著者
Tami Saito Tuula Oksanen Kokoro Shirai Takeo Fujiwara Jaana Pentti Jussi Vahtera
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20190061, (Released:2019-09-07)
参考文献数
36
被引用文献数
3

Background: While marriage and education help maintain older adults’ health, their joint association with mortality remains unclear. This cross-national study examined the combined effect of marriage and education on the mortality of older Japanese and Finnish adults.Methods: Data on 22,415 Japanese and 11,993 Finnish adults, aged 65–74 years, were obtained from the Japan Gerontological Evaluation Study of 2010–2012 and the Finnish Public Sector Study of 2008–2009 and 2012–2013. We followed up on respondents’ survival status for 5 years using public records. Marital status, educational level, and other variables in both datasets were harmonized.Results: The Cox proportional hazards model showed that unmarried men had a higher mortality risk than married men in both countries (hazard ratio [HR] 1.47; 95% confidence interval [CI], 1.21–1.79 for Japanese and HR 1.94; 95% CI, 1.29–2.91 for Finnish); no such difference was observed in women. The highest mortality risk was observed in unmarried men with tertiary education in both Japan (HR 1.85; 95% CI, 1.21–2.83) and Finland (HR 2.21; 95% CI, 1.26–3.89), when adjusted for baseline age, health-related behaviors, and illnesses.Conclusions: Our findings showed similarity in the combined effect of marriage and education between Japan and Finland, differing from observations in countries with more apparent socioeconomic health disparities. Further studies should examine the reasons for the excessive mortality risk in highly educated, unmarried men in both countries and consider whether selection bias led to underestimation of the true risk in unmarried older adults with lower education.
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

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
Tami Saito Tuula Oksanen Kokoro Shirai Takeo Fujiwara Jaana Pentti Jussi Vahtera
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.30, no.10, pp.442-449, 2020-10-05 (Released:2020-10-05)
参考文献数
36
被引用文献数
1 3

Background: While marriage and education help maintain older adults’ health, their joint association with mortality remains unclear. This cross-national study examined the combined effect of marriage and education on the mortality of older Japanese and Finnish adults.Methods: Data on 22,415 Japanese and 11,993 Finnish adults, aged 65–74 years, were obtained from the Japan Gerontological Evaluation Study of 2010–2012 and the Finnish Public Sector Study of 2008–2009 and 2012–2013. We followed up on respondents’ survival status for 5 years using public records. Marital status, educational level, and other variables in both datasets were harmonized.Results: The Cox proportional hazards model showed that unmarried men had a higher mortality risk than married men in both countries (hazard ratio [HR] 1.47; 95% confidence interval [CI], 1.21–1.79 for Japanese and HR 1.94; 95% CI, 1.29–2.91 for Finnish); no such difference was observed in women. The highest mortality risk was observed in unmarried men with tertiary education in both Japan (HR 1.85; 95% CI, 1.21–2.83) and Finland (HR 2.21; 95% CI, 1.26–3.89), when adjusted for baseline age, health-related behaviors, and illnesses.Conclusions: Our findings showed similarity in the combined effect of marriage and education between Japan and Finland, differing from observations in countries with more apparent socioeconomic health disparities. Further studies should examine the reasons for the excessive mortality risk in highly educated, unmarried men in both countries and consider whether selection bias led to underestimation of the true risk in unmarried older adults with lower education.