著者

Hiroyuki Ohbe Yusuke Sasabuchi Ryosuke Kumazawa Hiroki Matsui Hideo Yasunaga

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.12, pp.535-542, 2022-12-05 (Released:2022-12-05)

参考文献数

31

被引用文献数

14

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Background: Detailed data on intensive care unit (ICU) occupancy in Japan are lacking. Using a nationwide inpatient database in Japan, we aimed to assess ICU bed occupancy to guide critical care utilization planning.Methods: We identified all ICU patients admitted from January 1, 2015 to December 31, 2018 to ICU-equipped hospitals participating in the Japanese Diagnosis Procedure Combination inpatient database. We assessed the trends in daily occupancy by counting the total number of occupied ICU beds on a given day divided by the total number of licensed ICU beds in the participating hospitals. We also assessed ICU occupancy for patients with mechanical ventilation, patients with extracorporeal membrane oxygenation, and patients without life-supportive therapies.Results: Over the 4 study years, 1,379,618 ICU patients were admitted to 495 hospitals equipped with 5,341 ICU beds, accounting for 75% of all ICU beds in Japan. Mean ICU occupancy on any given day was 60%, with a range of 45.0% to 72.5%. Mean ICU occupancy did not change over the 4 years. Mean ICU occupancy was about 9% higher on weekdays than on weekends and about 5% higher in the coldest season than in the warmest season. For patients with mechanical ventilation, patients with extracorporeal membrane oxygenation, and patients without life-supportive therapies, mean ICU occupancy was 24%, 0.5%, and 30%, respectively.Conclusion: Only one-fourth of ICU beds were occupied by mechanically ventilated patients, suggesting that the critical care system in Japan has substantial surge capacity under normal temporal variation to care for critically ill patients.

著者

Megumi Tsubota-Utsugi Yuki Yonekura Ruriko Suzuki Ryohei Sasaki Kozo Tanno Haruki Shimoda Akira Ogawa Seiichiro Kobayashi Kiyomi Sakata

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.12, pp.527-534, 2022-12-05 (Released:2022-12-05)

参考文献数

43

被引用文献数

3

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Background: People with poor health or mental conditions are generally unwilling to participate in the health examinations, and no studies have directly examined the relationship of psychological distress among disaster survivors with participation status to date. The present study thus examined psychosocial differences according to the respondent status in a 5-year follow-up survey among participants in the prospective health surveys on survivors of the Great East Japan Earthquake and Tsunami Disaster study in Iwate Prefecture, Japan.Methods: We analyzed data from 10,203 Japanese survivors aged ≥18 years (mean age, 65.6 years; 38.0% men) and who underwent health examinations at baseline in 2011. Participants were classified into responders and nonresponders according to their 2015 health examination participation status. Psychological distress was evaluated using the Kessler 6 scale and categorized as none, mild, and severe. Multinominal logistic regression was used to examine the risk of psychological distress in relation to participation status.Results: In the 2015 survey, 6,334 of 6,492 responders and 1,686 of 3,356 nonresponders were analyzed. The most common reasons for nonparticipation in the survey were participated in other health examinations, examined at a hospital, and did not have time to participate. Nonresponse in males was associated only with mild psychological stress, whereas nonresponse in females was associated with mild and severe psychological distress.Conclusion: Nonresponders in the follow-up survey had a higher risk of psychological distress than responders. Continuous monitoring of the health of nonresponders and responders may help to prevent future health deterioration.

著者

Satoshi Seino Shoji Shinkai Akihiko Kitamura Yu Nofuji Yuri Yokoyama Toshiki Hata Yoshinori Fujiwara

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.11, pp.524-526, 2022-11-05 (Released:2022-11-05)

参考文献数

8

被引用文献数

1 3

著者

Daisuke Nishioka Chisato Tamaki Noriko Furuita Hirokazu Nakagawa Erin Sasaki Rika Uematsu Takeshi Ozaki Satoshi Wakata Naoki Kondo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.11, pp.519-523, 2022-11-05 (Released:2022-11-05)

参考文献数

24

被引用文献数

1 5

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Background: The Free/Low-Cost Medical Care Program (FLCMC) can subsidize the payment (exempt/lower) in designated institutions in Japan. Given that poverty is a multidimensional concept including social isolation, the FLCMC applicants may need social support over and above financial aid to improve their quality of life. However, there was no data to discuss what services should be provided and to whom. Hence, we aimed to describe the changes in health-related quality of life scores among users of the FLCMC, with respect to their socioeconomic backgrounds.Methods: This cohort study included patients who newly used FLCMC from July 2018 to April 2019. We used patients’ social work records, obtained at baseline, and self-report questionnaires on the Medical Outcomes Study 8 Items Short Form Health Survey (SF-8), measured both at baseline and 6 months after the application. We used the change in physical and mental health component summary scores (PCS-8 and MCS-8, respectively) as outcome variables.Results: Multiple linear regression analyses, adjusting for age, sex, healthcare institute, and baseline PCS-8 and MCS-8, showed that lower income was associated with an increase in PCS-8 (coef. −0.09; 95% CI, −0.15 to, −0.03) and MCS-8 (coef. −0.04; 95% CI, −0.11, to 0.03). Living alone (versus living with someone) was potentially associated with a decrease in both PCS-8 (coef. −1.58; 95% CI, −7.26 to 4.09) and MCS-8 (coef. −3.62; 95% CI, −9.19 to 1.95).Conclusion: Among patients using FLCMC, those who live alone may need additional support. Further study testing the generalizability of the findings is required.

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

vol.32, no.11, pp.510-518, 2022-11-05 (Released:2022-11-05)

参考文献数

32

被引用文献数

2 10

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Background: Increases in human mobility have been linked to rises in novel coronavirus disease 2019 (COVID-19) transmission. The pandemic era in Japan has been characterized by changes in inter-prefectural mobility across state of emergency (SOE) declarations and travel campaigns, but they have yet to be characterized.Methods: Using 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.Results: Inter-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).Conclusion: The 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

Chih-Ching Liu Chien-Hui Liu Yu Sun Huey-Jane Lee Li-Yu Tang Ming-Jang Chiu

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.11, pp.502-509, 2022-11-05 (Released:2022-11-05)

参考文献数

53

被引用文献数

6 16

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Background: Screening or diagnosis for the elderly with dementia in rural regions might be delayed and underestimated due to limited utilization of healthcare resources. This study aimed to evaluate the disparities of prevalence and risk factors of mild cognitive impairment (MCI) and dementia between urban and rural residence.Methods: In this nationwide door-to-door survey, 10,432 participants aged 65 years and more were selected through computerized random sampling from all administrative districts in Taiwan and were assessed using an in-person interview. We calculated the prevalence of MCI and dementia, with their risk factors examined using multivariable logistic regression.Results: The prevalence of dementia in rural, suburban, and urban areas among the elderly was 8.69% (95% CI, 8.68–8.69), 6.63% (95% CI, 6.62–6.63), and 4.46% (95% CI, 4.46–4.47), respectively. A similar rural-suburban-urban gradient relationship on the dementia prevalence was observed in any age and sex group. The rural:urban ratio was higher in women than in men for both MCI and dementia. Urbanization remained to be an independent factor for both MCI and dementia after adjustment for age, gender, education, lifestyle, and health status. The beneficial effects of exercise on dementia were more evident in rural areas than in urban ones.Conclusion: Significantly higher prevalence of MCI and dementia were found in rural areas than in urban ones, especially for women. The odds of risk factors for MCI and dementia varied by urbanization status. Focus on the rural-urban inequality and the modification of associated factors specifically for different urbanization levels are needed.

著者

Mayu Yasuda Uemura Tetsuya Ohira Seiji Yasumura Akira Sakai Atsushi Takahashi Mitsuaki Hosoya Masanori Nagao Hironori Nakano Hitoshi Ohto Kenji Kamiya

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.11, pp.496-501, 2022-11-05 (Released:2022-11-05)

参考文献数

27

被引用文献数

2

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Background: The proportion of overweight individuals living in the evacuation zone of Fukushima increased after the Great East Japan Earthquake. However, the change in the prevalence of abdominal obesity has not been reported. Lifestyle habits and changes in these habits after the disaster might have affected the onset of abdominal obesity; however, the association between the two is unclear.Methods: This study evaluated 19,673 Japanese participants of the Fukushima Health Management Survey. We used data from general health check-ups conducted in 13 municipalities between 2008 and 2010. Follow-up examinations were performed from June 2011 to March 2013. Changes in the proportion of individuals with abdominal obesity before and after the disaster were compared. Then, lifestyle habits affecting these changes were assessed.Results: We found that 34.2% and 36.6% of participants (P < 0.001), both evacuees (37.0% and 42.1% [P < 0.001]) and non-evacuees (32.8% and 34.0% [P < 0.001]), had abdominal obesity before and after the disaster, respectively. Abdominal obesity was positively associated with smoking cessation, snacking after dinner, and non-breakfast skipping after the disaster and alcohol drinking before and after the disaster (all P < 0.05). Smoking cessation was positively associated with abdominal obesity in both evacuees and non-evacuees and in both men and women (all P < 0.01).Conclusion: The prevalence of abdominal obesity increased among residents in the area affected by nuclear disaster. It might be associated with not only lifestyle habits before the disaster but also changes in these habits after the disaster, especially smoking cessation.

著者

Masaki Machida Tomoko Takamiya Shiho Amagasa Hiroshi Murayama Takeo Fujiwara Yuko Odagiri Hiroyuki Kikuchi Noritoshi Fukushima Mitsuo Kouno Yu Saito Fumitoshi Yoshimine Shigeru Inoue Yugo Shobugawa

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.11, pp.489-495, 2022-11-05 (Released:2022-11-05)

参考文献数

43

被引用文献数

7 9

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Background: The hippocampus is a brain structure important for memory and cognitive function. Physical activity may help prevent hippocampal atrophy. However, few studies have measured sedentary behavior (SB) and intensity-specific physical activity using an accelerometer. This study aimed to examine the cross-sectional associations of objectively-determined SB, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) measured by an accelerometer with hippocampal volume among community-dwelling older adults using compositional data analysis (CoDa) approach.Methods: This cross-sectional study was part of the Neuron to Environmental Impact across Generations (NEIGE) study. A randomly recruited sample of 485 Japanese older adults (47% male; aged 65–84 years) wore tri-axial accelerometers (Omron Healthcare) for 7 consecutive days in 2017. Hippocampal volume was measured with magnetic resonance imaging and the left and right hippocampal volumes were automatically segmented using FreeSurfer software. Associations of sedentary and physically active behaviors with hippocampal volume were examined with compositional linear regression analysis based on isometric log-ratio transformations of time use adjusted for potential confounding factors.Results: The relative proportion of time spent in MVPA, compared to the other two activities, was significantly positively associated with right hippocampal volume (β: 57.1, P-value = 0.027). However, no association existed between higher proportions of MVPA and left hippocampal volume, or between proportions of SB or LPA with either left or right hippocampal volumes.Conclusion: The proportion of time spent in MVPA, relative to the other two activities, was significantly positively associated with right hippocampal volume. MVPA may be beneficial for maintaining hippocampal volume.

著者

Ryosuke Fujii Asahi Hishida Takeshi Nishiyama Masahiro Nakatochi Keitaro Matsuo Hidemi Ito Yuichiro Nishida Chisato Shimanoe Yasuyuki Nakamura Tanvir Chowdhury Turin Sadao Suzuki Miki Watanabe Rie Ibusuki Toshiro Takezaki Haruo Mikami Yohko Nakamura Hiroaki Ikezaki Masayuki Murata Kiyonori Kuriki Nagato Kuriyama Daisuke Matsui Kokichi Arisawa Sakurako Katsuura-Kamano Mineko Tsukamoto Takashi Tamura Yoko Kubo Takaaki Kondo Yukihide Momozawa Michiaki Kubo Kenji Takeuchi Kenji Wakai

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.11, pp.483-488, 2022-11-05 (Released:2022-11-05)

参考文献数

38

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Background: Inflammation is thought to be a risk factor for kidney disease. However, whether inflammatory status is either a cause or an outcome of chronic kidney disease remains controversial. We aimed to investigate the causal relationship between high-sensitivity C-reactive protein (hs-CRP) and estimated glomerular filtration rate (eGFR) using Mendelian randomization (MR) approaches.Methods: A total of 10,521 participants of the Japan Multi-institutional Collaborative Cohort Study was analyzed in this study. We used two-sample MR approaches (the inverse-variance weighted (IVW), the weighted median (WM), and the MR-Egger method) to estimate the effect of genetically determined hs-CRP on kidney function. We selected four and three hs-CRP associated single nucleotide polymorphisms (SNPs) as two instrumental variables (IV): IVCRP and IVAsian, based on SNPs previously identified in European and Asian populations. IVCRP and IVAsian explained 3.4% and 3.9% of the variation in hs-CRP, respectively.Results: Using the IVCRP, genetically determined hs-CRP was not significantly associated with eGFR in the IVW and the WM methods (estimate per 1 unit increase in ln(hs-CRP), 0.000; 95% confidence interval [CI], −0.019 to 0.020 and −0.003; 95% CI, −0.019 to 0.014, respectively). For IVAsian, we found similar results using the IVW and the WM methods (estimate, 0.005; 95% CI, −0.020 to 0.010 and −0.004; 95% CI, −0.020 to 0.012, respectively). The MR-Egger method also showed no causal relationships between hs-CRP and eGFR (IVCRP: −0.008; 95% CI, −0.058 to 0.042; IVAsian: 0.001; 95% CI, −0.036 to 0.036).Conclusion: Our two-sample MR analyses with different IVs did not support a causal effect of hs-CRP on eGFR.

著者

Moemi Shimamura Yusuke Matsuyama Ayako Morita Takeo Fujiwara

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.10, pp.464-468, 2022-10-05 (Released:2022-10-05)

参考文献数

34

被引用文献数

1 3

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Background: Procrastination is associated with stress and unhealthy behaviors. The oral condition reflects the long-term history of an individual’s stress exposure and oral health behaviors; however, empirical studies on the association of procrastination in childhood with remaining teeth in older age are limited. We investigated the association of procrastination in childhood with the number of remaining teeth among community-dwelling older Japanese adults.Methods: In total, 1,616 community-dwelling senior residents of Wakuya City (Miyagi Prefecture, Japan) who were enrolled in the National Health Plan & the Medical Care System for the Elderly completed a self-administered questionnaire on the number of teeth. Procrastination was measured using a single binary question about timing of holiday homework completion in childhood. The number of remaining teeth was assessed via a questionnaire with response options of ≥20, 10–19, 1–9, and 0 teeth. Ordered logistic regression models with potential confounders (sex, age, maternal education, childhood socioeconomic status [SES], childhood maltreatment, conscientiousness trait) and mediators (adulthood SES, smoking history, alcohol use history) were estimated.Results: Forty-six percent of participants reported a higher tendency to procrastinate in childhood. The proportions of participants with ≥20, 10–19, 1–9, and 0 teeth were 39.6%, 22.7%, 24.0%, and 13.7%, respectively. After adjusting for all covariates, a higher tendency to procrastinate in childhood was significantly associated with having fewer remaining teeth (odds ratio 1.28; 95% confidence interval, 1.05–1.57).Conclusion: A higher tendency to procrastinate in childhood was associated with having fewer remaining teeth in later life.

著者

Ping Li Mingjia Yang Dong Hang Yongyue Wei Hongling Di Hongbing Shen Zhihong Liu

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.10, pp.449-455, 2022-10-05 (Released:2022-10-05)

参考文献数

40

被引用文献数

1

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Background: Chronic kidney disease (CKD) is an important contributor to morbidity and mortality from noncommunicable diseases. We aimed to examine the longitudinal trajectories in risk factors, estimate their impact on CKD burden in China from 1991 to 2011, and project trends in the next 20 years.Methods: We used data from a cohort of the China Health and Nutrition Survey and applied the comparative risk assessment method to estimate the number of CKD events attributable to all non-optimal levels of each risk factors.Results: In 2011, current smoking was the leading individual attributable factor for CKD burden in China responsible for 7.9 (95% confidence interval [CI], 7.5–8.3) million CKD cases with a population-attributable fraction of 8.7% (95% CI, 6.0–11.6), while the rates of smoking have reduced and may have mitigated the increase in CKD. High triglyceride (TG) and high systolic blood pressure (SBP) were the leading metabolic risk factors responsible for 6.8 (95% CI, 6.4–7.1) million and 5.8 (95% CI, 5.5–6.1) million CKD-attributable cases, respectively. Additionally, the number of CKD cases associated with high body mass index (BMI), high diastolic blood pressure (DBP), high plasma glucose, and low high-density lipoprotein cholesterol (HDL-C) was 5.4 (95% CI, 5.1–5.6), 3.9 (95% CI, 3.7–4.1), 3.0 (95% CI, 2.8–3.1) and 2.6 (95% CI, 2.5–2.8) million, respectively.Conclusion: Current smoking, high TG, and high SBP were the top three risk factors that contributed to CKD burden in China. Increased BMI, DBP, plasma glucose, and decreased HDL-C were also associated with the increase in CKD burden.

著者

Hisashi Noma Kengo Nagashima Shogo Kato Satoshi Teramukai Toshi A. Furukawa

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.10, pp.441-448, 2022-10-05 (Released:2022-10-05)

参考文献数

30

被引用文献数

1 3

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Background: In meta-analysis, the normal distribution assumption has been adopted in most systematic reviews of random-effects distribution models due to its computational and conceptual simplicity. However, this restrictive model assumption is possibly unsuitable and might have serious influences in practices.Methods: We provide two examples of real-world evidence that clearly show that the normal distribution assumption is explicitly unsuitable. We propose new random-effects meta-analysis methods using five flexible random-effects distribution models that can flexibly regulate skewness, kurtosis and tailweight: skew normal distribution, skew t-distribution, asymmetric Subbotin distribution, Jones–Faddy distribution, and sinh–arcsinh distribution. We also developed a statistical package, flexmeta, that can easily perform these methods.Results: Using the flexible random-effects distribution models, the results of the two meta-analyses were markedly altered, potentially influencing the overall conclusions of these systematic reviews.Conclusion: The restrictive normal distribution assumption in the random-effects model can yield misleading conclusions. The proposed flexible methods can provide more precise conclusions in systematic reviews.

著者

Chihiro Nishiura Yosuke Inoue Ikuko Kashino Akiko Nanri Motoki Endo Masafumi Eguchi Takeshi Kochi Noritada Kato Makiko Shimizu Teppei Imai Akiko Nishihara Makoto Yamamoto Hiroko Okazaki Kentaro Tomita Toshiaki Miyamoto Shuichiro Yamamoto Tohru Nakagawa Toru Honda Takayuki Ogasawara Naoko Sasaki Ai Hori Isamu Kabe Tetsuya Mizoue Seitaro Dohi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.9, pp.431-437, 2022-09-05 (Released:2022-09-05)

参考文献数

23

被引用文献数

1 1

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Background: While it is essential to understand how long is sufficient for return-to-work when designing paid sick-leave systems, little attempt has been done to collect cause-specific information on when and how many of sickness absentees returned to work, became unemployed, or passed away.Methods: We studied the first sick-leave episode of ≥30 consecutive days in those ≤55 years of age during 2012–2013 among employees of 11 Japanese private companies (n = 1,209), which were followed until 2017. Overall and disease-specific cumulative incidences of return-to-work, resignations, and deaths were estimated using competing risk analysis.Results: During the 3.5-year period (follow-up rate: 99.9%), 1,014 returned to work, 167 became unemployed, and 27 died. Overall, return-to-work occurred within 1 year in 74.9% of all absentees and in 89.3% of those who successfully returned to work. Resignation occurred within 1 year in 8.7% of all absentees and in 62.9% of all subjects who resigned. According to ICD-10 chapters, the cumulative incidence of return-to-work ranged from 82.1% for mental disorders (F00–F99) to 95.3% for circulatory diseases (I00–I99). The cumulative incidence of return-to-work due to mental disorders ranged from 66.7% in schizophrenia (F20) to 95.8% in bipolar affective disorders (F31). Death was rarely observed except for cases of neoplasms (C00–D48), of which the cumulative incidence of death reached 14.2% by 1.5 years.Conclusion: Return-to-work and resignations occurred commonly within 1 year of sick leave among long-term sickness absentees in the Japanese private companies. Our findings may assist occupational physicians and employers in developing effective social protection schemes.

著者

Chung-Yi Li Chia-Lun Kuo Ya-Hui Chang Chin-Li Lu Santi Martini Wen-Hsuan Hou

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.9, pp.423-430, 2022-09-05 (Released:2022-09-05)

参考文献数

54

被引用文献数

2 5

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Background: We aimed to investigate associations between exposure to various trajectories of severe hypoglycemic events and risk of dementia in patients with type 2 diabetes.Methods: In 2002–2003, 677,618 patients in Taiwan were newly diagnosed as having type 2 diabetes. Among them, 35,720 (5.3%) experienced severe hypoglycemic events during the 3-year baseline period following diagnosis. All patients were followed from the first day after baseline period to the date of dementia diagnosis, death, or the end of 2011. A group-based trajectory model was used to classify individuals with severe hypoglycemic events during the baseline period. Cox proportional hazard models with the competing risk method were used to relate dementia risk to various severe hypoglycemia trajectories.Results: After a median follow-up 6.70 and 6.10 years for patients with and without severe hypoglycemia at baseline, respectively, 1,952 (5.5%) individuals with severe hypoglycemia and 23,492 (3.7%) without developed dementia during follow-up, for incidence rates of 109.80 and 61.88 per 10,000 person-years, respectively. Four groups of severe hypoglycemia trajectory were identified with a proportion of 18.06%, 33.19%, 43.25%, and 5.50%, respectively, for Groups 1 to 4. Groups 3 (early manifestation but with later decrease) and 4 (early and sustained manifestation) were associated with a significantly increased risk of dementia diagnosis, with a covariate-adjusted subdistribution hazard ratio of 1.22 (95% confidence interval, 1.14–1.31) and 1.25 (95% confidence interval, 1.02–1.54), respectively.Conclusion: Our analysis highlighted that early manifestation of severe hypoglycemic events may contribute more than does late manifestation to the risk of dementia among individuals newly diagnosed as having type 2 diabetes.

著者

Chao Wang Heng Jiang Yi Zhu Yingying Guo Yong Gan Qingfeng Tian Yiling Lou Shiyi Cao Zuxun Lu

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.9, pp.415-422, 2022-09-05 (Released:2022-09-05)

参考文献数

52

被引用文献数

1 2

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Background: Increasing number of studies have suggested the time to first cigarette after waking (TTFC) have significant positive effect on respiratory diseases. However, few of them focused on the Chinese population. This study aims to estimate the impact of TTFC on the prevalence of chronic respiratory diseases (CRD) in Chinese elderly and explore the association in different sub-populations.Methods: Cross-sectional data of demographic characteristics, living environment, smoking-related variables, and CRD were drawn from the Chinese Longitudinal Healthy Longevity Survey in 2018. Multivariate stepwise logistic regression analyses were conducted to examine the association of the TTFC with the prevalence of CRD.Results: This study includes 13,208 subjects aged 52 years and older, with a mean age of 85.3 years. Of them, 3,779 participants were ex- or current smokers (44.9% had the TTFC ≤30 minutes, 55.1% >30 minutes) and 1,492 had suffered from CRD. Compared with non-smokers, participants with TTFC ≤30 minutes seemed to have higher prevalence of CRD (OR 1.97; 95% CI, 1.65–2.35) than those with TTFC >30 minutes (OR 1.70; 95% CI, 1.44–2.00), although the difference was statistically insignificant (Pinteraction = 0.12). Compared with TTFC >30 minutes, TTFC ≤30 minutes could drive a higher prevalence of CRD among female participants, those aged 90 years and older, urban residents, and ex-smokers (Pinteraction < 0.05).Conclusion: Shorter TTFC relates to higher prevalences of CRD in Chinese older females, those aged 90 years and older, urban residents, and ex-smokers. Delaying TTFC might partially reduce its detrimental impact on respiratory disease in these specific subpopulations.

著者

Haruhiko Inada Jun Tomio Masao Ichikawa Shinji Nakahara

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.9, pp.408-414, 2022-09-05 (Released:2022-09-05)

参考文献数

40

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Background: Modal shifts in transport may reduce overall road injuries. Cyclist junior high school students are at a high risk of road injuries while commuting in Japan, and injuries among junior high school students could be reduced if the cyclists switch to other transport modes.Methods: We estimated the change in the incidence of road deaths and serious injuries while commuting in months with heavy snowfall, when cyclists are likely to switch to other transport modes. Using police data on the monthly number of road injuries while commuting among junior high school students in Japan between 2004 and 2013 and corresponding population statistics and snowfall data, we calculated the monthly injury rate (number of deaths and serious injuries divided by population) at the prefecture level. We conducted Poisson regression analysis to estimate the change in the rate in months with a snowfall of ≥100 cm, compared to months without snowfall.Results: A total of 3,164 deaths and serious injuries occurred during 2004 to 2013. The injury rate among cyclists was almost zero in months with a snowfall of ≥100 cm. That among cyclists and pedestrians in these months was reduced by 68% (95% confidence interval, 43–82%).Conclusion: In months with heavy snowfall, road injuries while commuting were reduced due to the near-elimination of cycling injuries among junior high school students in Japan. Switching from cycling to other transport modes would reduce overall road injuries among this population, and inducing modal shifts can be an important tool for road safety.

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

Eiji Nakatani Yasuharu Tabara Yoko Sato Atsuko Tsuchiya Yoshiki Miyachi

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.8, pp.391-400, 2022-08-05 (Released:2022-08-05)

参考文献数

28

被引用文献数

6 23

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Background: Analyzing real-world data, including health insurance claims, may help provide insights into preventing and treating various diseases. We developed a database covering Shizuoka Prefecture (Shizuoka Kokuho Database [SKDB]) in Japan, which included individual-level linked data on health- and care-insurance claims and health checkup results.Methods: Anonymized claims data on health insurance (National Health Insurance [age <75 years] and Latter-Stage Elderly Medical Care System [age ≥75 years]), care insurance, subscriber lists, annual health checkups, and all dates of death were collected from 35 municipalities in Shizuoka Prefecture. To efficiently link claims and health checkups, unique individual IDs were assigned using a novel procedure.Results: From April 2012 to September 2018, the SKDB included 2,230,848 individuals (men, 1,019,687; 45.7%). The median age (min–max) of men and women was 60 (0–106) and 62 (0–111) years, respectively. During the study period, the median subscription time was 4.4 years; 40.8% of individuals continuously subscribed for the 6.5 years; 213,566 individuals died. Health checkup data were available for 654,035 individuals, amounting to 2,469,648 records. Care-service recipient data were available for 283,537 individuals; they used care insurance to pay for care costs.Conclusion: SKDB, a population-based longitudinal cohort, provides a comprehensive dataset covering health checkups, disorders, medication, and care service. This database may provide a robust platform to identify epidemiological problems and generate hypotheses for preventing and treating disorders in the elderly.

著者

Rand Jarroch Behnam Tajik Tomi-Pekka Tuomainen Jussi Kauhanen

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.8, pp.384-390, 2022-08-05 (Released:2022-08-05)

参考文献数

31

被引用文献数

2

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Background: Little is known about the role of economic recessions in the risk of cancer. Therefore, we evaluated the impact of the severe economic recession in Finland from 1991–1994 on the incidence of all cancers and cancer subtypes among a middle-age and older population.Methods: From the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), a population-based sample of 1,620 women and men aged 53–73 years were examined from 1998–2001. The cancer-free participants completed a questionnaire on the possible impact of the 1990s recession in Finland on their lives. Incident cases of cancer were obtained through record linkage with the Finnish Cancer Registry. Cox proportional hazards regression was used to estimate hazard ratios (HR) of incident cancer events after adjusting for possible confounders.Results: A total of 1,096 cancer-free participants had experienced socioeconomic hardships due to the recession at the baseline. During 20 years of follow-up, 473 participants developed cancer. After adjustment for age, baseline socioeconomic position, and lifestyle factors, the risk of all cancers was 32% higher among men who experienced socioeconomic hardships compared to those who did not (HR 1.32; 95% confidence interval [CI], 1.00–1.74, P = 0.05). Prostate-genital cancer was 71% higher among men with hardships (n = 103, HR 1.71; 95% CI, 1.06–2.74, P = 0.02). No association was observed between socioeconomic hardships and subsequent risk of total or any subtype of cancer among women.Conclusion: The 1990s economic recession was associated with increased risk of all cancers, especially prostate-genital cancer among Finnish middle-age and older men, but no association with cancer was observed in women.

著者

Nguyen Van Tien Kokichi Arisawa Hirokazu Uemura Nahomi Imaeda Chiho Goto Sakurako Katsuura-Kamano

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.8, pp.376-383, 2022-08-05 (Released:2022-08-05)

参考文献数

36

被引用文献数

1 7

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Backgrounds: The fatty liver index (FLI) is a good non-invasive approach for fatty liver disease diagnosis. The objective of this study was to examine the associations of nutrient patterns with non-alcoholic fatty liver disease (NAFLD) in a Japanese population.Methods: A total of 1,588 subjects (789 men and 799 women) aged 35–69 years were recruited in the baseline survey of the Japan Multi-Institutional Collaborative Cohort (J-MICC) Study in Tokushima Prefecture. Factor analysis was applied to energy-adjusted intake of 21 nutrients, and nutrient patterns were extracted. Multiple logistic regression analysis was used to analyze the relationships between nutrient patterns and the high FLI category (≥60).Results: Four nutrient patterns were extracted: Factor 1, vitamins, dietary fiber, iron and potassium pattern; Factor 2, fats and fat-soluble vitamins pattern; Factor 3, saturated fat, calcium, vitamin B2 and low carbohydrate pattern; and Factor 4, sodium, protein and vitamin D pattern. After adjustment for sex, age, and other potential confounding variables, higher Factor 1 scores were significantly associated with lower odds ratios of NAFLD (P for trend <0.05). Analysis of each component of FLI showed that there were significant inverse associations between Factor 1 scores and high body mass index and large waist circumference.Conclusion: The present findings suggest that a nutrient pattern rich in vitamins, fiber, iron, and potassium was associated with lower prevalence of NAFLD in a Japanese population. Obesity and abdominal obesity may be intermediate variables for the association between this nutrient pattern and NAFLD.