[Show abstract][Hide abstract] ABSTRACT: Background:
The association between social isolation and psychological distress among disaster survivors is inconclusive. In addition, because these previous studies were cross-sectional in design, the longitudinal association between time-varying social isolation and psychological distress was not clear. The present study examined the longitudinal association between social isolation and psychological distress after the Great East Japan Earthquake.
We analyzed longitudinal data for 959 adults who had responded to the self-report questionnaires about Lubben Social Network Scale-6 (LSNS-6) and K6 in both a community-based baseline survey (2011) and a follow-up survey (2014) after the disaster. Participants were categorized into four groups according to changes in the presence of social isolation (<12/30 of LSNS-6) at two time points (2011 and 2014): "remained socially isolated", "became not socially isolated", "remained not socially isolated", and "became socially isolated". We defined a K6 score of ≥10/24 as indicating the presence of psychological distress. We used multiple logistic regression analysis to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to indicate how the change in social isolation was related to changes in psychological distress over 3 years.
Among the participants who had not shown psychological distress at the baseline, the rates of deterioration of psychological distress were significantly lower in participants who "became not socially isolated" (multivariate OR = 0.26, 95% CI = 0.08-0.70) and "remained not socially isolated" (multivariate OR = 0.49, 95% CI = 0.27-0.91), compared with participants who "remained socially isolated". Among the participants who had psychological distress at the baseline, the rate of improvement of psychological distress was significantly higher in participants who "remained not socially isolated" (multivariate OR = 2.61, 95% CI = 1.08-6.44).
The present findings suggest that prevention of social isolation may be an effective public health strategy for preventing psychological distress after a natural disaster.
Full-text · Article · Jan 2016 · Social Science [?] Medicine
[Show abstract][Hide abstract] ABSTRACT: Background:
It has been suggested that constipation is associated with cardiovascular disease (CVD). The association between defecation frequency and CVD mortality in a large population has not been reported hitherto. The aim of this study was to examine whether defecation frequency is related to CVD mortality.
Methods and results:
A total of 45,112 eligible Japanese men and women aged 40-79 years participated in the Ohsaki Cohort study. Defecation frequency was evaluated at the baseline using a self-administered questionnaire. Hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular disease mortality were calculated according to defecation frequency (≥1 time/day, 1 time/2-3 days, ≤1 time/4 days) by the Cox proportional hazards model. During 13.3 years of follow-up, 2028 participants died due to CVD. Compared with those in the ≥1 time/day group, the risk of overall CVD mortality was significantly higher in the 1 time/2-3 days and ≤1 time/4 days groups; the multivariate HR (95%CI) for 1 time/2-3 days and ≤1 time/4 days was 1.21 (95% CI: 1.08-1.35) and 1.39 (95% CI: 1.06-1.81), respectively.
A lower defecation frequency was associated with risk of CVD mortality in this Japanese population. Future studies, aiming at elucidating the mechanisms underlying the associations between chronic constipation and risk of CVD mortality, may be facilitated by our findings.
[Show abstract][Hide abstract] ABSTRACT: Epidemiological studies of the association between coffee consumption and dementia have yielded inconsistent results. Therefore, we investigated the association between coffee consumption and incident risk of dementia in an elderly Japanese population. 23,091 subjects aged ≥65 y living in Ohsaki City, northeastern Japan, responded to the baseline survey in 2006. Of these, we analyzed 13,137 subjects who gave informed consent and were not disabled at baseline. The outcome was the incidence of disabling dementia defined by usage of the Long-term Care Insurance database. We used the Cox proportional hazards regression model for multivariate analysis. During 5.7 y of follow-up period, we identified 1,107 cases of incident dementia. Overall, coffee consumption was significantly associated with a lower risk of incident dementia. The multivariate-adjusted HRs for the incidence of dementia according to coffee consumption categories (never, occasionally, 1-2 cups/d, and ≥3 cups/d) were 1.00, 0.73 (95% CI, 0.62-0.86), 0.72 (95% CI, 0.61-0.84), and 0.82 (95% CI, 0.65-1.02; p for trend = 0.009), respectively. In addition, this significant inverse association was more remarkable among women, non-smokers, and non-drinkers. Coffee consumption is significantly associated with a lower risk of incident dementia.
No preview · Article · Dec 2015 · Journal of Alzheimer's disease: JAD
[Show abstract][Hide abstract] ABSTRACT: It has been unclear whether the prevalence of disability is higher in an area affected by natural disaster than in other areas even if more than one year has passed since the disaster. The aim of this ecological study was to examine whether the rate of increase in disability prevalence among the older population was higher in disaster-stricken areas during the 3 years after the Great East Japan Earthquake (GEJE) and tsunami. This analysis used public Long-term Care Insurance (LTCI) data covering 1570 municipalities. "Disaster areas" were considered to be the three prefectures most affected by the earthquake and tsunami: Iwate, Miyagi, and Fukushima. The outcome measure was the number of aged people (≥65 years) with LTCI disability certification. Rates of change in disability prevalence from January 2011 to January 2014 were used as the primary outcome variable, and compared by analysis of covariance between "coastal disaster areas", "inland disaster areas" and "non-disaster areas". The mean rate of increase in disability prevalence in coastal (14.7%) and inland (10.0%) disaster areas was higher than in non-disaster areas (6.2%) (P < 0.001). During the 3 years after the earthquake, the increase of disability prevalence from before the GEJE continued to be higher in the disaster-stricken areas.
No preview · Article · Dec 2015 · Social Science & Medicine
[Show abstract][Hide abstract] ABSTRACT: In March 2011, the Great East Japan Earthquake (GEJE), which was followed by a devastating tsunami, destroyed the societal and the public hygiene systems in Japanese coastal areas. Insomnia, the greatest issue among disaster victims, has detrimental effects on both physical and psychological health. Periodontitis causes chronic discomfort and inflammation, and little is known about its impact on insomnia. Three months after the earthquake, a health panel survey was conducted over four surveys, till September 2013, in which information regarding 8,015 adults was collected and used. In addition to the heath-related questionnaire, other variables including subjective symptoms of oral diseases were recorded, and the Athens Insomnia Scale was used to evaluate the severity of insomnia. The association between insomnia and periodontal disease was examined using multilevel logistic models on the panel data, after adjusting for sex, age, economic status, comorbidities, body mass index, post-traumatic stress reactions, habitual smoking and alcohol drinking, and the Kessler Psychological Distress Scale score. In addition to the higher prevalence of insomnia among GEJE victims, significant association was revealed between insomnia and gum problems (OR = 2.16, 95% CI = 1.43-3.26), and difficulty chewing (OR = 2.22, 95% CI = 1.40-3.51), after adjusting for all covariates. The present study revealed significant association between insomnia and periodontal disease among GEJE victims. This indicated that together, integrated oral health care for disaster victims would contribute not only to prevention of oral infectious diseases, but may also help alleviate other problems caused by these harmful events.
Preview · Article · Sep 2015 · The Tohoku Journal of Experimental Medicine
[Show abstract][Hide abstract] ABSTRACT: Objectives:
Interventions that promote physical activity to prevent psychological distress and disuse syndromes were carried out in disaster-stricken areas. However, the effect of these interventions to promote physical activity in disaster-stricken areas has not yet been fully clarified. The purpose of this study was to examine the health effects of promoting physical activity in a disaster-stricken area.
We conducted an exercise intervention as part of a health survey project among residents of Ishinomaki-city, Miyagi, Japan in 2012. To determine if changes in health condition differed between intervention participants and nonparticipants, health condition data from 81 participants were compared with data from 81 nonparticipants selected by propensity score matching. Factors including sex, age, original address (pre-quake), and six outcome variables (psychological distress [K6 score], subjective health status, sleep duration, sleep quality, frequency of outings, and time spent walking) were used for matching. A linear mixed model was used for statistical analysis.
There were no significant differences in K6 score between participants and nonparticipants (P=0.913). Significant improvements were observed in subjective health status (P=0.011) and outing frequency (P=0.002), but not in other outcome variables.
Subjective health status and outing frequency were significantly improved among participants of the exercise intervention. Exercise intervention may be an effective public health strategy in disaster-stricken areas.
No preview · Article · Apr 2015 · [Nippon kōshū eisei zasshi] Japanese journal of public health
[Show abstract][Hide abstract] ABSTRACT: AimThe aim of the present ecological study was to evaluate the relationship between the rate of participation in Secondary Preventive Services (SPS) and the incidence of disability in Japanese municipalities.Methods
We used the national statistics data for Long-term Care Insurance (LTCI), because all Japanese people aged ≥65 years are eligible for LTCI services depending on their functional status assessed by a national uniform standard in all municipalities. The disability incidence rate for the 2-year period in 2009–2010 was compared among five different levels of SPS participation in 2006–2008. The primary outcome was the sum total disability incidence rate in LTCI from 2009 to 2010. The outcome was divided according to disability level into three patterns: “all levels (Support Level 1 – Care Level 5)”, “mild disability (Care Level ≤1)” and “moderate to severe disability (Care Level ≥2)”.ResultsThere was a significant inverse association between the SPS participation rate and disability incidence rate. Among 1541 municipalities, those in the highest SPS participation rate quintile (≥9.79 per 1000 elderly population) had a lower disability incidence rate for all levels than those in the lowest quintile (<1.86 per 1000 elderly population; absolute rate difference 0.6%; age-adjusted incident rate ratio 0.94; 95% CI 0.89–0.99). This inverse association was observed for mild disability and not for moderate to severe disability.Conclusions
Municipalities with a higher SPS participation rate have a lower incidence rate of mild disability. SPS could be an effective health policy for containing mild disability incidence among the elderly. Geriatr Gerontol Int 2015; ●●: ●●–●●.
No preview · Article · Feb 2015 · Geriatrics & Gerontology International
[Show abstract][Hide abstract] ABSTRACT: Objectives:
An earlier study using the data from the Japanese Long-term Care Insurance (LTCI) system reported a scenario for achieving the target of Health Japan 21 (the second term): future gains in health expectancy from 2011 to 2020 must be larger than gains in expectancy. According to this scenario (the Healthy Life Expectancy Extension Scenario), the proportion of disability (cases≥Care Level 2 in LTCI disability certification) will gradually decrease by 1% per year from 2011. The purpose of this study was to estimate the cost savings in long-term care and medical care if the Healthy Life Expectancy Extension Scenario is achieved.
We used data from Japanese national statistics and a survey conducted in Osaki city, Miyagi. The natural course of disability cases (≥Care Level 2) was estimated under the assumption that the future population composition would be equal to the population projections for Japan and the future proportion of disabilities for each age grade would be equal to that of 2010. Then, the decrease in the number of disabilities based on the Healthy Life Expectancy Extension Scenario was calculated. Finally, the cost savings in long-term care and medical care associated with the assumed decrease in the number of disability cases was calculated.
When the disability cases (≥Care Level 2) were shifted to "no disability certification (not requiring care)," a total estimated cost reduction of 5,291 billion yen was achieved from 2011 to 2020. Furthermore, a total estimated reduction of 2,491 billion yen was achieved for the same period when all disability shifts to "Care Level 1" were accounted for.
As a rough calculation, if the Health Japan 21 (second term) target is achieved, approximately 2,500-5,300 billion yen will be saved in the cost of long-term care and medical care.
No preview · Article · Dec 2014 · [Nippon kōshū eisei zasshi] Japanese journal of public health
[Show abstract][Hide abstract] ABSTRACT: To evaluate dietary patterns in relation to colorectal cancer risk in Japanese.
We prospectively assessed the association between dietary patterns among the Japanese and the risk of colorectal cancer. Dietary information was collected from 44,097 Japanese men and women aged 40-79 years without a history of cancer at the baseline in 1994.
During 11 years of follow-up, we documented 854 cases of colorectal cancer, which included 554 cases of colon cancer and 323 cases of rectal cancer. Factor analysis (principal component analysis) based on a validated food frequency questionnaire identified three dietary patterns: (1) a Japanese dietary pattern, (2) an "animal food" dietary pattern, and (3) a high-dairy, high-fruit-and-vegetable, low-alcohol (DFA) dietary pattern. After adjustment for potential confounders, the DFA pattern was inversely associated with the risk of colorectal cancer (hazard ratio of the highest quartile vs the lowest, 0.76; 95 % confidence interval 0.60-0.97; p for trend = 0.02). When colon and rectal cancers were separated, the inverse association between the DFA pattern and cancer risk was observed for rectal cancer (p for trend = 0.003), but not for colon cancer (p for trend = 0.43). No apparent association was observed for either the Japanese dietary pattern or the "animal food" dietary pattern.
The DFA dietary pattern was found to be inversely associated with the risk of colorectal cancer. This association was observed for rectal cancer, but not for colon cancer.
No preview · Article · Mar 2014 · Cancer Causes and Control
[Show abstract][Hide abstract] ABSTRACT: To examine the hypothesis that disability prevalence has increased to a greater degree in the areas severely affected by the earthquake and tsunami of 11 March 2011 than in other areas.
Longitudinal analysis using public statistics data from the Ministry of Health, Labour and Welfare in Japan. The analysis included 1549 municipalities covered by the Long-term Care Insurance (LTCI) system. 'Disaster areas' were defined as three prefectures (Iwate, Miyagi, Fukushima). The outcome measure was the number of aged people (≥65 years) with LTCI disability certification. Rates of change in disability prevalence from February 2011 to February 2012 were used as the primary outcome variable, and were compared by analysis of covariance between 'Coastal disaster areas', 'Inland disaster areas' and 'Non-disaster areas'.
Regarding disability prevalence at all levels, the mean value of the increase rate in Coastal disaster areas (7.1%) was higher than in Inland disaster areas (3.7%) and Non-disaster areas (2.8%) (p<0.001).
The areas that were severely affected by the earthquake and tsunami had a significantly higher increase in disability prevalence during the 1 year after the earthquake disaster than other areas.
No preview · Article · Feb 2014 · Journal of epidemiology and community health
[Show abstract][Hide abstract] ABSTRACT: To examine the relationship between changes in time spent walking since middle age and incident functional disability.
In 2006, we conducted a prospective cohort study of 7,177 disability-free Japanese individuals aged ≥65years lived in Ohsaki City, Miyagi Prefecture, Japan. Participants were categorized into four groups according to changes in time spent walking based on two questionnaire surveys conducted in 1994 and in 2006. Incident functional disability was retrieved from the public Long-term Care Insurance database, and the subjects were followed up for 5years. The Cox proportional hazards model was used to investigate the association between changes in time spent walking and the risk of incident functional disability.
Compared with subjects who remained sedentary, the multivariate-adjusted hazard ratios (95% confidence intervals) were 0.69 (0.49-0.98) among those who became active and 0.64 (0.50-0.82) among those who remained active. These results did not alter when analyses were stratified by gender, age and motor function status.
An increase in time spent walking among sedentary adults is significantly associated with a lower risk of incident functional disability.
No preview · Article · Nov 2013 · Preventive Medicine
[Show abstract][Hide abstract] ABSTRACT: To date, little is known about the association between dietary pattern and disability in older adults. The present prospective cohort study investigated the association between dietary patterns and incident functional disability.
Information on food consumption and other lifestyle factors was collected from Japanese older persons aged ≥65 years via a questionnaire. Three dietary patterns (Japanese pattern, animal food pattern, and high dairy pattern) were derived using principal component analysis of the consumption of 39 food and beverage items. Data on functional disability were retrieved from the public Long-term Care Insurance database, in which participants were followed up for 5 years. The Cox model was used to estimate the multivariate-adjusted hazard ratios of incident functional disability.
Among 14,260 participants, the 5-year incidence of functional disability was 16.6%. The Japanese pattern score was associated with a lower risk of incident functional disability (hazard ratio of the highest quartile vs the lowest, 0.77; 95% confidence interval: 0.68-0.88; p trend <.001). An animal food pattern and a high dairy pattern tended to have a higher risk of incident functional disability, but not to a significant degree.
In Japanese older persons, the Japanese dietary pattern is associated with a decreased risk of incident functional disability.
No preview · Article · Nov 2013 · The Journals of Gerontology Series A Biological Sciences and Medical Sciences
[Show abstract][Hide abstract] ABSTRACT: Objectives:
The purpose of this study was to examine the relationship between serum total cholesterol levels and certification eligibility for long-term care insurance in elderly Japanese individuals.
The Tsurugaya Project was a comprehensive geriatric assessment conducted for community-dwelling elderly individuals aged ≥70 years in the Tsurugaya area, Sendai, Japan. Of the 2,925 inhabitants, 958 subjects participated in the Tsurugaya Project. For this analysis, we used 827 subjects who gave informed consent and were not qualified for long-term care insurance at the time of the baseline survey. Subjects were followed up for 6 years. We classified the subjects into 4 quintiles and used the fourth quintile (212-230 mg/dL) as a reference for statistical analysis. We used Cox proportional hazards model to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of certification eligibility for long-term care insurance according to total cholesterol levels in serum.
During 6 years of follow-up, a total of 214 subjects were qualified for long-term care insurance certification. The lowest serum total cholesterol level (<177 mg/dL) was significantly associated with increased eligibility for long-term care insurance certification. Compared with the fourth quintile, multivariate HRs (95%CIs) of long-term care insurance certification were 1.91 (1.23-2.98), 1.36 (0.85-2.18), 0.99 (0.62-1.56), 1.38 (0.88-2.17), for <177 mg/dL, 177-194 mg/dL, 195-211 mg/dL, and ≤231 mg/dL, respectively. Moreover, the association was statistically significant even after excluding subjects with a history of liver disease or cancer, an abnormality in the liver function test, or high levels of high-sensitivity C-reactive protein.
Low serum total cholesterol levels were significantly associated with increased eligibility for long-term care insurance certification even after adjusting for a variety of confounding factors.
No preview · Article · Oct 2013 · [Nippon kōshū eisei zasshi] Japanese journal of public health
[Show abstract][Hide abstract] ABSTRACT: Background:
Epidemiological evidence regarding the effect of coffee on the incidence of prostate cancer is inconsistent. We aimed to investigate coffee consumption and the risk of prostate cancer risk in a general Japanese population.
We conducted a prospective cohort study in Ohsaki city, Japan, where 18 853 men aged 40–79 years participated in a baseline survey. Coffee consumption was assessed via a validated self-administered questionnaire. During 11 years of follow-up (from January 1 1995 to December 31, 2005), 318 incident cases of prostate cancer were detected. The Cox proportional hazards regression model was used to calculate the hazard ratios (HRs) and 95% confidence interval (CIs).
There was a significant inverse association between coffee consumption and the incidence risk of prostate cancer. Compared with those who did not drink coffee, the multivariate adjusted HRs were 0.81 (95% CI: 0.61–1.07), 0.73 (95% CI: 0.53–1.00), and 0.63 (095% CI: 0.39–1.00) for those who drank coffee occasionally, 1–2 cups per day, and ⩾3 cups per day, respectively, with a P for trend of 0.02.
This prospective finding from a Japanese population adds evidence that coffee intake is inversely associated with the incidence of prostate cancer.
Full-text · Article · May 2013 · British Journal of Cancer
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVES: To assess whether oral care (tooth brushing, regular dental visits, and use of dentures) affects mortality in elderly individuals with tooth loss. DESIGN: A 4-year prospective cohort study. SETTING: Ohsaki City, Japan. PARTICIPANTS: Twenty-one thousand seven hundred thirty community-dwelling individuals aged 65 and older. MEASUREMENTS: In a baseline survey in 2006, data were collected on number of remaining teeth and oral care status as measures of dental health. Data were also collected on age, sex, education level, smoking, alcohol drinking, time spent walking daily, medical history, psychological distress, and energy and protein intake as covariates. During the 4-year follow-up between 2006 and 2010, information on mortality was obtained from Ohsaki City government. RESULTS: The multivariate-adjusted Cox proportional hazards model showed an inverse dose-response relationship between number of remaining teeth and mortality (P for trend <.001). In participants with 0 to 19 teeth, practicing oral care was inversely associated with mortality. The multivariate hazard ratio for mortality in participants who practiced all three types of oral care was 0.54 (95% confidence interval = 0.45-0.64), compared with participants who practiced none of the three. CONCLUSION: Tooth brushing, regular dental visits, and use of dentures are inversely associated with mortality in elderly individuals with tooth loss.
No preview · Article · Apr 2013 · Journal of the American Geriatrics Society
[Show abstract][Hide abstract] ABSTRACT: Although breastfeeding is associated with a reduction in the risk for breast cancer, its relationship with another hormone-related female cancer, endometrial cancer, has not been fully investigated. The objective of the present study was to prospectively examine the association between lactation pattern and the risk for incidence of breast cancer and endometrial cancer in Japanese women. We analyzed data for 26 680 women registered in the Ohsaki National Health Insurance Cohort Study, who were 40-79 years old at the baseline. During the 11 years of follow-up, we identified 148 incident cases of breast cancer and 32 incident cases of endometrial cancer. Compared with breastfeeding only, multivariate hazard ratios and 95% confidence intervals for the risk of breast cancer incidence were 1.12 (0.92-1.37) for women who had performed mixed feeding and 1.80 (1.14-2.86) for those who fed their babies only with formula (P-trend=0.014). For endometrial cancer incidence, multivariate hazard ratios and 95% confidence intervals were 1.32 (0.86-2.03) for women who had performed mixed feeding and 3.26 (1.23-8.61) for those who had performed only formula feeding (P-trend=0.018). Our findings appear to raise the possibility that nonbreastfeeding is positively associated with the risks for both breast cancer incidence and endometrial cancer incidence. Confirmation of our findings would require further investigation.
No preview · Article · Mar 2013 · European journal of cancer prevention: the official journal of the European Cancer Prevention Organisation (ECP)
[Show abstract][Hide abstract] ABSTRACT: Background:
Patients with physical disease are known to suffer considerable psychological distress. Social support may confound the association between physical disease and psychological distress. Population-based epidemiological studies have not been conducted on the association between history of physical disease, psychological distress and social support.
Using cross-sectional data from 2006, we studied 43 487 community-dwelling people aged ≥40 years living in Japan. We examined the association between 13 self-reported histories of physical disease and psychological distress evaluated using the Kessler 6-item psychological distress scale (K6), defined as ≥13 points out of 24. To investigate the association, we performed multiple logistic regression analyses adjusted for age, gender, social support and possible confounders. Social support, as the interaction between physical disease and psychological depression, was tested through the addition of cross-product terms to the multivariate-adjusted model.
The following histories of physical disease were found significantly and positively associated with psychological distress: cancer, diabetes mellitus, hyperlipidemia, hypertension, myocardial infarction, stroke, gastric or duodenal ulcer, liver disease, arthritis, osteoporosis, kidney disease and fall or fracture (odds ratio, 1.2-2.3). Social support did not modify the association between most histories of physical disease and psychological distress.
Subjects with a history of physical disease were significantly and positively associated with psychological distress, and social support did not modify this association for most physical diseases. Even after patients have left hospital following treatment for physical disease, they require continuous monitoring for psychological distress by doctors and paramedics.
Full-text · Article · Feb 2013 · The European Journal of Public Health