, fundus examination, lipid examination, and inflammation examination were shown.

It was shown that subjective dizziness is related to the obesity, dermatitis, swollen eyes, and coughing.

Table 11 Results of binomial logistic analysis of subjective dizziness and other test results (Variables included in the regression equation (partial regression coefficient confidence interval)

In addition, Table 12 shows the results of the comparison with the questionnaire results in the field of otolaryngology. A subjective feeling of dizziness was shown to be associated with tinnitus, headache, and measured olfactory test results. There was a statistically significant difference between subjective dizziness and odor test results.

Table 12 Results of binomial logistic analysis of subjective dizziness and otorhinolaryngology test results (Variables included in the regression equation (partial regression coefficient confidence interval)

IV. DISCUSSION

From the results of this study, the degree of obesity, urine test results, fundus test results, lipid test results, and inflammation test results were shown as items related to subjective dizziness. In particular, it was revealed that the relationship with inflammatory reaction is substantial. In otolaryngology, there was a relationship between tinnitus, headache, olfactory perception tests results, and subjective dizziness.

Since participants with a higher olfactory recognition rate feel subjective dizziness, it may be that the dizziness is caused by being sensitive to odors. No relationship was found with the results of the questionnaire on food intake. This finding follows the previous report on questionnaire responses (the subjective evaluation of sensory functions) which differed from the sensory test result1-6). In the future, it will be necessary to investigate in detail the relationship between subjective dizziness and olfactory test results. Moreover, we need to investigate in detail the relationship between subjective dizziness and inflammation test results.