著者

Akio Yagi Shinya Hayasaka Toshiyuki Ojima Yuri Sasaki Taishi Tsuji Yasuhiro Miyaguni Yuiko Nagamine Takao Namiki Katsunori Kondo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20180123, (Released:2018-10-27)

参考文献数

40

被引用文献数

8

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Background: While bathing styles vary among countries, most Japanese people prefer tub bathing to showers and saunas. However, few studies have examined the relationship between tub bathing and health outcomes. Accordingly, in this prospective cohort study, we investigated the association between tub bathing frequency and the onset of functional disability among older people in Japan.Methods: We used data from the Japan Gerontological Evaluation Study (JAGES). The baseline survey was conducted from August 2010 to January 2012 and enrolled 13,786 community-dwelling older people (6,482 men and 7,304 women) independent in activities of daily living. During a 3-year observation period, the onset of functional disability, identified by new certification for need of Long-Term Care Insurance, was recorded. Tub bathing frequencies in summer and winter at baseline were divided into 3 groups: low frequency (0-2 times/week), moderate frequency (3-6 times/week), and high frequency (≥ 7 times/week). We estimated the risks of functional disability in each group using a multivariate Cox proportional hazards model.Results: Functional disability was observed in a total of 1,203 cases (8.7%). Compared with the low-frequency group and after adjustment for 14 potential confounders, the hazard ratios (95% confidence intervals) of the moderate- and high-frequency groups were 0.91 (0.75-1.10) and 0.72 (0.60-0.85) for summer and 0.90 (0.76-1.07) and 0.71 (0.60-0.84) for winter.Conclusion: High tub bathing frequency is associated with lower onset of functional disability. Therefore, tub bathing might be beneficial for older people’s health.

著者

Hiroshi Hirai Masao Ichikawa Naoki Kondo Katsunori Kondo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20180260, (Released:2019-06-22)

参考文献数

26

被引用文献数

17 18

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Background: Population ageing and stringent licensing policies will increase the number of older drivers who stop driving. Adverse health outcomes owing to driving cessation and their prevention are emerging concerns. Therefore, we longitudinally examined the impact of driving cessation and alternative transportation use after cessation on the risk of functional limitations in a cohort of community-dwelling people (65 years and older) in Japan.Methods: Using cohort data of those who drove as of 2006/07, we compared the risk of functional limitations between 2,704 current drivers and 140 former drivers (who stopped driving by 2010). Of the former drivers, 77 did not use public transportation or bicycles after driving cessation (thus losing independent mobility). We calculated the hazard ratios (HRs) for the incidence of functional limitations with 95% confidence intervals (CIs) based on the Cox proportional hazards model with the covariates influencing the functional limitations.Results: From 2010 through 2016, 645 people had functional limitations, which included 38, 82, and 119 per 1,000 person-years among current drivers, former drivers who used public transportation or bicycles, and former drivers who were only driven by others, respectively (HR 1.69; 95% CI, 1.15–2.49 and HR 2.16; 95% CI, 1.51–3.10, relative to current drivers).Conclusion: Driving cessation is associated with an increased risk of functional limitations among older adults, but this risk might be alleviated if they are able to maintain independent mobility using public transportation or bicycles after driving cessation.

著者

Yudai Tamada Kenji Takeuchi Chikae Yamaguchi Masashige Saito Tetsuya Ohira Kokoro Shirai Katsunori Kondo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200051, (Released:2020-05-16)

参考文献数

34

被引用文献数

19

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Background: While laughter is broadly recognized as a good medicine, a potential preventive effect of laughter on disability and death is still being debated. Accordingly, we investigated the association between the frequency of laughter and onset of functional disability and all-cause mortality among the older adults in Japan.Methods: The data for a 3-year follow-up cohort including 14,233 individuals (50.3% men) aged ≥ 65 years who could independently perform the activities of daily living and participated in the Japan Gerontological Evaluation Study were analyzed. The participants were classified into four categories according to their frequency of laughter (almost every day, 1–5 days/week, 1–3 days/month, and never or almost never). We estimated the risks of functional disability and all-cause mortality in each category using a Cox proportional hazards model.Results: During follow-up, 605 (4.3%) individuals developed functional disability, identified by new certification for the requirement of Long-Term Care Insurance, and 659 (4.6%) deaths were noted. After adjusting for the potential confounders, the multivariate-adjusted hazard ratio of functional disability increased with a decrease in the frequency of laughter (p for trend = 0.04). The risk of functional disability was 1.42 times higher for individuals who laughed never or almost never than for those who laughed almost every day. No such association was observed with the risk of all-cause mortality (p for trend = 0.39).Conclusions: Low frequency of laughter is associated with increased risks of functional disability. Laughter may be an early predictor of functional disability later on in life.

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

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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

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

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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

Taiji Noguchi Takaaki Ikeda Takao Kanai Masashige Saito Katsunori Kondo Tami Saito

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20230127, (Released:2023-09-09)

参考文献数

58

被引用文献数

2

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Background: Per the biopsychosocial model, pain, especially chronic low back pain, which often presents with nonspecific pain, requires a comprehensive approach involving social factors. However, the association of social factors, including social isolation and loneliness, with this condition remains unclear. This study examined the cross-sectional association of social isolation and loneliness with chronic low back pain among older adults.Methods: We recruited functionally independent older adults through a mail survey in 2019 from the Japan Gerontological Evaluation Study (JAGES). Chronic low back pain was defined as low back pain lasting more than three months. Social isolation was identified based on face-to-face and non-face-to-face interactions (“not isolated,” “isolated tendency,” and “isolated”). Loneliness was assessed using the UCLA Loneliness Scale (“not lonely,” “lonely tendency,” and “lonely”).Results: Consequently, 21,463 participants were analyzed (mean age: 74.4 years; 51.5% females); 12.6% reported chronic low back pain. Multivariable Poisson regression analysis revealed that loneliness was significantly associated with the likelihood of chronic low back pain; compared with “not lonely”, the prevalence ratio (PR) was 1.14 (95% confidence interval [CI]: 1.05–1.25) for “lonely tendency” and 1.40 (1.27–1.54) for “lonely.” Social isolation was not associated; compared with “not isolated,” the PR (95% CI) was 0.96 (0.88–1.05) for “isolated tendency” and 0.99 (0.89–1.10) for “isolated.” A positive multiplicative interaction between social isolation and loneliness for chronic low back pain was found.Conclusions: Lonelier individuals were more likely to experience chronic low back pain, and those with loneliness and social isolation were synergistically more likely for this condition.

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

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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

Akio Yagi Shinya Hayasaka Toshiyuki Ojima Yuri Sasaki Taishi Tsuji Yasuhiro Miyaguni Yuiko Nagamine Takao Namiki Katsunori Kondo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.29, no.12, pp.451-456, 2019-12-05 (Released:2019-12-05)

参考文献数

40

被引用文献数

7 8

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Background: While bathing styles vary among countries, most Japanese people prefer tub bathing to showers and saunas. However, few studies have examined the relationship between tub bathing and health outcomes. Accordingly, in this prospective cohort study, we investigated the association between tub bathing frequency and the onset of functional disability among older people in Japan.Methods: We used data from the Japan Gerontological Evaluation Study (JAGES). The baseline survey was conducted from August 2010 through January 2012 and enrolled 13,786 community-dwelling older people (6,482 men and 7,304 women) independent in activities of daily living. During a 3-year observation period, the onset of functional disability, identified by new certification for need of Long-Term Care Insurance, was recorded. Tub bathing frequencies in summer and winter at baseline were divided into three groups: low frequency (0–2 times/week), moderate frequency (3–6 times/week), and high frequency (≥7 times/week). We estimated the risks of functional disability in each group using a multivariate Cox proportional hazards model.Results: Functional disability was observed in a total of 1,203 cases (8.7%). Compared with the low-frequency group and after adjustment for 14 potential confounders, the hazard ratios of the moderate- and high-frequency groups were 0.91 (95% confidence interval [CI], 0.75–1.10) and 0.72 (95% CI, 0.60–0.85) for summer and 0.90 (95% CI, 0.76–1.07) and 0.71 (95% CI, 0.60–0.84) for winter.Conclusion: High tub bathing frequency is associated with lower onset of functional disability. Therefore, tub bathing might be beneficial for older people’s health.

著者

Sakura Kiuchi Taro Kusama Kemmyo Sugiyama Takafumi Yamamoto Upul Cooray Tatsuo Yamamoto Katsunori Kondo Ken Osaka Jun Aida

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.7, pp.330-336, 2022-07-05 (Released:2022-07-05)

参考文献数

50

被引用文献数

2 13

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Background: Although the feasibility of randomized trials for investigating the long-term association between oral health and cognitive decline is low, deriving causal inferences from observational data is challenging. We aimed to investigate the association between poor oral status and subjective cognitive complaints (SCC) using fixed-effects model to eliminate the confounding effect of unobserved time-invariant factors.Methods: We used data from Japan Gerontological Evaluation Study (JAGES) which was conducted in 2010, 2013, and 2016. β regression coefficients and 95% confidence intervals [CIs] were calculated using fixed-effects models to determine the effect of deteriorating oral status on developing SCC. Onset of SCC was evaluated using the Kihon Checklist-Cognitive function score. Four oral status variables were used: awareness of swallowing difficulty, decline in masticatory function, dry mouth, and number of teeth.Results: We included 13,594 participants (55.8% women) without SCC at baseline. The mean age was 72.4 (standard deviation [SD], 5.1) years for men and 72.4 (SD, 4.9) years for women. Within the 6-year follow-up, 26.6% of men and 24.9% of women developed SCC. The probability of developing SCC was significantly higher when participants acquired swallowing difficulty (β = 0.088; 95% CI, 0.065–0.111 for men and β = 0.077; 95% CI, 0.057–0.097 for women), decline in masticatory function (β = 0.039; 95% CI, 0.021–0.057 for men and β = 0.030; 95% CI, 0.013–0.046 for women), dry mouth (β = 0.026; 95% CI, 0.005–0.048 for men and β = 0.064; 95% CI, 0.045–0.083 for women), and tooth loss (β = 0.043; 95% CI, 0.001–0.085 for men and β = 0.058; 95% CI, 0.015–0.102 for women).Conclusion: The findings suggest that good oral health needs to be maintained to prevent the development of SCC, which increases the risk for future dementia.

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 7

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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

Keiko Ishimura Ryoto Sakaniwa Kokoro Shirai Jun Aida Kenji Takeuchi Katsunori Kondo Hiroyasu Iso

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220221, (Released:2023-03-25)

参考文献数

35

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BackgroundThe association between the frequency of going outdoors and the risk of poor oral health has been reported in several studies; however, the findings have been inconclusive.MethodsWe conducted a three-year longitudinal study of 19,972 Japanese adults aged ≥65 years who reported no poor oral condition at baseline in 2013. The respondents rated their frequency of going outdoors in three categories (≤1, 2–3, or ≥4 times/week), and the oral conditions reported in 2016 included tooth loss, chewing difficulty, swallowing difficulty, dry mouth, and composite outcomes. The associations between the frequency of going outdoors and the risk of poor oral health were examined as relative risk ratios (RR) and 95% confidence intervals (CI) using multivariable Poisson regression, while mediation analysis was performed to investigate indirect effects.ResultsDuring the follow-up, 32.5% of participants developed poor oral health. In the mediation analysis, indirect effects were observed through low instrumental activities of daily living, depressive symptoms, little social network diversity, and underweight.Compared to going outdoors ≥4 times/week, the multivariable RR(95%CI) of composite poor oral health conditions was 1.12 (1.05–1.20) for 2–3 times/week and 1.22 (1.07–1.39) for ≤1 time/week (P-trend<0.001). Similar associations were observed for tooth loss, chewing difficulty, and swallowing difficulty; the corresponding RRs(95%CIs) were 1.07(0.97–1.19) and 1.36(1.13–1.64) (P-trend=0.002), 1.18(1.06–1.32) and 1.30(1.05–1.60) (P-trend<0.001), and 1.15(1.01–1.31) and 1.38(1.08–1.77) (P-trend=0.002), respectively.ConclusionThe frequency of going outdoors was inversely associated with the risk of poor oral health through several modifiable risk factors in the older population.

著者

Koryu Sato Naoki Kondo Chiyoe Murata Yugo Shobugawa Kousuke Saito Katsunori Kondo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.9, pp.401-407, 2022-09-05 (Released:2022-09-05)

参考文献数

40

被引用文献数

5

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Background: Increasing the coverage of vaccinations recommended by the World Health Organization in the older adult population is an urgent issue, especially in the context of avoiding co-epidemics during the current coronavirus disease 2019 crisis. The aim of this study was to examine factors associated with the quality of perceived patient–physician communication and whether this variable was associated with increased odds of vaccination.Methods: We used cross-sectional data from the Japan Gerontological Evaluation Study conducted from October 2016 to January 2017. The participants were 22,253 physically and cognitively independent individuals aged 65 or older living in 39 municipalities in Japan. Multilevel logit models were used to estimate the odds of vaccination.Results: Among the participants, 40.0% and 58.8% had received pneumococcal and influenza vaccinations as per the recommended schedule, respectively. People with low educational levels were more likely to have a family physician but rate their experience in asking questions lower than those with higher educational levels. Having a family physician and high rating for physicians’ listening attitude were positively associated with increased odds of pneumococcal and influenza vaccinations. High rating for patients’ questioning attitude and shared decision-making, compared to an ambiguous attitude toward medical decision-making, were positively associated with increased odds of pneumococcal vaccination.Conclusion: The results suggest that promotion of having a family physician, better patient–physician communication, and shared decision-making may encourage older adults to undergo recommended vaccinations.

著者

Tomoko Tsubokawa Yugo Shobugawa Seitaro Iguchi Tsubasa Suzuki Michiko Watanabe Reiko Saito Katsunori Kondo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.6, pp.254-269, 2022-06-05 (Released:2022-06-05)

参考文献数

36

被引用文献数

3

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Background: Homebound status is one of the most important risk factors associated with functional decline and long-term care in older adults. Studies show that neighborhood built environment and community social capital may be related to homebound status. This study aimed to clarify the association between homebound status for community-dwelling older adults and community environment—including social capital and neighborhood built environment—in rural and urban areas.Methods: We surveyed people aged 65 years and older residing in three municipalities of Niigata Prefecture, Japan, who were not certified as requiring long-term care. The dependent variable was homebound status; explanatory variables were community-level social capital and neighborhood built environment. Covariates were age, sex, household, marital status, socioeconomic status, instrumental activities of daily living, the Geriatric Depression Scale-15, self-rated health, number of diseases under care, and individual social capital. The association between community social capital or neighborhood built environment and homebound status, stratified by rural/urban areas, was investigated using multilevel logistic regression analysis.Results: Among older adults (n = 18,099), the homebound status prevalence rate was 6.9% in rural areas and 4.2% in urban areas. The multilevel analysis showed that, in rural areas, fewer older adults were homebound in communities with higher civic participation and with suitable parks or pavements for walking and exercising. However, no significant association was found between community social capital or neighborhood built environment and homebound status for urban older adults.Conclusion: Community social capital and neighborhood built environment were significantly associated with homebound status in older adults in rural areas.

著者

Takaaki Ikeda Noriko Cable Masashige Saito Shihoko Koyama Taishi Tsuji Taiji Noguchi Katsunori Kondo Ken Osaka Jun Aida

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.10, pp.523-529, 2021-10-05 (Released:2021-10-05)

参考文献数

39

被引用文献数

3 14

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Background: Existing evidence suggest that those who are socially isolated are at risk for taking up or continuing smoking. This study investigated country-based differences in social isolation and smoking status.Methods: We performed a repeated cross-sectional study using two waves of data from two ongoing aging studies: the English Longitudinal Study of Ageing and the Japan Gerontological Evaluation Study. Participants from both studies aged ≥65 years were included. We applied a multilevel Poisson regression model to examine the association between social isolation and smoking status and adjusted for individual sociodemographic characteristics. We used the social isolation index which comprises the following domains: marital status; frequency of contact with friends, family, and children; and participation in social activities. Interaction terms between each country and social isolation were also entered into the mode.Results: After exclusion of never smokers, we analyzed 75,905 participants (7,092 for ELSA and 68,813 for JAGES, respectively). Taking ex-smokers as the reference, social isolation was significantly associated with current smoking; the prevalence ratios (PRs) were 1.06 (95% credible interval [CrI], 1.05–1.08) for men and 1.08 (95% CrI, 1.04–1.11) for women. Taking Japan as a reference, the interaction term between country and social isolation was significant for both sexes, with increased PRs of 1.32 (95% CrI, 1.14–1.50) for men and 1.30 (95% CrI, 1.11–1.49) for women in England.Conclusions: Older people who were less socially isolated were more likely to quit smoking in England than in Japan, possibly explained by the strict tobacco control policies in England.

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

7

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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

Yudai Tamada Kenji Takeuchi Chikae Yamaguchi Masashige Saito Tetsuya Ohira Kokoro Shirai Katsunori Kondo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.5, pp.301-307, 2021-05-05 (Released:2021-05-05)

参考文献数

34

被引用文献数

19

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Background: While laughter is broadly recognized as a good medicine, a potential preventive effect of laughter on disability and death is still being debated. Accordingly, we investigated the association between the frequency of laughter and onset of functional disability and all-cause mortality among the older adults in Japan.Methods: The data for a 3-year follow-up cohort including 14,233 individuals (50.3% men) aged ≥65 years who could independently perform the activities of daily living and participated in the Japan Gerontological Evaluation Study were analyzed. The participants were classified into four categories according to their frequency of laughter (almost every day, 1–5 days/week, 1–3 days/month, and never or almost never). We estimated the risks of functional disability and all-cause mortality in each category using a Cox proportional hazards model.Results: During follow-up, 605 (4.3%) individuals developed functional disability, identified by new certification for the requirement of Long-Term Care Insurance, and 659 (4.6%) deaths were noted. After adjusting for the potential confounders, the multivariate-adjusted hazard ratio of functional disability increased with a decrease in the frequency of laughter (P for trend = 0.04). The risk of functional disability was 1.42 times higher for individuals who laughed never or almost never than for those who laughed almost every day. No such association was observed with the risk of all-cause mortality (P for trend = 0.39).Conclusions: Low frequency of laughter is associated with increased risks of functional disability. Laughter may be an early predictor of functional disability later on in life.

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

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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

Takaaki Ikeda Noriko Cable Masashige Saito Shihoko Koyama Taishi Tsuji Taiji Noguchi Katsunori Kondo Ken Osaka Jun Aida

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20200138, (Released:2020-08-08)

参考文献数

39

被引用文献数

14

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Background: Existing evidence suggest that those who are socially isolated are at risk for taking up or continuing smoking. This study investigated country-based differences in social isolation and smoking status.Methods: We performed a repeated cross-sectional study using two waves of data from two ongoing aging studies: the English Longitudinal Study of Ageing and the Japan Gerontological Evaluation Study. Participants from both studies aged ≥65 years old were included. We applied a multilevel Poisson regression model to examine the association between social isolation and smoking status and adjusted for individual sociodemographic characteristics. We used the social isolation index which comprises the following domains: marital status; frequency of contact with friends, family, and children; and participation in social activities. Interaction terms between each country and social isolation were also entered into the mode.Results: After exclusion of never smokers, we analyzed 75,905 participants (7,092 for ELSA and 68,813 for JAGES, respectively). Taking ex-smokers as the reference, social isolation was significantly associated with current smoking; the prevalence ratios (PRs; 95% credible intervals [CrIs]) were 1.06 (1.05–1.08) for men and 1.08 (1.04–1.11) for women. Taking Japan as a reference, the interaction term between country and social isolation was significant for both sexes, with increased PRs (95% CrIs) of 1.32 (1.14–1.50) for men and 1.30 (1.11–1.49) for women in England.Conclusions: Older people who were less socially isolated were more likely to quit smoking in England than in Japan, possibly explained by the strict tobacco control policies in England.

著者

Miwa Yamaguchi Yosuke Inoue Tomohiro Shinozaki Masashige Saito Daisuke Takagi Katsunori Kondo Naoki Kondo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.29, no.10, pp.363-369, 2019-10-05 (Released:2019-10-05)

参考文献数

46

被引用文献数

40

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Background: This study aimed to examine the contextual effects of community-level social capital on the onset of depressive symptoms using a longitudinal study design.Methods: We used questionnaire data from the 2010 and 2013 waves of the Japan Gerontological Evaluation Study that included 14,465 men and 14,600 women aged over 65 years from 295 communities. We also used data of a three-wave panel (2006–2010–2013) to test the robustness of the findings (n = 7,424). Using sex-stratified multilevel logistic regression, we investigated the lagged associations between three scales of baseline community social capital and the development of depressive symptoms.Results: Community civic participation was inversely associated with the onset of depressive symptoms (men: adjusted odds ratio [AOR] 0.93; 95% confidence interval [CI], 0.88–0.99 and women: AOR 0.94; 95% CI, 0.88–0.997 per 1 standard deviation unit change in the score), while no such association was found in relation to the other two scales on social cohesion and reciprocity. This association was attenuated by the adjustment of individual responses to the civic participation component. Individual-level scores corresponding to all three community social capital components were significantly associated with lower risks for depressive symptoms. The results using the three-wave data set showed statistically less clear but similar associations.Conclusions: Promoting environment and services enhancing to community group participation might help mitigate the impact of late-life depression in an aging society.

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

48

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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.