Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

OBJECTIVES: Dual decline in gait speed and cognition has been found to have higher dementia risk than no decline or pure decline. However, evidence from the Asian population is lacking. Therefore, we aimed to investigate the association of dual decline from age 65 to 70 years with late-life dementia in older Japanese adults with different personal characteristics. METHODS: Data were collected from an age-specific cohort study conducted in 482 Japanese 65-year-old adults. We investigated participant demographics, medical histories, lifestyles, subjective gait speed, and cognition at both 64/65 and 70/71 years old, and confirmed dementia until age of 85 years. Cox proportion hazard models were used to estimate the risk of dementia, with adjustments for covariates, and death was treated as a competing risk. RESULTS: After a mean follow-up period of 12.5-years, 111 participants developed dementia. Older adults with dual decline are more likely to have hyperlipidemia, diabetes, and smoking habits. And we found that dual decline in gait speed and domain-specific cognition was associated with a higher risk of dementia compared with no decline in most cognitive tests, with the highest risk observed for gait speed combined with memory (sub-distribution hazard ratio:3.89, 95 %, confidence intervals: [1.68-9.01]). However, significant differences only existed in men after stratification by sex. CONCLUSIONS: A dual decline in subjective gait speed and cognition may serve as a robust predictor of dementia over a decade prior to its onset, particularly in men. These findings highlighted the importance of screening for dual decline at an early age.

DOI： 10.1016/j.archger.2023.105254

PubMed

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

OBJECTIVES: To examine the effects of changes in individual/multiple social activities between 65 and 70 years of age on incident long-term care (LTC) needs between 70 and 80 in older adults with depressive symptoms. METHODS: Participants were recruited from the New Integrated Suburban Seniority Investigation Project, an ongoing prospective cohort study. A total of 525 older adults with depressive symptoms were included. The validated 15-item Geriatric Depression Scale was used to assess depressive symptoms. A self-report questionnaire was used to measure social activities (social-related, learning, and personal). LTC needs was defined according to Japan's Long-term Care Insurance System. A competing risk model and a Laplace regression model were used to estimate the hazard ratios of LTC needs incidence and the 25th percentile difference in LTC-needs-free survival time and their 95% confidence intervals. RESULTS: Out of 4314 person-years of mild LTC needs, 108 individuals developed it. Participants who increased their frequency of learning activities have a lower risk of developing mild LTC needs. Increasing the frequency could also prolong LTC-needs-free survival time by approximately 2.61 years. Out of 4535 person-years for severe LTC needs, 54 individuals developed it. Participants with a continuous regular frequency of learning activities had a lower risk of developing severe LTC needs. However, the association between this frequency and LTC-needs-free survival time for severe LTC needs was insignificant in the multivariable models. CONCLUSIONS: Increased frequency of learning activities reduced the risk of LTC needs among older adults with depressive symptoms and prolonged their LTC-needs-free survival time.

DOI： 10.1016/j.archger.2023.105163

PubMed

Publishing type：Research paper (scientific journal)   International / domestic magazine：Domestic journal  

<p>The Japanese diet has attracted attention as a factor contributing to the Japanese population’s longevity. A typical Japanese meal, traditionally called “ichiju-sansai,” is composed of various dishes. This study assessed the nutritional adequacy of the Japanese diet using the number of dishes in all meals (NDAM) compared to existing dietary diversity indices (DDIs). This cross-sectional study used data from the 2012 National Health and Nutrition Survey. A total of 25,976 participants aged ≥20 y were included in this study. NDAM was calculated for whole dishes or single foods (except supplements and beverages) from one-day weighted dietary records. The food variety score (FVS), number of foods, dietary diversity score (DDS), and number of food groups are some of the existing DDIs. NDAM had relatively high positive correlation coefficients with potassium, magnesium, and dietary fiber. The partial correlation coefficients with an indicator of the overall nutrient adequacy of NDAM was 0.42 for men and 0.42 for women. It was almost the same as that of the FVS (men: 0.44, women: 0.42) and DDS (men: 0.44, women: 0.43). On the other hand, NDAM, similar to existing DDIs, was also positively correlated with nutrient restriction in both sexes. These findings indicate that the nutrient adequacy of NDAM is similar to that of the existing DDIs. Because of the higher sodium intake and cholesterol intake in higher NDAM and existing DDIs, the effect of higher NDAM on health outcomes must be investigated in future studies.</p>

DOI： 10.3177/jnsv.69.197

PubMed

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

Our study aimed to demonstrate the association between physical activity (PA) and frailty incidence among Japanese communitydwelling older adults with a narrow age range of 70-74 years. This study included 485 participants from the Japan Gerontological Evaluation Study. Frailty was assessed at baseline and 3 years later by using the Kaigo-Yobo Checklist. PA was assessed using the short-term International PA Questionnaire at baseline. Logistic regression was performed to calculate the odds ratio with 95% confidence intervals after adjusting for potential confounders. The associations of frailty scores with both PA volume and daily walking time presented a U-shaped curve, albeit only the latter was statistically significant. After adjusting for potential confounders, walking for 0.5-1 hr/day displayed a greater association with decreased frailty risk than higher levels of daily walking time. Further study is needed to cumulate the evidence that moderate PA levels may delay frailty incidence and improve the aging process.

DOI： 10.1123/japa.2022-0052

PubMed

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

Sleep is essential for our health. Short sleep is known to increase disease risks via imbalance of intestinal microbiota, dysbiosis. However, mechanisms by which short sleep induces dysbiosis remain unknown. Small intestinal Paneth cell regulates the intestinal microbiota by secreting antimicrobial peptides including α-defensin, human defensin 5 (HD5). Disruption of circadian rhythm mediating sleep-wake cycle induces Paneth cell failure. We aim to clarify effects of short sleep on HD5 secretion and the intestinal microbiota. Fecal samples and self-reported sleep time were obtained from 35 healthy middle-aged Japanese (41 to 60-year-old). Shorter sleep time was associated with lower fecal HD5 concentration (r = 0.354, p = 0.037), lower centered log ratio (CLR)-transformed abundance of short-chain fatty acid (SCFA) producers in the intestinal microbiota such as [Ruminococcus] gnavus group (r = 0.504, p = 0.002) and Butyricicoccus (r = 0.484, p = 0.003), and lower fecal SCFA concentration. Furthermore, fecal HD5 positively correlated with the abundance of these genera and SCFA concentration. These findings suggest that short sleep relates to disturbance of the intestinal microbiota via decreased HD5 secretion.

DOI： 10.1080/19490976.2023.2190306

PubMed

Publishing type：Research paper (scientific journal)  

＜Highlight＞●日本人一般集団において、血清ヒドロキシビタミンD3低値は糖尿病と関連があった。●血清ヒドロキシビタミンD3と自然対数変換したインスリン抵抗性指数(HOMA-R)の間には軽微な負の関連があった。●これらの観察された関連は、社会人口学、生活習慣、身体および環境に関する因子と独立していた。●血清ヒドロキシビタミンD3と自然対数変換したインスリン分泌指数(HOMA-β)の間には明確な関連がなかった。(著者抄録)

Publishing type：Research paper (scientific journal)   International / domestic magazine：Domestic journal  

<p><b>Background:</b> Both decreased insulin sensitivity and impaired insulin secretion are common in Asian populations with diabetes, in contrast to Western populations. There is limited evidence regarding the association between insulin response in diabetes in Asian populations and serum 25-hydroxyvitamin D₃ (25[OH]D₃) insufficiency.</p><p><b>Methods:</b> The present cross-sectional study compared the prevalence of diabetes, defined as a fasting plasma glucose level ≥126 mg/dL and/or a HbA1c level ≥6.5%, among 480 participants aged 35–79 years not taking anti-diabetes medications, based on serum 25(OH)D₃ levels. A logistic regression model was used to calculate the odds ratios for diabetes in each serum 25(OH)D₃ group. Furthermore, this study examined the association between serum 25(OH)D₃ levels and the index of homeostasis model assessment of insulin resistance (HOMA-IR) using a linear regression model.</p><p><b>Results:</b> The prevalence of diabetes was 7.29% in the study population, and was higher in lower serum 25(OH)D₃ quartile groups. The odds ratios for diabetes in the first, second, and third serum 25(OH)D₃ quartile groups (25[OH]D₃: ≤18.10, 18.11–22.90, and 22.91–28.17 ng/mL) were 4.02 (95% confidence interval [CI], 1.25–12.92), 2.50 (95% CI, 0.77–8.10), and 1.91 (95% CI, 0.60–6.09), respectively, with the fourth quartile group (⩾28.18 ng/mL) serving as the reference group, after adjusting for sociodemographic, lifestyle, physical and environmental factors. Serum 25(OH)D₃ levels showed an inverse association with log-transformed HOMA-IR after adjusting for similar factors (standardized β = −0.08; 95% CI, −0.14 to −0.02).</p><p><b>Conclusion:</b> Serum 25(OH)D₃ levels were inversely associated with diabetes prevalence in a general Japanese population, with a slight inverse association between serum 25(OH)D₃ levels and HOMA-IR.</p>

DOI： 10.2188/jea.je20210007

PubMed

CiNii Article

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

OBJECTIVE: We aimed to explore the association between changes in social activities and the occurrence/persistence of depressive symptoms and investigate the difference in effect sizes among the types and combinations of social activities. METHODS: The study adopted a valid 15-item Geriatric Depression Scale to assess depressive symptoms in 2480 community-dwelling adults aged 64/65 years. Changes in social-related, learning, and personal activities were classified into four categories: continued low frequency (CLF), increased frequency (IF), decreased frequency (DF), and continued regular frequency (CRF)1. Relative ratios (RRs) and 95% confidence intervals (95% CI) were calculated using a modified Poisson regression model. RESULTS: Those without depressive symptoms at baseline and who engaged in social-related (RRIF = 0.56 (0.39, 0.81), RRCRF = 0.55 (0.41, 0.74)), learning (RRIF = 0.63 (0.44, 0.89), RRCRF = 0.62 (0.46, 0.85)), and personal activities (RRIF = 0.37 (0.24, 0.57), RRCRF = 0.41 (0.30, 0.56)) at IF or CRF were less likely to develop depressive symptoms. Those with depressive symptoms at baseline, engaging in personal activities at IF (RR=0.67 (0.51, 0.87)) and CRF (RR= 0.80 (0.65-1.00)) were less likely to have persistent depressive symptoms. Participation in all three activities consistently at a regular frequency was inversely associated with the occurrence/persistence of depressive symptoms. CONCLUSIONS: The effect of personal activities was more manifest in preventing depressive symptoms than the other two kinds, regardless of depressive symptoms at baseline. Regularly engaging in a combination of all three activities at baseline and follow-up was associated with the occurrence and persistence of depressive symptoms.

DOI： 10.1016/j.archger.2022.104800

PubMed

Publishing type：Research paper (scientific journal)  

前期高齢者の生活満足度(LS)が機能低下に及ぼす影響について経時的に検討した。65歳の地域住民1899名(男性977名)をLS尺度得点の四分位で4群(Q1～4)に分け、8、10、12、14年後の介護保険認定または死亡の発生リスクをCoxモデルにより算出した。その結果、女性において、Q3はQ1に比べ8年後(72/73歳時)に要支援・要介護となるリスクが有意に低かったが(ハザード比(HR) 0.30)、以後LSの影響は漸減しHRは10年後0.55、12年後0.72、14年後0.68となった。要介護や死亡の発生リスクにも同様の傾向が認められ、4時点におけるQ3の要介護または死亡のHRは0.24→0.31→0.57→0.60、要支援・要介護または死亡のHRは0.30→0.46→0.67→0.65といずれも経時的に上昇した。男性では全時点でLSと機能低下または死亡の間に有意な関連は認められなかった。

Publishing type：Research paper (scientific journal)   International / domestic magazine：Domestic journal  

<p><b>Background:</b> Although life satisfaction (LS) has been shown to predict mortality, research studying the relationship between LS and functional decline is scarce. This study examined the association between LS and functional decline across four time points in young-old Japanese adults.</p><p><b>Methods:</b> We analysed 1,899 community-dwelling 65-year-olds in this age-specific cohort study conducted between 2000 and 2005. The Life Satisfaction Index K was used to evaluate LS and was classified into quartiles. Functional decline was determined using the Japanese Long-Term Care Insurance (LTCI) system: 1) mild disability; 2) severe disability; 3) all-cause mortality; 4) mild or severe disability; 5) severe disability or death; 6) mild or severe disability, or death. Adjusted hazard ratios (HR) with 95% confidence intervals (CI) were calculated using the Cox proportional hazard model. The analyses were conducted in the 8^th, 10^th, 12^th, and 14^th years to assess the effect of LS on functional decline across time points.</p><p><b>Results:</b> The impact of LS gradually weakened over time. In the 8^th year (aged 72–73), a higher LS was associated with a lower risk of mild or severe disability among the women participants (adjusted HR [95% CI] = 0.30 [0.11–0.81]). However, the effect disappeared gradually (adjusted HR [95% CI] = 0.55 [0.27–1.14]) in the 10^th year (aged 74–75), 0.72 (0.41–1.26) in the 12^th year (aged 76–77), and 0.68 (0.41–1.14) in the 14^th year (aged 78–79). This trend continued in severe disability or death (adjusted HR [95% CI] = 0.24 [0.06–0.70], 0.31 [0.11–0.76], 0.57 [0.28–1.14], and 0.60 [0.32–1.12]) and mild or severe disability, or death (adjusted HR [95% CI] = 0.30 [0.14–0.68], 0.46 [0.24–0.87], 0.67 [0.41–1.10], and 0.65 [0.42–1.02]) in the 8^th, 10^th, 12^th, and 14^th years, respectively. No statistically significant association was found among men at any time points or in any classification of outcomes.</p><p><b>Conclusions:</b> Higher LS scores in 65-year-old women were associated with a lower risk for functional decline in any combination of mild disability, severe disability, or death. Additionally, the effect of LS was observed to weaken over time.</p><p><b>Trial registration:</b> This is not an intervention survey and does not require registration.</p>

DOI： 10.1265/ehpm.23-00019

PubMed

Publishing type：Research paper (scientific journal)  

Introduction: In this cross-sectional study, we aimed to investigate the factors for preferring homes as the location to receive long-term care in community-dwelling populations. Methods: A total of 4,113 individuals with a response rate of 36.7% from four areas in Japan were analyzed. All information was obtained from a questionnaire survey conducted in 2019. We used negative binominal regression modeling with adjustments for areas to calculate the prevalence ratios (PRs) and 95% confidence intervals (CIs) for the preference of long-term home care about factors. All missing values were input using multiple imputations. Results: The results show that the prevalence of preferring homes as the location for receiving long-term care was 73.4%. Being employed (PR: 1.04; 95% CI: 1.00–1.09), living with others (PR: 1.12; 95% CI: 1.05–1.19), feeling satisfied with the environment of nursing care in residential areas (PR: 1.05; 95% CI: 1.00–1.10), feeling satisfied with the natural surroundings in the community (PR: 1.18; 95% CI: 1.07–1.31), the presence of people in the community who can be consulted about problems (PR: 1.05; 95% CI: 1.00–1.10), and the presence of close friends in the community (PR: 1.09; 95% CI: 1.03–1.15) were significantly associated with the preference for long-term home care. Conclusion: We suggest that municipalities should consider these social and interpersonal associations to support older residents’ preference of receiving home care services.

DOI： 10.2174/18749445-v16-e230419-2022-178

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

OBJECTIVE: This study aimed to investigate the association between daily sleep duration and incident dementia among physically and socially independent older people with/without diseases (hypertension, diabetes mellitus, cardiovascular diseases) in a Japanese age-specific cohort. METHODS: We carried out a prospective cohort study including 1954 (1006 men and 948 women) Japanese individuals aged 64/65 years. Information on daily sleep duration, medical status, demographics, and lifestyle characteristics was collected by a baseline questionnaire survey and health checkup (2000-2005). Dates of incident dementia were confirmed using the nationally standardized dementia scale proposed by the Ministry of Health, Labor, and Welfare. A competing risk model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident dementia. We treated censored cases due to death as competing events. RESULTS: During a median of 15.6 years of follow-up, 260 participants reported incident dementia. Compared with participants without diseases and who slept 6-7.9 h/day, those with a shorter daily sleep duration of <6 h/day, presence of disease and shorter, moderate, or longer daily sleep duration ≥8 h/day had an increased risk of incident dementia (HR 1.73; 95% CI 1.04-2.88, HR 1.98; 95% CI 1.14-3.44, HR 1.44; 95% CI 1.03-2.00, and HR 2.09; 95% CI 1.41-3.09, respectively) with a significant interaction between the presence of diseases and sleep duration (p < 0.001). CONCLUSIONS: The present findings suggest that habitual sleep duration predicts future risk of dementia.

DOI： 10.1016/j.sleep.2022.08.022

PubMed

Publishing type：Research paper (scientific journal)  

高齢者における食生活の多様性と全死亡率との関連およびBMIの影響について検討した。NISSIN Projectに参加した高齢者2944名(年齢64～65歳、男性1481名)を対象とした。調査項目は自記式食品摂取頻度調査票(食品多様性スコア[FVS]、3分位により低、中、高に分類)、BMIなどとした。追跡期間中央値16.6年で、男性454名(30.7%)、女性222名(15.2%)が死亡した。Cox比例ハザード回帰分析の結果、食物多様性スコアと全死因死亡率に有意な関連は認められなかった。BMIによる層別解析の結果、痩せの高齢者では、低FVS群と比較した中FVS群の調整ハザード比(95%CI)は0.56(0.32～0.96)、高FVS群は0.50(0.25～1.02)であった(p for trend 0.059)。過体重/肥満女性では、有意ではないものの、低FVS群と比較して中・高FVS群で全死因死亡率が高かった。以上から、痩せ型の日本人高齢者では食事の多様性を促進する必要があることが示された。

Publishing type：Research paper (scientific journal)   International / domestic magazine：Domestic journal  

AIM: Dietary diversity might reduce the risk of malnutrition, although it is also linked to obesity. We examined whether dietary diversity is associated with all-cause mortality in Japanese older adults based on their body mass index (BMI). METHODS: The current study included 2944 people aged 64-65 years who participated in the New Integrated Suburban Seniority Investigation (NISSIN) project from 1996 to 2005. Dietary diversity was measured using the Food Variety Score (FVS), which calculates the frequency of all food items consumed daily using a self-administered food frequency questionnaire. Participants were divided into tertiles according to their FVS (first: low, second: middle, third: high). Multivariate adjusted hazard ratios with 95% confidence intervals were calculated using the Cox proportional hazard regression model. For the stratified analysis, BMI was used to divide the participants into three groups - lean (BMI <20), normal (BMI 20-24.9) and overweight/obese (BMI ≥25). RESULTS: Overall, 454 (30.7%) men and 222 (15.2%) women died over a median follow-up period of 16.6 years. No significant association was observed between FVS and all-cause mortality. However, when grouped by BMI, for the participants in the lean group, the multivariate adjusted hazard ratios were 0.56 (95% confidence interval 0.32-0.96) for the middle FVS and 0.50 (95% confidence interval 0.25-1.02) for the high FVS, compared with the low FVS (P for trend = 0.059). In overweight/obese women, although not significant, total mortality was higher in the middle and high FVS. CONCLUSIONS: These findings show that dietary diversity should be promoted in lean older Japanese adults. Geriatr Gerontol Int 2022; 22: 736-744.

DOI： 10.1111/ggi.14446

PubMed

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

OBJECTIVE: Regular engagement in behavioral activities plays a crucial role against depressive symptoms in older adults. This study aims to explore the relationship between behavioral activities and the temporal evolution of depressive symptoms. METHODS: We included community-dwelling Japanese adults aged 64 or 65 years with and without depressive symptoms enrolled in the New Integrated Suburban Seniority Investigation (NISSIN) project. Depressive symptoms at baseline and follow-up were assessed using the 15-item Geriatric Depression Scale. Behavioral activities were measured by self-reported questions. Risk ratios and 95% confidence intervals were calculated using modified Poisson regression, adjusting for relevant sociodemographic variables and health-related confounders. RESULTS: During the 6 year follow-up period, 139 (10.1%) without depressive symptoms at baseline developed such symptoms over time, while 174 (51.6%) with depressive symptoms improved to the point of these symptoms being absent. The participants without depressive symptoms at baseline and those who engaged in social activity or daily walking at a continued regular frequency (CRF) or an increased frequency (IF) and exercise habits at CRF were the least likely to have depressive symptoms onset at follow-up. There was no significant difference between the changes in behavioral activities and the improvement of depressive symptoms after controlling for confounders. Participants engaging in a greater variety of behavioral activities at CRF were less likely to experience a new onset of depressive symptoms. CONCLUSIONS: Consistent and regular participation in one or more behavioral activities was significantly associated with the onset of depressive symptoms in Japanese community-dwelling older adults.

DOI： 10.1002/gps.5778

PubMed

Publishing type：Research paper (scientific journal)  

Details of correction Existing text: Abstract A total of 58,767 (23,162 men and 34,232 women) Japanese participants Corrected text should read: A total of 58,767 (23,162 men and 35,605 women) Japanese participants.

DOI： 10.1017/S0007114522000277

PubMed

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

DOI： 10.1017/S0007114522000277

PubMed

Publishing type：Research paper (scientific journal)  

Introduction:

This systematic review aimed to assess the association between social participation in group activities or associations and the risk of dementia based on longitudinal cohort studies.

Methods:

We searched the electronic database PubMed for relevant studies in English published up to April 13, 2021. The search strategy included a combination of terms related to (1) longitudinal cohort studies, (2) assessing the association between social participation in group activities or associations and the risk of dementia, and (3) the article must be published in English or Japanese.

Results:

Of the 1,881 identified studies, 7 were included in the current systematic review. Five of these seven studies indicated social participation in group activities or associations to be significantly associated with a decreased risk of dementia. Our search also revealed the following points: 1) four studies evaluated the association between the specific type of social participation and the risk of dementia; 2) two studies evaluated the association between the frequency of social participation and the risk of dementia, and 3) one study investigated the effects of changes in the state of social participation on the risk of dementia.

Conclusion:

To clarify the association between social participation in group activities or associations and the risk of dementia, future studies should: 1) evaluate the association between the specific type and frequency of social participation and the risk of dementia, and 2) investigate the effects of changes in the states of social participation on the risk of dementia.

DOI： 10.2174/18749445-v15-e2204141

Other URL： https://openpublichealthjournal.com/contents/volumes/V15/e187494452204141/e187494452204141.xml

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

Aging is important medical and social problem. Excessive angiopoietin-like protein (ANGPTL)-2 signaling causes chronic tissue inflammation, promoting development and progression of aging-related diseases. Moreover, circulating ANGPTL2 levels reportedly predict risk of some aging-related diseases and subsequent death. However, there are as yet no reports of whether circulating ANGPTL2 levels predict vital prognosis in younger-old, community-dwelling populations. This study investigated associations between plasma ANGPTL2 levels and all-cause and specific-cause mortality in this population. The case-cohort study was abstracted from an on-going, age-specific prospective cohort study: the New Integrated Suburban Seniority Investigation Project. This project enrolled 3073 participants aged 64 years at the beginning of the investigation from 1996 through 2005. A sub-cohort of 714 randomly sampled participants plus 387 cases representing deceased participants followed through 2015 underwent survival analysis. Plasma ANGPTL2 concentrations were positively associated with >80% and 100% higher risk of all-cause mortality and cancer mortality, respectively, after adjustment for gender, smoking, alcohol consumption, walking time, sleep duration, caloric intake, medical status, disease history, BMI, and triglyceride, creatinine, uric acid, and high sensitivity C-reactive protein levels. More robust association between ANGPTL2 levels and all-cause and cancer mortality was seen in subjects with either frailties or with lifestyles of heavier drinking or current smoking. Elevated plasma ANGPTL2 levels are associated with high all-cause and cancer mortality in a community-dwelling sample of younger-old adults. These findings expand our knowledge of human aging and associated diseases.

DOI： 10.1093/gerona/glac017

PubMed

Publishing type：Research paper (scientific journal)   International / domestic magazine：Domestic journal  

AIM: We prospectively examined the association between leisure activities and changes in instrumental activities of daily living (IADL) among participants of the Japan Gerontological Evaluation Study (JAGES). METHODS: We analyzed data collected from 49 732 JAGES participants (23 359 men and 26 373 women), aged ≥65 years, from 24 municipalities in Japan. MEASUREMENTS: Baseline data were obtained for 25 types of leisure activities in which the cohort members participated. Baseline (2010) and follow-up (2013) data on IADL were collected - the outcome indicated changes in IADL scores from 2010 to 2013. We regressed changes in IADL scores from the 2010 to 2013 to the number of leisure activities. RESULTS: Older adults who engaged in more leisure activities had higher changes in IADL scores than those who engaged in fewer leisure activities: the β values (95% confidence interval [CI]) of the IADL scores were 0.001 [-0.04-0.04], 0.04 [0.01-0.08], 0.09 [0.05-0.13], 0.09 [0.05-0.14], 0.08 [0.02-0.13], and 0.13 [0.07-0.18] for having one, two, three, four, five, and more than six types of leisure activities (P for trend <0.001), respectively. Similar associations were found for different types of leisure activities, including predominantly physical and cultural activities. Statistically significant linear trends were obtained among the group, solitary, and other leisure activity subgroups (P for trend <0.05). CONCLUSIONS: Encouraging engagement in leisure activities may promote maintenance of IADL among older populations. Different types of leisure activities appear to have similar positive impacts on IADL. Geriatr Gerontol Int 2021; ••: ••-••.

DOI： 10.1111/ggi.14334

PubMed

Publishing type：Research paper (scientific journal)  

日本老年学的評価研究データを用いて、余暇活動と手段的日常生活動作(IADL)の変化との関連について検討した。2010年にベースライン調査、2013年に追跡調査を実施した。評価項目はベースライン調査における25種類の余暇活動の実施状況(余暇活動数、種類[身体的、文化的、その他]、人数[グループ、単独、その他])、両時点での老研式活動能力指標などとした。49732名(男性23359名)を解析対象とした。その結果、余暇活動数の多い高齢者ほど高いIADLスコアが維持されることが示された。同様の関連は、主に身体的活動や文化的活動などの余暇活動でも認められた。以上から、余暇活動の参加奨励は、高齢者におけるIADL維持を促進する可能性が示された。

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

BACKGROUND: Sedentary behavior and decreased physical activity are associated with reduced kidney function, yet most evidence is based on self-reported physical activity. This study investigated the association between accelerometer-based physical activity level and kidney function in a general Japanese population. METHODS: A cross-sectional study was conducted in 440 community-dwelling Japanese participants, aged 35-79 years. Time (min/d) was assessed for the following types of physical activity: sedentary behavior, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Kidney function was assessed using estimated glomerular filtration rate (eGFR). A linear regression model was employed to calculate the β coefficient of eGFR for a 60-min/d increase in sedentary behavior and LPA and a 10-min/d increase in MVPA. A logistic regression model was used to calculate the odds ratio for low eGFR (< 60 versus ≥60 mL/min/1.73m2) for a 60-min/d or 10-min/d increase in each physical activity type. RESULTS: MVPA time and eGFR were positively associated in both men and women, after adjusting for age, body mass index, and other clinical characteristics (Men: β, 0.91; P = 0.021; Women: β, 0.70; P = 0.034). In women, sedentary behavior and eGFR were inversely associated after adjusting for the same factors (β, - 1.06; P = 0.048). The odds ratio (95% confidence interval) for low eGFR associated with a 60-min increase in sedentary behavior was 1.65 (1.07-2.55) after adjusting for the same factors in women. CONCLUSION: Longer sedentary behavior and shorter MVPA time were associated with lower kidney function in the Japanese population.

DOI： 10.1186/s12882-021-02635-0

PubMed

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

OBJECTIVE: The relationship between physical activity (PA) and the risk of frailty has not reached a conclusive result. This systematic review with meta-analysis aimed to evaluate the effect of PA on the onset of frailty in the community-dwelling middle and older age adults by pooling data from cohort studies. METHODS: A systematic literature search was performed via PubMed, Embase, and Web of Science up to June 01, 2021. Pooled adjusted effect estimates (ES) with 95% confidence interval (CI) were calculated by using the random-effect model and by comparing the highest with lowest levels of PA. Heterogeneity was tested using the I2 statistic and Q-test. The quality of evidence was evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: A total of ten cohort studies with 14 records were selected, and the GRADE approach classified the quality of evidence as low. In comparison with the lowest level of PA, the highest level of PA was associated with 41% decreased odds of frailty (ES: 0.59, 95% CI: 0.51-0.67; I2 = 70.0%, P-heterogeneity < 0.001) after pooling results from included studies. In stratified analysis by frailty assessment approach, the highest level of PA was significantly associated with 37% (ES 0.63, 95% CI: 0.52-0.77, 49% (ES: 0.51, 95% CI: 0.41-0.63), and 30% (ES: 0.70, 95% CI: 0.65-0.75) reduced odds of frailty when pooling studies using criteria of physical frailty, multidimensional model, and accumulation of disability, respectively. Stratified analyses further by PA indicators and PA assessment tools yielded similar protective effects in any subgroups. CONCLUSIONS: This study with moderate-certainty evidence shows that a higher level of PA was associated with lower odds of frailty, and the benefits of PA for frailty prevention were independent of frailty assessment tools, PA indicators, and PA assessment methods. Findings from this study may help implement active exercise strategies to prevent frailty.

DOI： 10.1371/journal.pone.0278226

PubMed

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

BACKGROUND: Gait was proved to be strongly associated with global cognitive function and multiple cognitive domains; however, previous research usually concentrated on individual gait parameters. This study used wearable sensors to measure gait parameters in different aspects and comprehensively explored the association of gait with global cognitive function and cognitive domains. METHODS: The data of this cross-sectional study were obtained from 236 community-dwelling Japanese older adults (125 men and 111 women) aged 70-81 years. Gait was measured by asking participants to walk a 6-m course and back using the Physilog® sensors (GaiUp®, Switzerland). Global cognitive function and cognitive domains were evaluated by face-to-face interviews using the Japanese version of the Montreal Cognitive Assessment. Twenty gait parameters were summarized as independent gait factors using factor analysis. A generalized linear model and linear regression model were used to explore the relationship of gait with global cognitive function and cognitive domains adjusted for several confounding factors. RESULTS: Factor analysis yielded four gait factors: general cycle, initial contact, propulsion, and mid-swing. Among them, general cycle factor was significantly associated with global cognitive function (β = - 0.487, [- 0.890, - 0.085]) and executive function (P = 0.049); initial contact was associated with executive function (P = 0.017). CONCLUSION: General cycle of gait might be the better marker of global cognitive function and gait is most strongly associated with executive function. The longitudinal relationships should be examined in future cohort studies.

DOI： 10.1186/s12877-021-02467-5

PubMed

Publishing type：Research paper (scientific journal)  

＜Highlight＞●北海道の寿都町在住者を対象に加速度計を用いて座位行動・身体活動を評価し、その性差を検討した。●中高強度身体活動には性差がみられなかったが、女性は男性よりも低強度身体活動が多く、総身体活動量が多かった。●女性は男性よりも座位行動が少なかった。●身体活動ガイドラインを満たしている者の割合には性差がみられなかった。●これまで男性の方が活動的と繰り返し報告されてきたが、健康効果が報告されている座位行動や低強度身体活動を踏まえると、女性の方が好ましい身体活動パターンである可能性が示唆された。(著者抄録)

Publishing type：Research paper (scientific journal)   International / domestic magazine：International journal  

Serum fatty acids (FAs) exist in the four lipid fractions of triglycerides (TGs), phospholipids (PLs), cholesteryl esters (CEs) and free fatty acids (FFAs). Total fatty acids (TFAs) indicate the sum of FAs in them. In this study, four statistical analysis methods, which are independent component analysis (ICA), factor analysis, common principal component analysis (CPCA) and principal component analysis (PCA), were conducted to uncover food sources of FAs among the four lipid fractions (CE, FFA, and TG + PL). Among the methods, ICA provided the most suggestive results. To distinguish the animal fat intake from endogenous fatty acids, FFA variables in ICA and factor analysis were studied. ICA provided more distinct suggestions of FA food sources (endogenous, plant oil intake, animal fat intake, and fish oil intake) than factor analysis. Moreover, ICA was discovered as a new approach to distinguish animal FAs from endogenous FAs, which will have an impact on epidemiological studies. In addition, the correlation coefficients between a published dataset of food FA compositions and the loading values obtained in the present ICA study suggested specific foods as serum FA sources. In conclusion, we found that ICA is a useful tool to uncover food sources of serum FAs.

DOI： 10.1038/s41598-021-97349-6

PubMed

Publishing type：Research paper (scientific journal)  

AIM: We aimed to clarify whether snacking habits decrease the risk of all-cause mortality in an older Japanese population. METHODS: The study participants were 64- or 65-year-old community-dwelling residents recruited each survey year from 1996 through 2005. Data on the frequency of snacking and other lifestyle factors were obtained during the baseline survey using self-administered questionnaires, and the participants were followed up annually until the end of 2017. In total, 2943 participants (1484 men and 1459 women) were eligible. All-cause mortality was compared among participants grouped by frequency of snacking (no snacking, one to four times/week, or every day). RESULTS: The number of deaths recorded over the study period of 43 204 person-years was 357 (24.1%) for men and 173 (11.9%) for women. The mean ± standard deviations for the follow-up period were 14.2 ± 4.9 years in men and 15.2 ± 4.5 years in women. Cox proportional hazard regression analyses showed that after adjusting for potential confounding factors, the hazard ratios for women were 0.64 (95% confidence interval [CI], 0.43-0.94) in the group that had a habit of snacking one to four times/week, and 0.93 (95% CI 0.63-1.36) in the group that had a habit of snacking every day compared with those in the no snacking group. These associations were not observed among men. CONCLUSIONS: A moderate frequency of snacking slightly decreases the risk of all-cause mortality among women. Our findings might be useful for improving the nutrition statuses in older female adults. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2021; ••: ••-••.

DOI： 10.1111/ggi.14209

PubMed

Publishing type：Research paper (scientific journal)  

64歳または65歳の地域住民2943名(男性1484名、女性1459名)を対象に間食習慣が全死亡リスクを低下させるか調べた。ベースライン調査では、自記式質問票を用いて間食頻度やその他の生活習慣因子に関するデータを取得し、毎年追跡調査を行った。全死亡率を、間食頻度別(間食なし、1～4回/週、毎日)に比較した。その結果、43204人・年の研究期間中に記録された死亡数は、男性357名(24.1%)、女性173名(11.9%)であった。平均追跡期間は、男性で14.2±4.9年、女性で15.2±4.5年であった。Cox比例ハザード回帰分析の結果、潜在的交絡因子で調整後の女性のハザード比は、間食なし群と比較して間食1～4回/週群で0.64(95%CI 0.43～0.94)、毎日間食群で0.93(95%CI 0.63～1.36)であった。これらの関連性は男性では認められなかった。適度な頻度の間食は、女性の全死亡リスクを僅かに低下させることが示された。

Publishing type：Research paper (scientific journal)  

Recently, aging is considered a risk factor for various diseases. Although changes in the intestinal microbiota along with aging are thought to associate with the increased disease risk, mechanisms that cause age-related transition of the intestinal microbiota remain unknown. This study aims to clarify relationships between the amount of human defensin 5 (HD5), a Paneth cell α-defensin, which is known to regulate the intestinal microbiota, and age-related differences of the intestinal microbiota composition. Fecal samples from 196 healthy Japanese (35 to 81 years old) were collected and measured HD5 concentration. HD5 concentration in the elderly group (age > 70 years old) was significantly lower than the middle-aged group (age ≤ 70 years old). Furthermore, individual age was negatively correlated with HD5 concentration (r =  - 0.307, p < 0.001). In β-diversity, the intestinal microbiota of the elderly showed a significantly different composition compared to the middle-aged. At the genus level, relative abundance of Collinsella, Alistipes, Peptococcaceae; unassigned, Lactobacillus, Lactococcus, Weissella, Christensenellaceae R-7 group, Megasphaera, and [Eubacterium] eligens group was significantly higher, and Lachnospiraceae; unassigned, Blautia, Anaerostipes, Fusicatenibacter, Dorea, and Faecalibacterium was significantly lower in the elderly compared to the middle-aged. In addition, HD5 concentration was negatively correlated with Alistipes, Peptococcaceae; unassigned, and Christensenellaceae R-7 group and positively correlated with Lachnospiraceae; unassigned and Dorea. These results provide novel insights into the immunosenescence of enteric innate immunity, indicating low HD5 is suggested to contribute to the age-related differences in the intestinal microbiota and may relate to increased risk of diseases in elderly people.

DOI： 10.1007/s11357-021-00398-y

PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.1186/s12199-021-00977-7

PubMed

Publishing type：Research paper (scientific journal)  

BACKGROUND: We developed and compared two liquid chromatography methods, one with UV/Visible spectrophotometric detection (HPLC) and the other with mass spectrometric detection (LC-MS), for quantifying very-long chain fatty acids (VLCFA) in human plasma. Association of VLCFA with various cardiovascular risk factors were evaluated. METHOD: Fasting blood samples were collected from 541 human volunteers (242 men and 299 women; mean age ±SD, 58.9 ± 12.4 years), including 429 and 112 individuals with and without hypertriglyceridemia, respectively. Esterified VLCFA were saponified and derivatized with 2-nitrophenylhydrazine. Separation of VLCFA species was achieved with C4 Mightysil column (HPLC) and Ascentis Express Phenyl-Hexyl column (LC-MS) followed by spectrophotometric and selected-reaction monitoring mode of mass spectrometric detection, respectively. RESULTS: The HPLC assay of VLCFA was precise with intra-assay imprecision of 2.5% to 6.9% and inter-assay imprecision of 3.2% to 9.5%. Moreover, there was an excellent correlation (r > 0.96) between HPLC and LC-MS methods. The 95 percentile reference intervals (RI; upper limit) of VLCFA were determined to be 41.3 µmol/L in healthy volunteers. Plasma VLCFA were significantly correlated with triglycerides (Spearman's ρ = 0.306, P < 0.001) and total cholesterol (Spearman's ρ = 0.251, P < 0.001). All species of VLCFA were significantly elevated in hypertriglyceridaemic individuals compared with control. CONCLUSION: We established LC-based assays of VLCFA with either spectrophotometry or mass spectrometry as a detection system. Hypertriglyceridaemia is significantly associated with elevated concentration of each species of VLCFA.

DOI： 10.1177/00045632211007157

PubMed

Publishing type：Research paper (scientific journal)  

BACKGROUND: Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex. METHODS: We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2000 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model. RESULTS: Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714-0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699-0.771). CONCLUSIONS: We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.

DOI： 10.1186/s12199-021-00968-8

PubMed

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

PURPOSE: Sedentary behavior attributes to the increased risk of some cancers and all-cause mortality. The evidence is limited for the association between television (TV) viewing time, a major sedentary behavior, and risk of colorectal cancer death. We aimed to examine this association in Japanese population. Materials and Methods: A prospective cohort study encompassed of 90,834 men and women aged 40-79 years with no prior history of colorectal cancer who completed a self-administered food frequency questionnaire, and provided their TV viewing information. The participants were followed-up from 1988-1990 to the end of 2009. The hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated by the Cox proportional hazard regression for risk of colorectal cancer mortality according to TV viewing time. RESULTS: During the median 19.1-year follow-up period, we documented 749 (385 men and 364 women) colorectal cancer deaths. The multivariable-adjusted HRs for mortality from colorectal cancer were 1.11 (0.88-1.41) for 1.5 to < 3 hr/day, 1.14 (0.91-1.42) for 3 to < 4.5 hr/day and 1.33 (1.02-1.73) for ≥ 4.5 hr/day in comparison to < 1.5 hr/day TV watching; p-trend=0.038, and that for 1-hour increment in TV viewing time was 1.06 (1.01-1.11). Moreover, the multivariable-adjusted HR (95%CI) of colon cancer for 1-hour increment in TV viewing time was 1.07 (1.02-1.13). Age, body mass index, and level of leisure-physical activity did not show significant effect modifications on the observed associations. CONCLUSION: TV viewing time is associated with the increased risk of colorectal cancer mortality among Japanese population, more specifically colon rather than rectal cancer.

DOI： 10.4143/crt.2020.327

PubMed

Publishing type：Research paper (scientific journal)  

目的 積雪寒冷地域である北海道6町に在住する高齢者の近隣環境の認識と冬季における1日平均歩数の目標達成との関連を明らかにする。対象と方法 要介護認定を受けていない69〜78歳、569人を対象に、環境に関する自記式質問紙調査と、3軸加速度活動量計による活動量調査を行い、データの得られた457人を解析対象者とした。1日の平均歩数を厚生労働省の示す目標値によって、目標達成群(男性7,000歩以上、女性6,000歩以上)と目標未達成群に分類し分析を行った。結果 目標達成群には男性の13.1%、女性の17.2%が分類された。運動や散歩に適した公園や歩道があることはないことに比べ冬季の歩数の性別、年齢で調整した目標達成割合比は1.86(95% CI:0.92-3.74)、生鮮食料品が手に入る商店・施設・移動販売が身近にあることは、ないことに比べ0.90(95% CI:0.57-1.45)だった。考察 積雪寒冷地域であっても運動や散歩に適した公園や歩道があることで、冬季においても歩数を維持できる可能性が示唆された。(著者抄録)

Publishing type：Research paper (scientific journal)  

目的 積雪寒冷地域である北海道6町に在住する高齢者の近隣環境の認識と冬季における1日平均歩数の目標達成との関連を明らかにする。対象と方法 要介護認定を受けていない69〜78歳、569人を対象に、環境に関する自記式質問紙調査と、3軸加速度活動量計による活動量調査を行い、データの得られた457人を解析対象者とした。1日の平均歩数を厚生労働省の示す目標値によって、目標達成群(男性7,000歩以上、女性6,000歩以上)と目標未達成群に分類し分析を行った。結果 目標達成群には男性の13.1%、女性の17.2%が分類された。運動や散歩に適した公園や歩道があることはないことに比べ冬季の歩数の性別、年齢で調整した目標達成割合比は1.86(95% CI:0.92-3.74)、生鮮食料品が手に入る商店・施設・移動販売が身近にあることは、ないことに比べ0.90(95% CI:0.57-1.45)だった。考察 積雪寒冷地域であっても運動や散歩に適した公園や歩道があることで、冬季においても歩数を維持できる可能性が示唆された。(著者抄録)

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Evaluating the effects of dietary intake on mortality in older populations has become increasingly important in modern aging societies. The objective of the present study was to investigate the associations between food group intakes and all-cause mortality among a young older population. We conducted a prospective study on 1,324 men and 1,338 women aged 64-65 years at baseline who were living in a suburban city from 1996 to 2005. The participants were followed for all-cause mortality from 1996 through 2015 to assess the effects of 17 food group intakes (g) per 1,000 kcal after multivariable adjustments in proportional hazard models. During follow-up (mean: 13.2 years), 339 deaths were registered. In women, total mortality was significantly and inversely associated with the consumption of milk and dairy products and vegetables. The hazard ratios across intake quartiles after multivariable adjustment were 1, 0.70 (95% confidence interval: 0.42-1.17), 0.66 (0.40-1.10), and 0.40 (0.22-0.75) (P for trend = 0.003) for milk and dairy products, and 1, 0.77 (0.46-1.28), 0.83 (0.50-1.38), and 0.42 (0.23-0.78) (P for trend = 0.008) for vegetables. In men, a positive association was found between total mortality and sugar and sweetener consumption (P for trend = 0.038). Higher consumption of milk and dairy products and vegetables was suggested to reduce all-cause mortality in young older women.

DOI： 10.18999/nagjms.83.1.169

PubMed

Publishing type：Research paper (scientific journal)  

PURPOSE: The aim of the present study was to investigate the association between falls, including falls on frozen roads, and physical activity among older people living in cold, snowy regions in Japan. METHODS: Participants were subjects of the Japan Gerontological Evaluation Study 2016 who had agreed to the Hokkaido additional visit survey in winter 2017/18 and lived in cold, snowy regions in Japan. The analysis included 461 participants (mean age 74.7 years; standard deviation 2.8 years; 46.5% male). Sociodemographic characteristics, physical activity (min/day of moderate-to-vigorous intensity physical activity [MVPA] and light intensity physical activity, and walking steps/day) measured by accelerometer, cognitive function, depression, visual impairment, and history of stroke were surveyed. Poisson regression analyses were performed to clarify the association between prevalence of falls and physical activity. RESULTS: Of those who reported a fall with location, 86 (69.9%) fell on frozen roads, 24 (19.5%) fell on unfrozen roads and 13 (10.6%) fell indoors. There were significant positive associations between MVPA (adjusted prevalence ratio [aPR] Tertile [T] 3 vs T1, 1.73; 95% confidence interval [CI], 1.04-2.87) and all falls. When limited to falls on frozen roads, higher MVPA levels and walking steps were associated with falls on frozen roads (MVPA, aPR T3 vs T1, 2.16; 95% CI, 1.19-3.94; walking steps, aPR T3 vs T1, 2.49; 95%CI 1.33-4.68). CONCLUSION: The risk of falls, especially on frozen roads, increased among active older people living in cold, snowy regions, and environmental factors should be considered when determining prevention strategies.

DOI： 10.1007/s41999-020-00398-9

PubMed

Publishing type：Research paper (scientific journal)  

Whether the source of dietary protein intake is related to appendicular skeletal muscle mass (AMM) and muscle mass (MM) remains unclear. We conducted this cross-sectional study of 277 residents (115 men, 162 women) aged ≥65 years in Japan to examine the association of the amount of dietary protein intake with AMM and MM. We measured dietary protein intake using a brief self-administered diet history questionnaire. AMM and MM were assessed based on bioelectrical impedance. Multivariable linear regression analyses were used to estimate β coefficients that were adjusted for potential confounders. Among Japanese women aged ≥75 years, but not among women aged 65-74 years, dietary animal protein intake was significantly associated with AMM (β (95% confidence interval (CI)): 0.25 (0.10, 0.40)) and MM (β (95% CI): 0.40 (0.16, 0.64)). However, dietary vegetable protein intake was not associated with AMM (β (95% CI): -0.17 (-0.74, 0.41)) and MM (β (95% CI): -0.30 (-1.23, 0.63)). Furthermore, in men aged ≥65 years, dietary protein intake was not associated with AMM or MM. In conclusion, dietary animal protein intake, but not vegetable protein intake, were positively associated with AMM and MM among this population of Japanese women aged ≥75 years.

DOI： 10.3390/nu13010187

PubMed

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Serum high-molecular-weight adiponectin (HMWA) has a positive correlation with insulin secretion in the Japanese population. To validate this correlation, we investigated the correlation between serum HMWA and proinsulin, a marker of β-cell dysfunction, in this population. A total of 488 participants (53.9% women) aged 35-79 years not taking oral hypoglycemic agents and/or insulin were enrolled. HMWA was significantly and inversely correlated with proinsulin adjusted for age and sex (partial regression coefficient β = -0.37; 95% confidence interval -0.46 to -0.28). When the participants were divided into two groups by median values of body mass index (23.2 kg/m2 ), serum insulin (4.3 µU/mL) or homeostasis model assessment of insulin resistance (1.0), similar inverse correlations were observed adjusted for age and sex in both groups. Our results showed that the HMWA level was inversely correlated with the proinsulin level in a general Japanese population.

DOI： 10.1111/jdi.13323

PubMed

Publishing type：Research paper (scientific journal)  

In Western populations, fecal concentrations of short-chain fatty acids (SCFAs) are positively correlated with the prevalence of obesity. However, gut microbiota involved in the production of SCFA varies between races. Our purpose was to investigate the associations between fecal SCFAs and the prevalence of obesity in a community-based Japanese population. We classified a total of 568 participants aged ≥18 into four quartiles of fecal concentrations of SCFA subtypes (acetate, butyrate, and propionate) and total SCFAs to compare the prevalence of obesity, defined as a body mass index ≥ 25.0 kg/m2. Using the first quartile SCFA group as a reference, the prevalence ratios of obesity were calculated for each SCFA group through a log-binomial regression model adjusted for major potentially confounding factors including age, sex, exercise habits, total energy intake, and total dietary fiber intake. In the study population, the prevalence of obesity was 35.8%. The prevalence ratios (95% confidence intervals) of obesity in the second, third, and fourth quartile groups of fecal total SCFAs were 1.30 (0.89-1.89), 1.74 (1.23-2.47) and 1.70 (1.19-2.41), respectively, after adjusting for the confounders. Similar positive associations were observed for every subtype. The prevalence ratios (95% confidence intervals) in the fourth quartile groups of fecal acetate, butyrate, and propionate were 1.41 (1.02-1.97), 2.16 (1.49-3.14), and 1.97 (1.35-2.89), respectively, after adjusting for the confounders. In conclusion, our results demonstrated that fecal SCFA concentrations of every subtype were positively associated with the prevalence of obesity in a community-based Japanese population.

DOI： 10.1016/j.orcp.2021.06.003

PubMed

Publishing type：Research paper (scientific journal)  

幅広い産業分野の事業場(12ヶ所)に昼間勤務する多様な職種の労働者から正常血圧者4314名(男性3153名)を抽出し、2年後の高血圧発症率を世帯年収区分別に比較した。世帯年収500万円未満を対照に、年収区分ごとの高血圧発症のハザード比をCox比例ハザードモデルにて算出した。年齢、調査開始時の収縮期血圧、事業場、職種、家族人数、喫煙状況で補正したハザード比(95%信頼区間)は、男性の場合、世帯年収500〜790万円で1.52(1.08〜2.18)、800〜990万円で1.49(0.98〜2.27)、1000万円以上で1.92(1.23〜3.01)であった。飲酒とBMIで補正するとこの関連は減弱したが、依然有意であった。女性では有意な関連は認められなかったが、高世帯年収区分の女性は高血圧発症リスクが低い傾向にあった。以上から、昼間勤務の男性被雇用者において、世帯年収は高血圧発症と正の関連がみられた。

Publishing type：Research paper (scientific journal)  

This cohort study aimed to investigate the association between household income and incident hypertension in a Japanese employed population. During 2012, a total of 4314 normotensive daytime employees (3153 men and 1161 women) were included in this study. Participants had a wide range of occupations and were employed at one of 12 workplaces from various economic sectors in Japan. After a 2-year follow-up, incident hypertension was compared among groups according to household income: <5.0, 5.0-7.9, 8.0-9.9, and ≥10.0 million Japanese yen (\)/year. A Cox proportional hazard model was used to calculate the hazard ratio for incident hypertension in each household income group, compared with the group earning <5.0 million \/year. The hazard ratios for men were 1.52 (95% confidence interval, 1.08-2.18) for 5.0-7.9 million \/year, 1.49 (0.98-2.27) for 8.0-9.9 million \/year, and 1.92 (1.23-3.01) for ≥10.0 million \/year after adjusting for age, baseline systolic blood pressure, worksite, type of occupation, number of family members, and smoking status. This positive relationship was attenuated but remained significant after further adjustment for alcohol consumption and body mass index, both of which were higher among men with higher household income. Conversely, there was no significant difference for women in the risk of incident hypertension among household income groups, although those with higher household income tended to have a lower risk of incident hypertension. Household income is positively associated with the onset of hypertension in Japanese employed men working daytime hours.

DOI： 10.1038/s41440-020-0517-y

PubMed

Publishing type：Research paper (scientific journal)  

Publishing type：Research paper (scientific journal)  

Japan Gerontological Evaluation Studyの2010年調査に参加した高齢者44978名(男性22750名、女性22228名)を3年間にわたり追跡調査し、社会活動参加パターンがその後の要介護認定率に及ぼす影響について検討した。2010年時に質問票により、社会活動8種(スポーツ関係のグループやクラブ、趣味関係のグループ、ボランティアグループ、市民/消費者団体、宗教関係、政治関係の団体や会、町内会などの地域社会活動、業界・同業者団体)への参加頻度を調査した。探索的因子分析を用いて、得られた社会活動情報から社会参加パターンを抽出し、要介護認定発生率を比較した。その結果、2種類の社会参加パターン(スポーツ・趣味パターン、政治・同業者団体パターン)が抽出された。観察期間中、3221名が要介護認定を受けた。社会活動参加頻度が最も低い群(Q1)を基準とした場合のQ4群要介護認定ハザード比は、スポーツ・趣味パターンで0.66(95%CI 0.59〜0.74,P for trend<0.001)、政治・同業者団体パターンで0.81(95%CI 0.72〜0.90,P for trend<0.001)であった。スポーツ・趣味関係のグループやクラブ、政治・同業者団体への参加頻度が高い人では、要介護認定リスクが低下する可能性が示唆された。

Publishing type：Research paper (scientific journal)  

AIM: To examine whether patterns of social participation vary in their associations with functional disability. METHODS: Data from 44 978 participants (22 750 men and 22 228 women) who participated in the 2010 Japan Gerontological Evaluation Study were analyzed; a study of those aged ≥65 years from 23 municipalities in eight prefectures. Social participation information was obtained at baseline with an eight-item questionnaire. Incidence of functional disability from 2010 to 2013 was defined as a new certification of eligibility for municipal public long-term care insurance. Social participation patterns were analyzed using exploratory factor analysis and participants were classified into quartiles of factor scores of social participation patterns. A competing risk model was used to calculate the hazard ratios and 95% confidence intervals for the incidence of functional disability in 3 years of follow-up. RESULTS: Two social patterns were identified: sports groups/clubs and hobby groups, and political groups/organizations and industry/trade associations. For both patterns, compared with participants in the lowest quartile, participants in the highest quartile were more likely to be male, college educated, high-income and current drinkers. Both patterns were associated with reduced incidence of functional disability (adjusted hazard ratios for top quartile of sports and hobby pattern: 0.66, 95% confidence interval: 0.59, 0.74; for political and industry/trade pattern: 0.81, 95% confidence interval: 0.72, 0.90; P for trend <0.001 for both). CONCLUSIONS: Those whose social participation patterns were characterized by frequent participation in sports groups/clubs and hobby groups or political groups/organizations and industry/trade associations were less likely to develop a functional disability. Geriatr Gerontol Int 2020; 20: 765-772.

DOI： 10.1111/ggi.13966

PubMed

Publishing type：Research paper (scientific journal)  

AIMS/INTRODUCTION: We explored the association between fatty liver and pancreatic β-cell dysfunction in a general population. MATERIALS AND METHODS: This cross-sectional study included 489 (53.8% women) community-dwelling Japanese adults. The extent of fatty liver was estimated using the fatty liver index (FLI). After all participants were divided into three groups - low (FLI <30), moderate (30 ≤FLI <60) or high (FLI ≥ 60) degree of fatty liver - serum proinsulin levels transformed into natural logarithms were compared among the three groups. To determine whether obesity modified the association of interest, the participants were stratified into two groups according to the median body mass index. Next, to determine whether hyperinsulinemia modified the association of interest, a similar stratified analysis was carried out using the median serum insulin level. RESULTS: Logarithm (proinsulin) was significantly higher in the high FLI group than in the moderate and low groups, and it was significantly higher in the moderate group than in the low group after adjustment for age and sex (P < 0.05). Logarithm (proinsulin) was significantly higher in the high FLI group than in the low FLI group, regardless of body mass index, after adjustment for age and sex. A similar pattern was observed regardless of serum insulin levels. CONCLUSIONS: The degree of fatty liver was positively associated with proinsulin level, regardless of the presence of obesity or hyperinsulinemia, suggesting that fatty liver reflects pancreatic β-cell dysfunction.

DOI： 10.1111/jdi.13221

PubMed

Publishing type：Research paper (scientific journal)  

北海道寿都町の35〜79歳の住民が参加したDOSANCO Health Studyにおいて、489名を対象に脂肪肝と膵β細胞機能障害の関連について検討した。脂肪肝の程度の指標であるfatty liver index(FLI)により対象を低FLI群(FLI<30、303例)、中FLI群(30≦FLI<60、106例)、高FLI群(FLI≧60、80例)に分類した。年齢および性別で調整後の血清プロインスリン対数変換値は、中FLI群および低FLI群に比べ高FLI群で、低FLI群に比べ中FLI群で有意に高値であった。また高FLI群ではBMIあるいは血清インスリン値にかかわらず、年齢および性別で調整後の血清プロインスリン対数変換値が低FLI群に比べ有意に高値であった。脂肪肝の程度は肥満あるいは高インスリン血症にかかわらずプロインスリン値と正の関連を示したことから、脂肪肝は膵β細胞機能障害を反映することが示唆された。

Publishing type：Research paper (scientific journal)  

This study investigated the association between intake of common alcoholic and non-alcoholic beverages and breast cancer risk among Japanese women. This study included 33,396 Japanese women aged 40-79 years from 24 areas in Japan from the Collaborative Cohort study. During the follow-up period (≥20 years), 245 incidents or mortal breast cancers were documented. Multivariable logistic regression analysis was performed to assess the independent association between breast cancer risk and the intake of Japanese green tea, coffee, and alcohol. Japanese green tea was the most commonly consumed non-alcoholic beverage (81.6% of participants), followed by coffee (34.7%) and alcohol (23.6%). No significant associations were identified between the intake of green tea and coffee with breast cancer risk (odds ratio OR 1.15, 95% confidence interval [CI] 0.82-1.60, and OR 0.84, 95% CI 0.64-1.10, respectively). Alcohol intake was associated with significant breast cancer risk (OR 1.46, 95% CI 1.11-1.92), and even infrequent alcohol consumption (.

DOI： 10.31557/APJCP.2020.21.6.1701

PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.2337/db20-2268-PUB

Publishing type：Research paper (scientific journal)  

<p>Cholesteryl ester (CE) is an ester of cholesterol and fatty acid (FA). Plasma CE reflects complicated metabolisms of cholesterol, phospholipids, lipoproteins, and dietary FAs. An informatics approach could be useful for analysis of the CE species. In this study, two basic dimension reduction methods, principal component analysis (PCA) and factor analysis, were applied to serum CE species determined by LC-MS/MS in a Japanese population (<i>n</i> = 545). PCA and factor analysis both reflected the size (concentration), food source, fat solubility, and biological aspect of the CE species. In a comparison between PCA (PC4) and factor analysis (factor 4), the latter was found to be more suggestive from a biological aspect of n-6 FAs. Cholesteryl docosahexaenoate (DHA) was found to be unique by a factor analysis, possibly relevant to the unique accumulation of DHA in the brain. An informatics approach, especially factor analysis, might be useful for the analysis of complicated metabolism of CE species in the serum.</p>

DOI： 10.2116/analsci.19P321

PubMed

CiNii Article

Publishing type：Research paper (scientific journal)  

高齢者の転倒は要介護となる原因の一つであり、公衆衛生上重要な課題である。寒冷地における凍結路面での転倒を含めた高齢者の転倒の特徴を明らかにするため、北海道における地域在住高齢者を対象に、転倒場所や受傷の有無を含めた調査を行った。北海道の69歳から80歳の介護認定を受けていない地域在住高齢者に対し、質問票により転倒に関する調査を行った。対象者569名(74.8±2.8歳、男性52.9%)のうち、過去1年以内に転倒した割合は27.1%(154名)であった。転倒の時期は12月から3月の4ヵ月で68.6%を占めた。転倒場所は屋外(凍結路面)が68.1%、屋外(通常路面)が20.1%、屋内が11.3%であった。転倒に伴う受傷は、受傷なし55.2%、打撲34.2%、骨折7.9%で、転倒場所による有意な違いはなかったが(p=0.21)、転倒回数1回の対象者に限定した場合、有意差がみられた(p=0.013)。北海道における地域在住高齢者の転倒は冬季の割合が高く、寒冷地での転倒に関する要因の検討の際には、転倒場所を考慮した検討が必要である。(著者抄録)

Publishing type：Research paper (scientific journal)  

高齢者の転倒は要介護となる原因の一つであり、公衆衛生上重要な課題である。寒冷地における凍結路面での転倒を含めた高齢者の転倒の特徴を明らかにするため、北海道における地域在住高齢者を対象に、転倒場所や受傷の有無を含めた調査を行った。北海道の69歳から80歳の介護認定を受けていない地域在住高齢者に対し、質問票により転倒に関する調査を行った。対象者569名(74.8±2.8歳、男性52.9%)のうち、過去1年以内に転倒した割合は27.1%(154名)であった。転倒の時期は12月から3月の4ヵ月で68.6%を占めた。転倒場所は屋外(凍結路面)が68.1%、屋外(通常路面)が20.1%、屋内が11.3%であった。転倒に伴う受傷は、受傷なし55.2%、打撲34.2%、骨折7.9%で、転倒場所による有意な違いはなかったが(p=0.21)、転倒回数1回の対象者に限定した場合、有意差がみられた(p=0.013)。北海道における地域在住高齢者の転倒は冬季の割合が高く、寒冷地での転倒に関する要因の検討の際には、転倒場所を考慮した検討が必要である。(著者抄録)

Publishing type：Research paper (scientific journal)  

日本人被験者545名を対象としたLC-MS/MS法による血清コレステロールエステル(CE)種の測定に際して、2種類の基本的な次元削減法、主成分分析(PCA)法と要因分析(FA)法を適用した。その結果、PCA法とFA法の結果はいずれもCE種のサイズ(濃度)、食物源、脂質溶解性、および生物学的側面を反映していたが、PCA法とFA法の結果を比較すると、FA法の方がn-6脂肪酸の生物学的側面でより示唆に富んでいた。FA法ではドコサヘキサエン酸コレステロールエステル(CDHA)が特異的であったが、脳内へのCDHAの特異な蓄積によると思われた。以上より、情報科学的手法の中でも特にFAは血清中CE種の複雑な代謝の解析に有用であると考えられた。

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日本人一般集団を対象に糖耐性とβ細胞機能との関連を調べた。Dynamics of Lifestyle and Neighborhood Community on Health Studyのデータを解析した。β細胞機能のホメオスタシスモデルアセスメント、プロインスリン値(PI)、Cペプチド指標、プロインスリン/Cペプチド比(PI/CPR)、プロインスリン/インスリン比によってβ細胞機能を推定した。β細胞機能のパラメータを自然対数(ln)変換によって正規化した。非糖尿病被験者で糖耐性とβ細胞機能との関連を調べた。糖耐性は糖化ヘモグロビン(HbA1c)値に基づいて評価した。489名(女性53.8%、平均58.0±12.5歳)を、耐糖能正常群328名、前糖尿病群113名、糖尿病群48名に分けた。ln(PI)とln(PI/CPR)は糖尿病群の方が耐糖能正常群、前糖尿病群よりも有意に高く、耐糖能正常群よりも前糖尿病群の方が有意に高かった。年齢、性別、BMIの補正後、前糖尿病群のln(PI)は耐糖能正常群と比較して有意に高かった。ln(PI)は非糖尿病被験者のHbA1c四分位と有意に正に関連した。

Publishing type：Research paper (scientific journal)  

<p><b>Objective </b>The burden of death from pneumonia is expected to increase with the aging of the population, as has been observed in Japan. Depressive tendency, a common psychosocial sign, may be a risk factor for pneumonia due to its possible association with some immune dysfunction. This study aimed to clarify the association between depressive tendency and the risk of death from pneumonia. </p><p><b>Methods </b>A population-based cohort that consisted of 75,174 Japanese men and women was followed for a median of 19.1 years. Four psychological and behavioral symptoms (depressive symptoms) were used to evaluate depressive tendency. </p><p><b>Results </b>A total of 1,329 deaths from pneumonia were observed. Depressive symptoms were positively and dose-dependently associated with the risk of death from pneumonia (p<0.001 for trend), and subjects with ≥2 depressive symptoms showed a significantly elevated risk compared to those without any symptoms [multivariable hazard ratio (HR), 1.66; 95% confidence interval (CI), 1.39-1.99]. This association was not significantly affected by sex or age at baseline. The elevated risk was still significant even when subjects were limited to those without any medical histories. The excess risk was observed not only for death occurring within the first 10 years of follow-up (multivariable HR, 2.05; 95% CI, 1.51-2.78) but also for that occurring in the longer follow-up period (multivariable HR, 1.48; 95% CI, 1.18-1.85). </p><p><b>Conclusion </b>Depressive tendency may be a risk factor for death from pneumonia. Further studies using a more reliable tool for the evaluation of depressive state are necessary to confirm this relationship. </p>

DOI： 10.2169/internalmedicine.5052-20

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CiNii Article

Publishing type：Research paper (scientific journal)  

<p><b>Background:</b> Previous research has established that women accumulate less moderate-to-vigorous physical activity (MVPA) than men. To date, however, little is known about the gender differences in device-based activity patterns of sedentary behavior (SB) and light-intensity physical activity (LPA). We aimed to compare time spent in SB and different intensities of physical activity taking into account of co-dependence of time use domains.</p><p><b>Methods:</b> This cross-sectional study was conducted in Suttu town, Hokkaido, Japan. Data were analyzed from 634 Japanese adults (278 men, aged 19–92 years) who provided valid accelerometer (HJA-750C) data. Gender differences in activity behavior patterns were tested using multivariate analysis of covariance (MANCOVA) based on isometric log-ratio transformations of time use, adjusting for age. We also developed bootstrap percentile confidence intervals (CI) to support the interpretation of which behavior differed between genders.</p><p><b>Results:</b> Overall, participants had percent time spent in SB, LPA, MVPA during wearing time (mean, 14.8 hours) corresponding to 53.9%, 41.7%, and 4.4% of wearing time, respectively. Activity behavior patterns differed significantly between genders after controlling for time spent in all activities. Women spent relatively 13.3% (95% CI, 9.9–15.9%) less time in SB and 19.8% (95% CI, 14.9–24.6%) more time in LPA compared to men. The difference of time spent in MVPA was not statistically significant.</p><p><b>Conclusions:</b> In contrast with previous studies, our findings suggest that Japanese women are more physically active than men when all intensities of activities are considered. Given the health benefits of LPA, evaluating only MVPA may disproportionately underestimate the level of physical activity of women.</p>

DOI： 10.2188/jea.JE20200185

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CiNii Article

Publishing type：Research paper (scientific journal)  

DOI： 10.1111/ggi.13732

PubMed

Publishing type：Research paper (scientific journal)  

日本の前期高齢者における1日の睡眠時間とインシデント障害の関連を調べる前向きコホート研究を実施した。New Integrated Suburban Seniority Investigation Projectでは、65歳以上の身体的および社会的に自立した日本人1895名(男性962名、女性933名)が含まれた。1日の睡眠時間、人口動態、ライフスタイル特性、医学的状態に関する情報は質問票および1996〜2005年の毎年の健康診断結果から調べた。インシデント障害の日付は長期介護保険認定により確認した。競合リスクモデルを用いてインシデント障害に対するハザード比および95%信頼区間を算出した。中央値12.7年の追跡期間において、256名(男性114名、女性142名)がインシデント障害を報告した。1日の睡眠時間7〜7.9時間と比較して、6時間未満の睡眠時間はインシデント障害のリスクを上昇した。以上から、高齢の日本人において短い睡眠時間はインシデント傷害高リスクに関連することが示された。

Publishing type：Research paper (scientific journal)  

OBJECTIVE: Previous studies have associated dietary patterns with diabetes risk in Western countries, but such studies among the Japanese population are scarce. The present study aimed to investigate dietary patterns associated with abnormal glucose tolerance determined by elevated glycated Hb (HbA1c) levels. DESIGN: The 2012 National Health and Nutrition Survey (NHNS) database was used for the cross-sectional study. Dietary patterns were analysed by factor analysis of twenty-five food items from the dietary intake survey and household-based semi-weighed dietary records. OR and 95 % CI for elevated HbA1c levels (≥6·5 %) according to dietary patterns were estimated using logistic regression models. SETTING: Japan. PARTICIPANTS: The study population comprised 9550 Japanese aged ≥40 years registered in the nationwide NHNS. RESULTS: Three dietary patterns were identified: (i) high-bread and low-rice; (ii) high-meat and low-fish; and (iii) vegetable. The high-bread and low-rice pattern, characterised by high frequent consumption of bread, milk and dairy products, and fruits, and low rice intake, was associated with marginally decreased prevalence of elevated HbA1c levels (Ptrend=0·047). The vegetable pattern, characterised by vegetables, mushrooms, soyabeans and soybean products, was significantly inversely associated with elevated HbA1c levels (4th v. 1st quartile: multivariable OR=0·68; 95 % CI 0·49, 0·95; Ptrend=0·007). CONCLUSIONS: Our findings suggest that the vegetable pattern is associated with decreased prevalence of elevated HbA1c levels among Japanese.

DOI： 10.1017/S1368980019000120

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DOI： 10.1111/jdi.13106

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DOI： 10.2337/db19-1497-P

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＜Highlight＞●肺炎は、先進国における代表的な死因の一つである。●高齢者の中には、肺炎罹患のリスクを増加させる可能性がある慢性疾患を有する者がいる。●日常の歩行は、心・脳血管疾患既往の有無によらず肺炎による死亡を減少させる可能性がある。(著者抄録)

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DOI： 10.1186/s12199-019-0787-7

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DOI： 10.1016/j.sleep.2019.01.046

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DOI： 10.1016/j.ypmed.2018.11.006

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DOI： 10.1186/s13104-018-3849-9

PubMed

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Publishing type：Research paper (scientific journal)  

日本人を対象としたコホート研究において、インスリン耐性(IR)の補正の有無でのインスリン分泌の指標を用いた影響に特に焦点を当てて、高分子アディポネクチン値とインスリン分泌との関連を調べた。「健康に暮らせる町づくりを目的とした生活習慣および健康状態の調査」に参加した488名(男性225名、女性263名、平均57.6±12.5歳)のデータを解析した。血液検体を採取し、空腹時血糖値(FPG)、インスリン、Cペプチド、糖化ヘモグロビン、高分子アディポネクチンを測定した。IRとインスリン分泌はインスリン抵抗性指数(HOMA-IR)とβ細胞機能のホメオスタシスモデルアセスメント(HOMA-β%)を用いて推定した。解析の1セットでは、インスリン分泌を、ディスポジションインデックス(DI)を用いてIRに対して補正した。年齢と女性の比率は高分子アディポネクチン四分位と正に関連し、BMI、胴囲、FPG、HOMA-IR、HOMA-β%、インスリン、Cペプチドは逆相関した。IRで補正したDIとインスリン分泌指標は有意に正に関連した。年齢、性別、BMIで補正した多重直線回帰分析では、高分子アディポネクチンはHOMA-β%と逆相関した。高分子アディポネクチンはDIと有意かつ正に関連した。

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DOI： 10.1017/S000711451800154X

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DOI： 10.22034/APJCP.2018.19.8.2089

PubMed

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＜Highlight＞・Adiponectinとがん死亡および全死亡の関連を地域在住高齢者コホート(n=697)から検討した。・血漿Adiponectinとがん死亡および全死亡の間には非線形の有意な正の関連がみられた。・本結果から複雑な機序の存在が示唆され、さらなる検討が必要である。(著者抄録)

Publishing type：Research paper (scientific journal)  

<p><b>Objective</b>　Hokkaido is a geographically vast area comprising a variety of natural environments and major industries. Therefore, we presume that there are large differences in lifestyles and lifestyle-related disease mortality in community people based on region. The aim of this study was to investigate the regional differences in mortality and food and nutrient intake, and their associations among secondary healthcare service areas in Hokkaido.</p><p><b>Methods</b>　This study's design was ecological. We collected mortality data using public health statistics from the year 2005 to 2009 of the Hokkaido prefecture. We calculated the average of the standardized mortality ratio (SMR) over those five years. Data on food and nutrient intake were obtained from the Hokkaido Health and Nutrition Survey in 2006 conducted in the Hokkaido prefecture. The association between mortality and nutritional status was examined using the Spearman rank correlation coefficient.</p><p><b>Results</b>　The mortality rates were higher in the southern and eastern areas of Hokkaido and in the lower internal area in the northern area of Hokkaido and the Tokachi area. There were regional differences of 400-500 kcal of energy, 20-30 g of protein, 4-5 g of salt, 60 g of green and yellow vegetables, and 100 g of other vegetables among 21 secondary healthcare service areas in Hokkaido.</p><p>　In women alone, we observed a positive association between cancer mortality and fat intake from dairy products. By contrast, we observed an inverse, significant association between cancer mortality and rice intake, and cardiovascular mortality and soybean and soybean product intake, only in women.</p><p><b>Conclusion</b>　We present regional differences in mortality and food and nutrient intake among secondary healthcare areas in Hokkaido. We also reveal a significant association between mortality and food and nutrient intake only in women. Further research is needed to examine whether socioeconomic, environmental, or other lifestyle factors are associated with regional health gaps.</p>

DOI： 10.11236/jph.65.5_210

PubMed

CiNii Article

Publishing type：Research paper (scientific journal)  

目的 北海道は面積が広く、地域により自然環境、主要産業が多様であることから社会経済状況の影響を受ける生活習慣ならびに生活習慣病による死亡率の地域差が大きい可能性がある。本研究は、北海道の地域間における健康格差縮小に取り組む際の資料を得ることを目的とし、北海道の二次医療圏を単位として、死亡率と栄養摂取状況の地域差の実態と、それらの関連を検討した。方法 本研究は生態学的研究である。死亡に関する情報の把握には、北海道保健統計年報ならびに北海道内の二次医療圏を単位として作成されている地域保健情報年報を用いた。平成17年〜21年のデータから北海道全体と、各二次医療圏の標準化死亡比(SMR)の5年平均値を算出した。栄養素摂取量の把握には、平成16年度健康づくり道民調査のデータを用いた。二次医療圏の死亡率と栄養素摂取量の関連は、Spearmanの相関係数を用いて検討した。結果 死亡率は道南、道東の沿岸部で高く、道北地域の内陸部、十勝地域で低い傾向にあった。また、二次医療圏間の栄養素摂取量における最大値と最小値の差に関しては、エネルギーは400kcal〜500kcal、タンパク質は20g〜30g、食塩は4g〜5g、緑黄色野菜は60g、淡色野菜は100gであった。死亡率と栄養素摂取量の関連については、女性でのみ悪性新生物死亡と脂質摂取量、牛乳・乳製品摂取量の間に正の関連、悪性新生物死亡と米の摂取量の間、心疾患死亡と大豆・大豆製品摂取量の間に負の関連が認められた。結論 北海道の二次医療圏間における死亡率および栄養素摂取量の地域差の実態が明らかになった。また、女性でのみ死亡率と栄養摂取量との間に関連が認められた。今後は、地域の健康指標、生活習慣に関する情報に加え、社会経済環境に関する情報も含めて地域差の要因について検討することが課題であると考える。(著者抄録)

Publishing type：Research paper (scientific journal)  

目的 北海道は面積が広く、地域により自然環境、主要産業が多様であることから社会経済状況の影響を受ける生活習慣ならびに生活習慣病による死亡率の地域差が大きい可能性がある。本研究は、北海道の地域間における健康格差縮小に取り組む際の資料を得ることを目的とし、北海道の二次医療圏を単位として、死亡率と栄養摂取状況の地域差の実態と、それらの関連を検討した。方法 本研究は生態学的研究である。死亡に関する情報の把握には、北海道保健統計年報ならびに北海道内の二次医療圏を単位として作成されている地域保健情報年報を用いた。平成17年〜21年のデータから北海道全体と、各二次医療圏の標準化死亡比(SMR)の5年平均値を算出した。栄養素摂取量の把握には、平成16年度健康づくり道民調査のデータを用いた。二次医療圏の死亡率と栄養素摂取量の関連は、Spearmanの相関係数を用いて検討した。結果 死亡率は道南、道東の沿岸部で高く、道北地域の内陸部、十勝地域で低い傾向にあった。また、二次医療圏間の栄養素摂取量における最大値と最小値の差に関しては、エネルギーは400kcal〜500kcal、タンパク質は20g〜30g、食塩は4g〜5g、緑黄色野菜は60g、淡色野菜は100gであった。死亡率と栄養素摂取量の関連については、女性でのみ悪性新生物死亡と脂質摂取量、牛乳・乳製品摂取量の間に正の関連、悪性新生物死亡と米の摂取量の間、心疾患死亡と大豆・大豆製品摂取量の間に負の関連が認められた。結論 北海道の二次医療圏間における死亡率および栄養素摂取量の地域差の実態が明らかになった。また、女性でのみ死亡率と栄養摂取量との間に関連が認められた。今後は、地域の健康指標、生活習慣に関する情報に加え、社会経済環境に関する情報も含めて地域差の要因について検討することが課題であると考える。(著者抄録)

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s10552-018-1001-8

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DOI： 10.1016/j.clnu.2018.01.018

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DOI： 10.1111/jdi.12821

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DOI： 10.6133/apjcn.042018.06

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DOI： 10.2188/jea.JE20170341

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CiNii Article

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DOI： 10.2188/jea.JE20170087

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CiNii Article

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日本人初老者を対象に、余暇の身体活動量と障害発生の関連について検討した。New Integrated Suburban Seniority Investigation Project(the NISSIN Project)の一環として行われた。1996〜2013年に64〜65歳で、脳血管疾患の既往のない地域在住者2888名を、中央値11.6年間追跡した。障害の定義は、介護保険制度の分類に基づき、要支援・要介護(要支援1〜2または要介護1〜5)、要介護2〜5、認知症かつ要支援または要介護、要介護2〜5または死亡とした。更に全死亡率を評価した。社会人口学的背景、生活習慣、医学的因子を調整後、身体活動レベルが中央値(18.1MET-時/週)以上の男性は、身体活動レベル0の男性に比べ、認知症かつ要支援または要支援に分類されるリスクが52%低かった(ハザード比0.48,95%CI 0.25〜0.94)。女性では、余暇の活動量と障害発生に有意な関連を認めなかった。認知症を伴う障害を予防するためには、初老男性に対して身体活動レベルの向上を推奨する必要があることが示唆された。

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DOI： 10.1016/j.je.2016.11.004

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CiNii Article

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DOI： 10.1002/gps.4576

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J-GLOBAL

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DOI： 10.1016/j.je.2017.04.001

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CiNii Article

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DOI： 10.1007/s10552-017-0884-0

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DOI： 10.1007/s00038-016-0938-1

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DOI： 10.1016/j.je.2016.12.004

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バイオバンク・ジャパン・プロジェクトに登録されている前立腺癌患者の臨床特性と組織病理学的特性を分析し、前立腺癌の相対生存(RS)率を算出した。4202例中、4171例(99.3%)が腺癌であり、平均年齢は72.5歳であった。非喫煙者の割合は30.7%、非飲酒者の割合は28.0%であった。BMI 18.5〜24.9kg/m2の患者は66.6%、運動していない患者は58.1%、前立腺特異抗原レベル正常は67.6%、前立腺癌の家族歴ありは6.5%に認められた。疾患ステージIは0.0%、ステージIIは24.4%、ステージIIIは7.3%、ステージIVは4.4%であった。手術施行症例の割合はステージIIで45.8%、ステージIIIで37.7%、ステージIVで16.3%であった。63.9%の患者では疾患ステージの情報を得ることができなかった。前立腺癌の診断から90日以内の患者は869例で、5年生存率は96.3%、10年生存率は100.5%であった。

Publishing type：Research paper (scientific journal)  

47疾患の罹患者約20万名が参加したバイオバンク・ジャパン・プロジェクトのデータを用いて、肝癌患者の概要を調べた。肝癌患者1733例(男性1316例、女性417例)の組織型、患者特性、臨床特性、死因に関するデータを収集し、さらに累積生存率と相対生存率を算出した。組織型データの入手が可能であった1354例のうち91.9%が肝細胞癌であった。国民健康栄養調査の結果と比較して、本コホートでは日常的飲酒率が高く(26%)、さらに男性の過体重/肥満患者の割合が高かった(22%)。日本はアジアで唯一のC型ウイルス肝炎(HCV)関連肝細胞癌が優勢の国であるが、HCV感染率は以前の調査に比べて低かった(44%)。男性の3年、5年、10年累積生存率は男性ではそれぞれ57%、47%、25%、女性では49%、41%、27%であった。

Publishing type：Research paper (scientific journal)  

バイオバンク・ジャパン・プロジェクトに参加した大腸癌・直腸癌患者5864例(男性3699例、女性2165例)を対象に、患者背景と予後を分析した。大腸癌患者(平均67.4歳)と直腸癌患者(平均65.5歳)は別々に分析した。診断から90日以内の患者については累積5年生存率と相対5年生存率を算出し、全死因死亡への生活習慣要因の影響を解析した。大腸結腸癌患者の12%に2型糖尿病の既往があり、13%以上が大腸結腸癌の家族歴を有していた。大腸癌群および直腸癌群において95%以上が腺癌であった。直腸癌患者は、大腸癌患者に比べて肉を多く摂取し、緑色葉野菜の摂取量が少ない傾向にあることが示された。大腸癌群において、累積5年生存率は73.0%、相対5年生存率は80.6%であった。直腸癌群では、累積5年生存率は73.3%、相対5年生存率は80.9%であった。生活習慣要因(緑色葉野菜の摂取量が少ない、低体重、喫煙、飲酒なし、運動なし)は低い生存率と相関することが示された。

Publishing type：Research paper (scientific journal)  

バイオバンク・ジャパン(BBJ)・プロジェクトのデータを用いて、日本人女性乳癌患者の生活習慣、臨床特性、予後、全死因死亡率を調べた。対象は乳癌診断から90日以内にBBJに登録された日本人女性2034例で、このうちステージ0/分類なしは11.4%、ステージIは47.9%、ステージIIは37.0%、ステージIIIは2.9%、ステージIVは0.8%であった。組織型の割合は、非浸潤癌(腺管癌および小葉癌)が12.9%、浸潤癌(乳頭腺管癌、充実腺管癌、硬性癌ほか)が81.0%、ページェット病が0.2%、その他5.8%であった。エストロゲン受容体陽性は75.8%、プロゲスチン受容体陽性は62.1%であった。1860例のうち218例が追跡期間の144.54人・年以内に死亡した。ベースライン時のステージ進行、血清癌胎児性抗原上昇、炭水化物抗原レベル15-3、エストロゲン受容体欠如は年齢補正後の全死因死亡率上昇リスクと相関していた。

Publishing type：Research paper (scientific journal)  

バイオバンク・ジャパンのデータを用いて、日本人肺癌患者の生活習慣、臨床特性、予後を男女別に調べた。対象は肺癌診断から90日以内の男性患者764例と女性患者415例とした。全死因死亡に及ぼす各特性の影響についても評価した。潜在性(ステージ0)、ステージI、II、III、IVの割合は、男性でそれぞれ0.4%、55.8%、10.8%、22.0%、11.0%、女性でそれぞれ0.3%、62.4%、9.9%、17.1%、10.2%であった。組織型の割合は、腺癌は男性56.3%、女性82.4%、扁平上皮癌は男性26.9%、女性8.2%、その他は男性4.6%、女性3.8%であった。診断から90日以内に登録した1120例のうち572例が追跡期間中の5811人・年以内に死亡した。ベースラインにおけるBMI低値、喫煙歴あり、進行ステージ高値、扁平上皮癌/小細胞癌、血清癌胎児性抗原高値は年齢補正後の全死因死亡リスク上昇と相関していた。

Publishing type：Research paper (scientific journal)  

バイオバンク・ジャパン・プロジェクトに参加した食道癌および胃癌患者における人口統計学的要因と生活習慣要因を調べた。対象は食道扁平上皮癌(ESCC)患者365例、胃癌患者1574例とした。追跡期間中にESCC患者213例(追跡期間中央値4.4年)と胃癌患者603例(追跡期間中央値6.1年)が死亡した。試験参加時点で診断から90日以上経過していた患者の5年相対生存率は、ESCC群で49.6%、胃癌群で75.7%であった。ESCC患者の死亡リスクは、飲酒歴あり群が飲酒歴なし群よりも高かった。胃癌患者では、標準体重群と比較して低体重群で死亡率が高かった。運動習慣のない胃癌患者と比較して、週に3回以上運動をする胃癌患者は死亡リスクが低かった。ESCC患者において、飲酒患者は予後が不良であり、低体重の胃癌患者の予後も不良であったが、身体運動習慣を有する胃癌患者の予後は良好であった。

Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.je.2016.12.002

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DOI： 10.1016/j.je.2016.12.008

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DOI： 10.1016/j.je.2016.12.007

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DOI： 10.1016/j.je.2016.12.010

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DOI： 10.1016/j.je.2016.12.009

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DOI： 10.1007/s12282-016-0689-0

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J-GLOBAL

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Japan Collaborative Cohort Studyのデータを用いて、23172例の女性における食事パターンと乳癌発症リスクとの関連性について検討した。中央値16.9年の経過観察期間中、119件の乳癌が発生した。因子分析によって食事パターンの情報を入手し、Cox比例モデルを用いて乳癌発症に関するハザード比(HR)および95%信頼区間(95%CI)を推定した。「野菜が多い食事パターン」「動物性食品が多い食事パターン」「乳製品が多い食事パターン」の3パターンが特定された。潜在的交絡因子を調整した後、野菜が多い食事パターンおよび乳製品が多い食事パターンと、乳癌発症のリスクとの間に有意な関連は認められなかった。閉経前女性において、動物性食品が多い食事パターンと乳癌発症のリスクの低下との間に有意な関連性が認められ、最低三分位群と比較したHRは、第2三分位群で0.47、第3三分位群で0.42であった。

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Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s13340-016-0263-1

J-GLOBAL

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Hemoglobin A1c(HbA1c)値の測定に用いた方法が健康診断結果に及ぼす影響について検討した。2施設で健康診断を受けた被験者337名を対象とした。施設1では、HbAlc値は2012年には高速液体クロマトグラフィ(HPLC)、2013年には免疫アッセイ(IA)で測定され、施設2では、両年共にHPLCで測定された。施設1では、平均HbA1c値は2012年から2013年に有意に低下したが、平均空腹時血糖値(FPG)は2012年から2013年に有意に上昇した。施設1の被験者202名中、2012年にHbA1c値≧5.6%であった97名が2013年に同値<5.6%を示した。施設2では、平均HbA1c値はわずかに上昇したが、FPG値は両年で同等であった。同じ施設でHPLCおよびIAの両方による検査を受けた健康被験者27名の血液検体の追加検査から、平均HbAlc値はIAでHPLCよりも有意に低かったことが認められた。HbA1c測定法の標準化が行われていないことは、健康診断結果に大きな影響を及ぼす可能性が示唆された。

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Publishing type：Research paper (scientific journal)  

DOI： 10.1161/CIRCULATIONAHA.116.023671

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J-GLOBAL

Publishing type：Research paper (scientific journal)  

特定健診の結果から把握できる情報を用いて,積極的支援利用者の1年後の体重減少に影響を与える個人特性を検討した。2008(平成20)〜2011(平成23)年度に多施設共同研究に参加した4施設で特定健診を受け「積極的支援レベル」該当となった者のうち,積極的支援を利用し,かつ翌年の特定健診の結果から評価の可能であった40歳以上65歳未満の職域保険に加入する男性5888人を対象とした。年齢,BMI,収縮期血圧,拡張期血圧,中性脂肪,HDLコレステロール,空腹時血糖,HbA1c,喫煙状況を個人特性とし,これらの個人特性が1年後の体重減少に与える影響について多変量ロジスティック回帰分析を用いて検討した。その結果,対象者のうち2122人(36.0%)が3%以上の減量を達成した。1年後の体重減少に影響を与えた個人特性は,喫煙状況,収縮期血圧,中性脂肪であった。非喫煙者と比較し喫煙者で減量達成のオッズ比が0.84(95%信頼区間:0.74,0.95)と有意に低く,減量達成しづらかった。一方,収縮期血圧&lt;130mmHgと比較して≧130mmHgの者で,また中性脂肪&lt;150mg/dLと比較して≧150mg/dLの者で,有意ではないものの減量達成しやすい傾向にあった(p=0.07)。以上のことから,職域保険に加入する男性において,積極的支援による減量効果の大きい個人特性は,喫煙状況,収縮期血圧,中性脂肪であることが明らかになった。保健指導担当者は,積極的支援を利用する者の中でも非喫煙者,収縮期血圧高値者,中性脂肪高値者に対して保健指導により効率よく減量を促すことができる可能性が示唆された。(著者抄録)

CiNii Article

J-GLOBAL

Other URL： http://search.jamas.or.jp/link/ui/2016211622

Publishing type：Research paper (scientific journal)  

特定健診の結果から把握できる情報を用いて,積極的支援利用者の1年後の体重減少に影響を与える個人特性を検討した。2008(平成20)〜2011(平成23)年度に多施設共同研究に参加した4施設で特定健診を受け「積極的支援レベル」該当となった者のうち,積極的支援を利用し,かつ翌年の特定健診の結果から評価の可能であった40歳以上65歳未満の職域保険に加入する男性5888人を対象とした。年齢,BMI,収縮期血圧,拡張期血圧,中性脂肪,HDLコレステロール,空腹時血糖,HbA1c,喫煙状況を個人特性とし,これらの個人特性が1年後の体重減少に与える影響について多変量ロジスティック回帰分析を用いて検討した。その結果,対象者のうち2122人(36.0%)が3%以上の減量を達成した。1年後の体重減少に影響を与えた個人特性は,喫煙状況,収縮期血圧,中性脂肪であった。非喫煙者と比較し喫煙者で減量達成のオッズ比が0.84(95%信頼区間:0.74,0.95)と有意に低く,減量達成しづらかった。一方,収縮期血圧<130mmHgと比較して≧130mmHgの者で,また中性脂肪<150mg/dLと比較して≧150mg/dLの者で,有意ではないものの減量達成しやすい傾向にあった(p=0.07)。以上のことから,職域保険に加入する男性において,積極的支援による減量効果の大きい個人特性は,喫煙状況,収縮期血圧,中性脂肪であることが明らかになった。保健指導担当者は,積極的支援を利用する者の中でも非喫煙者,収縮期血圧高値者,中性脂肪高値者に対して保健指導により効率よく減量を促すことができる可能性が示唆された。(著者抄録)

Publishing type：Research paper (scientific journal)  

前期高齢者を対象に、転倒と自己報告による抑うつ症状または視覚障害との関連性を検討した。New Integrated Suburban Seniority Investigation Project(1996〜2005年)から、64歳の参加者1904例(男性986例、女性918例)を本研究に登録した。抑うつ症状は老人うつ病尺度により評価した。視覚障害は自記式質問票により評価した。アウトカム変数は、70歳時の自己報告による傷害を伴う転倒とした。転倒の発生に対する抑うつ症状および視覚障害の影響を潜在的交絡因子を調整したロジスティック回帰モデルにより推定した。全体で77例(7.8%)の男性と126例(13.7%)の女性が、70歳時に過去1年以内の転倒を報告した。女性においては、抑うつ症状と視覚障害が転倒と有意に関連していたが、男性ではこのような関連はなかった。両病状を有する女性では、いずれの病状もみられない者と比べ、潜在的交絡因子後の転倒リスクが有意に高かった。この関連性は、男性においては有意でなかった。

Publishing type：Research paper (scientific journal)  

DOI： 10.1111/ggi.12487

PubMed

J-GLOBAL

Publishing type：Research paper (scientific journal)  

DOI： 10.1080/01635581.2016.1192202

PubMed

J-GLOBAL

Publishing type：Research paper (scientific journal)  

年齢別コホート研究であるNew Integrated Suburban Seniority Investigation(NISSIN)に参加した、65歳で心筋梗塞/高血圧症の既往のない地域在住高齢者1003名を対象に、65歳時のBMIとその後5年間の高血圧症発症との関連を検討した。いずれも1996〜2005年に検診を受けており、70歳時の2度目の検診時に高血圧症の有病率を確認した。完全調整モデルを用いた結果、65歳時のBMI<18.5[オッズ比(OR)4.08、95%CI 1.32〜1.83]、BMI 23.0〜24.9(OR 2.00、95%CI 1.18〜3.40)、BMI≧25.0(OR 1.98、95%CI 1.10〜3.56)は、BMI 18.5〜22.9と比較して高血圧症の発症リスクが高いことが明らかになった。以上から、65歳時の痩せまたは過体重/肥満は、その後の高血圧症発症リスクを増大させることが示された。

Publishing type：Research paper (scientific journal)  

心疾患、脳血管疾患、癌などの重大な疾患を有する/有さない初老者において、死亡に対する毎日の歩行の影響を検討した。64〜65歳の地域在住男性1239例を対象に、潜在的交絡因子(調査年、婚姻状況、就労状況、教育、喫煙および飲酒習慣、BMI、定期的な運動/スポーツ、睡眠時間、医学的状況、既往歴、機能的能力)を調整後、1日の歩行時間別の全死亡のハザード比(HR)を算出した。追跡期間中(12829人-年)に175例が死亡した。重大な疾患を有さない男性では、歩行時間の増加とともに死亡リスクは線形に低下し(p for trend=0.018)、1日の歩行時間≧2時間では全死亡リスクが有意に低下した[HR 0.49、95%信頼区間(CI) 0.27〜0.90]。重大な疾患を有する男性では、1日の歩行時間1〜2時間では<0.5時間より全死亡リスクが低下したが(HR 0.29、95%CI 0.06〜1.20)、≧2時間では有意なリスク低下を認めなかった。

Publishing type：Research paper (scientific journal)  

公立学校の教師における長時間労働と睡眠障害の関連性について横断研究により検討した。日本の北海道において2013年7月中旬-9月に実施した。公立中学校の教師に質問票を配布し、515名(男性335名。女性180名)の回答を研究対象とした。労働時間などの基礎的特徴についての情報およびピッツバーグ睡眠質問票に対する回答を収集した。多重ロジスティック回帰分析を実施して、男女別に長時間労働と睡眠障害との関連に関するオッズ比(OR)を計算した。睡眠障害は男性の41.5%および女性の44.4%で特定された。週に60時間超勤務する男性教師では、勤務が40時間以下の男性教師と比較して、睡眠障害リスクが有意に高いことが示された。女性教師においては有意な関連は認められなかった。

Publishing type：Research paper (scientific journal)  

糖尿病(DM)と分泌型免疫グロブリンA(s-IgA)分泌率との関係について、日進市のthe New Integrated Suburban Seniority Investigation(NISSIN)プロジェクトに参加する64歳前後の2306名(男1209、女1097)を対象に前向き研究を行なった。DMは、空腹時血糖とHbA1cから判定し、正常群1262名(男635、女627)、DM予備群791名(男398、女393)、DM群253名(男176、女77)に分類した。s-IgA分泌率は、唾液を5分間採取して測定した。その結果、DM群のs-IgA分泌率は、交絡因子の影響除外後も、正常群に比べ、DM群で低かった。糖尿病は低いIgA分泌率と相関していることが示された。IgA低値は、糖尿病患者における易感染性の機序となっていることが示唆された。

Publishing type：Research paper (scientific journal)  

DOI： 10.1002/gps.4311

PubMed

J-GLOBAL

Publishing type：Research paper (scientific journal)  

健康診断時に協力者を募り、テレビ(TV)視聴時間や生活習慣に関する質問票調査を行った。1988〜1990年時点で、癌、脳卒中、心筋梗塞や結核症ではなかった76688名(男33414、女43274)を対象に、標記についてCox比例ハザードモデルを用いて分析した。経過観察期間の中央値は19.4年で、男性244名、女性34名が慢性閉塞性肺疾患(COPD)で死亡した。TV視聴時間が1日4時間以上の男性は、2時間未満の男性に比べて、COPDで死亡する確率が高い傾向が示され、これは主な交絡因子とは無関係であった。女性ではTV視聴時間とCOPDによる死亡との間に関連は見られなかった。座ったままの生活習慣、特にテレビ視聴時間の延長を防ぐことは、男性において、COPD関連死を予防する上で有用と考えられた。

Publishing type：Research paper (scientific journal)  

北海道の東川町、東神楽町、美瑛町に居住する70〜74歳の高齢者で、介護認定を受けていない241名(男性148名、女性93名)を対象とし、標題の影響について、地理情報システム(GIS)を用いた物理的環境要因評価と、質問紙を用いた社会環境要因評価によって検討した。結果、日常の身体活動(1日の歩数)に影響を及ぼす有意な因子として、男女とも[地域で参加しているグループの数]が抽出され、グループ数が多いほど歩数が高値であった。また、男性では[居住地から最も近いバス停までの距離]が長いほど、女性では同距離が短いほど歩数が上昇する傾向にあった。

Publishing type：Research paper (scientific journal)  

平成23年11月に実施された平成23年度健康づくり道民調査の富良野圏域の結果を用いて、富良野圏域の農業者と非農業者の生活習慣を比較した。対象者は平成23年10月に富良野圏域の5市町村から任意に選定された3地区87世帯303人のうち、調査協力の得られた57世帯149人であった。96人から有効回答を得た。対象者のうち農業者は53人(55.2%)であった。農業者で男性の割合が高かった。平均年齢は農業者で男性55.5歳、女性54.6歳、非農業者で男性56.5歳、女性57.0歳であった。農業者と非農業者で、1日の歩行数(農業者8904歩、非農業者6703歩)に有意差がみられた。しかし、運動習慣のあるものの割合は農業者のほうが低い傾向にあることが分かった。また、脂質(農業者46.1g/非農業者53.7g)、食塩(農業者11.5g/非農業者9.4g)の摂取量に有意差が見られた。また、農業者は有意に野菜類の摂取が多く、肉類、油脂類の摂取量が有意に低いことが明らかになった。

Publishing type：Research paper (scientific journal)  

DOI： 10.1093/ageing/afu121

PubMed

J-GLOBAL

Publishing type：Research paper (scientific journal)  

目的 本報告の目的は、現在までに我が国で報告されている二次予防事業の対象者(特定高齢者)への介入研究についてシステマティックレビューし、介入の効果と今後の課題を検討することである。方法 Medline、CINAHL、PsycInfo、医学中央雑誌文献データベースを用いて検索された61編(英文7編、和文54編)について、対象者の年齢と男女比、研究デザイン、介入プログラムの3項目について検討した。結果 以下の3つの知見が得られた。(1)研究対象者は、後期高齢者と女性の比率が高い。(2)研究デザインついては、前後比較試験が大半である。(3)介入方法としては、公民館等で実施される集合型の筋力トレーニングや運動による介入を行うことで、運動器の機能改善を報告する文献が多い。結論 今後の課題として、訪問型の介護予防プログラムの普及や、いまだ有効とされる介入が少ない生活機能や栄養状態、口腔機能、閉じこもり、認知機能、抑うつ改善を目的とした介入方法の確立が求められるとともに、すでに多くの前後比較試験で有効性が報告された筋力トレーニングや運動については無作為化比較試験による効果の検証が期待される。(著者抄録)

Publishing type：Research paper (scientific journal)  

学校教師における長時間労働と心理的苦痛の関連について横断的調査により検討した。北海道において2013年の7月中旬-9月に調査を実施した。労働時間等の基礎的特性に関する情報と精神健康調査票28項目版への回答を匿名で収集した。多重ロジスティック回帰分析を使用し、性別による長時間労働と心理的苦痛間の関連性に対するオッズ比(OR)を計算した。522名(男性337名、女性185名)の教師を対象とした。心理的苦痛は男性の47.8%、女性の57.8%に認められた。労働時間が1週間に60時間を超える男性においてのみ、労働時間が1週間に40時間以下の者と比べて、リスクが有意に上昇した。女性については、長時間労働と心理的苦痛の間に有意な関連性はなかった。男性教師においては長時間労働と心理的苦痛の間に有意な関連性があった。

Publishing type：Research paper (scientific journal)  

DOI： 10.2188/jea.JE20140185

PubMed

Publishing type：Research paper (scientific journal)  

<b>Objectives</b>&emsp;The aim of this study was to systematically review intervention programs for frail elderly people enrolled in the Japanese social long-term care insurance system to clarify the effects and identify any problems.<br/><b>Methods</b>&emsp;We reviewed 61 articles (7 in English and 54 in Japanese) from four databases: MEDLINE, CINAHL, PsycInfo, and &ldquo;Igaku Chuo Zasshi Web&rdquo; (the Japana Centra Revuo Medicina) version 5. We focused on the following three areas: age and male/female ratio of participants, study design, and intervention program.<br/><b>Results</b>&emsp;The results showed that (1) participants tended to be &ge;75 years of age and female, (2) more than half of the programs were of a before and after design, and (3) most interventions took place in local community centers and were group programs for muscle training and/or physical exercise that improved physical function.<br/><b>Conclusion</b>&emsp;Future studies focusing on the following intervention programs are necessary: individual programs such as home visits for those who do not want to participate in group programs and programs that improve instrumental activities of daily living, nutrition, oral function, cognitive function, and depression. Additionally, while there are many studies reporting the effect of muscle training and exercise, randomized controlled studies are necessary to more accurately evaluate the effects.

DOI： 10.11236/jph.62.1_3

PubMed

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J-GLOBAL

Publishing type：Research paper (scientific journal)  

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DOI： 10.1539/joh.15-0053-OA

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DOI： 10.1539/joh.14-0127-OA

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DOI： 10.2188/jea.JE20140190

PubMed

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DOI： 10.2188/jea.JE20140088

PubMed

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DOI： 10.2169/internalmedicine.54.4702

PubMed

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DOI： 10.1111/ajag.12024

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DOI： 10.1007/s10552-014-0380-8

PubMed

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Publishing type：Research paper (scientific journal)  

本研究は、寒冷地域に居住する65歳以上の高齢者を対象に、「在宅高齢者生活機能向上ツール(FIT)」を用いた家庭訪問の介入群、ツールを用いない非訪問の対照群による無作為化比較対照研究を実施し、家庭訪問によって両群のソーシャル・キャピタル(social capital 以下SC)が影響されるかどうかを検討することを目的とする。FITは、高齢者と訪問者が対等な関係を築き、共に話し合いながら高齢者自身が生活目標を見つけ、自己の役割を再確認するツールであり、自己効力感や主観的健康度の向上、自己疎外感の低下などが期待される。調査は、2008年10月〜2009年3月に北海道新ひだか町静内地区、日高町門別地区、日高町日高地区の2町3地区で実施した。対象者は同地区の自宅居住者で65歳以上の高齢者のうち、自身で身の回りのことができ、自由に外出できる要介護度1以下とした。介入群92名、対照群99名に対して介入前後の計2回、両群のSC変数を測定し、両群の平均値の変化を比較した。SC変数として、認知的SCでは「一般的信頼」、構造的SCでは「社会的役割」「社会参加」を使用した。交流指数は「別居家族との交流」「別居家族の有無」「緊急時、すぐに駆けつけてくれる人の有無」「看病してくれる人の有無」と定義した。解析は対応のあるt検定並びに性別、年齢、教育年数、交流指数、年収、抑うつで調整した共分散分析(analysis of covariance:ANCOVA)を行なった。介入群では「社会的役割」「社会参加」に有意な減少が認められた(いずれもP<0.05)。一方の対照群では「社会的役割」は微増したものの有意な変化は見られず(p=0.64)、「社会参加」に有意な減少が認められた(p<0.05)。共分散分析の結果、「一般的信頼感」「社会的役割」に介入群と対照群で有意な差が認められた(いずれもP<0.05)。今回の結果、介入により他者とのコミュニケーションをとろうとする意識は高まったものの、介入時期が冬期であったことから頻繁にわたる別居家族や友人などとの交流が難しく、SCが下がった可能性が示唆された。(著者抄録)

Publishing type：Research paper (scientific journal)  

2008年11月〜2009年1月に札幌に住む6〜12歳の小児6393例の親に対し、家庭環境と小児の喘息症状についての質問票調査を行い、暖房器具の機械的換気および送気管使用と喘息症状の相関を横断的に検討した。回答率は69.5%(4445例)で、3874例(60.6%)について解析した。現在の喘息症状の有病率は12.8%、過去の喘息症状の有病率は30.9%であった。性別、学年、親のアレルギー既往、学校、居住地域、カーペットの部屋、家庭での喫煙者の有無、室内の湿度を調整後、電気式暖房器具と比べた場合の現在の喘息症状のリスクは、機械的換気のない排煙暖房器具で1.62倍、機械的換気のある非排煙暖房器具で1.77倍、機械的換気のない非排煙暖房器具で2.23倍であった。室内の湿気にかかわらず、機械的換気のある/ない非排煙暖房器具は、現在の喘息症状と有意に関連した。以上から、電気式暖房器具に比べて、灯油式暖房器具は小児の現在の喘息症状と有意に相関するが、ガス式暖房器具は相関しないことが示された。

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PubMed

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DOI： 10.1007/s00420-012-0814-0

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DOI： 10.1007/s10552-013-0231-z

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DOI： 10.1002/gps.2835

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DOI： 10.1111/j.1741-6612.2012.00589.x

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DOI： 10.1002/gps.2753

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背景:廃用症候群を原因とする要介護者の急増が社会的問題となっているが,在宅において個別に生活機能の改善を促すことを目的とした研究報告はほとんど認めない。筆者らは,在宅高齢者生活機能向上ツール(FIT)を開発し家庭訪問を実践した。本報告では,FITを用いた家庭訪問の方法と家庭訪問の意義に関して報告する。対象と方法:特定高齢者選定用基本チェックリスト,および軽度要介護認定者から選ばれた65歳以上の在宅高齢者を対象とした。研究参加の同意を得た125名に対して月1回,3ヵ月間で計3回,1回あたり約1時間のFITを用いた家庭訪問を実施した。家庭訪問では,FITの実施に加えて要望により生活や健康相談に応じた。FITは,日々の生活を振り返ることで,高齢者が楽しいことや大切だと思うことに気づき,高齢者自身が生活目標を再設定する機会を提供するためのツールである。これにより,身体・認知・精神機能や活動,参加を促すことで生活を活性化し,廃用症候群を予防する。3回目の家庭訪問終了後に感想と要望を尋ねるアンケートを実施した。結果:アンケートに回答した94名のうち,約2割がFITを難しいと回答した。生活そのものの変化では,計算や書字など具体的な作業や「自信をもった」との回答も認めた。結論:筆者らは,すでにFITによる認知機能改善効果を報告している。本結果はFITが容易に作成できるという利便性だけでなく,高齢者の生活改善もあわせもつ有用なツールとなる可能性を示唆した。(著者抄録)

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先行研究で池野らは、北海道本別町と鷹栖町において75歳以上の高齢者36名を対象に「作業バランス自己診断」を用いた家庭訪問を実施し、生活機能や認知機能の改善に有効であったことを報告した。今回著者等は、池野らの「作業バランス自己診断」をもとに、高齢者がさらに理解しやすいよう改良した「在宅高齢者生活機能向上ツール」を作成し、これを用いた家庭訪問による介入が認知機能に与える影響について検討した。対象は北海道新ひだか町と日高町市街地に在住する65歳以上の高齢者で、[要支援1][要支援2][経過的要介護][要介護1]に認定されているか、または特定高齢者選定用スクリーニングの基本チェックリスト25項目のうち1項目以上チェックがついた人199名とした。介入群(99名)と非介入群(100名)に無作為に分け、Mini-Mental State Examinationの得点を比較しところ、介入群のほうが有意に高値であり、介入の効果が示された。

Publishing type：Research paper (scientific journal)   Kind of work：Single Work  

在宅高齢者生活機能向上ツールを用いた家庭訪問が、地域在住高齢者の認知機能に及ぼす影響を無作為化比較試験により明らかにした。軽症認知機能障害群において、介入群のMMSE得点は有意に増加した。非介入群では、事前評価と事後評価において有意差を認めなかった。一方、重度認知機能障害群、認知機能障害なし群においては、介入群、非介入群ともに、事前評価と事後評価のMMSE得点において有意差ある得点の変化は認めなかった。事前評価のMMSE得点、年齢、性別で補正した共分散分析を実施した結果、非介入群と比較して介入群のMMSE得点変化が有意に高かった。軽症認知機能障害群において、非介入群と比較して介入群のMMSE得点変化が有意に高かった。一方、重度認知機能障害群、認知機能障害なし群においては、介入群と非介入群のMMSE得点変化に有意差を認めなかった。

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DOI： 10.2337/db20-1573-P

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DOI： 10.1016/j.je.2016.11.004

PubMed

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特定健診の結果から把握できる情報を用いて,積極的支援利用者の1年後の体重減少に影響を与える個人特性を検討した。2008(平成20)〜2011(平成23)年度に多施設共同研究に参加した4施設で特定健診を受け「積極的支援レベル」該当となった者のうち,積極的支援を利用し,かつ翌年の特定健診の結果から評価の可能であった40歳以上65歳未満の職域保険に加入する男性5888人を対象とした。年齢,BMI,収縮期血圧,拡張期血圧,中性脂肪,HDLコレステロール,空腹時血糖,HbA1c,喫煙状況を個人特性とし,これらの個人特性が1年後の体重減少に与える影響について多変量ロジスティック回帰分析を用いて検討した。その結果,対象者のうち2122人(36.0%)が3%以上の減量を達成した。1年後の体重減少に影響を与えた個人特性は,喫煙状況,収縮期血圧,中性脂肪であった。非喫煙者と比較し喫煙者で減量達成のオッズ比が0.84(95%信頼区間:0.74,0.95)と有意に低く,減量達成しづらかった。一方,収縮期血圧<130mmHgと比較して≧130mmHgの者で,また中性脂肪<150mg/dLと比較して≧150mg/dLの者で,有意ではないものの減量達成しやすい傾向にあった(p=0.07)。以上のことから,職域保険に加入する男性において,積極的支援による減量効果の大きい個人特性は,喫煙状況,収縮期血圧,中性脂肪であることが明らかになった。保健指導担当者は,積極的支援を利用する者の中でも非喫煙者,収縮期血圧高値者,中性脂肪高値者に対して保健指導により効率よく減量を促すことができる可能性が示唆された。(著者抄録)

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北海道の東川町、東神楽町、美瑛町に居住する70〜74歳の高齢者で、介護認定を受けていない241名(男性148名、女性93名)を対象とし、標題の影響について、地理情報システム(GIS)を用いた物理的環境要因評価と、質問紙を用いた社会環境要因評価によって検討した。結果、日常の身体活動(1日の歩数)に影響を及ぼす有意な因子として、男女とも[地域で参加しているグループの数]が抽出され、グループ数が多いほど歩数が高値であった。また、男性では[居住地から最も近いバス停までの距離]が長いほど、女性では同距離が短いほど歩数が上昇する傾向にあった。

CiNii Article

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平成23年11月に実施された平成23年度健康づくり道民調査の富良野圏域の結果を用いて、富良野圏域の農業者と非農業者の生活習慣を比較した。対象者は平成23年10月に富良野圏域の5市町村から任意に選定された3地区87世帯303人のうち、調査協力の得られた57世帯149人であった。96人から有効回答を得た。対象者のうち農業者は53人(55.2%)であった。農業者で男性の割合が高かった。平均年齢は農業者で男性55.5歳、女性54.6歳、非農業者で男性56.5歳、女性57.0歳であった。農業者と非農業者で、1日の歩行数(農業者8904歩、非農業者6703歩)に有意差がみられた。しかし、運動習慣のあるものの割合は農業者のほうが低い傾向にあることが分かった。また、脂質(農業者46.1g/非農業者53.7g)、食塩(農業者11.5g/非農業者9.4g)の摂取量に有意差が見られた。また、農業者は有意に野菜類の摂取が多く、肉類、油脂類の摂取量が有意に低いことが明らかになった。

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本研究は、寒冷地域に居住する65歳以上の高齢者を対象に、「在宅高齢者生活機能向上ツール(FIT)」を用いた家庭訪問の介入群、ツールを用いない非訪問の対照群による無作為化比較対照研究を実施し、家庭訪問によって両群のソーシャル・キャピタル(social capital 以下SC)が影響されるかどうかを検討することを目的とする。FITは、高齢者と訪問者が対等な関係を築き、共に話し合いながら高齢者自身が生活目標を見つけ、自己の役割を再確認するツールであり、自己効力感や主観的健康度の向上、自己疎外感の低下などが期待される。調査は、2008年10月〜2009年3月に北海道新ひだか町静内地区、日高町門別地区、日高町日高地区の2町3地区で実施した。対象者は同地区の自宅居住者で65歳以上の高齢者のうち、自身で身の回りのことができ、自由に外出できる要介護度1以下とした。介入群92名、対照群99名に対して介入前後の計2回、両群のSC変数を測定し、両群の平均値の変化を比較した。SC変数として、認知的SCでは「一般的信頼」、構造的SCでは「社会的役割」「社会参加」を使用した。交流指数は「別居家族との交流」「別居家族の有無」「緊急時、すぐに駆けつけてくれる人の有無」「看病してくれる人の有無」と定義した。解析は対応のあるt検定並びに性別、年齢、教育年数、交流指数、年収、抑うつで調整した共分散分析(analysis of covariance:ANCOVA)を行なった。介入群では「社会的役割」「社会参加」に有意な減少が認められた(いずれもP<0.05)。一方の対照群では「社会的役割」は微増したものの有意な変化は見られず(p=0.64)、「社会参加」に有意な減少が認められた(p<0.05)。共分散分析の結果、「一般的信頼感」「社会的役割」に介入群と対照群で有意な差が認められた(いずれもP<0.05)。今回の結果、介入により他者とのコミュニケーションをとろうとする意識は高まったものの、介入時期が冬期であったことから頻繁にわたる別居家族や友人などとの交流が難しく、SCが下がった可能性が示唆された。(著者抄録)

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背景:廃用症候群を原因とする要介護者の急増が社会的問題となっているが,在宅において個別に生活機能の改善を促すことを目的とした研究報告はほとんど認めない。筆者らは,在宅高齢者生活機能向上ツール(FIT)を開発し家庭訪問を実践した。本報告では,FITを用いた家庭訪問の方法と家庭訪問の意義に関して報告する。対象と方法:特定高齢者選定用基本チェックリスト,および軽度要介護認定者から選ばれた65歳以上の在宅高齢者を対象とした。研究参加の同意を得た125名に対して月1回,3ヵ月間で計3回,1回あたり約1時間のFITを用いた家庭訪問を実施した。家庭訪問では,FITの実施に加えて要望により生活や健康相談に応じた。FITは,日々の生活を振り返ることで,高齢者が楽しいことや大切だと思うことに気づき,高齢者自身が生活目標を再設定する機会を提供するためのツールである。これにより,身体・認知・精神機能や活動,参加を促すことで生活を活性化し,廃用症候群を予防する。3回目の家庭訪問終了後に感想と要望を尋ねるアンケートを実施した。結果:アンケートに回答した94名のうち,約2割がFITを難しいと回答した。生活そのものの変化では,計算や書字など具体的な作業や「自信をもった」との回答も認めた。結論:筆者らは,すでにFITによる認知機能改善効果を報告している。本結果はFITが容易に作成できるという利便性だけでなく,高齢者の生活改善もあわせもつ有用なツールとなる可能性を示唆した。(著者抄録)

DOI： 10.11477/mf.1664101760

CiNii Article

J-GLOBAL

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Kind of work：Single Work  

在宅高齢者生活機能向上ツールを用いた家庭訪問が、地域在住高齢者の認知機能に及ぼす影響を無作為化比較試験により明らかにした。軽症認知機能障害群において、介入群のMMSE得点は有意に増加した。非介入群では、事前評価と事後評価において有意差を認めなかった。一方、重度認知機能障害群、認知機能障害なし群においては、介入群、非介入群ともに、事前評価と事後評価のMMSE得点において有意差ある得点の変化は認めなかった。事前評価のMMSE得点、年齢、性別で補正した共分散分析を実施した結果、非介入群と比較して介入群のMMSE得点変化が有意に高かった。軽症認知機能障害群において、非介入群と比較して介入群のMMSE得点変化が有意に高かった。一方、重度認知機能障害群、認知機能障害なし群においては、介入群と非介入群のMMSE得点変化に有意差を認めなかった。

CiNii Article

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

先行研究で池野らは、北海道本別町と鷹栖町において75歳以上の高齢者36名を対象に「作業バランス自己診断」を用いた家庭訪問を実施し、生活機能や認知機能の改善に有効であったことを報告した。今回著者等は、池野らの「作業バランス自己診断」をもとに、高齢者がさらに理解しやすいよう改良した「在宅高齢者生活機能向上ツール」を作成し、これを用いた家庭訪問による介入が認知機能に与える影響について検討した。対象は北海道新ひだか町と日高町市街地に在住する65歳以上の高齢者で、[要支援1][要支援2][経過的要介護][要介護1]に認定されているか、または特定高齢者選定用スクリーニングの基本チェックリスト25項目のうち1項目以上チェックがついた人199名とした。介入群(99名)と非介入群(100名)に無作為に分け、Mini-Mental State Examinationの得点を比較しところ、介入群のほうが有意に高値であり、介入の効果が示された。

CiNii Article

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Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

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Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

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Presentation type：Oral presentation (general)  

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Presentation type：Oral presentation (general)  

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Presentation type：Oral presentation (general)  

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Presentation type：Oral presentation (general)  

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Presentation type：Oral presentation (general)  

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Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

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Presentation type：Oral presentation (general)  

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Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

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Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)