# Introduction ased 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 21 2 nd plan is being carried out. The Healthy Japan 21 2 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 using12 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 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 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%). # None Somtmes 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 5 shows a subjective sense of smell. Both males and females showed a marked decline in olfaction with age. In particular, males in their 60s and 70s felt that their subjective sense of smell was inferior to that of females. 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. # None Table 7 shows the results of the 12 odor tests on the odor sticks. It has been found that the sense of smell declines with aging. It was found that there was more males in their 50s to 80s who had less recognition of odor than females. # None Hard to understand Somwhat confusing understand 40s(n=10) 0 ( 0.0%) 0 ( 0.0%) # Female # Female (n=169) 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 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. 40s(n=10) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 1 (10.0 %) 2 (20.0 %) 1 (10.0 %) 2 (20.0 %) 1 (10.0 %) 2 (20.0 %) 1 (10.0 %) 50s(n=24) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 1 (4. 40s(n=23) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 1 (4.3 %) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 7 (30.4 %) 4 (17.4 %) 5 (21.7 %)4 (17.4%) % 2 (8.7 %) 50s(n=39) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 2 (5.1 %) 1 (2.6 %) 1 (2.6 %) 6 (15.4 %) 7 (17.9 %) 7 (17.9 %) 11 (47.8 %) 4 (17.4 %) 60s (n=67) 0 (0.0 %) 0 (0.0 %) 1 (1.5 %) 0 (0.0 %) 4 6.0%) 0 (0.0 %) 6 (9.0 %) 5 (7.5 %) 10 (14.8 %) 8 (11.9 %) 9 (13.4 %) 18 (26.9 %) 6 (9.0 %) 70s (n=37) 0 (0.0 %) 0 (0.0 %) 1 (2.7 %) 1 (2.7 %) 1 ( 2.7%) 6 (16.2 %) 4 (10.8 %) 2 ( 5.4%) 8 (21.6 %) 7 (18.9 %) 6 (16.2 %) 1 (2.7 %) 0 (0.0 %) 80s (n=3) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 1 (33.3 %) 0 (0.0 %) 0 (0.0 %) 1 (33.3 %) 1 (33.3 %) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) 0 (0.0 %) Total 169 0 (0.0 %) 0 (0.0 %) 2 (1.2%) 2 (1.2%) 6 (3.6%) 8 (4.7%) 11 (6.5%) 9 (5.3%) 32 (18.9%) 26 (15.4%) 27 (16.0%) 34 (20.1%) 12 (7.1%) 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. 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. # 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. 4OccasionallySometimesAlways 5MaleMale (n=128)FemaleFemale (n=169) 61 ( 10.0%)9 ( 90.0%) 10Table 8 Taste test results in each age group numbetr(?)MaleNormal range Observation required Consultation required Male (n=128)No answer40s(n=10)9 (90.0 %)1 (10.0 %)0 (0.0%)0 (0.0%)50s(n=24)18 (75.0 %)3 (12.5 %)3 ( 12.5%)0 (0.0 %)60s (n=49)487.89 ( %)1 ( 2.4%)5 ( 10.2%)0 (0.0 %)70s (n=39)30 (76.9 %)2 ( 5.1%)7 ( 17.9%)0 (0.0 %)80s (n=6)6 ( 100.0%)0 (0.0 %)0 (0.0 %)0 (0.0 %)Total 128106 (82.8%)7 (5.5%)15 (11.7%)0 (0.0%)FemaleNormal range Observation required Consultation required Female (n=169)No answer40s(n=23)19 (82.6 %)3 ( 13.0%)1 (4.3 %)0 (0.0%)50s(n=39)32 (82.1 %)5 ( 12.8%)2 ( 5.1%)0 (0.0 %)60s (n=67)56 ( 83.6%)8 ( 11.9%)3 ( 4.5%)0 (0.0 %)70s (n=37)31 ( 83.8%)3 ( 8.1%)3 ( 8.1%)0 (0.0 %)80s (n=3)2 ( 66.7%)0 (0.0 %)1 (33.1 %)0 (0.0 %)Total 169140 (82.8%)19 (11.2%)10 (5.9%)0 (0.0%)0123456789101112 9MaleMale (n=128)FemaleFemale (n=169) 11Table 10 Cognitive resultsof salt concentretion in a salty taste test(number??)Male0.60%0.80%1.00%1.20% Male (n=128)1.40%1.60%1.60% more40s(n=10)3 ( 30.0%)4 ( 40.0%)0 ( 0.0%)2 ( 20.0%)0 (0.0 %)1 (10.0 %)0 (0.0 %)50s(n=24)11 ( 45.6%)2 ( 8.2%)3 ( 12.5%)2 (8.2 %)0 (0.0 %)3 (12.5 %)3 ( 12.5%)60s (n=49)23 ( 46.9%)8 ( 16.3%)8 ( 16.3%)4 ( 8.2%)1 (2.0 %)5 ( 10.2%)0 (0.0%)70s (n=39)18 ( 46.2%)9 (23.1%)4 ( 10.3%)0 ( 0.0%)1 (2.6 %)1 (2.6 %)6 (15.4 %)80s (n=6)1 ( 16.7%)2 ( 33.3%)2 (33.3 %)1 (16.7 %)0 (0.0 %)0 (0.0 %)0 (0.0 %)Total 12856 (43.8%)25 (19.5%)17 (13.3%)9 (7.0%)2 (1.6%)10 (7.8%)9 (7.0%)Female0.60%0.80%1.00%1.20% Female (n=169)1.40%1.60%1.60% more40s(n=23)12 (52.2 %)2 (8.7 %)4 (17.4 %)1 (4.3 %)2 (8.7 %)1 ( 4.3%)1 (4.3 %)50s(n=39)19 (48.7 %)11 (28.2 %)2 (5.1 %)0 (0.0 %)5 ( 12.8%)0 (0.0 %)2 (5.1 %)60s (n=67)32 (47.8 %)17 (25.4 %)5 (7.5 %)2 (3.0 %)4 ( 6.0%)3 (4.5 %)4 (6.0 %)70s (n=37)16 (43.8 %)9 ( 24.3%)4 (10.8 %)1 (2.7 %)2 ( 5.2%)2 ( 5.4%)3 ( 8.1)80s (n=3)1 (33.3 %)1 (33.3 %)0 (0.0 %)0 ( 0.0%)0 ( 0.0%)0 ( 0.0%)1 (33.3 %)Total 16980 (47.3%)40 (23.7%)15 (8.9%)4 (2.4%)13 (7.7%)5 (3.6%)11 (6.5%)confidence interval)Variableegression co tandard err partial regression lower limit Upper limitOdds ratiolower limit Upper limit Wald ree of freed P value ?*P<0.05, **P0.01 dence intervals for partial regression co confidence interval for the odds nce test for partial regression coGender0.23580.45630.1168-0.5686 1.13011.25690.51763.0960.26710.6054Age-0.02810.0223-0.2786-0.0718 0.01560.97230.93071.01571.592310.207Urology comperhensive judgment0.12060.33920.0872-0.5441 97,8541.12820.58032.19330.126510.7221Summary Obesity0.91440.42020.51450.09081.7382.94531.0955.68594.735110.0296*Summary Urinalysis-1.30250.4709-0.8078-2.2254 -0.3796 0.27190.1080.68427.65110.0057**Summary blood pressure0.06650.16890.0862-0.2645 0.39751.06870.76761.48810.154910.6939Summary electrocardiogram-0.61850.3584-0.4027-1.3209 0.08380.53870.26691.08742.979310.0843Summary fundus examination-0.89720.3451-0.7467-1.5736 -0.2208 0.40770.20730.80196.758610.0093**Sunnary anemia test-0.95060.4669-0.4718-1.7658 0.06460.42720.17111.06673.318310.0685Summary diabetes test-0.16680.3191-0.15-0.7922 0.45850.84640.45291.58180.273310.6011Summary liver function tests-0.06230.3552-0.0372-0.75860.6340.93960.46831.88510.030710.8608Summary renal function test0.35750.42530.1896-0.4761 1.19111.42980.62123.29070.706510.4006Summary lipid test0.71250.1740.97360.37141.05352.0391.44972.8678 16.759910.0001**Summary gout test0.80810.46390.3312-0.1011 1.71742.24370.90385.573.034710.0815Summary inflammation test6.13171.04271.86174.0888.1755 460.235 59.6203 3552.754 34.578910.0001**regression coefandard err partial regression lower limit Upper limitOdds ratiolower limit Upper limit Wald ree of free P value ?*P<0.05, **P0.01Gender0.0260.3430.0128 -0.64630.69831.02630.5242.01020.005710.9397Age-0.00850.0164-0.0844 -0.04070.02370.99150.96011.0240.26810.6047Subjective tinnitus0.75560.23390.48460.29721.2142.12891.3463.36710.43610.0012 **Subjective headache1.3040.50070.35180.32272.28543.68421.38099.82946.783510.0092 **Subjective sense of smell-0.4210.253-0.28 -0.91690.07490.65640.39971.07772.769110.0961Subjective sense of taste-0.4430.3099-0.2106 -1.05170.16310.64130.34941.17712.055810.1516Taste 3-level evaluation-0.36150.3445-0.3114 -1.03670.31370.69670.35461.36851.100910.2941Smell 3-level evaluation0.12580.3870.0864 -0.63270.88441.13410.53112.42140.105710.7451Olfactory measurement value0.19210.09760.53670.00090.38331.21181.0091.46723.877810.0489 *Salt taste measurement value0.75970.74220.2932 ^0.69512.21442.13760.4999.15611.047510.3061 * Discrepancies between self-reported hearing difficulty and hearing loss diagnosed by audiometry: prevalence and associated factors in a national survey JieunChoi Il JoonMoon Sun-YoungBek SeonWooKim Yang-SunCho Doi: 10.1136/ bmjopen- 2018-022440 BMJ Open 9 4 e022440 2019 May 1 * Prevalence and relationship of olfactory dysfunction and tinnitus among middleand old-aged population in Korea DYPark 10.1371/journal.pone.0206328 PLoS One13 e0206328 2018 * Prevalence of olfactory impairment in older adults CMurphy doi:10.1001/ jama.288.18.2307 2002 288 * Comparison of subjective olfaction ratings in patients with and without olfactory disorders BRHaxel 10.1017/S002221511200076X J Laryngol 126 2012 * Evaluation of Olfactory Function with Objective Tests in COVID-19-Positive Patients: A Cross-Sectional Study EDGozen 10.1177/0145561320975510 Ear Nose Throat J100, 169S-173S 2021 * Self-report Measures of Hearing and Vision in Older Adults Participating in the Canadian Longitudinal Study of Aging are Explained by Behavioral Sensory Measures, Demographic, and Social Factors AHamalainen MKPichora-Fuller WWittich NAPhillips PMick 10.1097/AUD.0000000000000992 Ear 42 2021