著者

Soichiro Saeki

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.9, pp.439, 2022-09-05 (Released:2022-09-05)

参考文献数

4

被引用文献数

2

著者

Soichiro Saeki

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.9, pp.438, 2022-09-05 (Released:2022-09-05)

参考文献数

6

被引用文献数

1 8

著者

Susumu Yagome Takehiro Sugiyama Kosuke Inoue Ataru Igarashi Ryotaro Bouchi Mitsuru Ohsugi Kohjiro Ueki Atsushi Goto

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.10, pp.476-482, 2022-10-05 (Released:2022-10-05)

参考文献数

25

被引用文献数

11

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Background: Regular visits with healthcare professionals are important for preventing serious complications in patients with diabetes. The purpose of this retrospective cohort study was to clarify whether there was any suppression of physician visits among patients with diabetes during the spread of the novel coronavirus 2019 (COVID-19) in Japan and to assess whether telemedicine contributed to continued visits.Methods: We used the JMDC Claims database, which contains the monthly claims reported from July 2018 to May 2020 and included 4,595 (type 1) and 123,686 (type 2) patients with diabetes. Using a difference-in-differences analysis, we estimated the changes in the monthly numbers of physician visits or telemedicine per 100 patients in April and May 2020 compared with the same months in 2019.Results: For patients with type 1 diabetes, the estimates for total overall physician visits were −2.53 (95% confidence interval [CI], −4.63 to 0.44) in April and −8.80 (95% CI, −10.85 to −6.74) in May; those for telemedicine visits were 0.71 (95% CI, 0.47–0.96) in April and 0.54 (95% CI, 0.32–0.76) in May. For patients with type 2 diabetes, the estimates for overall physician visits were −2.50 (95% CI, −2.95 to −2.04) in April and −3.74 (95% CI, −4.16 to −3.32) in May; those for telemedicine visits were 1.13 (95% CI, 1.07–1.20) in April and 0.73 (95% CI, 0.68–0.78) in May.Conclusion: The COVID-19 pandemic was associated with suppression of physician visits and a slight increase in the utilization of telemedicine among patients with diabetes during April and May 2020.

著者

Takashi Oshio

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.8, pp.363-369, 2022-08-05 (Released:2022-08-05)

参考文献数

43

被引用文献数

3

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Background: Enhanced female labor force participation is raising the importance of grandparents’ caring for their grandchildren. However, previous studies have reported mixed results of the association between grandchild care and grandparents’ health.Methods: Longitudinal data of 33,204 individuals born between 1946 and 1955 were collected from a 14-wave nationwide panel survey conducted from 2005 to 2018. We examined how caring for at least one co-residing grandchild aged <6 years was associated with grandparents’ psychological distress (defined by five or higher Kessler 6 score) and poor self-rated health in pooled cross-sectional, fixed-effects, and 3-year follow-up logistic models.Results: While pooled cross-sectional models showed a positive association between grandchild care and grandparents’ health, the fixed-effects or follow-up logistic models did not find any significant association between them. In the case of grandmothers, the odds ratio of reporting psychological distress in response to caring for grandchildren was 0.98 (95% confidence interval [CI], 0.89–1.08) and 1.04 (95% CI, 0.85–1.27) observed from fixed-effects and 3-year follow-up models, respectively, compared to 0.86 (95% CI, 0.81–0.91) in the pooled cross-sectional model. Similar patterns were observed for self-rated health for grandmothers, while grandfathers’ health outcomes were not sensitive to grandchild care. These results contrasted with those of caring for parents, which had almost consistently a negative association with grandparents’ health.Conclusion: The results suggest that caring for grandchildren does not have a beneficial or detrimental effect on grandparents’ 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

Soichiro Saeki Kaori Minamitani Isao Muraki Tomoko Shingaki Koji Nagura Ken Nakata Hiroyasu Iso

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.2, pp.112-113, 2022-02-05 (Released:2022-02-05)

参考文献数

7

被引用文献数

1 11

著者

Taiji Noguchi Fumi Kondo Takeshi Nishiyama Takahiro Otani Hiroko Nakagawa-Senda Miki Watanabe Nahomi Imaeda Chiho Goto Akihiro Hosono Kiyoshi Shibata Hiroyuki Kamishima Akane Nogimura Kenji Nagaya Tamaki Yamada Sadao Suzuki

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.2, pp.89-95, 2022-02-05 (Released:2022-02-05)

参考文献数

37

被引用文献数

1

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Background: Marital transitions are associated with adverse health events, such as mortality and cardiovascular disease. Since marital transitions (eg, becoming widowed) are unavoidable life events, it is necessary to identify modifiable intermediate outcomes. Thus, we examined the association between marital transitions and vegetable intake among middle-aged and older Japanese adults.Methods: This longitudinal study included Japanese adults aged 40–79 years who received an annual health checkup between 2007 and 2011 (baseline) and 5 years later (follow-up). Marital transitions were classified as whether and what type of transition occurred during the 5-year period and comprised five groups: consistently married, married to widowed, married to divorced, not married to married, and remained not married. Changes in total vegetable, green and yellow vegetable, and light-colored vegetable intake from baseline to follow-up were calculated using the Food Frequency Questionnaire.Results: Data from 4,813 participants were analyzed (mean age, 59.4 years; 44.1% women). Regarding marital transitions, 3,960 participants were classified as “consistently married,” 135 as “married to widowed,” 40 as “married to divorced,” 60 as “not married to married,” and 529 as “remained not married.” Multivariable linear regression analysis revealed that compared to consistently married, married to widowed was inversely associated with the change in total vegetable intake (β = −16.64, SE = 7.68, P = 0.030) and light-colored vegetable intake (β = −11.46, SE = 4.33, P = 0.008).Conclusion: Our findings suggest that being widowed could result in a reduced intake of vegetables. Hence, dietary counseling according to marital situation is necessary.

著者

Ikuyo Tsutsumi Yusuke Tsutsumi Chikashi Yoshida Takuya Komeno Yuichi Imanaka

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.1, pp.27-33, 2022-01-05 (Released:2022-01-05)

参考文献数

24

被引用文献数

5

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Background: The number of new noncommercial clinical studies conducted in Japan declined within the first year of the implementation of the Clinical Trials Act (CTA) on April 1, 2018. This study aimed to examine the impact of the CTA’s enforcement on the number of new noncommercial clinical studies registered in the Japanese Clinical Trial Registry.Methods: An interrupted time-series design was used in the analysis, which was conducted from April 2015 to March 2019. We collected data for studies registered in the Clinical Trial Registry, managed by the University Hospital Medical Information Network.Results: In total, 35,811 studies were registered; of these, 16,455 fulfilled the eligibility criteria. The difference in the trend of monthly number of new studies after CTA enforcement decreased significantly by 15.0 (95% confidence interval [CI], −18.7 to −11.3), and the level decreased by 40.8 (95% CI, −68.2 to −13.3) studies from the pre-enforcement to the post-enforcement period. Multigroup analyses indicated that the act exerted a significant effect on the trend of new clinical studies, particularly those with smaller sample sizes, interventional study designs, and nonprofit funding sponsors.Conclusions: The number of Japanese noncommercial clinical studies declined significantly following implementation of the CTA. It is necessary to establish a system to promote clinical studies in Japan while ensuring transparency and safety.

著者

Yuri Ito Seiichiro Yamamoto Kenichi Nakamura

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.1, pp.2-3, 2022-01-05 (Released:2022-01-05)

参考文献数

8

被引用文献数

1

著者

Naoko Hatakeyama Masamitsu Kamada Naoki Kondo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.1, pp.4-11, 2022-01-05 (Released:2022-01-05)

参考文献数

52

被引用文献数

4

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Background: Sedentary behaviors are prevalent among children and can have a detrimental effect on their health. Little is known about the influence of parental time on children’s sedentary behavior. This study examined the association between parental working hours and children’s sedentary time.Methods: Cross-sectional data were drawn from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE) in 2010 and 2011. Participants were 886 children aged 7–18 years and their parents. The primary outcome was self-reported sedentary time after school that comprised screen time and non-screen time. The main explanatory variable was parental working hours. We used multiple regression analysis adjusting for sociodemographic factors.Results: Children’s mean sedentary time was 222 (standard deviation [SD], 123) min/day; 144 (SD, 108) min/day screen time and 78 (SD, 65) min/day non-screen time. Children whose mothers worked ≥20 hours/week had 28 (95% CI, 9 to 48) min/day longer sedentary time than children of homemakers (240 min/day vs 214 min/day). The longer maternal working hours, the longer sedentary time (P for trend <0.01). In contrast, children whose fathers worked ≥48 hours/week had 82 (95% CI, −156 to −7) min/day shorter sedentary time than children of non-working fathers (179 min/day vs 264 min/day). When limited to children whose fathers worked, there was no statistically significant association between children’s sedentary time and paternal working hours.Conclusions: Children with mothers who work long hours or fathers not working tend to sit more. Supplementing the shortages in resources for childcare may be necessary among those families.

著者

Wei-Shan Chin Shih-Cheng Liao Shin-Chun Pan Yue-Liang Leon Guo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.1, pp.12-20, 2022-01-05 (Released:2022-01-05)

参考文献数

51

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Background: The long-term effects of occupational injury (OI) on psychiatric diseases are unclear. This study assessed and compared the effects of OI, no injury (control), and non-OI (NOI) on the development of psychiatric diseases.Methods: We used Taiwan’s National Health Insurance Research Database to investigate the incidence of psychiatric disorders in OI, NOI, and control groups. The subjects were aged 20–50 years, actively employed in 2000, and did not have history of injury or psychiatric disorders. All subjects were followed from 2000 and were classified into OI, NOI, and control groups according to occurrence of target injury later on. Individuals in each group were matched by age, sex, insurance premium before the index date, and year of the index date. Psychiatric disease-free days were compared among the groups using survival analysis and Cox regression.Results: We included a total of 12,528 patients for final analysis, with 4,176 in each group. Compared with the control group, the OI group had an increased occurrence of trauma and stress-related disorder, depressive disorders, anxiety disorders, and alcohol and other substance dependence. These increases were similar to those in the NOI group. Elevated cumulative incidence rate of any psychiatric disorders was observed among those with OI or NOI up to 10 years after injury.Conclusion: We confirmed that OI and NOI induced psychiatric disorders. These findings highlight the need for workers’ compensation mechanisms to consider long-term psychological care among injured workers.

著者

Akira Takagi Satoko Ohfuji Takashi Nakano Hideaki Kumihashi Munehide Kano Toshihiro Tanaka

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.1, pp.21-26, 2022-01-05 (Released:2022-01-05)

参考文献数

17

被引用文献数

3 9

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Background: Mumps deafness causes serious problems, and incidence data are needed to identify its disease burden. However, such data are limited, and the reported incidence is highly variable. Nationwide studies in Japan with a large age range are lacking.Methods: This was a retrospective observational investigation of the 2005–2017 mumps burden using employment-based health insurance claims data. Data were analyzed for 5,190,326 people aged 0–64 years to estimate the incidence of mumps deafness.Results: Of 68,112 patients with mumps (36,423 males; 31,689 females), 102 (48 males; 54 females) developed mumps deafness—an incidence of 15.0 per 10,000 patients (1 in 668 patients). Fifty-four (52.9%) patients had mumps deafness in childhood (0–15 years), and 48 (47.1%) had mumps deafness in adolescence and adulthood (16–64 years); most cases occurred in childhood, the peak period for mumps onset. The incidence of mumps deafness per 10,000 patients was 73.6 in adolescence and adulthood, 8.4 times higher than the incidence of 8.8 in childhood (P < 0.001). In childhood, the incidence of mumps deafness was 7.2 times higher among 6–15-year-olds (13.8; 95% CI, 10.2–18.2) than among 0–5-year-olds (1.9; 95% CI, 0.6–4.5), and this difference was statistically significant (P < 0.001). No sex difference was observed.Conclusions: The incidence of mumps deafness per 10,000 patients aged 0–64 years was 15.0 (1 in 668 patients). A secondary risk of deafness following mumps virus infection was identified not only for children, but also for adolescents and adults.

著者

Yoshihiro Kaneko Yutaka Motohashi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.17, no.4, pp.114-119, 2007 (Released:2007-07-18)

参考文献数

26

被引用文献数

29 55

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BACKGROUND: Both male gender and low socioeconomic status have been related to depression and suicide, but their possible relationship to mental health literacy remains uncertain. The objectives of this study were to assess the level of mental health literacy in rural communities in Japan and to examine related factors.METHODS: A population-based cross-sectional study using a questionnaire was conducted. Response rate was 88.2% from 8163 residents aged 30-69 years. The relationships between mental health literacy (including cognition of depression, attitude toward depression, and acceptance of suicide) and demographics, socioeconomic status, and the severity of depression were assessed by logistic regression analysis.RESULTS: Of the respondents, 25.2% showed an inadequate cognition of depression, 12.5% showed an inadequate attitude toward depression, and 13.1% showed an acceptance of suicide. Of the complete respondents (65.5%), an inadequate cognition of depression was associated with being male (adjusted odds ratio=1.93, 95% confidence interval: 1.68-2.22), advanced age (2.18, 1.58-3.00), and a lower level of education (1.95, 1.34-2.86); an inadequate attitude toward depression was associated with being male (2.18, 1.82-2.61), a lower education (2.34, 1.38-3.97), and the severity of depression (2.26, 1.54-3.32); and an acceptance of suicide was associated with being male (1.33, 1.13-1.58) and the severity of depression (5.77, 4.20-7.93).CONCLUSIONS: Poor mental health literacy related strongly to male gender and a low level of education. According to our results, poor mental health literacy may possibly be a factor contributing to male vulnerability to suicide.J Epidemiol 2007; 17: 114-119.

著者

Mariko Kanamori Naoki Kondo Yasuhide Nakamura

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.31, no.1, pp.43-51, 2021-01-05 (Released:2021-01-05)

参考文献数

47

被引用文献数

2 5

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Background: Recent research suggests that Japanese inter-prefecture inequality in the risk of death before reaching 5 years old has increased since the 2000s. Despite this, there have been no studies examining recent trends in inequality in the infant mortality rate (IMR) with associated socioeconomic characteristics. This study specifically focused on household occupation, environment, and support systems for perinatal parents.Methods: Using national vital statistics by household occupation aggregated in 47 prefectures from 1999 through 2017, we conducted multilevel negative binomial regression analysis to evaluate occupation/IMR associations and joinpoint analysis to observe temporal trends. We also created thematic maps to depict the geographical distribution of the IMR.Results: Compared to the most privileged occupations (ie, type II regular workers; including employees in companies with over 100 employees), IMR ratios were 1.26 for type I regular workers (including employees in companies with less than 100 employees), 1.41 for the self-employed, 1.96 for those engaged in farming, and 6.48 for unemployed workers. The IMR ratio among farming households was 1.75 in the prefectures with the highest population density (vs the lowest) and 1.41 in prefectures with the highest number of farming households per 100 households (vs the lowest). Joinpoint regression showed a yearly monotonic increase in the differences and ratios of IMRs among farming households compared to type II regular worker households. For unemployed workers, differences in IMRs increased sharply from 2009 while ratios increased from 2012.Conclusions: Inter-occupational IMR inequality increased from 1999 through 2017 in Japan. Further studies using individual-level data are warranted to better understand the mechanisms that contributed to this increase.

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.12, pp.570, 2022-12-05 (Released:2022-12-05)

著者

Hiroyuki Masaoka Keitaro Matsuo Isao Oze Takashi Kimura Akiko Tamakoshi Yumi Sugawara Ichiro Tsuji Norie Sawada Shoichiro Tsugane Hidemi Ito Keiko Wada Chisato Nagata Tetsuhisa Kitamura Ling Zha Ritsu Sakata Kotaro Ozasa Yingsong Lin Tetsuya Mizoue Keitaro Tanaka Sarah Krull Abe Manami Inoue

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220085, (Released:2022-10-29)

参考文献数

29

被引用文献数

3

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Background: Although cigarette smoking is an established risk factor for bladder cancer, assessment of smoking impact on bladder cancer in Asian populations has been hindered by few cohort studies conducted in Asian populations. We therefore investigated the risk of bladder cancer associated with smoking status, cumulative smoking intensity and smoking cessation in Japan.Methods: We analyzed data for 157,295 men and 183,202 women in ten population-based cohort studies in Japan. The risk associated with smoking behaviors was estimated using Cox regression models within each study, and pooled hazard ratios (HR) and their 95% confidence intervals (CI) for the incidence of bladder cancer were calculated.Results: During 4,729,073 person-years of follow up, 936 men and 325 women developed bladder cancer. In men, former smokers (HR 1.47; 95% CI, 1.18-1.82) and current smokers (HR 1.96; 95% CI, 1.62-2.38) had higher risk than never smokers. In women, current smokers had higher risk than never smokers (HR 2.35; 95% CI, 1.67-3.32). HRs in men linearly increased with increasing pack-years. Risk decreased with increasing years of smoking cessation in men with a significant dose-response trend. Former smokers with a duration of more than 10 years after smoking cessation had no significantly increased risk compared with never smokers (HR 1.26; 95% CI, 0.97-1.63).Conclusions: Data from a pooled analysis of ten population-based cohort studies in Japan clearly show an association between cigarette smoking and bladder cancer risk. The risk of smokers may approximate that of never smokers following cessation for many years.

著者

Cyrus Ghaznavi Daisuke Yoneoka Yuta Tanoue Stuart Gilmour Takayuki Kawashima Akifumi Eguchi Yumi Kawamura Hiroaki Miyata Shuhei Nomura

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20220064, (Released:2022-07-02)

参考文献数

32

被引用文献数

10

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BackgroundIncreases in human mobility have been linked to rises in COVID-19 transmission. The pandemic era in Japan has been characterized by changes in inter-prefectural mobility across state of emergency declarations (SOE) and travel campaigns, but they have yet to be characterized.MethodsUsing Yahoo Japan mobility data extracted from the smartphones of more than 10 million Japanese residents, we calculated the monthly number of inter-prefectural travel instances, stratified by residential prefecture and destination prefecture. We then used this adjacency matrix to calculate two network connectedness metrics, closeness centrality and effective distance, that reliably predict disease transmission.ResultsInter-prefectural mobility and network connectedness decreased most considerably during the first SOE, but this decrease dampened with each successive SOE. Mobility and network connectedness increased during the Go To Travel campaign. Travel volume between distant prefectures decreased more than travel between prefectures with geographic proximity. Closeness centrality was found to be negatively correlated with the rate of COVID-19 infection across prefectures, with the strength of this association increasing in tandem with the infection rate. Changes in effective distance were more visible among geographically isolated prefectures (Hokkaido and Okinawa) than among metropolitan, central prefectures (Tokyo, Aichi, Osaka, and Fukuoka).ConclusionsThe magnitude of reductions in human mobility decreased with each subsequent state of emergency, consistent with pandemic fatigue. The association between network connectedness and rates of COVID-19 infection remained visible throughout the entirety of the pandemic period, suggesting that inter-prefectural mobility may have contributed to disease spread.

著者

Hiroyuki Kikuchi Masaki Machida Itaru Nakamura Reiko Saito Yuko Odagiri Noritoshi Fukushima Tomoko Takamiya Shiho Amagasa Keisuke Fukui Takako Kojima Hidehiro Watanabe Shigeru Inoue

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20210397, (Released:2022-04-16)

参考文献数

45

被引用文献数

6

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BackgroundThis longitudinal study aimed to investigate how psychological distress levels changed from early to middle phases of the new coronavirus (COVID-19) pandemic depending on the living arrangements of individuals.MethodAn internet-based, longitudinal survey of 2,400 Japanese people was conducted every 5-6 weeks between February 2020 and January 2021. The presence of severe psychological distress (SPD) was measured using the Kessler’s psychological distress scale. Living arrangements were classified into two groups, i.e. living alone or living with others. Mixed-effects logistic regression analysis was performed to assess whether changes in SPD status were different depending on living arrangements.ResultsOf 2400 respondents, 446 (18.5%) lived alone. Although the proportion of SPD in both individuals living alone and those living with others increased to the same extent in the early phase of the pandemic, however, after early phase of pandemic, the distress levels decreased in the group living with others, compared with the group living alone, which remained high. The odds ratio (OR) of developing SPD in interaction term with survey phases tended to be higher among those who lived alone than those who lived with others in Phase 6 (OR: 1.89, CI: 0.99-3.64) and Phase 7 (OR:1.88, CI: 0.97-3.63)ConclusionsDuring the COVID-19 pandemic, those living alone are persistently at a higher risk of SPD compared to those living with others. Effective countermeasures targeting those living alone such as enhancing online communication or providing psychological therapies are essential.

著者

Yuta Yokokawa Toshimasa Sone Sanae Matsuyama Yukai Lu Yumi Sugawara Akira Fukao Ichiro Tsuji

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20210493, (Released:2022-05-07)

参考文献数

41

被引用文献数

1

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Background: Desired longevity represents how strongly people esteem possible extensions of their own lifetime. The association between desired longevity and mortality risk has been reported in only one prospective study, which examined a small sample of older participants. We aimed to examine the hypothesis that desired longevity at middle-age predicted long-term survival.Methods: In the prospective cohort study, residents aged 40–64 years were asked how long they would like to live and asked to choose one from three options: longer than, as long as, or shorter than the life expectancy. We used Cox proportional hazards model to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality according to the three groups for desired longevity, treating the “longer than” group as the reference. We conducted mediation analysis to investigate the mechanism for the association between desired longevity and mortality.Results: 39,902 residents were recruited to the study. Risk of all-cause mortality was significantly higher in the “shorter than” group (HR 1.12; 95% CI, 1.04-1.21). The association was independent of sex, age, marital status, education, medical history and health status. Regarding cause of death, mortality risk of cancer (HR 1.14; 95% CI, 1.00-1.29) and suicide (HR 2.15; 95% CI, 1.37-3.38) were also higher in the “shorter than” group. The unhealthy lifestyle mediated this association with all-cause mortality by 30.4%.Conclusions: Shorter desired longevity was significantly associated with an increased risk of all-cause mortality, and mortality from cancer and suicide. Lifestyle behaviors particularly mediated this association.

著者

Etsuji Suzuki Michio Yamamoto Eiji Yamamoto

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20210352, (Released:2022-01-22)

参考文献数

26

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Background: The counterfactual definition of confounding is often explained in the context of exchangeability between the exposed and unexposed groups. One recent approach is to examine whether the measures of association (e.g., associational risk difference) are exchangeable when exposure status is flipped in the population of interest. We discuss the meaning and utility of this approach, showing their relationships with the concept of confounding in the counterfactual framework.Methods: Three hypothetical cohort studies are used, in which the target population is the total population. After providing an overview of the notions of confounding in distribution and in measure, we discuss the approach from the perspective of exchangeability of measures of association (e.g., factual associational risk difference vs. counterfactual associational risk difference).Results: In general, if the measures of association are non-exchangeable when exposure status is flipped, confounding in distribution is always present, although confounding in measure may or may not be present. Even if the measures of association are exchangeable when exposure status is flipped, there could be confounding both in distribution and in measure. When we use risk difference or risk ratio as a measure of interest and the exposure prevalence in the population is 0.5, testing the exchangeability of measures of association is equivalent to testing the absence of confounding in the corresponding measures.Conclusions: The approach based on exchangeability of measures of association essentially does not provide a definition of confounding in the counterfactual framework. Subtly differing notions of confounding should be distinguished carefully.