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Sense of Life Worth Living (Ikigai) and Mortality in Japan: Ohsaki Study
Abstract
To investigate the association between the sense of "life worth living (ikigai)" and the cause-specific mortality risk. The psychological factors play important roles in morbidity and mortality risks. However, the association between the negative psychological factors and the risk of mortality is inconclusive.
The Ohsaki Study, a prospective cohort study, was initiated on 43,391 Japanese adults. To assess if the subjects found a sense of ikigai, they were asked the question, "Do you have ikigai in your life?" We used Cox regression analysis to calculate the hazard ratio of the all-cause and cause-specific mortality according to the sense of ikigai categories.
Over 7 years' follow-up, 3048 of the subjects died. The risk of all-cause mortality was significantly higher among the subjects who did not find a sense of ikigai as compared with that in the subjects who found a sense of ikigai; the multivariate adjusted hazard ratio (95% confidence interval) was 1.5 (1.3-1.7). As for the cause-specific mortality, subjects who did not find a sense of ikigai were significantly associated with an increased risk of cardiovascular disease (1.6; 1.3-2.0) and external cause mortality (1.9; 1.1-3.3), but not of the cancer mortality (1.3; 1.0-1.6).
In this prospective cohort study, subjects who did not find a sense of ikigai were associated with an increased risk of all-cause mortality. The increase in mortality risk was attributable to cardiovascular disease and external causes, but not cancer.
... Specifically, it has been linked to a reduction in depressive symptoms [19] and both a decreased risk of all-cause mortality and improved longevity [20]. Additionally, Ikigai can enhance social functioning by positively affecting the willingness to engage in new interactions [21], among other physical, mental, and social health benefits [22][23][24][25][26][27][28][29]. Despite these advancements, a significant gap remains in understanding the widespread relevance and applicability of Ikigai in different cultural contexts. ...
... Several studies have highlighted the significant role of Ikigai in predicting mortality risk. Lack of Ikigai was independently associated with an increased risk of all-cause mortality [28]. Having a sense of Ikigai was associated with a decreased risk of mortality from all causes, such as ischemic heart disease (IHD), cerebrovascular disease (CVD) [20,[25][26][27], decreased risk of breast cancer [62,63], and enhanced physical health [19]. ...
... An estimated 12 billion working days are lost every year to depression and anxiety at a cost of $1 trillion per year in lost productivity [3]. Ikigai is associated with decreased hopelessness, higher happiness, and life satisfaction [28,38], and decreased addiction to alcohol through strengthening psychological defense [46]. Blending Ikigai (Eastern concept) with behavioral activation (Western concept) could be a valuable tool in the prevention and treatment of depression [61]. ...
There has been growing recognition of the importance of cultural factors in shaping health outcomes. There is an established interconnectedness among meaning, purpose, and health. Understanding cultural factors, which support a positive linear effect on health, could help establish their role in medical practice and lifestyle practices across various cultures. Ikigai is a Japanese term coined from two words—“iki” meaning “to live” and “gai” meaning “reason”—and became a concept in the early 20th century. Mieko Kamiya, a Japanese psychiatrist, pioneered Ikigai research in 1966, and most of the research studies supporting its usefulness have come from Japanese communities.
In this first‐ever scoping review of the effects of Ikigai on various aspects of health, as defined by the World Health Organization, we report findings from 86 articles after an extensive review process involving a validated website‐based screening and data extraction tool. By examining the available evidence in a scoping review, we aim to provide a comprehensive overview of the current knowledge regarding Ikigai and its implications for clinical practice and future research. Although our primary focus is on mental health outcomes, we examined the potential impact on physical and social health measures.
Findings indicate that Ikigai positively influences depression scores, helps cultivate a sense of purpose, and enhances well‐being and life satisfaction. Further, Ikigai is associated with a reduced risk of all‐cause mortality and functional disability, additionally increasing social connectedness and participation in recreation and employment. Through this effort, this review aims to bridge the gap between non‐traditional philosophies and traditional approaches to mental health treatment, fostering a more inclusive and culturally sensitive framework for promoting psychological well‐being and health in diverse populations.
... Ikigai was introduced in Japanese literature by Kamiya (1966) and, although it has no exact translation, it refers to a sense of "life worth living" (Kotera et al., 2021;Weiss et al., 2005), encompassing well-being (Shirai et al., 2006), "purpose in life" or "reason for living" (Mathews, 1996;Mori et al., 2017;Sone et al., 2008). It can be defined as "a feeling obtained by a person who is doing something useful for someone else or society and, consequently, feels that life is worth living" (Fukuzawa et al., 2019, p. 1). ...
... Two decades of essentially Japanese empirical research on ikigai have been conducted in medicine (Ishida, 2012;Nakanishi, 1999;Shirai et al., 2006;Sone et al., 2008), psychology (Fukuzawa et al., 2019;Kamiya, 1966;Kumano, 2012Kumano, , 2018, education (Hikmawan et al., 2019), anthropology (Mathews, 1996;Murray, 1993), and social sciences (Kono et al., 2019). Ikigai is said to improve health (Nakanishi, 1999) and longevity (Sone et al., 2008;Tanno et al., 2009) by reducing risks of all-cause mortality. ...
... Two decades of essentially Japanese empirical research on ikigai have been conducted in medicine (Ishida, 2012;Nakanishi, 1999;Shirai et al., 2006;Sone et al., 2008), psychology (Fukuzawa et al., 2019;Kamiya, 1966;Kumano, 2012Kumano, , 2018, education (Hikmawan et al., 2019), anthropology (Mathews, 1996;Murray, 1993), and social sciences (Kono et al., 2019). Ikigai is said to improve health (Nakanishi, 1999) and longevity (Sone et al., 2008;Tanno et al., 2009) by reducing risks of all-cause mortality. As such, it appears as an inspiring concept intrinsically linked to Japanese unique culture. ...
In the Japanese philosophy of life, ‘ikigai’ broadly refers to having a ‘reason for living’, or a purpose in life. From a phenomenological and empirical viewpoint, ikigai is reported to increase human well-being and even life expectancy. However, it remains difficult to translate, define and formalize with regard to contemporary psychological theories. In this respect, the aim of this paper is twofold: to capture as accurately as possible what ikigai is, and to examine whether the concept applies to a professional context. We first offer a comprehensive overview of ikigai, bridge the gap between this specific body of literature and related psychological theoretical frameworks, such as those addressing motivation, well-being, and attention. On this basis, we conceptualize an integrated cognitive-motivational model of ikigai using an IPO (Input-Process-Output) framework: we organize dispositional or situational factors supposedly supporting ikigai as inputs, fueling the core process of ikigai (mainly built from motivational and attentional mechanisms), which produce outcomes (including well-being). A feedback loop completes the model and allows the process to maintain over time. This conceptual proposal is a first step towards applying and testing the model in professional contexts, in order to renew our approach of engagement, well-being, and performance at work as well as inspire workplace evolution.
... Ikigai, in Japanese culture, reflects the views that make life meaningful, and life is worth living (Sone et al., 2008). Furthermore, the term ikigai refers to having a "reason for living" or "purpose in life" (Mori et al., 2017;Park, 2015). ...
... It is also associated with concepts such as enjoying life, happiness, selfconfidence, and ethics, and has been shown to have similar characteristics to subjective well-being in literature (Belice et al., 2022;Park, 2015;Seko & Hirano, 2021). In short, ikigai is a comprehensive perspective that includes the meaning and purpose of life, as well as fun and happiness (Sone et al., 2008;Tanno et al., 2009;Weiss et al., 2005). In other words, it is a synthesis of a positive future perception and current social satisfaction (Fukuzawa et al., 2019). ...
... Studies on social support and ikigai give some clues for a healthy life (Gökçearslan et al., 2018;Nakao et al., 2021;Sone et al., 2008;Uchino et al., 1996). Social support and ikigai stand out independently of each other in order to overcome mental problems and support subjective well-being (Turner & Brown, 2010;Wilkes et al., 2022). ...
Social support and ikigai (making life worthwhile) have positive effects on problematic smartphone use and are seen to be related to each other. However, what mediates these relationships has not been adequately analyzed. This study aims to examine how the effect between social support and problematic smartphone use occurs by suggesting the mediator role of ikigai. The study was designed as quantitative and cross-sectional, and 1189 university participants aged 18 and over were reached online. The multidimensional scale of perceived social support, ikigai-9 scale, smartphone application-based addiction scale and sociodemographic information form were used as data collection tools in the study. The data obtained were carried out using SPSS 24 and Amos 25 statistical programs. Established hypotheses were tested with correlation, multiple regression and mediation analyzes. The results confirmed that social support was positively associated with ikigai, and ikigai was negatively associated with problematic smartphone use. In addition, interaction analyzes found that ikigai had a mediating effect. These findings show the importance of implementing specific applications based on the meaning and purpose of life (ikigai), especially for vulnerable groups, to minimize the problems that may arise with the excessive use of smartphones.
... Ikigai is a psychological concept broadly defined as "what makes life worth living 8) ." Ikigai includes aspects of eudaimonic well-being (i.e., well-being that seeks important meaning and value over life, such as the purpose of life) 9,10) , as well as aspects of hedonic well-being (i.e., well-being related to motivation, such as satisfaction from hobbies, travel, and food) [11][12][13][14][15] , which has been associated with physical activity, mortality, disease risk reduction, and QOL 9,10,16,17) . The concept of Ikigai, with its various related aspects, has also attracted attention in other countries 18,19) . ...
... Ikigai is a psychological concept broadly defined as "what makes life worth living 8) ." Ikigai includes aspects of eudaimonic well-being (i.e., well-being that seeks important meaning and value over life, such as the purpose of life) 9,10) , as well as aspects of hedonic well-being (i.e., well-being related to motivation, such as satisfaction from hobbies, travel, and food) [11][12][13][14][15] , which has been associated with physical activity, mortality, disease risk reduction, and QOL 9,10,16,17) . The concept of Ikigai, with its various related aspects, has also attracted attention in other countries 18,19) . ...
Objective: This study investigated the factors that influence Ikigai among people aged 75 years and older using home medical and nursing care with home-visit rehabilitation. Methods: This cross-sectional study involved 66 home-visit rehabilitation users aged 75 years or older who received home medical and nursing care at 2 home-care nursing stations. The following attributes were evaluated: Ikigai-9, life-space assessment (LSA), home-based LSA (Hb-LSA), Frenchay activities index (FAI), functional independence measure (FIM), self-efficacy for activities of daily living (SEADL), self-efficacy scale for going out among community-dwelling elderly (SEGE), and physical function. The correlation between Ikigai-9 scores and each assessment was examined. Multiple regression analysis was performed using the Ikigai-9 as the dependent variable and the correlated items as independent variables. Results: The Hb-LSA, FAI, FIM, SEADL, and SEGE were correlated with Ikigai-9. Among the correlated items, the FAI was selected for multiple regression analysis. Conclusion: Home-visit rehabilitation users aged 75 and over may be more likely to feel Ikigai if they have higher instrumental ADLs.
... many times an author (or a document) included in this database has been cited by the documents not included in the collection. As a key reference paper, the Ohsaki Study by Sone et al. (2008) is identified. ...
... The Ohsaki study by Sone et al. (2008) is a central scientific reference point for investigating the Ikigai framework. Critical parts of the following review are direct or indirect paraphrases it has a meaning akin to having a "purpose in life" and "reason for living." ...
Entrepreneurship has gained increased attention over the last decades. This article evaluates modern entrepreneurship approaches based on the Ikigai framework, a traditional Japanese concept of "life worth living", and the Entrepreneur-Opportunity Nexus, which both holistically address and integrate personal (internal) and environmental (external) criteria. This article argues that modern approaches, such as Design Thinking, Lean Startup, Business Model Canvas and Effectuation, are not sufficiently integrating the internal perspective of the entrepreneurial individual. Further, this paper evaluates Ikigai's usefulness in expanding entrepreneurship education towards an entrepreneur-centred view for a holistic approach to entrepreneurship. Using Ikigai and extending the existing double diamond model with the "entrepreneur space", we are integrating life design into the entrepreneurial process.
... [3][4][5][6] Desired longevity has been associated with positive psychological wellbeing, such as happiness, optimism, life satisfaction, purpose in life, and so forth. 9,10 Although the association between positive psychological wellbeing and lower risks of mortality and morbidity has been verified by prospective cohort studies, [11][12][13][14][15][16] evidence on the association between desired longevity and mortality is limited. 17 There is only one prospective study, which reported that shorter desired longevity was significantly associated with an increased risk of all-cause mortality. ...
... The results of the present study were similar to those of previous studies about positive psychologies. Positive psychologies, such as subjective sense of well-being, 11,12 ikigai (life worth living), 13 happiness, 14 optimism, 15 and enjoyment, 16 are known to be associated with lower risk of morbidity and mortality by three pathways: 1) biological processes; 2) social factors; and 3) health behaviors. 31 As biological processes, some explanatory mechanisms were suggested: positive psychologies (a) "may alter people's susceptibility to disease by decreasing the activity of the sympathetic nervous system and increasing the activation of the parasympathetic nervous system", 32 and (b) "may reduce cortisol and stress-induced elevations of inflammatory and coagulation factors, such as fibrinogen and interleukin-6". ...
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.
... It has been suggested that incorporating the philosophical attributes of Ikigai into an individual's lifestyle can contribute to positive health outcomes and reduce the risks of all-cause mortality. 6,7 Psychologically, a lifestyle incorporating Ikigai can lead to increased subjective well-being accompanied by a reduction in psychological stress and depressive symptoms. 8 Ikigai is a powerful concept due to its recognized potential to facilitate meaningful and engaging social relations. ...
... Stronger sense of purpose has been associated with various markers of healthy ageing, such as better subjective health, higher cognitive and physical functioning and increased longevity (e.g., Scheier et al., 2006;Kim et al., 2022;Boyle et al., 2009;Sone et al., 2008). ...
Sense of purpose is a key construct explaining individual differences in health. However, much is still unclear about how sense of purpose and health affect each other over time in older age. Using four waves of data from the Health and Retirement Study (N = 11,390) spanning 12 years, we investigated the reciprocal associations between sense of purpose and multiple objective and subjective markers of health (e.g., self-reported health; grip strength). Across the 12 years, better health was associated with higher levels of purpose for all investigated health markers. Cross-lagged panel models implied reciprocal associations for six of the 11 health markers. When looking at within-person associations (i.e., random intercept cross-lagged models), purpose emerged as a stronger predictor of later health than the other way around, with purpose changes predicting subsequent changes in five health markers while changes in only two health markers predicted later changes in purpose. Taken together, these findings further support the notion that sense of purpose has protective effects against health decline in older age. We discuss the findings in the context of lifespan theory and emphasize the potential benefit of considering sense of purpose as a potential target for public health interventions.
... In addition, people with DLB experience psychological distress due to difficulties in maintaining a social life, such as interacting with others and going out. Having a purpose in life significantly impacts the progression of dementia (Sone et al., 2008), and social relationships have a meaningful impact on morbidity, mortality, and mental health (Boyle et al., 2012). As mentioned earlier, individuals with DLB experience cognitive decline and a decline in physical function and ADLs due to various symptoms, such as parkinsonism. ...
Dementia with Lewy bodies (DLB) is the second most common cause of dementia and is associated with unique difficulties due to its characteristic symptoms. This study aimed to identify daily life changes experienced by people with DLB due to characteristic symptoms other than visual hallucinations. Semi-structured interviews and content analyses were conducted on 13 people with DLB and their 17 family members. Qualitative content analysis identified three categories of difficulties experienced by people with DLB in daily life: body discomfort, obstacles in daily life, and psychological pain. Participants experienced not only physical changes due to symptoms such as cognitive fluctuations, parkinsonism, and rapid eye movement sleep behavior disorder but also psychological pain related to daily life difficulties. This suggests the need for care that appreciates the unique experiences of people with DLB and includes psychological care to develop appropriate individual coping strategies, rather than focusing solely on alleviating physical symptoms.
... It is a comprehensive concept that includes not only enjoyment and happiness, but also the meaning of life and self-actualization, and it has important impacts on physical and psychological well-being [16]. In a study of about 40,000 Japanese citizens, those without Ikigai were at significantly higher risk of all causes of mortality than those with Ikigai [17]. Other cohort studies have suggested that Ikigai is significantly associated with the risk of mortality due to cardiovascular disease [18,19]. ...
Background
Having positive psychological well-being has been associated with serum high-density lipoprotein cholesterol (HDLC), but no longitudinal study to date has examined the association between Ikigai and serum HDLC. Therefore, we examined the association between Ikigai and change in serum HDLC over time using a cohort dataset spanning 2010–2018.
Methods
The study included 471 men and 776 women aged 40–74 years who underwent a cardiovascular examination in 2010 and were asked their levels of Ikigai. We combined “definitely yes” and “yes” as “with Ikigai” and recorded “a little” as “with a little Ikigai” and “no” as “without Ikigai”. We measured serum HDLC using direct methods. The association between Ikigai and serum HDLC levels at baseline, and changes in this relationship during an eight-year period, were analyzed using linear mixed-effect models.
Results
At the baseline, relative to those without Ikigai, women with Ikigai had higher serum HDLC (baseline difference in those with a little Ikigai = 7.52 mg/dl, 95% confidence interval [CI]: 1.12 to 13.9 and in those with Ikigai = 8.11 mg/dl, 95% CI: 1.54 to 14.7). The difference in serum HDLC between women with and without Ikigai remained over the eight-year follow-up period. There were no similar Ikigai-associated differences in the serum HDLC of men.
Conclusions
Women with Ikigai showed differences in serum HDLC that were observed at baseline and persisted over time.
... The processes entailed attaching meaning to one's life events, setting life goals, committing oneself to an activity, as well as accepting past, current, and future challenges. The conceptual foundation was further strengthened by epidemiological studies showing that the ikigai state is associated with lower mortality rates (Sone et al., 2008;Tanno et al., 2009), milder functional disability (Mori et al., 2017;Tomioka et al., 2016), and better mental health (Okuzono et al., 2022;Wilkes et al., 2022). ...
Objective: Ikigai is a Japanese concept of a life worth living and related to eudaimonic well-being. Supporting the pursuit of ikigai is of central importance to recovery-oriented psychiatric rehabilitation for people with serious mental illnesses (SMI). While research suggests that work, leisure, and social relationships are potential sources of ikigai, people with SMI have restricted access to these as they encounter systemic barriers to participating in such activities. This study investigated how people with SMI in Japan pursued sources of ikigai in the face of barriers. Methods: A total of 21 community-living individuals who had SMI and were recruited from community psychiatric rehabilitation service providers in Japan participated in the study. Photo-elicitation interviews were conducted, and the interview transcripts were analyzed using reflexive thematic analysis. Results: Three themes were generated: (a) self-determination as a key to ikigai, (b) explorations needed to identify sources of ikigai, and (c) navigating the challenges to engage in the explorations. It was found that a self-determined activity tends to be a source of ikigai. However, participants had to grapple with challenges because identifying a source of ikigai involved the exploration of their personal interests, and the exploration could not be continued without managing the stigma of mental illness. Conclusions and Implications for Practice: Results suggest that ikigai cannot be achieved instantly. To achieve eudaimonic well-being outcomes, psychiatric rehabilitation professionals should allow consumers to choose activities based on their personal interests and encourage them to try out various activities while they provide continued support to overcome stigma.
... Having Ikigai has been reported to be associated with various systemic health conditions in older adults. A 7-year prospective cohort study by Sone et al. reported that the risk of death in those who did not have Ikigai increased compared to those who had Ikigai [14]. Mori et al. reported that having Ikigai significantly reduces the risk of developing physical dysfunction in the future [15]. ...
Ikigai—a Japanese concept that includes elements such as life’s purpose and meaning—has been reported to be associated with various systemic health conditions, such as the risk of developing physical dysfunction or death in older adults. However, there are no reports that comprehensively examine the psychological and social aspects of Ikigai. We attempted to clarify the characteristics of Ikigai by examining it from a biopsychosocial model using physical, psychological, and social perspectives through a cross-sectional study on sarcopenia, frailty and healthy life expectancy in a hilly and mountainous area of Japan. Koyadaira in Mima City, which is located in a hilly and mountainous region on Shikoku Island in Japan, was targeted. This cross-sectional study included 105 outpatients aged 65 and over, with an average age of 79.02 ± 6.91 years. Ikigai (self-rating score on a scale of 0 (no Ikigai) to 5 (the highest Ikigai)) participants’ level of physical activity (the Physical Activity Scale for the Elderly, PASE), degree of depression (the Geriatric Depression-15 Scale, GDS-15), cognitive function (the Mini-Mental State Examination, MMSE) and social isolation (the abbreviated Lubben Social Network Scale, LSNS-6) was assessed. Significant positive correlations were found between PASE and MMSE. The LSNS-6 significantly correlated with the MMSE and GDS-15. In a path model, out of four paths from PASE, GDS-15, MMSE, and LSNS-6 to Ikigai, the path from the GDS-15 alone was significant (correlation coefficient −0.271, p < 0.01). The adaptability of this model was good. This study indicates that depressive status has a large impact on Ikigai, along with physical, cognitive, and social conditions; thus, it is appropriate to consider that an affective psychological status, such as depressive symptoms, is a fundamental condition for having Ikigai.
... 14,15) (日本語の「生きがい」16,17,18) に類似する)などの心理学 的概念に関わる「エウダイモニア」と呼ばれる領域への関心が高ま っており 19,20) 、 OECD も 『主観的幸福を測る OECD ガイドライン』 21) で測定を推奨している。エウダイモニアは定義が最も紛糾してい ＊ 1 九州大学大学院人間環境学研究院 助教・博士(工学) ＊ 2 千葉大学大学院工学研究院 教授・博士(工学) ＊ 3 職業能力開発総合大学校 准教授・博士(人間科学) Assis. Prof., Fac. of Human-Environment Studies, Kyushu Univ., Ph.D. Prof., Grad. ...
We defined home-related subjective well-being by constructing sets of its elements and examined its factor structure. The following findings were obtained:
1. A statistically supported three-factor model of home-related SWB, comprising home satisfaction, emotion at home and eudaimonia derived from home, was identified through factor analysis.
2. The domain of ‘eudaimonia derived from home’ can be characterized by the elements of ‘engagement and accomplishment,’ ‘aesthetic experience,’ ‘meaning,’ and ‘self-acceptance and self-esteem’.
3. ‘Attachment to home’ was found not to be associated with a specific domain of the home-related SWB.
4. Each domain of the home-related SWB has distinct determinants.
... It includes the hedonic well-being, which signifies pleasure or happiness as well as eudaimonic well-being which describes life purpose (Trudel-Fitzgerald et al., 2019). Psychological well-being has been investigated in a number of studies with regard to health, and found that, for instance, psychological well-being was associated with reduced mortality (Boyle et al., 2009;Trudel-Fitzgerald et al., 2019); lower likelihood of death over two years using a sample of 7675 older United States of American women (Zaslavsky et al., 2014) reduced vulnerability to mortality over 5-s7 years in Japan (Sonne et al., 2008;Tanno et al., 2009). ...
Psychological wellbeing of Medical patients , forgiveness, assertiveness and marital status
... Another recent mixed methods study also demonstrated that health is the most common source of ikigai based on data from older adults in Japan [10]. Other research revealed that a lack of ikigai was associated with an increased risk of all-cause mortality based on data from a prospective cohort study of Japanese adults [11]. Overall, the aforementioned studies showed that ikigai can contribute to health outcomes as well as subjective well-being. ...
Background: The Japanese concept of “ikigai” embodies the feeling of having a meaningful purpose in life. It is associated with several positive outcomes. This study aimed to translate and validate the German version of the Ikigai-9 scale (Ikigai-9-G)—and ikigai scores for certain groups of interest were presented. Methods: Data were taken from a quota sample of the German adult population aged 18 to 74 years (n = 5000; representative in terms of age, sex, and state). Data were collected in August/September 2023. The translation process was conducted in accordance with the existing guidelines. Reliability (Cronbach’s alpha; McDonald’s omega) was assessed. Moreover, we evaluated the structure’s soundness using confirmatory factor analysis for construct validity and examined concurrent validity by exploring pairwise correlations between the Ikigai-9-G with life satisfaction, happiness, health-related quality of life, depressive symptoms, and anxiety symptoms. Additionally, we presented ikigai scores for specific sociodemographic groups of interest. Results: Cronbach’s alpha for the Ikigai-9-G equaled 0.88. The results of confirmatory factor analysis supported the original three-factor model as initially proposed. A higher sense of ikigai was associated with less depressive symptoms (r = −0.43, p < 0.001), less anxiety symptoms (r = −0.39, p < 0.001), higher health-related quality of life (r = 0.42, p < 0.001), higher happiness levels (r = 0.62, p < 0.001), and higher satisfaction with life levels (r = 0.57, p < 0.001). Conclusion: The Ikigai-9 scale is a psychometrically sound tool offering the possibility for assessing ikigai among German speakers. Additional translation and validation studies are required to facilitate comparisons across different countries.
... Ikigai is a comprehensive concept that includes joy and happiness, things that give one's life meaning, and the mental and spiritual conditions that give people the sense that their lives are valuable [70,71]. A previous study found that ikigai could lead to decreased psychological distress and improved subjective well-being among older adults [72], and is associated with reduced mortality [73]. To extend the healthy life expectancy, the Japanese Government recently decided to make ikigai of the older population a policy priority [74,75]. ...
... Karakteristik genarasi Z berkaitan dengan lurus dengan ciri masyarakat postmodern, salah satunya adalah multikultural. Generasi Z memiliki tempat tersendiri dalam kajian psikologi yaitu rentan dan peka terhadap permasalahan mental (Sone, 2008).Generasi ini bahkan dilabeli sebagai Strawberry Generation karena memiliki karakter yang mudah rapuh dan tidak memiliki nilai juang hidup yang tinggi dibandingkan dengan generasi lainnya. Hal ini membuat generasi Z memiliki karkater yang open minded dan self centric. ...
The concept of ikigai is a philosophical concept originating from Japan regarding the human perspective on life. The four components of ikigai are mission, passion, profession, and vocation. The function of ikigai is to form individual personalities who can understand life in terms of things that need to be prepared from a young age. The purpose of this service activity is to provide an introduction to generation Z about the concept of ikigai. The method used is giving pre-test and post-test. The results obtained were that 65% of the participants could understand the ikigai concept that had been given.
... Several participants encouraged trainees to reflect on their strengths and weaknesses and pursue a career that they could enjoy. A participant used the Japanese concept of ikigai ("reason for being" [20]) to guide a trainee's search for an enjoyable career. The most rewarding career could be found at the intersection of "what you love, what the world needs, what you are good at and what you will be paid for" (participant 4). ...
Many Canadian-trained geriatricians from the subspecialty’s first decade of existence continue to practice today. The objective of this study was to examine the experiences and perspectives of the earliest cohort of geriatricians in Canada. Using qualitative description method, we conducted semi-structured interviews to explore participants’ experiences in training and practice. We included geriatricians who trained in Canada between 1980–1989 and were in active clinical practice as of October 2021. Each transcript was coded independently by two investigators. Thematic analysis was used to develop key themes. Fourteen participants (43% female, mean years in practice 35.9) described their choice to enter geriatric medicine, their training process, the roles of a geriatrician, challenges facing the profession and advice for trainees. Two themes were developed from the data: (i) advocacy for the older adult and (ii) geriatrics as “the road less taken”. Advocacy was described as the “core mission” of a geriatrician. Participants discussed the importance of advocacy in clinical practice, education, research and disseminating geriatric principles in the health system and society. “The road less taken” reflected the challenges participants faced during training, which led to relatively few geriatricians for the growing number of older adults in Canada. Despite these challenges, participants described rewarding careers and encouraged trainees to consider the profession.
... It is defined as something to live for or the joy and purpose for living in Japanese dictionaries and has been associated with eudaimonic wellbeing (Kumano, 2018). In this sense, it has also been presented as one of the factors behind the country's longest life expectancy (Sone et al., 2008). To a certain extent, psychological meaningfulness at work can promote ikigai. ...
Japan has been experiencing a long decline in its workforce. Companies in Japan are eager to retain their existing employees and diversify their recruitment. Employees with long-term and open-ended employment are also switching companies at a greater rate. Consequently, Japanese firms have started paying attention to employee subjective wellbeing, now recognized as a source of higher job performance. This study empirically explores the predictors of subjective wellbeing at work for Japanese regular employees beyond those already identified in Europe and U.S.-centric research. We applied a two-stage design, consisting of interviews and a questionnaire survey to identify those factors that promote subjective wellbeing in Japanese corporations where long-time employment and group cohesiveness and achievement are valued over individual achievement. We identified eight factors affecting subjective wellbeing at work for Japanese regular employees: meaningful work, relationships, culture, workspace, evaluation, time off, financial benefits, and diversity at work. Consequent regression analyses highlighted the discriminant importance of work relationships, evaluation, diversity, workspace, and meaningful work. Eudaimonic and hedonic happiness were found to be caused by different factors. As expected, meaningful work led to eudaimonic satisfaction of life at work in Japan. In contrast hedonic happiness was affected by factors external to work itself, such as work relationships, work evaluation and diversity. Interestingly, diversity at work was found to have an ambivalent effect as it was related to both positive and negative affects at work. These findings will help Japanese companies create a work environment that can maximize regular employees’ wellbeing, job performance, and retention.
... In Japan, studies indicated that ikigai has associated with health benefits, such as better physical health [21] or reduced psychological burden on caregivers [22]. Sone et al. [23] indicated the association between ikigai and mortality in Japanese society. In recent years, there has been an increase in studies on ikigai and its association with aspects of mental health. ...
Originating from Japan, the concept of ‘ikigai’ refers to a ‘reason for living’, a ‘reason for being’ or a ‘reason for waking up in the morning’. Ikigai is a combination of four elements: what you love, what you are goodat, what the world needs, and what you can be paid for. Even though Ikigai has made its first steps into the Vietnamese culture through written media, the concept and its associations with mental health aspects in Vietnamese society have not yet been studied. Therefore, this study aimed to assess the validity of the Ikigai-9 scale and its relationships the with mental health aspects of students at a private university in Ho Chi MinhCity. A total of 2933 students participated in the research survey to self-report levels of Ikigai, well-being, self-efficacy, stress, depression, and anxiety. The findings indicated that Ikigai has a positive association with well-being and selfefficacy, and a negative association with depression, anxiety, and stress. Therefore, the study isof significance to higher education authorities to introduce new policies to improve students’ mental health
... 11 In a previous prospective cohort study of 43 391 Japanese adults over 7 years' follow-up, the presence of a sense of Ikigai was associated with decreased risk of all-cause and cardiovascular mortality among middle-aged and elderly Japanese men and women. 12 A panel study of 6739 US adults aged 53-105 years over a 4-year follow-up showed that a higher level of purpose in life was associated with a 22% reduced incidence of stroke after ...
Objectives:
To investigate whether having a purpose in life (Ikigai) is associated with risk of cardiovascular disease (CVD) mortality and whether the association varies by employment status.
Design:
Prospective cohort study.
Setting:
Residents in 45 municipalities, Japan.
Participants:
29 517 men and 41 984 women aged 40-79 years, free of CVD and cancer at baseline from 1988 to 1990.
Primary outcome measures:
CVD mortality.
Results:
During the median follow-up of 19.1 years, 4680 deaths (2393 men and 2287 women) from total CVD were observed. Greater Ikigai was associated with a lower risk of CVD mortality, and the result was stronger for men than for women. Stratified by employment status, the inverse association was confined to unemployed persons. Among unemployed persons, the multivariable HRs of total CVD were higher for moderate and high versus low levels of Ikigai. Multivariable HRs (95% CIs) were 0.74 (0.57 to 0.97) and 0.69 (0.52 to 0.93), P for trend <0.044, respectively in men, and 0.78 (0.64 to 0.95) and 0.77 (0.61 to 0.97), P for trend=0.039 in women. No association was observed among the employed, including part-time workers, self-employed and homemakers for both men and women. Such an inverse association remained even after excluding early deaths within 5 years from the baseline survey.
Conclusion:
Higher levels of Ikigai were associated with a lower risk of CVD mortality, especially for unemployed men and women.
... In a cohort study conducted by Sone et al 75 they found that Japanese residents that had a lack of 'ikigai' were associated with a higher risk of mortality (mainly due to CVD), increased levels of CRP and pro-inflammatory cytokines and decreased levels of high-density cholesterol (HDL). 75 ...
Blue Zones are regions of the world that have a higher number of individuals who live longer than the expected average. The current paper revisits principles previously identified to be common in Blue Zones and to be contributing to longevity ( move naturally, eat wisely, improve resilience to stress, get adequate sleep, keep strong family ties, stimulate strong community support, respect for the planet and having a purpose in life’), compares these to the 6 pillars of Lifestyle Medicine ( healthy eating, exercising, avoidance of smoking and other risky substances, stress management, restorative sleep, and forming and maintaining relationships) and reviews new studies investigating the association between behavioral factors and longevity. In addition to the role of behavior, the review also discusses the important role of genetics and emphasizes the importance of conducting further research to understand how behavioral and genetic factors may affect molecular pathways with consequent effects on wellbeing and longevity.
... A relevant concept that reflects the active and creative aspect of meaning and purpose is Ikigai. Conceptually, Ikigai has been defined as a sense of "a life worth living" (Sone et al., 2008) or the "reason for living" or "the reason for which you wake up in the morning" (Mathews, 1996) and the "feeling of being alive" (Hasegawa et al., 2001). Exploring these questions with the students-what makes them come alive or wake up in the morning-and creating concrete reminders or cues such as drawings or photos to represent their Ikigai may serve as an anchor for continuous implementation of their deeply held intentions and values. ...
Education is among the most powerful gateways to social change and mobility. It is also a potentially vital backbone for the development of young people’s sense of meaning, purpose, and responsibility, enhancing their ability to face the unique challenges of our volatile, uncertain, complex, and ambiguous (VUCA) world. The global scale of the current wave of political and social changes heightens the need for a renewed examination of the educational system and its challenges. This paper asserts the importance of education for meaning and meaningful education as essential ingredients in preparing children and adolescents for the changing and uncertain world of the future. Yet meaning in life, which is almost unanimously recognized as a fundamental component of subjective well-being, has received little attention in education. This paper considers empirical evidence of the importance of meaning to the education and healthy development of children and adolescents and then proposes a heuristic model for intervention.
... Particularly the fulfillment -or lacking fulfillment -of eudaimonic wellbeing and respective needs might be an important resource for coping with and adjusting to pain in very late life. Eudaimonic indicators have indeed been found to predict health, disability and mortality (56)(57)(58)(59)(60)(61), they are associated with various biological correlates, including daily salivary cortisol, pro-inflammatory cytokines, cardiovascular risk, and REM sleep duration (62). Eudaimonic wellbeing might thus be a factor that promotes physiological functioning (63), and it could also be an important compensatory psychosocial resource that prevents or buffers pain and minimizes the impact on pain on everyday life functioning. ...
Pain is common in very old age and in the last years prior to death. However, little is known regarding longitudinal trajectories of pain in very old age and at the end of life. Moreover, whereas medical and morbidity-related factors contributing to pain are established, the role of psychosocial factors, such as eudaimonic wellbeing or personality as potential determinants of late-life pain trajectories has so far not been sufficiently investigated. We used data from the LateLine project. The sample consisted of n = 118 very old adults (M = 90.5 years, SD = 2.8 years) who were living alone at baseline and who had died between 2009 and 2021. They took part in up to 16 measurement occasions (M = 5.2, SD = 4.7, range 1–16) within an observational interval of 7 years. Assessment of pain was based on the SF-36 bodily pain subscale. Key indicators of eudaimonic wellbeing (autonomy, environmental mastery, and purpose in life) as well two of the Big Five personality traits (neuroticism and extraversion) were included as predictors. We controlled in all analyses for gender, education, subjective health, and depressive symptoms. Contrasting pain trajectories over chronological age (time since birth) vs. time to death, a time-to-death-related model resulted in a better model fit and accounted for a larger amount of pain variability than the age-related model. Mean-level change in pain, both over age and time to death, was not significant, but there was substantial interindividual variability in intraindividual trajectories. Age-related change in pain was significantly predicted by autonomy and neuroticism, with increasing pain among those who had lower initial autonomy scores and higher initial neuroticism scores. With regard to time-to-death-related trajectories of pain, higher purpose in life as well as lower extraversion at baseline predicted less increase or even steeper decrease in pain with approaching death. Our findings suggest that, despite overall mean-level stability in pain both over age and time to death, there is a substantial proportion of individuals who reveal deterioration in pain over time. Regarding the role of psychosocial predictors, personality traits and eudaimonic wellbeing are related with late-life pain trajectories both over age and time-to-death.
Ao articular o processo de envelhecimento, a Educação de Jovens e Adultos (EJA) e a capacidade de realização de projetos vitais em qualquer fase ou momento da vida, o presente trabalho apresenta o desenvolvimento e o planejamento de um curso de formação continuada aos docentes da EJA em uma escola pública do estado de São Paulo. A formação buscou articular a abordagem de conhecimentos, o uso de situações-problema, os princípios do aprender fazendo, o trabalho colaborativo e cooperativo e a interdisciplinaridade, promovendo uma formação sólida aos docentes e que enseja o desenvolvimento de habilidades inerentes à construção de projetos de vida para serem trabalhados na escola, assumindo a relevância de construir novas formas de se conceber os conteúdos, as formas e as relações na EJA. A pesquisa tem como objetivo fomentar novos estudos e práticas que favoreçam a construção de contextos educativos que contribuam para um processo de envelhecimento com sentido. Resultados parciais apontam a necessidade de uma mudança paradigmática capaz de promover o desenvolvimento das potencialidades do estudante idoso.
Background
This study examined the temporal relations between a decline in health and changes in life purpose to better understand the causal direction between life purpose and morbidity.
Methods
Over a 16-year period, 7598 individuals completed up to four quadrennial surveys, which included information on 14 health metrics (lung function, grip strength, walking speed, balance and diagnoses of hypertension, diabetes, cancer, lung disease, heart condition, stroke, psychiatric problem, arthritis, dementia and Alzheimer’s) and life purpose. Ordinary and logistic regressions were used to examine the temporal relations between changes in purpose and changes in health over both the same 4-year period and over the subsequent 8 years.
Results
A decline in health was associated with a 5% standard deviation decline (95% confidence interval −0.08, −0.02) in purpose over the same 4-year period. In contrast, there was no evidence that a decline in purpose was associated with a subsequent decline in health.
Conclusions
The results fail to support the hypothesis that life purpose causes subsequent morbidity but support the hypothesis that a decline in health causes a decline in purpose. There is little evidence that life-purpose intervention policies will meaningfully impact subsequent morbidity.
Prospective Ergonomics requires building a vision of the future, which can be achieved empirically (e.g. analysing unmet needs) and/or creatively (e.g. creating future needs). We develop an alternative way of imagining the future, through a model-driven approach. Based on several developmental models, we provide a global picture of possible future(s) emphasising higher-ordered motivations and values (e.g. meaningfulness, accomplishment). To implement them, we then present a model of human accomplishment reinterpreting the concept of ikigai in light of selected psychological theories (e.g. self-determination, eudaemonic well-being, mindfulness). Finally, we apply it to an Industry 5.0 case study named ikigai robotics: we designed an equipment for railway maintenance following a double design process - a functional design loop and a motivational design loop. The process proved inspirational and the results both original and promising, opening avenues for Prospective Ergonomics to develop a new approach for designing the future.
The aim of this pilot was to assess the feasibility and acceptability of virtual Narrative Healing Circles (NHC), a new form of Shared Medical Appointments (SMA) among mixed diagnosis population within an urban tertiary academic medical center. Methods: Multi-method, voluntary recruitment of eligible patients, included referrals, flyers, hospital events page, and patients who participated in an ongoing 7-week integrative oncology SMA series. Two physicians (lifestyle medicine and chaplaincy specialists), both trained in narrative medicine, co-led one-hour long virtual NHC SMAs held every other week for a total of either 4 or 8 sessions. Sessions included a centering meditation, brief check-in, topic introduction, short writing exercise initiated with a written, musical, or visual prompt, followed by time of sharing and listening. Optional electronic pre and post participant surveys were emailed at enrollment (7-questions, response rate 29%) and after 4-8 NHC SMA sessions (12-questions, RR 34%). Results: Virtual NHC SMA were offered from 2/23/22-8/30/23 with 62 unique participants, 266 total visits. Average age: 57 years (range: 27-84 years). Gender: 85% Female, 15% Male; Ethnicity: 73% White, 16% African American, 6% Asian, 5 % Hispanic. About half lived in underserved areas (Harlem, Bronx, Queens, Brooklyn). Payor mix included 40% Medicare, 60% Commercial insurance. Session attendance: 6 participants (mean); 1-13 (range). The number of sessions attended ranged between 1-28 sessions. Anxiety or fear (89%), depression (61%) and pain (67%) were the top 3 symptoms reported in the pre-survey. After 4-8 sessions, participants reported improvements in anxiety/fear (43%), sadness/depression/hopelessness (33%), irritability/stress (33%), isolation/loneliness (33%). They reported several positive changes: restarting yoga or meditation practice, greater focus on awe, journaling, increased mindfulness, and feeling better equipped to manage stress. 94% reported goals met, 95% would recommend the series to others. The 2 clinician leaders reported increased empathy, personal well-being, and work satisfaction. Conclusion: Virtual NHC SMA series among mixed diagnosis population is feasible, positively affects patients’ agency and well-being, and acceptable to patients and providers. A more formal study design with broader representation of diverse population and assessment of causality such as an RCT with longer follow-up is recommended.
The current chapter aims to give some examples of the link between the theory of passion and practice. In the first section, we show some ideas about how we can think with regard to increasing interests and passions in individuals throughout their lifespan. In the second section, we propose how society can work with passion development on a system level. An example of our Ignition project in the primary school in Iceland is presented. In the third section, we will share some thoughts about obstacles in passion development and the interesting interaction between passion and meaning in life. In the fourth section, we will give some examples of thinking from theory to practice.
The concept of ikigai, which translates to "reason for being," is deeply rooted in Japanese culture and philosophy. Héctor García and Francesc Miralles' book, Ikigai: The Japanese Secret to a Long and Happy Life, explores how the principles of ikigai can be applied to enhance personal fulfilment and longevity. This research paper examines the potential applications of ikigai in the field of management, offering insights into how managers can foster a purpose- driven, engaged, and productive workforce. Through an analysis of the book's key themes, this paper outlines practical strategies for integrating ikigai principles into organizational practices. Key Words: Ikigai, Reason for being, Japanese culture, Longevity, Management, Purpose-driven workforce, Engaged workforce, Productive Workforce “Management Lessons from Ikigai: The Japanese Secret to a Long and Happy Life”
Ikigai, a Japanese term often referred to as “purpose in life” or “the feeling that life is worthwhile”, is a commonly used indicator of well-being in studies focused on the elderly population in Japan. It can be identified within the different realms like family, work, and friendship. However, as individuals age, their sense of ikigai is prone to diminish. Teachable agents (TAs) have been employed in educational settings for decades to facilitate learning by teaching students. Previous research has indicated that TAs can have a positive impact on self-esteem which is an important aspect of ikigai. TAs may hold the potential to address issues related to declining ikigai that are often associated with aging. By engaging in the act of teaching the agent, elderly individuals may experience a sense of being needed, consequently enhancing their self-esteem and potentially leading to an improvement in their ikigai levels. In this paper, we introduce a TA designed around the concept of ikigai, aiming at assisting the elderly in maintaining a high level of ikigai to support healthy aging. Based on a user study conducted using the phenomenographical approach, we demonstrate the effectiveness of our proposed TA design.
This comprehensive exploration delves deeply into academic interventions aimed at guiding students toward a more profound sense of purpose throughout their educational journeys. It emphasizes that education offers a unique opportunity for students to discover their passions, interests, and aspirations beyond textbooks and exams. The interventions discussed, including mentorship, career counseling, experiential learning, and self-discovery exercises, are meticulously designed to empower students to recognize their distinct strengths and interests. These interventions not only aim to facilitate academic excellence but also enable students to pursue careers aligned with their core values and aspirations. The exploration scrutinizes effective strategies, programs, and support mechanisms, addressing challenges students face when making career choices, and culminates in recommendations for educators, career counselors, and policymakers interested in enriching students' educational experiences and fostering purpose-driven learners.
Dalam menghadapi perkembangan bisnis dan ekonomi global,
selain isu teknologi dan digitalisasi, kita semakin dihadapkan akan
pentingnya soft skill bagi diri kita sendiri, organisasi dan kehidupan sosial
bermasyarakat. Soft skill adalah kunci untuk meraih kesuksesan,
termasuk di dalamnya kepemimpinan, pengambilan keputusan,
penyelesaian konflik, komunikasi, kreativitas, kemampuan presentasi,
kerendahan hati dan kepercayaan diri, kecerdasan emosional, integritas,
komitmen, dan kerjasama.
Berdasarkan studi World Bank, banyak siswa/i yang mengenyam
pendidikan tinggi tapi tidak belajar apa-apa sehingga saat mereka lulus,
mereka tidak memiliki kemampuan untuk meningkatkan produktivitas.
Di sinilah pentingnya kualitas pendidikan dan ketepatan ilmu yang
diberikan.
Praktisi pendidikan formal maupun pelatihan profesional sudah
melakukan banyak upaya untuk merancang program pengembangan
soft skills yang integratif bagi pesertanya
Life satisfaction and purpose in life are fundamental yet separate ways to evaluate one’s life. Both positively predict physical health and longevity, making them key factors for length and quality of life. However, we do not know which of them predicts mortality, when controlling for the influence of each other. Given that purpose in life involves a more active engagement with life and can help to cope with suffering, we hypothesize that purpose in life could be a more direct prospective predictor of longevity, overshadowing any effect of life satisfaction, when the two are pitted against each other as prospective predictors of longevity. To examine these hypotheses, we utilized Midlife in the U.S. survey, which is a 23-year follow-up study, (N = 5,993) and Cox proportional hazards models, repeating the analyses both without covariates and when controlling for various demographic and health-related variables. We show that both life satisfaction and purpose in life predict mortality when modeled separately. When life satisfaction, purpose in life and self-rated health were entered as simultaneous predictors of mortality, purpose in life remained a slightly more robust predictor of mortality, while life satisfaction became only marginally significant, suggesting that some of the factors that connect it to mortality are covered by the other two subjective evaluations. Overall, the results demonstrate that purpose in life is a robust predictor of mortality, and thus a key dimension of well-being to attend to as people age, while the predictive power of life satisfaction is more dependent on the choice of covariates.
Background
Ikigai (meaning or purpose in life) is a concept understood by most older adults in Japan. The term has also garnered international attention, with recent academic attempts to map it to concepts in the Western well-being literature. In addition, efforts to use social and home robots to increase well-being have grown; however, they have mostly focused on hedonic well-being (eg, increasing happiness and decreasing loneliness) rather than eudaimonic well-being (eg, fostering meaning or purpose in life).
Objective
First, we explored how Japanese older adults experience ikigai and relate these to concepts in the Western well-being literature. Second, we investigated how a home robot meant to promote ikigai is perceived by older adults.
Methods
We used a mixed methods research design—including 20 interviews with older adults, a survey of 50 older adults, and 10 interviews with family caregivers. For interviews, we asked questions about older adults’ sources of ikigai, happiness, and social support, along with their perception of the robot (QT). For surveys, a number of well-being scales were used, including 2 ikigai scales—ikigai-9 and K-1—and 6 Patient-Reported Outcomes Measurement Information System scales, measuring meaning and purpose, positive affect, satisfaction with participation in social roles, satisfaction with participation in discretionary social activities, companionship, and emotional support. Questions related to the perception and desired adoption of the robot and older adults’ health status were also included.
Results
Our results suggest that health is older adults’ most common source of ikigai. Additionally, although self-rated health correlated moderately with ikigai and other well-being measures, reported physical limitation did not. As opposed to social roles (work and family), we found that ikigai is more strongly related to satisfaction with discretionary social activities (leisure, hobbies, and friends) for older adults. Moreover, we found that older adults’ sources of ikigai included the eudaimonic aspects of vitality, positive relations with others, contribution, accomplishment, purpose, and personal growth, with the first 3 being most common, and the hedonic aspects of positive affect, life satisfaction, and lack of negative affect, with the first 2 being most common. However, the concept of ikigai was most related to eudaimonic well-being, specifically meaning in life, along the dimension of significance. Finally, we found that Japanese older adults have high expectations of a home robot for well-being, mentioning that it should support them in a multitude of ways before they would likely adopt it. However, we report that those with the highest levels of meaning, and satisfaction with their leisure life and friendships, may be most likely to adopt it.
Conclusions
We outline several ways to improve the robot to increase its acceptance, such as improving its voice, adding functional features, and designing it to support multiple aspects of well-being.
Despite differences in how scholars define flourishing, they tend to approach the question of flourishing from a universalist perspective by assuming that it amounts to a single, overarching concept across cultures. We will review the weaknesses in this approach. First, we highlight limitations in current “cross-cultural” research on flourishing, which prioritizes psychometric validity at the expense of cultural validity. We then review the inherent Western assumptions that seem to underly the flourishing literature, which include the tendency to (1) focus on the person as an independent, autonomous unit, (2) neglect elements of duty and responsibility to others, (3) overlook communal flourishing (4) disregard the influence of religion and spirituality, and (5) emphasize high-arousal positive emotions (“joy,” “happiness,” “excitement”) at the expense of low-arousal positive emotions in conceptualizations of flourishing. These findings underscore the need to expand the existing paradigms of flourishing to include concepts that are relevant to how individuals conceptualize flourishing in their respective societies. Careful assessment and integration of sociocultural meaning systems and differing philosophical, religious, and political traditions is critically warranted to understand flourishing in diverse populations.
The aim of this study is to predict positivity impact on mental health and overall health of adult students. Objective of study: To explore the relationship between adult positivity connection with mental health. Predict the relationship between positive behaviour and its impact on mental health in adults. Check significance gender difference of adult positivity as a predictor of better health and mental health. Research Design: In this study, a correlational research design was employed. Sampling Techniques: The sample was taken using by purposive sampling technique. Sample: The sample (N=200; 100 males, 100 females) of the study includes Government and private university students from the city of Faisalabad. Participants in the study ranged in age from 18 to 35 years old. Tool: A reliable tool of positivity, Rosenberg self-esteem, life satisfaction and BBC subjective well-being scales have used to measure the variables. Statistically analyse: The data have statistically analyse descriptive statistics, correlation, independent sample T-test, and regression run by using the SPSS software, to test the hypothesis of the study. Results: The Statistical Package for Social Sciences was used to analyse the data (SPSS, V 12.0). For the analysis, a significance level of 0.05, 0.01 was employed.
Contexte : L’objectif général de cette recherche était de mieux comprendre comment le langage peut agir sur les états mentaux de personnes ayant subi des traumatismes physiques ou psychologiques majeurs pour favoriser leur bien-être.
Analyse : Nous avons choisi de répondre à cette question à travers une enquête empirique qualitative au cours de laquelle nous avons interrogé quarante-neuf (49) personnes (patients, proches aidants, professionnels). Afin d’aller au cœur de la « performativité » du langage et de sa capacité à modifier les états mentaux, nous avons identifié des phrases et des mots qui ont « fait du bien » aux personnes traumatisées.
Conclusion et implications : L’examen de ces mots et de ces phrases nous a permis d’identifier des grands thèmes que nous avons ensuite reliés à des besoins psychologiques fondamentaux et à des morphologies linguistiques élémentaires. Ceux-ci nous ont aidé à en saisir l’architecture de base sur laquelle il est possible de construire des outils conversationnels destinés à l’intervention psychosociale.
Robots are playing an increasingly important role in very different professional and personal contexts, including that of railway maintenance, which is starting to integrate robotic tools. By confronting industrial robotics part of industry 4.0 and 5.0 with service robotics, we realize that the railway maintenance sector does not refer to industry as manufacturing, nor to service robotics as such but rather as a common space between these two branches of robotics. Our objective is to take advantage of these two types of robotics to introduce a new concept, ikigai robotics. This notion reveals and explores the symbiotic relationship between well-being at work and performance. We have conducted a study that specifically highlights the fact that the need for affiliation is a positive factor for both well-being at work and performance in the specific context of railway maintenance. Finally, we provide first guidelines for the design of ikigai robots and open a discussion on how to image this concept beyond our specific context.
Abstract
Introduction
Ikigai, a concept originating in Japan, is related to life purpose and has been found to be involved in many studies related to physical and mental health. It is only very recently that it has started to be used in Western studies, through the Ikigai-9 questionnaire, developed in Japan.
Objectives
The objective of our study is the French validation of the Ikigai-9.
Method and results
An exploratory factor analysis on 170 participants resulted in a three-factor structure of the Ikigai-9: “attitudes toward the future”, “acknowledgement of one's own existence” and “emotions toward life”. A confirmatory factor analysis on an independent sample of 1205 participants allows us to switch an item to the appropriate dimension. The internal reliability indices of the three dimensions confirm the French validation of the Ikigai-9.
Conclusion
The French version of the Ikigai-9 allows for larger-scale cross-cultural studies and a better understanding of the concept of Ikigai in Western geographical areas.
This chapter traces the maturation of the discipline of psychology from its roots in the treatment of mental disorders and abnormal behavior to a more holistic focus that gives greater attention to the character strengths and virtues that make life worth living. It summarizes many of the foundations of wellbeing that have been identified by researchers in the positive psychology movement, and identifies the measurement of subjective wellbeing as a central tool in the psychologist’s arsenal.
Social participation promotes and maintains the health of older adults. Working is a type of social participation; however, the effect of employment in old age on health outcomes has not been established. This study aimed to review the relationship between employment in old age (≥60 years) and all‐cause mortality. For this systematic review, a computerized search was performed using PubMed, CINAHL and PsycINFO for prospective studies published through June 2020. The observational studies were extracted according to the study participants, indicators, follow‐up period, statistical approach and main results. The quality of the studies was assessed using the Newcastle–Ottawa Scale. Of the 37 832 records identified, 14 studies were included in the systematic review based on the inclusion and exclusion criteria. Eight studies were derived from Asian countries (four from Japan, two from Taiwan and one from Thailand and South Korea), three were from the United States, two were from Israel and one was from Brazil. The baseline data of 13 studies were collected before 2000. Thirteen of the 14 studies reported any association between employment in later life and a lower risk of mortality. Four studies examined the sex‐related differences in the effect of later‐life employment on all‐cause mortality, but the association was controversial. Overall, we revealed that working in old age would lower mortality risk. Although more findings based on recent data are required, this study indicates that working later in life is beneficial for promoting and maintaining health. Geriatr Gerontol Int ••; ••: ••–•• Geriatr Gerontol Int 2022; ••: ••–••.
Academic thriving stands for a combination of academic outcomes as well as success in other relevant domains, such as well-being or finding the right job. What causes students to thrive academically? The studies in this dissertation contributed to this question with the use of experimental, interdisciplinary and longitudinal studies, and a critical theoretical examination of the arguments against evidence-based education. A large-scale field experiment showed that first-year students who reflected on their desired future, prioritized goals, and wrote detailed plans on how to reach these goals, performed significantly better (in study credits and retention) than students who made a control assignment. This low-cost and scalable goal-setting assignment was made at the start of college and only took the students two hours to complete. Personalized follow-up feedback delivered by an AI-enhanced chatbot could further improve benefits to study outcomes as well as well-being. The final study in this dissertation tracked the effects of different types of work on the study progress of teacher education students over a four-year span. This longitudinal study showed that student who had a paid job in education gained more study credits than students with other types of work or without a job. Additionally it showed that working 8 hours per week relates with the most study progress in the first and third semester of college.
Purpose in life is anchored as a goal in national health promotion plans in several countries. Health literacy is the ability to find, understand, use, and evaluate health-related information; this ability has been investigated in terms of its effect on health outcomes and is said to play a critical role in health promotion. In the context of national health promotion, the effect of health literacy on purpose in life and life satisfaction remains unclear; therefore, this study aims to determine the effect of health literacy. A cross-sectional study was conducted on Japanese health management specialists (N = 1920). Health literacy was measured using the Communicative and Critical Health Literacy scale. Purpose in life and life satisfaction were measured using the Ikigai-9 scale and a Likert scale, respectively. We analyzed the associations between health literacy and purpose in life and life satisfaction with regression analyses. Age, sex, income, education, marital status, psychological stress, and diseases as present illness were adjusted in the statistical models. Our multiple linear regressions indicated that health literacy was significantly associated with purpose in life ( β = 0.199, p < 0.001), after adjusting for covariates (age, sex, income, education, marital status, psychological factor, and disease status). Life satisfaction was also significantly associated with health literacy ( β = 0.126, p < 0.001). Health literacy is associated with purpose in life and life satisfaction among specialists in health management. Health literacy plays a critical role in lifestyle-related disease prevention and health promotion. Interventions to improve health literacy may be warranted in the context of national health promotion.
The need to promote genuine interest for learning is especially required for STEM based understanding, knowledge and skills in very young learners. Parents involvement in STEM learning has been established as a critical factor that would move the students’ interest and adoption into STEM field and STEM related careers later in the future. This is critical even in the early childhood years where curiosity and interest are at its peak. Play based learning at home and in informal settings are one of the most effective way to experience STEM and this has been reflected in the literature especially where parents are involved. While the efficacy and usefulness of play-based learning is clear among children, the acceptance and thorough adoption among parents still requires clear method and direction. This research aims to explore and identify key factors of effective STEM learning for young children. Parents’ background and STEM career could influence their children’s interest and ability in STEM, while utility values by parents are key in nurturing children’s interest as children are independently evoked and may be influenced by their perceived utility-values by the parents.KeywordsParentsSTEMChildrenTalent
We examine the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples. Twenty-seven studies in U.S. and international journals show impressively consistent findings. Global self-rated health is an independent predictor of mortality in nearly all of the studies, despite the inclusion of numerous specific health status indicators and other relevant covariates known to predict mortality. We summarize and review these studies, consider various interpretations which could account for the association, and suggest several approaches to the next stage of research in this field.
To examine the impact of health-related lifestyle upon medical care utilization and its costs, we conducted a cohort study among all National Health Insurance beneficiaries aged from 40 to 79 years living in the catchment area of Ohsaki Public Health Center, Miyagi, Japan. The baseline survey, using self-completed questionnaire regarding health-related lifestyle, was conducted between October and December 1994. Out of 54,996 eligible subjects, 52,029 (94.6%) responded and formed the cohort under study. Medical care utilization (number of outpatient visits and days of inpatient care) and the costs for each subject have been obtained from National Health Insurance Claim History files since January 1995. The baseline characteristics of health-related lifestyle and medical history at the study subjects were consistent with those at our another cohort subjects (so-called Miyagi cohort study; N = 47,605), which included all the residents aged from 40 to 64 years at 14 municipalities in Miyagi Prefecture, Japan conducted in 1990. The medical costs per capita in this cohort was quite compatible with the national average. This prospective cohort study would quantitatively demonstrate the economic impact of health-related lifestyle, thus would lead us to better provision of cost-effective preventive health services.
The authors investigated the role of self-reported life satisfaction in mortality with a prospective cohort study (1976-1995). A nationwide sample of healthy adults (18-64 years, n = 22,461) from the Finnish Twin Cohort responded to a questionnaire about life satisfaction and known predictors of mortality in 1975. A summary score for life satisfaction (LS), defined as interest in life, happiness, loneliness, and general ease of living (scale range, 4-20), was determined and used as a three-category variable: the satisfied (LS, 4-6) (21%), the intermediate group (LS, 7-11) (65%), and the dissatisfied (LS, 12-20) (14%). Mortality data were analyzed with Cox regression. Dissatisfaction was linearly associated with increased mortality. The age-adjusted hazard ratios of all-cause, disease, or injury mortality among dissatisfied versus satisfied men were 2.11 (95% confidence interval (CI): 1.68, 2.64), 1.83 (95% CI: 1.40, 2.39), and 3.01 (95% CI: 1.94, 4.69), respectively. Adjusting for marital status, social class, smoking, alcohol use, and physical activity diminished these risks to 1.49 (95% CI: 1.16, 1.92), 1.35 (95% CI: 1.01, 1.82), and 1.93 (95% CI: 1.19, 3.12), respectively. Dissatisfaction was associated with increased disease mortality, particularly in men with heavy alcohol use (hazard ratio = 3.76, 95% CI: 1.61, 8.80). Women did not show similar associations between life satisfaction and mortality. Life dissatisfaction may predict mortality and serve as a general health risk indicator. This effect seems to be partially mediated through adverse health behavior.
to analyse the relationship between age, self-rated global health, morbidity, mobility, life satisfaction, marital status, social network and 6-year mortality in elderly men and women living at home.
the study area was a municipality in mid-eastern Sweden with a population of about 21,000. Data from interviews with non-institutionalized people aged 75 years and older in 1986 (n = 421) were linked to an individual-based research registry of prescription drug purchases. The elderly subjects were followed for 6 years. Information on mortality was obtained from the national cause of death register. A combined measure of morbidity captured both self-reported symptoms/diseases and prescription drugs.
mortality was higher in men than women (P < 0.001). Multivariate analysis was performed using logistic regression analysis. Among elderly men, morbidity-related factors-self-rated global health, heart problems and diabetes mellitus, for example--were the most important predictors of mortality. Among women, the predictors were spread over more domains (morbidity, mobility, social network).
This study presents a model of the mechanisms affecting how time since baseline affects the correlation between mortality and commonly used predictors.
In 1986, 421 persons (aged 75 years or older) in a Swedish community were interviewed. Fifteen-year mortality rates were analyzed by using hazard regressions. Rather than using average risk over the whole follow-up time, this study looks at temporal differences in predictor strength.
All studied health variables, living conditions, and life satisfaction were much stronger predictors of mortality during the first 1 or 2 years of follow-up than during later years. Gender, social contacts, and mental status were about equally correlated to mortality throughout the period.
Of the presented mechanisms affecting predictive strength, results suggest the importance of the instability of predictors over time. Especially in old populations, predictors that can change rapidly (e.g., health) are strongest for the short term, revealing a lower average mortality risk for longer follow-ups. Rather stable variables (e.g., gender or social contacts) are not affected by the length of follow-up. When average risk is studied over a longer follow-up, insignificant results may hide significant effects during a part of the follow-up. These findings are relevant for studies that examine any kind of outcome after a follow-up.
Green tea polyphenols have been extensively studied as cardiovascular disease and cancer chemopreventive agents in vitro and in animal studies. However, the effects of green tea consumption in humans remain unclear.
To investigate the associations between green tea consumption and all-cause and cause-specific mortality.
The Ohsaki National Health Insurance Cohort Study, a population-based, prospective cohort study initiated in 1994 among 40,530 Japanese adults aged 40 to 79 years without history of stroke, coronary heart disease, or cancer at baseline. Participants were followed up for up to 11 years (1995-2005) for all-cause mortality and for up to 7 years (1995-2001) for cause-specific mortality.
Mortality due to cardiovascular disease, cancer, and all causes.
Over 11 years of follow-up (follow-up rate, 86.1%), 4209 participants died, and over 7 years of follow-up (follow-up rate, 89.6%), 892 participants died of cardiovascular disease and 1134 participants died of cancer. Green tea consumption was inversely associated with mortality due to all causes and due to cardiovascular disease. The inverse association with all-cause mortality was stronger in women (P = .03 for interaction with sex). In men, the multivariate hazard ratios of mortality due to all causes associated with different green tea consumption frequencies were 1.00 (reference) for less than 1 cup/d, 0.93 (95% confidence interval [CI], 0.83-1.05) for 1 to 2 cups/d, 0.95 (95% CI, 0.85-1.06) for 3 to 4 cups/d, and 0.88 (95% CI, 0.79-0.98) for 5 or more cups/d, respectively (P = .03 for trend). The corresponding data for women were 1.00, 0.98 (95% CI, 0.84-1.15), 0.82 (95% CI, 0.70-0.95), and 0.77 (95% CI, 0.67-0.89), respectively (P<.001 for trend). The inverse association with cardiovascular disease mortality was stronger than that with all-cause mortality. This inverse association was also stronger in women (P = .08 for interaction with sex). In women, the multivariate hazard ratios of cardiovascular disease mortality across increasing green tea consumption categories were 1.00, 0.84 (95% CI, 0.63-1.12), 0.69 (95% CI, 0.52-0.93), and 0.69 (95% CI, 0.53-0.90), respectively (P = .004 for trend). Among the types of cardiovascular disease mortality, the strongest inverse association was observed for stroke mortality. In contrast, the hazard ratios of cancer mortality were not significantly different from 1.00 in all green tea categories compared with the lowest-consumption category.
Green tea consumption is associated with reduced mortality due to all causes and due to cardiovascular disease but not with reduced mortality due to cancer.
Objective: The purpose of this study was to evaluate the relationship between hopelessness and mortality in a biethnic cohort of older community-dwelling Mexican Americans, the most rapidly growing segment of the elderly, and European Americans. Methods: A total of 795 persons aged 64 to 79 years completed an English or Spanish Version of the 30-item Geriatric Depression Scale on entering the San Antonio Longitudinal Study of Aging, an epidemiologic survey, between 1992 and 1996. Women constituted 58% and Mexican Americans 54% of this randomly selected sample. Subjects who answered "no" to the item "Are you hopeful about the future?" were classified as hopeless. Results: As of August 1999, 29% of the 73 hopeless subjects had died, compared with 11% of the hopeful, a highly significant difference. The mortality rates for cardiovascular disease and cancer were significantly greater among the hopeless subjects (7%) than among the hopeful (3%). Hopelessness predicted all-cause mortality in a Cox proportional hazards model adjusted for age, ethnic background, current smoking status, number of comorbid medical conditions, self-rated health, and frequency of social contacts (risk ratio = 2.23, 95% confidence interval = 1.33 to 3.76, p = .0026). Neither sex nor probable depression was a significant predictor of mortality in this model. Conclusion: These findings, together with those of others, suggest that hopelessness is a significant predictor of mortality in older and middle-aged adults of various ethnic backgrounds. Further research is needed to evaluate the mechanisms that underlie this phenomenon and the effects of treating hopelessness on the quality and duration of subjects' lives.
Major depression has been associated with mortality from ischemic heart disease (IHD). In addition, a symptom of depression-hopelessness-has been suggested as a determinant of health status. We studied the relation of both depressed affect and hopelessness to IHD incidence using data from a cohort of 2,832 U.S. adults age 45-77 years who participated in the National Health Examination Follow-up Study (mean follow-up = 12.4 years) and had no history of IHD or serious illness at baseline. We used the depression subscale of the General Well-Being Schedule to define depressed affect and a single item from the scale to define hopelessness. At baseline, 11.1% of the cohort had depressed affect; 10.8% reported moderate hopelessness, and 2.9% reported severe hopelessness. Depressed affect and hopelessness were more common among women, blacks, and persons who were less educated, unmarried, smokers, or physically inactive. There were 189 cases of fatal IHD during the follow-up period. After we adjusted for demographic and risk factors, depressed affect was related to fatal IHD [relative risk = 1.5; 95% confidence interval (CI) = 1.0-2.3]; the relative risks of fatal IHD for moderate and severe levels of hopelessness were 1.6 (95% CI = 1.0-2.5) and 2.1 (95% CI = 1.1-3.9), respectively. Depressed affect and hopelessness were also associated with an increased risk of nonfatal IHD. These data indicate that depressed affect and hopelessness may play a causal role in the occurrence of both fatal and nonfatal IHD. (Epidemiology 1993;4:285-294)
(C) Lippincott-Raven Publishers.
The value of self-rated health in predicting mortality and the incidence of chronic diseases was studied in a cohort of 783 elderly Dutch men in the Zutphen Study. In 1985, 48% of the men felt "healthy," while 12% felt "moderately healthy" or "not healthy." As of 1990, 23% of the 783 men had died. Survival analysis showed that self-rated health was highly predictive of subsequent 5-year mortality from all causes (p < 0.001). When adjusted for the presence of major chronic diseases, age, medication use, smoking, alcohol consumption, physical activity, body mass index, systolic blood pressure, serum cholesterol, education, marital status, and family history of chronic diseases, the relative risk for "moderately healthy" or "not healthy" men compared with "healthy" men was 2.7 (95% confidence interval (CI) 1.8-4.3). Analysis of cause-specific mortality revealed that self-rated health was associated with cardiovascular mortality (crude relative risk (RR) = 2.7), but this finding resulted mainly from confounding by baseline prevalence of cardiovascular diseases (adjusted RR = 1.9, 95% CI 0.9-3.8). However, self-rated health was an independent risk factor for cancer mortality (adjusted RR = 4.2, 95% CI 1.9-9.4) and mortality due to other causes (adjusted RR = 3.0, 95% CI 1.2-7.8). Self-rated health did not independently predict the incidence of chronic diseases. This suggests that self-rated health especially affects fatality from chronic diseases rather than their onset, and this issue should be pursued further.
We examined the relationship among low, moderate, and high levels of hopelessness, all-cause and cause-specific mortality, and incidence of myocardial infarction (MI) and cancer in a population-based sample of middle-aged men. Participants were 2428 men, ages 42 to 60, from the Kuopio Ischemic Heart Disease study, an ongoing longitudinal study of unestablished psychosocial risk factors for ischemic heart disease and other outcomes. In 6 years of follow-up, 174 deaths (87 cardiovascular and 87 noncardiovascular, including 40 cancer deaths and 29 deaths due to violence or injury), 73 incident cancer cases, and 95 incident MI had occurred. Men were rated low, moderate, or high in hopelessness if they scored in the lower, middle, or upper one-third of scores on a 2-item hopelessness scale. Age-adjusted Cox proportional hazards models identified a dose-response relationship such that moderately and highly hopeless men were at significantly increased risk of all-cause and cause-specific mortality relative to men with low hopelessness scores. Indeed, highly hopeless men were at more than three-fold increased risk of death from violence or injury compared with the reference group. These relationships were maintained after adjusting for biological, socioeconomic, or behavioral risk factors, perceived health, depression, prevalent disease, or social support. High hopelessness also predicted incident MI, and moderate hopelessness was associated with incident cancer. Our findings indicate that hopelessness is a strong predictor of adverse health outcomes, independent of depression and traditional risk factors. Additional research is needed to examine phenomena that lead to hopelessness.
Several studies have reported an inverse relationship between cholesterol levels and death from violent causes, including suicide. Because depression and depressive symptoms are associated with suicide and trauma, the relation between cholesterol and depressive symptoms is of interest. The objective of the present study was to examine this relationship in a group of healthy women. The second main objective of the study was to investigate the association between cholesterol and other psychosocial factors (social support, vital exhaustion, and stressful life-events), which are known to be related to depression.
The study group consisted of 300 healthy women (aged 31 to 65 years) who were representative of women living in the greater Stockholm area. Depressive symptoms were measured by a nine-item questionnaire derived from Pearlin. For the measurement of social support a modified version of the Interview Schedule for Social Interaction was used. Health behaviors were measured by means of standard questionnaires. Lipids were analyzed by enzymatic and immunoturbidometric methods.
Women with a low serum cholesterol, defined as the lowest tenth of the cholesterol distribution (< or = 4.7 mmol/l), reported significantly more depressive symptoms. In addition, depressive symptoms showed a significant inverse linear association with high-density lipoprotein (HDL). In multivariate models, which adjusted for smoking, alcohol consumption, exercise habits, body-mass index, waist-hip ratio, menopausal status, age, and educational level, these associations remained significant. In addition, when analyzed in relation to other psychosocial factors, low cholesterol was found to be strongly associated with lack of social support. This association was not explained by depressive symptoms.
Low cholesterol levels in middle-aged healthy Swedish women were associated with a higher prevalence of depressive symptoms and with lack of social support. These findings may constitute a possible mechanism for the association found between low cholesterol and increased mortality, particularly suicide.
Cox regression models examined associations between 17 indicators of psychological functioning (intellectual abilities, personality,
subjective well-being, and social relations) and mortality. The sample (N = 516, age range 70–103 years) comprised participants
in the Berlin Aging Study assessed between 1990 and 1993. By 1996, 50% had died. Eleven indicators were identified as mortality
risk factors at the zero-order level and six when age was controlled. Low perceptual speed and dissatisfaction with aging
were uniquely significant after controls for age, SES, health, and the 16 other psychological factors. Low intellectual functioning
was a greater risk for individuals aged 70–84 years than for the oldest old (over 85 years). The effects of psychological
risk factors did not diminish over time. Future research should focus on the mechanisms and time frames that underlie the
death-relatedness of intellectual functioning and self-evaluation.
To measure the impact of disability on the use of medical care and its costs.
A 1-year prospective cohort study of National Health Insurance beneficiaries in a rural Japanese community. Their physical function was examined by the Medical Outcomes Study questionnaire at the end of 1994; medical care and its costs were then monitored for 1 year.
Participants were the 49,364 subjects, aged 40 to 79 years, who were beneficiaries of National Health Insurance and lived in the catchment area of Ohsaki Public Health Center, Miyagi, Japan. The subjects were mainly farmers, self-employed persons, housewives, or pensioners.
Medical care utilization (number of outpatient visits and days of inpatient care) and the costs for each subject were obtained from National Health Insurance Claim History files. These measurements were collected from January to December 1995, and the relationship between physical functioning levels and medical costs was analyzed.
The medical costs per capita increased with poorer physical function. Medical costs among those with limitations in performing self-care increased by 4 times in men and 3 times in women compared with those with no functional limitation. In this cohort, the 4.3% of the subjects who were dependent in self-care used 15% of the total inpatient days and 10% of the total medical costs.
Treatment of patients with disability requires a huge amount of medical resources. There is an urgent need for cost-effective intervention programs for disability prevention, which could be offset against the cost for treating the disabled.
The purpose of this study was to evaluate the relationship between hopelessness and mortality in a biethnic cohort of older community-dwelling Mexican Americans, the most rapidly growing segment of the elderly, and European Americans.
A total of 795 persons aged 64 to 79 years completed an English or Spanish version of the 30-item Geriatric Depression Scale on entering the San Antonio Longitudinal Study of Aging, an epidemiologic survey, between 1992 and 1996. Women constituted 58% and Mexican Americans 54% of this randomly selected sample. Subjects who answered "no" to the item "Are you hopeful about the future?" were classified as hopeless.
As of August 1999, 29% of the 73 hopeless subjects had died, compared with 11% of the hopeful, a highly significant difference. The mortality rates for cardiovascular disease and cancer were significantly greater among the hopeless subjects (7%) than among the hopeful (3%). Hopelessness predicted all-cause mortality in a Cox proportional hazards model adjusted for age, ethnic background, current smoking status, number of comorbid medical conditions, self-rated health, and frequency of social contacts (risk ratio = 2.23, 95% confidence interval = 1.33 to 3.76, p = .0026). Neither sex nor probable depression was a significant predictor of mortality in this model.
These findings, together with those of others, suggest that hopelessness is a significant predictor of mortality in older and middle-aged adults of various ethnic backgrounds. Further research is needed to evaluate the mechanisms that underlie this phenomenon and the effects of treating hopelessness on the quality and duration of subjects' lives.
The purpose of this study was to determine lifestyle factors in the elderly that affected longevity, using a population-based prospective study. The participants were 440 men and 625 women aged 60 to 74 living in a rural Japanese community. The baseline data such as age, sex, present illness, walking hours per day, sleeping hours per day, alcohol consumption, a history of smoking, and "ikigai" (meaningfulness of life) were collected in July 1990. During 90 months of follow-up from July 1990 to December 31 1997, there were 123 deaths. By Cox's multivariate hazard model adjusted age, sex, and medical histories, walking > or = 1 hour/day (HR = 0.63, 95% CI 0.44-0.91) and an "ikigai" (HR = 0.66, 95% CI 0.44-0.99) lowered the risk for all-cause mortality independently. In regard to hours of sleep, the cumulative survival curve showed that 7 hours/day was the border and sleeping > or = 7 hours/day lowered the risk (HR = 0.49 95% CI 0.33-0.74). Based on the findings in this study, walking > or = 1 hour/day, sleeping > or = 7 hours/day, and "ikigai" are important factors for longevity in the elderly.
Studies worldwide show that self-rated health (SRH) is a robust predictor of mortality among the elderly. Only few studies have focussed on a middle-aged population and no such study has been reported from Germany. This study examined the association between SRH and mortality in a middle-aged, population based cohort from Germany, using data from the MONICA (Monitoring Trends and Determinants in Cardiovascular Diseases) Augsburg project.
The cohort comprises 1521 men and 1498 women aged 35-64; they were followed over 11 years from 1984-1995. Participants provided extensive data on medical conditions and cardiovascular risk factors through interviews and examinations. SRH was assessed globally and in comparison to those of the same age. We estimated relative hazards for mortality from all-causes and cardiovascular disease according to self-ratings of health.
Among males the adjusted hazards rate ratio (HRR) of mortality from all-causes was 1.5 (95% CI 1.1-2.2) for combined fair/poor perceived health compared with good/excellent health. Women with fair/poor ratings had no increased risk of dying (HRR = 1.1, 95% CI 0.7-1.9). Men who perceived worse health than persons of the same age showed an adjusted HRR of 1.7 (95% CI 1.0-2.9) as compared to those perceiving better health; in women the adjusted HRR was 1.9 (95% CI 1.0-3.7). The adjusted hazards for dying from cardiovascular diseases in men were 1.3 (95% CI 0.8-2.1) for those perceiving fair/poor and 1.7 (95% CI 0.7-3.7) for those perceiving worse health.
Self-rated health was a predictor of mortality in a middle-aged German population and contains information that is not entirely reflected in underlying medical conditions and risk factors. Self-assessments of health in comparison to individuals of the same age were stronger and more consistently associated with mortality. Global self-ratings of health and self-ratings in comparison to those of the same age may measure slightly different dimensions and the effect of self-rated health may differ among men and women.
Depression increases the risk of cardiac mortality and morbidity in patients with coronary heart disease (CHD), but the mechanisms that underlie this association remain unclear. This review considers the evidence for several behavioral and physiological mechanisms that might explain how depression increases the risk for incident coronary disease and for subsequent cardiac morbidity and mortality. The candidate mechanisms include: (1). antidepressant cardiotoxicity; (2). association of depression with cardiac risk factors such as cigarette smoking, hypertension, diabetes, and reduced functional capacity; (3). association of depression with greater coronary disease severity; (4). nonadherence to cardiac prevention and treatment regimens; (5). lower heart rate variability (HRV) reflecting altered cardiac autonomic tone; (6). increased platelet aggregation; and (7). inflammatory processes. Despite recent advances in our understanding of these potential mechanisms, further research is needed to determine how depression increases risk for cardiac morbidity and mortality.
The relationship between self-reported health and mortality is well documented, but less well understood. This study uses the National Health Interview Survey linked to mortality data from the National Death Index to examine the association between self-reported health and a comprehensive set of underlying cause of death and multiple cause of death categories. We also examined whether gender moderates the relationship between self-reported health and cause-specific mortality risk. Results show that the relationship between self-rated health and mortality differs by cause of death and by number of causes. Deaths due to diabetes, infectious and respiratory diseases, and a higher number of causes are most strongly associated with subjective health. Self-reported health also exhibits a moderately strong association with deaths due to heart disease, stroke, and cancer. In contrast, self-rated health is only weakly or not associated with deaths due to accident, homicide, and suicide. The relationship between self-reported health and mortality risk is also found to be stronger among men for several causes, although not for all. These findings should help researchers and policy-makers to better understand the specific predictive power of this important global measure of health.
Self-rated health is a powerful and independent predictor of long-term health, but its biological basis is unknown. Because factors associated with poor self-rated health (eg, pain, daily discomforts, and low energy and fitness) resemble symptoms of a generalized cytokine-induced sickness response, we examined the relationship between circulating cytokines and self-rated health.
In 265 consecutive primary health care patients (174 women and 91 men), we examined self-rated and physician-rated health, circulating levels of interleukin (IL)-1beta, IL-1 receptor antagonist (IL-1ra), IL-6, and tumor necrosis factor (TNF)-alpha as determined from plasma samples using high-sensitivity enzyme-linked immunoassay.
Self-rated health correlated with levels of IL-1beta (r = 0.27; p <.001), IL-1ra (r = 0.19; p <.05) and TNF-alpha (r = 0.46; p <.001) in women but not in men. Thus, poorer subjective health was associated with higher levels of inflammatory cytokines. Even when controlling for age, education, physical health, and diagnoses in multiple regression analyses, self-rated health was an independent and more robust predictor of cytokine levels than physician-rated health.
The present findings suggest that an individual's health perception may be coupled to circulating cytokines. Because epidemiological research established that self-rated health predicts morbidity and mortality, the biological correlates and mechanisms of self-rated health need to be understood.
The purpose of the present study was to examine the association between alcohol consumption and in-patient and out-patient care utilization and its costs, respectively.
The present data were derived from a 4-year prospective observation of National Health Insurance beneficiaries in rural Japan. A total of 17 497 men aged 40-79 years were analysed, after excluding subjects who at the baseline reported having had at least one of four chronic diseases: stroke, myocardial infarction, liver disease and cancer. Alcohol intake was classified into five groups, not including ex-drinkers: life-long abstainers and ethanol intakes of 1-149 g/week, 150-299 g/week, 300-449 g/week, and > or = 450 g/week.
The hospital days and in-patient care cost showed a U-shaped relationship with alcohol consumption. In-patient cost was highest for those consuming more than 450 g/week [ pound 74.96, 95% confidence interval (CI): 54.39, 95.52] and for life-long abstainers ( pound 69.16, 95% CI: 62.08, 77.83), and lowest for those consuming 150-299 g/week ( pound 51.69, 95% CI: 45.33, 58.04). In-patient use by age specific analysis also showed a U-shape at all ages, and was lowest for those consuming 1-149 g/week in youngest age group. In contrast, the number of physician visits and out-patient cost showed an inverse linear relationships with alcohol consumption.
This study suggests that in-patient use shows a U-shaped curve and out-patient use shows an inverse linear relationship to alcohol consumption.
To examine the relationship between self-assessed masticatory disability and mortality.
Prospective.
Community based.
Total of 1,405 randomly selected people aged 65 and older living in Settsu, Osaka Prefecture, in October 1992.
Data on health status as indicated by disability scores, history of health management, self-assessed masticatory ability, and psychosocial conditions were collected by means of interviews during home visits at the time of enrollment. Nine-year follow-up was completed for 1,245 (88.6%; 398 deceased and 847 alive).
Self-assessed masticatory disability was significantly associated with being 75 and older, having overall disability, not using dental health checks or general health checks, not participating in social activities, not feeling that life is worth living (no ikigai), and finding relationships with people difficult. As for the association between self-assessed masticatory disability and mortality, the estimated survival rate for those with self-assessed masticatory disability was lower than that for those without for each group stratified by sex and age (65-74 and >or=75), and the equality of survival curves according to self-assessed masticatory disability was significant for each group. After controlling for potential predictors of mortality, self-assessed masticatory disability remained as a significant predictor of mortality (adjusted hazard ratio=1.63, 95% confidence interval=1.30-2.03, P<.001).
These results indicate that self-assessed masticatory disability may be associated with a greater risk of mortality in community-residing elderly people.
Health planners and policy makers are increasingly asking for a feasible method to identify vulnerable persons with the greatest health needs. We conducted a systematic review of the association between a single item assessing general self-rated health (GSRH) and mortality.
Systematic MEDLINE and EMBASE database searches for studies published from January 1966 to September 2003.
Two investigators independently searched English language prospective, community-based cohort studies that reported (1) all-cause mortality, (2) a question assessing GSRH; and (3) an adjusted relative risk or equivalent. The investigators searched the citations to determine inclusion eligibility and abstracted data by following a standardized protocol. Of the 163 relevant studies identified, 22 cohorts met the inclusion criteria. Using a random effects model, compared with persons reporting "excellent" health status, the relative risk (95% confidence interval) for all-cause mortality was 1.23 [1.09, 1.39], 1.44 [1.21, 1.71], and 1.92 [1.64, 2.25] for those reporting "good,"fair," and "poor" health status, respectively. This relationship was robust in sensitivity analyses, limited to studies that adjusted for co-morbid illness, functional status, cognitive status, and depression, and across subgroups defined by gender and country of origin.
Persons with "poor" self-rated health had a 2-fold higher mortality risk compared with persons with "excellent" self-rated health. Subjects' responses to a simple, single-item GSRH question maintained a strong association with mortality even after adjustment for key covariates such as functional status, depression, and co-morbidity.
To determine if self-rated health (SRH), a single-item measure of health status where individuals are asked to rate their own health, predicts mortality in a middle-aged sample and if the predictive ability of SRH diminishes with time.
Data (6316 men and 3035 women) are drawn from the Whitehall II study. SRH and covariates were measured at baseline (1985-1988) when the average age of individuals was 44.5 years (SD = 6.1). The mortality follow-up was available for a mean of 17.5 years and was classified as having occurred in the first 10 years or the subsequent follow-up period (range 6 to 9 years). The association between SRH and mortality was assessed using a Cox regression model with relative index of inequality (RII) to summarize associations.
There were no sex differences in the association between SRH and mortality in either the short (p = .39) or the long term (p = .16). Sex-adjusted short-term association (RII = 3.80; 95% confidence interval (CI) 2.28, 6.35) was significantly (p = .004) stronger than the long-term association (RII = 1.56; 95% CI 1.04, 2.34). Explanatory variables accounted for 80% of the SRH-mortality association in men and 29% in women.
SRH predicts mortality equally well in men and women. However, the covariates explained a much larger proportion of the SRH-mortality relationship in men compared with women. In this middle-aged cohort, SRH predicts mortality strongly in the short term but only weakly in the long term.
To examine the association between psychological factors and the risk of breast cancer prospectively in a non-Western population.
Data from the Japan Collaborative Cohort (JACC) study were analyzed. From 1988 to 1990, 34,497 women aged 40-79 years completed a questionnaire on medical, lifestyle and psychosocial factors. The rate ratios (RRs) of their responses were computed by fitting to proportional hazards models.
During the mean follow-up period of 7.5 years, 149 breast cancer cases were documented. Those individuals who possessed "ikigai" (Japanese term meaning something that made one's life worth living) showed a significantly lower risk of breast cancer (multivariate-adjusted RR=0.66; 95% confidence interval [CI]=0.47-0.94). Those who perceived themselves as able to make decisions quickly also had a lower risk of breast cancer (multivariate-adjusted RR=0.56; 95% CI=0.36-0.87). The other factors investigated, including ease of anger arousal and self-perceived stress of daily life were not associated with breast cancer risk.
Although further studies will be necessary to verify these findings, our results suggest that having "ikigai" and being decisive decrease an individual's subsequent risk of breast cancer.
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