- 著者
- Kei Hayashi Ichiro Kawachi Tetsuya Ohira Katsunori Kondo Kokoro Shirai Naoki Kondo
- 出版者
- 日本疫学会
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- vol.26, no.10, pp.546-552, 2016-10-05 (Released:2016-10-05)
- 参考文献数
- 32
- 被引用文献数
- 41
Background: We sought to evaluate the associations between frequency of daily laughter with heart disease and stroke among community-dwelling older Japanese women and men.Methods: We analyzed cross-sectional data in 20 934 individuals (10 206 men and 10 728 women) aged 65 years or older, who participated in the Japan Gerontological Evaluation Study in 2013. In the mail-in survey, participants provided information on daily frequency of laughter, as well as body mass index, demographic and lifestyle factors, and diagnoses of cardiovascular disease, hyperlipidemia, hypertension, and depression.Results: Even after adjustment for hyperlipidemia, hypertension, depression, body mass index, and other risk factors, the prevalence of heart diseases among those who never or almost never laughed was 1.21 (95% CI, −1.03–1.41) times higher than those who reported laughing every day. The adjusted prevalence ratio for stroke was 1.60 (95% CI, 1.24–2.06).Conclusions: Daily frequency of laughter is associated with lower prevalence of cardiovascular diseases. The association could not be explained by confounding factors, such as depressive symptoms.
6 0 0 0 OA Socio-economic disparities in early childhood education enrollment: Japanese population-based study
- 著者
- Yuko Kachi Tsuguhiko Kato Ichiro Kawachi
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- pp.JE20180216, (Released:2019-03-23)
- 参考文献数
- 27
- 被引用文献数
- 8
Background: Accumulating evidence has shown that high-quality early childhood education and care may be an effective way of promoting children’s optimal health and development, especially for the most disadvantaged. However, socially disadvantaged families are less likely to enroll children in center-based childcare. In this study, we explored characteristics associated with use of center-based childcare among Japanese families.Methods: We used data from two Japanese birth cohorts in 2001 (n=17,019) and 2010 (n=24,333). Enrollment in center-based childcare was assessed at the ages of three and four years in the 2001 cohort and at the age of three in the 2010 cohort. Logistic regression analyses were conducted.Results: Children in the lowest quintile of household income were 1.54 (95% confidence interval, 1.20-1.98) times more likely to not receive center-based childcare than those in the highest-income quartile at the age of four in the 2001 cohort. Other socio-economic disadvantage (mother’s low education, non-Japanese parent, and higher number of siblings) and child’s health and developmental problems (preterm birth, congenital diseases, and developmental delay) were also associated with the non-use of center-based childcare at the age of three in the 2001 and 2010 cohorts.Conclusions: An inverse care law operates in the use of early childhood education, i.e. children with the least need enjoy the highest access. Children with socio-economic, health, and developmental disadvantages are at a greater risk of not receiving early childhood education and care. Social policies to promote equal access to early childhood education are needed to reduce future socio-economic inequalities.
- 著者
- Kei Hayashi Ichiro Kawachi Tetsuya Ohira Katsunori Kondo Kokoro Shirai Naoki Kondo
- 出版者
- 日本疫学会
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- pp.JE20150196, (Released:2016-03-12)
- 参考文献数
- 32
- 被引用文献数
- 41
Background: We sought to evaluate the associations between frequency of daily laughter with heart disease and stroke among community-dwelling older Japanese women and men.Methods: We analyzed cross-sectional data in 20 934 individuals (10 206 men and 10 728 women) aged 65 years or older, who participated in the Japan Gerontological Evaluation Study in 2013. In the mail-in survey, participants provided information on daily frequency of laughter, as well as body mass index, demographic and lifestyle factors, and diagnoses of cardiovascular disease, hyperlipidemia, hypertension, and depression.Results: Even after adjustment for hyperlipidemia, hypertension, depression, body mass index, and other risk factors, the prevalence of heart diseases among those who never or almost never laughed was 1.21 (95% CI, −1.03–1.41) times higher than those who reported laughing every day. The adjusted prevalence ratio for stroke was 1.60 (95% CI, 1.24–2.06).Conclusions: Daily frequency of laughter is associated with lower prevalence of cardiovascular diseases. The association could not be explained by confounding factors, such as depressive symptoms.
- 著者
- Akiho Sugita Ling Ling Taishi Tsuji Katsunori Kondo Ichiro Kawachi
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- pp.JE20190337, (Released:2020-09-19)
- 参考文献数
- 34
- 被引用文献数
- 10
Background: Active engagement in intellectually enriching activities reportedly lowers the risk of cognitive decline; however, few studies have examined this association, including engagement in traditional cultural activities. This study aimed to elucidate the types of cultural engagement associated with lower risk of cognitive impairment.Methods: We examined the association between cultural engagement and cognitive impairment using Cox proportional hazards models in a cohort of 44,985 participants (20,772 males and 24,213 females) aged 65 years or older of the Japan Gerontological Evaluation Study from 2010 to 2016. Intellectual activities (e.g., reading books, magazines, and/or newspapers), creative activities (e.g., crafts and painting), and traditional cultural activities (e.g., poetry composition [haiku], calligraphy, and tea ceremony/flower arrangement) were included among cultural engagement activities.Results: Over a follow-up period of six years, incident cognitive disability was observed in 4,198 respondents (9.3%). After adjusting for potential confounders such as depression and social support, intellectual activities were protectively associated with the risk of cognitive impairment (hazard ratio, HR for those who read and stated that reading was their hobby: 0.75 [95% confidence interval, CI 0.66–0.85] and those who read but did not consider reading a hobby: 0.72 [95% CI, 0.65–0.80]). Engagement in creative activities was also significantly correlated with lower risk of cognitive impairment (crafts: 0.71 [95% CI, 0.62–0.81] and painting: 0.80 [95% CI, 0.66–0.96]). The association between traditional cultural activities and the risk of cognitive impairment was not statistically significant.Conclusions: Engagement in intellectual and creative activities may be associated with reduced risk of dementia.
- 著者
- Nam-Hee Kim Hawazin W. Elani Ichiro Kawachi
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- vol.33, no.2, pp.101-108, 2023-02-05 (Released:2023-02-05)
- 参考文献数
- 42
- 被引用文献数
- 1
Background: In 2012, the Korean government expanded dental insurance for the elderly to promote improved access to dental care. We examined the causal effect of this policy on dental care needs, focusing on low-income older adults.Methods: We compared data before and after policy implementation using double difference (DD) and triple difference (DDD) analyses. We used the nationally representative data from the Korea National Health and Nutrition Examination Survey from 2010 and 2016–2018. Individuals aged ≥65 years were included in the treatment group, and individuals aged <65 years were included in the control group.Results: Dental insurance expansion was associated with a paradoxical increase in perceived unmet dental needs among elderly individuals (8.8 percentage points increase, 95% CI: 4.7 to 13.0). However, there were improvements in dental prosthetics outcomes (denture wearing [4.0 percentage points, 95% CI: 0.2 to 7.9] and dental implants [5.0 percentage points, 95% CI: 2.1 to 7.9]; P < 0.01). Upon analyzing low-income elderly individuals using DDD analysis, we found that the insurance expansion led to a 21.6% smaller increase in unmet dental needs among low-income adults, compared to high-income adults (95% CI, −35.0 to −8.5; P < 0.01).Conclusion: Dental insurance expansion in South Korea resulted in improvements in access to dental prosthetic services overall. It also led to a smaller increase in unmet dental needs among low-income older adults, compared to high-income adults.
- 著者
- Takaki Kobayashi Yukako Tani Shiho Kino Takeo Fujiwara Katsunori Kondo Ichiro Kawachi
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- vol.32, no.6, pp.245-253, 2022-06-05 (Released:2022-06-05)
- 参考文献数
- 53
- 被引用文献数
- 2 6
Background: Engagement in leisure activities among older people is associated with a lower risk of mortality. However, no studies have been conducted focusing on the difference of associations with mortality risk among multiple types of leisure activities.Methods: We examined prospectively the association of engagement in leisure activities with all-cause mortality in a cohort of older Japanese adults. The Japan Gerontological Evaluation Study included 48,216 participants aged 65 years or older. During a mean follow-up period of 5.6 years, we observed 5,575 deaths (11.6%). We investigated the total number of leisure activities, as well as combinations of 25 different leisure activities with Cox proportional hazards models, adjusting for potential confounding factors.Results: We found a linear relationship between the total number of leisure activities and mortality hazard (adjusted hazard ratio, 0.93; 95% CI, 0.92–0.95). Furthermore, engagement in leisure activities involving physical activity, as well as group-based interactions, showed the strongest associations with lowered mortality. By contrast, engagement in cultural leisure activities and solitary leisure activities were not associated with all-cause mortality.Conclusion: Although we cannot rule out residual confounding, our findings suggest that encouraging engagement in physically-active group-based leisure activities may promote longevity in older adults.
- 著者
- Nam-Hee Kim Jarvis T. Chen Ichiro Kawachi
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- vol.32, no.5, pp.215-220, 2022-05-05 (Released:2022-05-05)
- 参考文献数
- 31
- 被引用文献数
- 2 2
Background: In 2012, the Korean National Health Insurance extended its coverage to include denture services for older adults. We examined whether the new policy resulted in improved chewing ability in the eligible population.Methods: We used interrupted time-series (ITS) analysis, a quasi-experimental design, to analyze the effect of the policy. We used data from the Korea National Health and Nutrition Examination Survey conducted from 2007 to 2016–2018. The study population consisted of two groups: the treatment group, aged 65 years or older and eligible for the dental insurance benefit; and the control group, those younger than 65 years and ineligible. The main evaluated outcome was self-reported chewing difficulty.Results: The ITS analysis showed that chewing difficulty decreased annually by 0.93% (95% CI, −1.30 to −0.55%) and 0.38% (95% CI, −0.59 to −0.16%) after the policy extension in the older than 65 and younger than 65 groups, respectively. However, we could not conclude that the insurance extension affected chewing difficulty because there was a decrease in the control group as well.Conclusion: Chewing ability improved in both older and younger adults regardless of dental insurance coverage for older adults. Other exogenous factors probably led to the improvements in chewing ability as well as dental insurance benefits.
- 著者
- Takaki Kobayashi Yukako Tani Shiho Kino Takeo Fujiwara Katsunori Kondo Ichiro Kawachi
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- pp.JE20200427, (Released:2021-02-06)
- 参考文献数
- 53
- 被引用文献数
- 6
Background: Engagement in leisure activities among older people is associated with a lower risk of mortality. However, no studies have been conducted focusing on the difference of associations with mortality risk among multiple types of leisure activities.Methods: We examined prospectively the association of engagement in leisure activities with all-cause mortality in a cohort of older Japanese adults. The Japan Gerontological Evaluation Study included 48,216 participants aged 65 years or older. During a mean follow-up period of 5.6 years, we observed 5,575 deaths (11.6%). We investigated the total number of leisure activities, as well as combinations of 25 different leisure activities with Cox proportional hazards models, adjusting for potential confounding factors.Results: We found a linear relationship between the total number of leisure activities and mortality hazard (adjusted hazard ratio, 0.93; 95% CI, 0.92–0.95). Furthermore, engagement in leisure activities involving physical activity, as well as group-based interactions, showed the strongest associations with lowered mortality. By contrast, engagement in cultural leisure activities and solitary leisure activities were not associated with all-cause mortality.Conclusions: Although we cannot rule out residual confounding, our findings suggest that encouraging engagement in physically-active group-based leisure activities may promote longevity in older adults.
- 著者
- Yuiko Nagamine Takeo Fujiwara Yukako Tani Hiroshi Murayama Takahiro Tabuchi Katsunori Kondo Ichiro Kawachi
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- vol.30, no.11, pp.497-502, 2020-11-05 (Released:2020-11-05)
- 参考文献数
- 36
- 被引用文献数
- 8
Background: Socioeconomic mobility affects health throughout the life course. However, it is not known whether there are gender differences in the association between life-course subjective socioeconomic status (SSS) mobility and mortality at older ages.Methods: Participants were 16,690 community-dwelling adults aged 65–100 years in the Japan Gerontological Evaluation Study (JAGES). Baseline information including demographic characteristics, depression, and lifestyle factors were collected in 2010. Participants’ vital status was confirmed in 2013 via linkage to death records. We categorized life-course socioeconomic mobility into the following categories: ‘persistently high’, ‘downward mobility’, ‘upward mobility’, and ‘persistently low’. Cox proportional hazard modeling was used to estimate hazard ratios (HR) for all-cause mortality.Results: Mortality HRs for the ‘downward’ group were 1.37 (95% confidence interval [CI], 1.08–1.74) among men and 1.27 (95% CI, 0.94–1.71) among women in comparison with the ‘persistently high’ group. Compared to the ‘persistently low’ group, the HRs for the ‘upward’ group were 0.54 (95% CI, 0.35–0.83) among women and 0.91 (95% CI, 0.73–1.24) among men. Associations were not changed after adjusting for objective socioeconomic status but were attenuated by depression.Conclusions: ‘Downward’ mobility was associated with mortality among men, but not among women. Depression appeared to mediate the association. A protective effect of upward mobility was observed among women but not among men.
- 著者
- Atsushi Miyawaki Yasuki Kobayashi Ichiro Kawachi
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- vol.30, no.2, pp.67-73, 2020-02-05 (Released:2020-02-05)
- 参考文献数
- 49
- 被引用文献数
- 12
Background: The association of sensory loss with mortality remains unclear. We aimed to explore the associations of hearing loss (HL), visual loss (VL), and dual sensory loss (DSL) with survival.Methods: Data came from the Komo-Ise study cohort in Gunma Prefecture, Japan, where the community-dwelling residents aged 40–69 years were followed up from 1993 to 2010. We analyzed 9,522 individuals who answered the follow-up questionnaires in 2000 (average age 64 [range, 47 to 77] years in 2000). The primary exposures were “HL only,” “VL only,” or “DSL”, with “no HL/VL” as the reference. These sensory loss statuses were assessed by asking the difficulty in hearing conversation or reading newspaper even with aids in the follow-up questionnaires in 2000. All-cause and cause-specific mortality were ascertained from linkage to death certificate data. Cox proportional hazards models adjusting for confounders, including demographic factors, socioeconomic status, and health status, were used. Potential mediators (depression, walking disability, and social participation) were additionally adjusted for.Results: There were 1,105 deaths over the 10-year follow-up. After adjustment for the potential confounders, HL and DSL were associated with increased all-cause mortality (hazard ratios of 1.74 [95% CI, 1.18–2.57] and 1.63 [95% CI, 1.09–2.42], respectively). Potential mediators explained a modest portion of the association. As for cause-specific mortality, HL was associated with increased cancer mortality, while VL and DSL were associated with increased cardiovascular disease mortality.Conclusions: Self-reported HL and DSL may be risk factors of mortality among middle-aged or elderly Japanese populations.
1 0 0 0 OA Social Capital and Dietary Intakes Following the 2011 Great East Japan Earthquake and Tsunami
- 著者
- Sayuri Goryoda Nobuo Nishi Haruki Shimoda Yuki Yonekura Kiyomi Sakata Seiichiro Kobayashi Akira Ogawa Ichiro Kawachi
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- vol.29, no.3, pp.92-96, 2019-03-05 (Released:2019-03-05)
- 参考文献数
- 25
- 被引用文献数
- 10
Background: Previous studies have identified poor dietary intake as a health risk affecting survivors of the 2011 Great East Japan Earthquake and Tsunami. We examined the association between different social factors (eg, living conditions and perceptions of community social capital) and dietary intakes among disaster-affected survivors.Methods: We studied 6,724 survivors in four municipalities of Iwate Prefecture 3 years after the disaster. Social capital was assessed via four items inquiring about respondents’ perceptions of social cohesion in their communities. Good dietary intake was defined according to the following criteria: intake of staple food ≥three times a day; intake of meat, fish and shellfish eggs, or soybean products ≥twice a day; vegetable intake ≥twice a day; and intake of fruit or dairy products ≥once a day. An individual who did not meet any of these criteria was defined as having poor dietary intake. We adjusted for covariates, including socioeconomic status, marital status, and residential area.Results: Poor dietary intake was reported by 31.6% of respondents. Poisson regression analyses revealed that the following factors were related to poor dietary intake: age <65 years (men: prevalence ratio [PR] 1.48; 95% confidence interval [CI], 1.29–1.71 and women: PR 1.55; 95% CI, 1.36–1.77), difficulties in living conditions (men: PR 1.18; 95% CI, 1.00–1.39 and women: PR 1.19; 95% CI, 1.01–1.40), and low perceptions of community social capital (women: PR 1.20; 95% CI, 1.04–1.38).Conclusions: Our findings suggest that social capital plays a role in promoting healthy dietary intake among women in disaster-affected areas.
- 著者
- Kaori Honjo Yukako Tani Masashige Saito Yuri Sasaki Katsunori Kondo Ichiro Kawachi Naoki Kondo
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- vol.28, no.7, pp.315-322, 2018-07-05 (Released:2018-07-05)
- 参考文献数
- 32
- 被引用文献数
- 47
Background: There is little longitudinal evidence on the impact of specific living arrangements (ie, who individuals live with) on mental health among older adults, and no studies have examined the modifying effect of residential social cohesion level on this association. We aimed to examine the association between living arrangements and depressive symptoms and whether this association varies with residential neighborhood social cohesion level among 19,656 men and 22,513 women aged 65 years and older in Japan.Methods: We analyzed the association between baseline living arrangements in 2010 and depressive symptoms in 2013. We calculated gender-specific odds ratios (ORs) of living arrangements for depressive symptoms using a logistic regression and conducted subgroup analyses by neighborhood social cohesion level.Results: Among men (but not women), living alone (OR 1.43; 95% confidence intervals [CI], 1.18–1.73) and living with spouse and parent (OR 1.47, 95% CI, 1.09–1.98) were associated with increased odds of depressive symptoms compared with living with a spouse only. Living with spouse and child was a risk for men in the young age group but a protective factor for women. We also identified that the negative impact of living arrangements on depressive symptoms was attenuated in neighborhoods with higher levels of social cohesion.Conclusions: Living arrangements are associated with risk of depressive symptoms among men and women; these associations differ by gender and neighborhood social cohesion level. Our results suggest the need to pay more attention to whether individuals live alone, as well as who individuals live with, to prevent depressive symptoms among older adults.