Tobacco Exposure During Pregnancy and Infections in Infants up to 1 Year of Age: The Japan Environment and Children's Study.

BACKGROUND: Tobacco exposure during pregnancy is associated with several adverse outcomes in infants. We investigated the association between tobacco exposure during pregnancy (both active and second-hand) and various infections in infants up to 1 year. METHODS: This prospective cohort study used a fixed dataset (jecs-an-20180131) from the Japan Environment and Children's Study of registered births in Japan during 2011-2014 that included 104,065 fetal records from enrolled pregnant women. Based on the participants' responses to the questionnaire on smoking status, mothers were first divided into "never smoked," "quit smoking," and "current smoker" groups and then into "no second-hand smoking (SHS)" and "SHS" groups. Infectious diseases included central nervous system infection, otitis media (OM), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), gastroenteritis (GI), and urinary tract infection. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated using logistic regression analysis and adjusted for maternal, socioeconomic, and postnatal confounding factors. RESULTS: Among the 73,205 newborns enrolled, multivariable analysis revealed that the aOR of LRTI and GI was 1.20 (95% CI, 1.07-1.33) and 1.18 (95% CI, 1.04-1.35), respectively, for the "current smoker with/without SHS" group compared with the "never smoked without SHS" group. "Quit smoking without SHS" was not associated with the risk of LRTI. SHS was associated with an increased risk of OM, URTI, LRTI, and GI, especially with LRTI and GI. CONCLUSION: Exposure to tobacco smoke during pregnancy was associated with an increased risk of OM, URTI, LRTI, and GI in infants during their first year of life.

[Association between gender role attitudes and social support from mothers and paternal involvement in childcare].

Objective　Paternal involvement in child-rearing is an action goal of Healthy Parents and Children 21 (Tier 2), and should be actively promoted. Clarifying the related factors may contribute to countermeasures for promoting paternal involvement in child-rearing. This study aimed to examine the association between fathers' gender role attitudes and social support from their spouses (i.e., the mothers of the children) and their involvement in child-rearing.Methods　We obtained the data of fathers involved in childcare (aged 25-50 years; all full-time workers) through an internet research company. The paternal involvement in childcare scale (11 items, 4-point scale, e.g., "taking care of children," "cooking") was used as the dependent variable. The independent variables were gender role attitude ("Husbands should work outside the home and wives should take care of the home," 4-point scale) and social support from the mothers of the children (including appraisal, emotional, and instrumental support). The control variables were father's age, mother's employment status, number of children, the age of the youngest child, children going to nursery school or kindergarten, use of childcare services, self-evaluation of low economic status, work hours on weekdays, and marital relationship satisfaction.Results　The data of 360 men were analyzed (mean age 36.8 years, standard deviation 5.6). The results of the multivariable regression analyses with interaction terms are as follows: gender role attitude was significantly associated with childcare (ß=-0.103) and housework (ß=-0.125); appraisal support was significantly associated with childcare (ß=0.142) and housework (ß=0.199); and the interaction between gender role attitude and instrumental support was significant (ß=0.176), indicating that, in individuals with a high gender role attitude score, a higher level of instrumental support was related to a higher childcare score (ß=0.242).Conclusions　Fathers with egalitarian gender role attitudes and those who receive appraisal support from the other parent are more likely to participate in childcare. In addition, fathers with traditional gender role attitudes who receive instrumental support from the other parent may tend to participate in childcare.

Association of personality traits with polypharmacy among community-dwelling older adults in Japan: a cross-sectional analysis of data from the SONIC study.

BACKGROUND: Polypharmacy is a serious concern among older adults and is frequently related to adverse outcomes, including health problems, reduced quality of life, and increased medical expenses. Although personality traits are associated with health behaviors and diseases, the effect of polypharmacy on personality traits is unclear. Therefore, we examined the association of personality traits with polypharmacy among community-dwelling older adults. METHODS: This cross-sectional study analysed data on 836 community-dwelling older adults aged 69-71 years who participated in the Japanese longitudinal cohort study of Septuagenarians, Octogenarians, and Nonagenarians Investigation with Centenarians. Polypharmacy was defined as the intake of ≥ 5 medications concurrently. Personality traits were assessed using the Japanese version of the NEO-Five-Factor Inventory (NEO-FFI). A five-factor model of personality traits, including "neuroticism," "extraversion," "openness," "agreeableness," and "conscientiousness," was measured by the NEO-FFI. RESULTS: The average number of medications was about 3 in both men and women. Among the participants, polypharmacy was observed in 23.9% of men and 28.0% of women. Multivariable logistic regression analysis showed that neuroticism (adjusted odds ratio [aOR] per 1 point increase = 1.078, 95% confidence interval [CI] = 1.015-1.144) in men and extraversion (aOR = 0.932, 95% CI = 0.884-0.983) in women were associated with polypharmacy. CONCLUSIONS: Higher neuroticism in men and lower extraversion in women were associated with polypharmacy. This study suggests that personality traits may be involved in the process leading to the development of polypharmacy. Information on individual personality traits may help medical professionals in decision-making regarding medication management for lifestyle-related diseases.

[Posttraumatic growth after the Fukushima nuclear disaster: Examination of free descriptions among Fukushima residents].

Objectives　Posttraumatic growth (PTG) refers to a positive psychological transformation experienced as a result of struggling with a major life crisis or traumatic event. In recent times, PTG has been used as a form of psychological support for those who have experienced trauma. In this study, we classified the free descriptions of PTG in Fukushima residents who experienced the Great East Japan Earthquake (GEJE). We examined the relationship between basic characteristics and PTG clusters, and between "recovery from radiation anxiety" and PTG clusters.Methods　A mail survey was conducted in August 2016 among 2,000 Fukushima residents, aged 20-79 years. We asked the participants for a free description of the specific content of their PTG. We also asked about their age, gender, and education, as well as about radiation anxiety immediately after the GEJE and at the time of the survey. Participants were divided into the following groups: "no anxiety," "recovered from anxiety," and "unrecovered from anxiety". The PTG free descriptions were classified into eight categories, including five dimensions based on the Posttraumatic Growth Inventory (Tedeschi & Calhoun, 1996) ("relating to others," "new possibilities," "personal strength," "spiritual change," and "appreciation of life") and three categories created according to Nishino et al. (2013) ("increased awareness of disaster prevention," "renewed recognition of nuclear-related issues," and "critical examination of information from authorities").Results　Of the 916 collected responses, data from 786 responses with no missing values were analyzed. Among women and young people, the proportion of those who answered "relating to others" and "appreciation of life" was high. For those with higher education, the proportion of those who answered "relating to others," "renewed recognition of nuclear issues," "critical examination of information from authorities," "personal strength," "spiritual change," and "appreciation of life" was high. In the "recovered from anxiety" group, the proportion of those who answered "renewed recognition of nuclear issues" was high.Conclusion　In assessing PTG, women and young people were more likely to report that they felt closely connected to family or friends, as well as to the community, and that they were grateful for their daily lives. Those with higher education tended to recognize that they have come to critically examine information provided by the national government, electric power companies, and national newspapers; they felt mental strength and growth after the earthquake. Those who recovered from radiation anxiety were more likely to report forming a heightened awareness of issues relating to nuclear power plants and energy.

[Relationship between media usage time and self-rated health among junior and senior high school students].

Objective　Due to the rapid development of the internet, its overuse and addiction among the younger population have increased. Several studies have reported a relationship between the prolonged usage hours of the internet and other media among junior and senior high school students and certain lifestyle habits, such as no breakfast, no exercise routine, lack of sleep, and mental health decline. There is a growing concern that the students' health could be affected due to over usage of the internet and other networking media. Therefore, we have examined the relationship between media usage time and self-rated health (SRH) of the junior and senior high school students.Methods　We analyzed the data of the "Fukushima Citizens' Health and Lifestyle Survey" conducted on May 2016. The participants included in the survey were junior and senior high school students from Fukushima City. We randomly selected 1,633 students and conducted a self-administered questionnaire survey. Of the 1,589 respondents, survey data from 1,480 students (583 junior and 897 senior high school students) were used in the analysis. The analysis was performed in each junior and senior high school student, with SRH as the dependent variable, media usage time as the independent variable, and various lifestyle factors as the adjustment variables. Furthermore, the odds ratio (OR) and 95% confidence interval (CI) were estimated.Results　Fifty-two junior high school students (8.9%) and 123 senior high school students (13.7%) had poor SRH. Among the junior and senior high school students, those who used media for >3 h were more likely to have poor SRH, and the significant association was noted among high school students (OR; 2.30, 95% CI; 1.36-3.90). For both junior and senior high school students, the SRH was significantly associated with obesity, no exercise routine, and stress. Additionally, for the high school students, the SRH was significantly associated with late bedtime routine.Conclusion　Our findings suggest that junior and high school students who overuse media are more likely to have a poor SRH.

Association of Perceived Environment and Physical Activity in Older Adults After the Great East Japan Earthquake.

The aim of this study was to examine the association between perceived environment and physical activity among older adults in Fukushima Prefecture after the 2011 Great East Japan Earthquake and the impact of evacuation. Questionnaires were distributed to individuals aged 65 years and older from October to November 2018. Perceived environment was assessed using a five-item questionnaire on home fitness equipment, access to facilities, neighborhood safety, enjoyable scenery, and frequency of observing others exercising. Physical activity, assessed via the Physical Activity Questionnaire for Elderly Japanese, was segregated into levels based on the median score. Data from 249 participants (74.2 ± 6.9 years) were analyzed. A logistic regression analysis found that the unenjoyable Scenery × Residing in restoration public housing interaction (odds ratio = 3.87, 95% confidence interval = [1.20, 12.46]) was significant. The association between enjoyable scenery and physical activity varied according to whether the participants had experienced evacuation or not.

[The relationship between information sources, media, and "anxiety about the effects of radiation on future generations" in Hamadori and Fukushima Prefecture's evacuation areas after the nuclear accident].

Objectives　Nine years after the accident at the TEPCO Fukushima Daiichi Nuclear Power Plant in March 2011, anxiety about the effects of radiation on future generations persists. We considered the possibility that information from mass media sources and the Internet might influence this anxiety. Thus, this study examined the relationship between information sources and anxiety; based on the results, we consider the necessary measures to reduce this anxiety.Methods　We conducted a mail-based survey by distributing an anonymous self-administered questionnaire to 2,000 Fukushima Prefecture residents aged 20 to 79. We randomly selected 500 residents from Aizu, Nakadori, Hamadori, and the evacuation areas, and compared the data obtained from Hamadori and the evacuation areas. The objective variable was anxiety about the effects (of radiation) on future generations, while the explanatory variables were trusted sources and media the respondents used to get information on radiation. Other variables assessed included health status and knowledge of radiation. We conducted univariate analysis of combined data to assess the relationship between anxiety and the questionnaire items. This was followed by multiple regression analysis with anxiety as the objective variable and those showing significant differences in the univariate analysis as the explanatory ones. We then conducted multiple regression analysis, that included the interaction means between explanatory variables and evacuation areas.Results　Of the 500, 201 respondents were from Hamadori (40.2%) and 192 from the evacuation areas (38.4%). Multiple regression analysis revealed that anxiety was significantly lower among those who trusted government ministries and those who were healthy. Anxiety was also significantly lower among those who correctly answered the question on the genetic influence of radiation, while it was significantly higher among those who correctly answered the question on the dose-response model of radiation-induced cancer. In Hamadori, anxiety was significantly higher among those who watched private national television. In the evacuation areas, the result was the same as that of the combined data.Conclusion　Different information sources and media were significantly associated with anxiety about the effects of radiation on future generations. Therefore, media sensationalism should be reduced to prevent anxiety among citizens. Our findings highlight the importance of selecting information sources and media that disseminate accurate information, as well as the need to improve media literacy among citizens. Furthermore, a dose-response model of radiation-induced cancer must be communicated in a way that is not misleading. Receiving accurate information on the genetic effects of radiation can reduce anxiety among citizens.

Personality and health literacy among community-dwelling older adults living in Japan.

BACKGROUND: Previous studies have demonstrated that health behaviours may be one of the major mechanisms underlying the relationship between personality and health outcomes. Such health behaviours may be established by consciousness toward one's health that include health literacy. Thus, this study aimed to explore the relationship between health literacy and its correlates, including personality, among community-dwelling older adults. METHODS: This was a cross-sectional study with 683 older individuals (aged 60-84 years; 326 men and 357 women). A questionnaire was used to assess health literacy, personality, socioeconomic status, health status, and lifestyles. Health literacy was measured using the Communicative and Critical Health Literacy Scale, which is a self-report questionnaire comprising five items assessing degrees of health literacy. The Big Five personality traits were measured using the Japanese version of the Ten-Item Personality Inventory. Other variables were measured as factors associated with health literacy, including age, gender, education, subjective economic status, social isolation, chronic diseases, functional capacity, smoking and drinking. RESULTS: Multiple regression analysis showed that education (ß = 0.10), subjective economic status (ß = -0.09), social isolation (ß = -0.08), functional dependence (ß = -0.22), neuroticism, (ß = -0.08), extraversion (ß = 0.10), openness (ß = 0.17), and conscientiousness (ß = 0.09) were independently and significantly associated with health literacy (coefficient of determination = 0.28). CONCLUSIONS: This study found significant and independent associations of personality, socioeconomic status, and health status with health literacy. These results may help facilitate the development of efficient strategies to improve health status by promoting health literacy in community-dwelling older adults.

[Relationship between prolonged media usage and lifestyle habits among junior and senior high school students].

Objective　In recent years, the long-term use of media (including the Internet, video games, and social networking services) at a young age has been regarded as a problem. It has been pointed out that prolonged media usage may have an undesirable effect on the growth of adolescents from the physical, mental, and social perspectives. Junior and senior high school students are in a particularly important period of self-management of the basic lifestyle habits acquired thus far. Additionally, they must cultivate the ability to interact appropriately with media used daily. In this study, we investigated the relationship between the time expended on media usage and lifestyle habits among junior and senior high school students.Methods　A sample of 1,633 students was extracted from all junior and senior high schools in Fukushima City. Principals of the schools distributed a self-administered questionnaire to their students. In total, 1,589 responses were obtained; as surveys of 30 students were missing values for gender and grade, they were excluded from the analysis, and data from 1,559 respondents were ultimately analyzed. A binomial logistic regression analysis was performed to examine the relationship between an independent variable (media usage time) and dependent variables (subjective health, lifestyle habits, and drinking and smoking experience) while controlling for gender and grade.Results　Among junior high students, media usage for more than three hours was significantly related to "no breakfast," "no exercise habits," "irregular sleep," "lack of rest," and "feeling stressed." Among high school students, media usage for three hours or more was significantly related to "poor subjective health status," "eating only one or two meals a day," "no breakfast," "low food diversity," "obesity," "no exercise habits," "irregular sleep," "late bedtime," "waking up late," "drinking," and "smoking."Conclusion　Our findings indicate that three or more hours of daily media usage is related to unhealthy lifestyles in terms of sleeping, eating, physical activity, drinking, and smoking. Junior and senior high school students who responded to the survey indicated that prolonged usage was also adversely related to their subjective health. Because the overuse of media is associated with students' lifestyles and health, it is important to develop an educational system that helps junior and senior high school students use media properly.

[Development of the Japanese version of the cognitive failure scale (the Short Inventory of Minor Lapses) for Japanese women involved in child care].

Objectives Child care involves mentally and physically intensive work. Women involved in child care are prone to various cognitive failures (e.g., forgetting to carry something or missing an appointment) because of being overburdened with child care activities and chores, constantly limited attention for coping with the frequent demands of children, and cognitive deterioration in the perinatal period. We conducted a survey of women caring for children aged 3 months to 6 years old, aiming to 1) develop a Japanese version of the cognitive failure scale (named the Short Inventory of Minor Lapses [SIML]), and 2) examine the psychometric properties of the scale (including factor structure, validity, reliability, and score distribution), and comparing the scale score according to job status, the youngest child's age, and the number of children.Methods We used data obtained through an internet research company from 310 women (aged 25-45 years; 155 full-time workers and 155 housewives), caring for children aged 3 months to 6 years old. We used the 15-item SIML with a five-point Likert-type scale. We also collected information about employment status, maternal age, the youngest child's age, the number of children, income, the status of using child-care services, sleep duration, fatigue, and neuroticism.Results The scale consisted of one factor. Cognitive failure was found to have the following correlations with memory complaints (polyserial correlation=0.66), sleep duration (r=-0.17), fatigue (r=0.32), and neuroticism (r=0.22). Cronbach's alpha for the scale was 0.94. A three-way analysis of variance (including main effects of working status, the youngest child's age, and the number of children) in cognitive failure revealed significant main effects of the youngest child's age (aged 0-3 years: mean (standard deviation [SD])=34.9 (11.5) point, > aged 4-6 years: mean (SD)=32.6 (10.5) point, partial η2=0.013), and the number of children (only one: mean (SD)=32.4 (11.3) points < two or more: mean (SD)=34.9 (10.9) points, and partial η2=0.014). A three-way analysis of covariance in cognitive failure adjusted for mother's age demonstrated a significant main effect of the youngest child's age (partial η2=0.014).Conclusion Our findings confirmed the psychometric properties of the Japanese version of SIML among women involved in child care (including factor structure, validity, reliability, and score distribution).

Psychometric evaluation of the simplified Japanese version of the Athens Insomnia Scale: The Fukushima Health Management Survey.

We investigated the psychometric properties of the simplified Japanese version of the Athens Insomnia Scale (AIS-SJ) using baseline data from the Fukushima Health Management Survey. Data from 22 878 men and 27 669 women aged 16 years and older were analysed (Mage  = 52.9 ± 18.6). Participants lived in the Fukushima evacuation zone and experienced the Great East Japan Earthquake. The AIS-SJ was used to assess participants' insomnia symptoms, and its validity was examined by administering the Kessler 6-item Psychological Distress Scale (K6) and assessing education, self-rated health and disaster-related experiences. A confirmatory factor analysis revealed that the two-factor model was a better fit than the one-factor model. The AIS-SJ and its subscales had acceptable reliability (Cronbach's alpha, 0.81). Test of measurement invariance confirmed strict invariance across groups for the participants' characteristics of gender and mental illness history, but not for participants' age. AIS-SJ scores exhibited a near-normal distribution (skewness, 0.45; kurtosis, -0.89). There were significant age differences only among women, and gender differences in AIS-SJ scores with small effect sizes. The AIS-SJ scores had weak-to-moderate correlations with mental illness history, bereavement, experiencing the tsunami, experiencing the nuclear power plant incident, housing damage and losing one's job (polyserial correlations, 0.36, 0.17, 0.13, 0.18, 0.13, and 0.15, respectively), and strong correlations with self-rated health (polyserial correlation, 0.51), psychological distress (rs , 0.60) and post-traumatic stress disorder (rs , 0.60). The AIS-SJ is a useful instrument for assessing community dwellers' insomnia symptoms.

[Psychometric properties of the diet-related quality of life (DRQOL) scale and its short version among older adults].

Objectives　The purpose of this study was to examine the psychometric properties of the diet-related quality of life (DRQOL) scale among older adults. Specifically, the study was conducted to confirm the scale's factor structure and construct a short version of the scale. Further, the scale's internal consistency and gender- and age-based differences as well as the validity of the DRQOL scale and its short version were examined.Methods　We surveyed a random sample of community-dwelling older Japanese adults (aged 60-84 years; N=1,200; response rate: 70.8%) and used the data of 780 participants (367 men and 413 women). We used the DRQOL scale, comprising 18 items that were measured using a five-point Likert-type scale. Additionally, we assessed subjective well-being, diet satisfaction, appetite, meal restriction, mastication, number of meals with others, frequency of using ready-made and instant food, information gathering regarding food, and dietary variety scores as external criterion variables; socioeconomic status and health habits were used to describe basic participant characteristics.Results　Confirmatory factor analysis revealed a replication of the four-factor structure of the measure ("pleasure from a meal," "eating satisfaction," "circumstances of meal," and "diet diversity"). A short version of the measure comprising 8 items was developed. The DRQOL scale, its subscales, and its short version had high Cronbach's alpha coefficients as indicators of reliability (0.94; 0.86, 0.89, 0.77, and 0.72; and 0.90, respectively). There were significant sex differences in the scores of all constructs, and no significant age-based differences. The DRQOL scale scores had weak-to-moderate correlations with the external criterion variables mentioned above.Conclusion　Overall, this study confirmed the psychometric properties of the DRQOL scale, including factor structure, reliability, gender and age differences, and its validity among older adults using data from the general population in Japan. In addition, a short version of the DRQOL scale was developed. Future studies should examine the factors associated with the DRQOL. The predictive validity of the scale, with health outcomes as external criteria, should be examined to test its usefulness for epidemiological surveys among older adults in community settings.

[Development of a leisure activity scale for contemporary older adults: Examination of its association with cognitive function].

Objectives　Leisure activities are important for older adults, not only to maintain their subjective well-being but also to prevent bedridden states. This study aimed to develop a leisure activity scale for contemporary older adults and examine its psychometric properties, based on a previous study from Iwasa et al. (2018). As people who actively engage in leisure activities are reportedly less likely to experience cognitive decline, the relationship between the scale score and cognitive function should be assessed while developing the scale. Specifically, the study was conducted to examine the reliability of the scale and its factor structure, confirm basic statistical characteristics, examine the scale's gender- and age-based differences, and the relationship between the scale score and cognitive function.Methods　We surveyed Japanese older adults living in a community (aged 70-84 years; N=594) and used data from 306 participants (151 men and 155 women). We developed and administered a scale comprising 11 items that were measured using a 4-point Likert-type scale. Additionally, we used cognitive function scales including the Mini-Mental State Examination (MMSE), the Memory Impairment Screen (MIS), and the Word Fluency Test. Covariates in tests for independent associations between the leisure activity scale score and cognitive function were socioeconomic status, chronic disease, functional capacity, and living alone. We conducted two web surveys with two-week intervals for test-retest reliability purposes and used data from 192 of those participants (aged 70-79 years; 101 men and 91 women).Results　A confirmatory factor analysis upheld the fact that the scale was comprised of one factor. The scale obtained high indicators of reliability: Cronbach's alpha coefficient (0.81) and test-retest reliability (0.81). The mean, standard deviation, median, skewness, and kurtosis of the scale score were 14.44, 7.13, 15, -0.12, and -0.73, respectively. The analysis of variance for the scale score indicated significant age-based differences (i.e., the score for those who were 70-74 years old was higher than for those who were 80-84 years old) and no significant gender differences. Multiple regression analyses demonstrated that the scale score was significantly and independently correlated with MMSE (ß=0.31), MIS (ß=0.24), and word fluency (ß=0.25).Conclusion　This study confirmed the psychometric properties of the leisure activity scale, including factor structure, reliability, basic statistical characteristics, no gender differences, significant age-based differences, and relationship to cognitive function. Future studies should examine the longitudinal relationship between the leisure activity scale score and cognition among older adults in community settings.

Efficacy of group intervention involving physical activity on subjective well-being of elderly returnees after evacuation following the Great East Japan Earthquake.

AIM: In general, physically activity contributes to better subjective well-being (SWB) in the elderly. However, the physical activity level of older people who experienced relocation after the Great East Japan Earthquake has been reported to be low, possibly leading to low SWB. This study aimed to examine the efficacy of group intervention involving physical activity on SWB among older returnees after the Great East Japan Earthquake. METHODS: The participants were randomly allocated to an intervention group (4 men, 10 women) or a control group (7 women). Participants in the intervention group attended a series of weekly classes over eight weeks to encourage daily physical activity, whereas participants in the control group received no intervention. SWB, the primary outcome, was assessed by the World Health Organization Five Well-Being Index. RESULTS: Median variation in the World Health Organization Five Well-Being Index scores at 3 months from the baseline in the intervention and control groups was -1.0 and -2.0 points, respectively; the difference was borderline significant (P = 0.06). There was no significant difference between the groups in the median of variation in muscle strength (P = 0.79) or mobility (P = 0.77) at 3 months. CONCLUSION: The intervention might prevent deterioration in participants' SWB. Further studies involving older returnees with poor physical activity and/or sedentary lifestyle may be beneficial for health promotion in the area.

Assessing competence at a higher level among older adults: development of the Japan Science and Technology Agency Index of Competence (JST-IC).

BACKGROUND AND AIMS: Older adults' ever-improving health and changing lifestyles necessitate the development of a scale that can better measure their competence at a higher level. We developed the Japan Science and Technology Agency Index of Competence (JST-IC) via item analysis and assessed its psychometric properties. METHODS: Participants were 1306 community-dwelling older adults (623 men and 683 women, 74.0 ± 2.8 years old) who completed the 54-item draft JST-IC to determine their level of independence. Three procedures (including item selection, factor analyses, and reliability and validity analyses) were conducted to finalize the JST-IC and evaluate its psychometric properties. RESULTS: The item selection resulted in exclusion of 26 items for the following reasons: (a) 15 because of very high ratios (80% or more) of responders who answered "yes", (b) one because of gender differences (phi coefficient = 0.34), (c) five because of their weak association with the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) (Pearson correlation coefficient of 0.30 or smaller), and (d) five because of redundancy of meaning with other items. Through factor analyses, we selected 16 items with a four-factor solution for the final version. JST-IC score exhibited a near-normal distribution and significant gender and age differences, and had moderate correlations with size of social network and level of subjective well-being and strong correlations with TMIG-IC score, physical fitness, and health literacy. CONCLUSIONS: The JST-IC is useful for assessing competence at a higher level in community-dwelling older adults.

[Normative data of middle-aged and older Japanese adults for the the Japanese version of the Ten-Item Personality Inventory (TIPI-J)].

Objectives　The purpose of this study was to provide normative data of middle-aged and older adults for the Japanese version of the Ten-Item Personality Inventory (TIPI-J), based on the Big Five model of personality (Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness).Methods　We surveyed a random sample of community-dwelling middle-aged and older Japanese adults (aged 60-84 years, N=1,200, response rate: 70.8%) and used data from 776 participants (368 men and 408 women). We used the TIPI-J as a measure of the Big Five model of personality comprising ten items, which were measured on a seven-point Likert-type scale. We also assessed the socio-economic and health variables to describe the basic characteristics of participants.Results　Standard psychometric methods showed a near-normal score distribution across all subscales; there were significant sex differences in Neuroticism and Openness, and there was no significant difference with respect to age.Conclusion　This study provided a grand total table and normative data for the TIPI-J, and examined gender- and age-based differences in the TIPI-J among middle-aged and older adults using data from the general population of Japan. In the future, factors associated with the TIPI-J scores and predictive validity of the scale for health outcomes as external criteria should be examined to test the scale's usefulness for epidemiological surveys among middle-aged and older adults in community settings.

Residence-related factors and psychological distress among evacuees after the Fukushima Daiichi nuclear power plant accident: a cross-sectional study.

BACKGROUND: Relocation following a disaster can impact the psychological well-being of evacuees. This study investigated the associations between residence-related factors and psychological distress among evacuees living in temporary housing after the Fukushima Daiichi Nuclear Power Plant accident. METHODS: Data from 525 participants living in temporary housing were collected. Associations between residence-related factors (frequent relocation, dissatisfaction with the residence, and plan to move to permanent housing) and psychological distress were measured. The psychological distress of evacuees was measured using the Japanese version of the 6-item Kessler scale (K6). We used a cut-off score of five to identify cases with psychological distress, the basis of Kessler's 6 items for psychological distress. RESULTS: Multivariate logistic regression analysis (n = 418) showed that frequent relocation (OR = 2.05, 95% CI: 1.14-3.66, p = 0.016) and dissatisfaction with the residence (OR = 2.48, 95% CI: 1.60-3.83, p < 0.001) was significantly associated with psychological distress. After stratifying by gender, dissatisfaction with the residence was associated with psychological distress, and a plan to move to permanent housing was significantly associated with psychological distress in women (OR = 1.93, 95% CI: 1.03-3.63, p = 0.041). CONCLUSIONS: Frequent relocation and dissatisfaction with the residence were associated with psychological distress among evacuees following the Fukushima nuclear disaster. Evacuees should be provided with comfortable living spaces, and steps should be taken to reduce repeated relocation of evacuees. Thus, particular attention should be paid to women with a plan to move to permanent housing within this context.

Longitudinal association between habitual physical activity and depressive symptoms in older people.

AIMS: Prevention of depressive symptoms is an essential issue with regard to the promotion of healthy lifestyles in older people. To date, few studies have examined the relation between fluctuations in physical activity and depression among older individuals. We thus conducted a longitudinal survey of older adults to examine the effect of long-term fluctuating physical activity on the incidence of depressive symptoms. METHODS: A 3-year prospective cohort study was performed in a community-based environment. A total of 680 individuals (291 men and 389 women) aged 65 years and over at the baseline assessment participated. The 15-item Geriatric Depression Scale was used to assess depressive symptoms, with scores of ≥6 indicative of depression. Participants were categorized into the following four groups based on change in physical activity status between 2002 and 2003: sedentary, cessation, initiation, and maintenance. RESULTS: The incidence of depressive symptoms was 16.9% (16.8% in men and 17.0% in women) at the 3-year follow up (in 2006). Multiple logistic regression analyses showed that physical activity maintenance (odds ratio, 0.50; 95% confidence interval, 0.30-0.83) only reduced the incidence of depressive symptoms at the 3-year follow up after adjusting for confounding variables. CONCLUSIONS: Continuous physical activity may be a valuable and simple way to prevent depressive symptoms in community-dwelling older people. Therefore, it is necessary to implement interventions that teach older adults how to integrate physical activity into their daily lives.

Information processing speed and 8-year mortality among community-dwelling elderly Japanese.

BACKGROUND: Cognitive function is an important contributor to health among elderly adults. One reliable measure of cognitive functioning is information processing speed, which can predict incident dementia and is longitudinally related to the incidence of functional dependence. Few studies have examined the association between information processing speed and mortality. This 8-year prospective cohort study design with mortality surveillance examined the longitudinal relationship between information processing speed and all-cause mortality among community-dwelling elderly Japanese. METHODS: A total of 440 men and 371 women aged 70 years or older participated in this study. The Digit Symbol Substitution Test (DSST) was used to assess information processing speed. DSST score was used as an independent variable, and age, sex, education level, depressive symptoms, chronic disease, sensory deficit, instrumental activities of daily living, walking speed, and cognitive impairment were used as covariates. RESULTS: During the follow-up period, 182 participants (133 men and 49 women) died. A multivariate Cox proportional hazards model showed that lower DSST score was associated with increased risk of mortality (hazard ratio [HR] = 1.62, 95% CI = 0.97-2.72; HR = 1.73, 95% CI = 1.05-2.87; and HR = 2.55, 95% CI = 1.51-4.29, for the third, second, and first quartiles of DSST score, respectively). CONCLUSIONS: Slower information processing speed was associated with shorter survival among elderly Japanese.

Association of Spousal Social Support in Child-Rearing and Marital Satisfaction with Subjective Well-Being among Fathers and Mothers.

This study explored the association of spousal support and marital satisfaction with the subjective well-being of fathers and mothers using a mediation analysis. Data were gathered from 360 fathers and 338 mothers (aged 25-50 years). Subjective well-being was measured as an outcome using the Japanese version of the World Health Organization-Five Well-Being Index. Marital satisfaction was measured as a mediating variable using the Japanese version of the Marital Relationship Satisfaction Scale. Spousal social support (including instrumental, emotional, and appraisal support) was measured as an independent variable using four-point scales. Control variables were the father's and mother's ages, number of children, age of the youngest child, children going to nursery school or kindergarten, use of childcare services, self-evaluated low economic status, and weekday working hours. Among fathers, instrumental and emotional support had significant direct and indirect effects, with the latter mediated by the impact of marital satisfaction on subjective well-being; appraisal support had only significant indirect effects. Among mothers, instrumental support had significant direct and indirect effects; emotional and appraisal support had only significant indirect effects. Our findings indicate that social support from spouses has protective direct and indirect effects on subjective well-being among parents and suggest the need for mutual support between spouses to facilitate effective co-parenting.