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1.
Dementia (London) ; 22(8): 1886-1899, 2023 Nov.
Article En | MEDLINE | ID: mdl-37857447

Background: Overcoming dementia stigma is a global challenge. Contact and education on dementia may be promising approaches for reducing public stigma; however, the current evidence is insufficient. This study examined the moderating factors associated with the public stigma against dementia, focusing on experiences of interacting with and learning about people with dementia. Methods: This cross-sectional study recruited 710 adults aged 20-69 years who were not involved in any medical or care work. Participants were recruited via a web-based questionnaire survey for a large internet survey agency's panel in Japan. In terms of the public stigma about dementia, four domains were assessed using a multidimensional assessment scale: personal avoidance, fear of labelling, person-centredness, and fear of discrimination. We compared the stigma scores according to the participants' experiences of interacting with people with dementia ('none', 'talking or activities together', or 'living together') and learning about dementia ('yes' or 'no'), adjusted for demographic and socioeconomic factors.Results: Compared with those without interaction experiences, those with experiences of talking or activities with people with dementia had lower personal avoidance (p = .001), fear of labelling (p = .026), and fear of discrimination (p = .031); those with experiences of living together with people with dementia had lower personal avoidance (p = .014) and fear of discrimination (p = .031). Compared with those without learning experiences related to dementia, those with such experiences had lower personal avoidance (p < .001) and higher person-centredness (p = .048).Conclusions: The findings suggest that the promotion of interaction with and learning about people with dementia may be important for addressing the public stigma.


Dementia , Adult , Humans , Cross-Sectional Studies , Social Stigma , Fear , Surveys and Questionnaires
3.
Geriatr Gerontol Int ; 22(9): 790-796, 2022 Sep.
Article En | MEDLINE | ID: mdl-36058625

AIM: Reducing stigma against dementia is a global challenge, but the assessment scale is not well established. We examined the validity and reliability of the Japanese version of the assessment scale of public stigma against dementia. METHODS: This study recruited 819 adults aged 20-69 years (mean age = 45.9 years; 52.0% females) through an internet survey, and 34 community-dwelling adults aged 20-78 years (mean age = 45.8 years; 55.9% females). Participants completed the Japanese version of the assessment scale of dementia stigma developed by Phillipson et al., with forward and back translations. In the internet survey sample, exploratory factor analysis was performed to verify factorial validity, and correlations with ageism and dementia attitudes were examined to test the concurrent validity. In the community sample, test-retest reliability was evaluated using intraclass correlation coefficients (ICCs) between two responses with a two-week interval. RESULTS: Factor analysis revealed a four-factor structure: "personal avoidance," "fear of labeling," "person centeredness," and "fear of discrimination" (Cronbach's α = 0.892, 0.840, 0.879, 0.829, respectively). Personal avoidance, fear of labeling, and fear of discrimination were positively correlated with ageism (r = 0.598, 0.214, 0.369) and negatively correlated with dementia attitudes (r = -0.745, -0.453, -0.475); person centeredness was inversely correlated with ageism (r = -0.322), but positively correlated with dementia attitudes (r = 0.537), showing good concurrent validity. The scale showed acceptable test-retest reliability (ICCs = 0.67-0.80). CONCLUSIONS: The Japanese version of the assessment scale of public stigma against dementia was established with good concurrent validity and adequate reliability. Geriatr Gerontol Int 2022; 22: 790-796.


Dementia , Social Stigma , Dementia/diagnosis , Female , Humans , Japan , Male , Reproducibility of Results , Surveys and Questionnaires
4.
Article En | MEDLINE | ID: mdl-35124843

OBJECTIVES: Art and cultural activities can benefit mental health. However, there is insufficient evidence on active engagement in art and cultural activities for preventing depressive symptoms among older adults. Therefore, we examined the association of active engagement in art and cultural activities with depressive symptom onset among older adults using 3-year longitudinal data. METHODS: This longitudinal study recruited non-institutionalised older adults independent in daily living from the Japan Gerontological Evaluation Study (JAGES) established in 2010, and those without depressive symptoms were followed for three years. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale. Active engagement in nine art and cultural activities, including Japanese traditional cultural activities, were evaluated (musical performance, singing, dancing, handicrafts, painting, photography, poetry composition, calligraphy, and tea ceremony/flower arrangement). RESULTS: Ultimately, 37,627 older adults without depressive symptoms at baseline were analysed. The participants' mean age (standard deviation) was 72.6 (5.5) years, and 51.5% were female. During the follow-up period, depressive symptoms occurred in 3844 participants (10.2%). Multivariable logistic regression analysis revealed that active engagement in art and cultural activities was inversely associated with depressive symptom onset (odds ratio = 0.80, 95% confidence interval = 0.73-0.87, p < 0.001). This association was confirmed regardless of age, gender, and socioeconomic status. Among the activities, especially dancing and photography were protective against depressive symptoms. CONCLUSION: Active engagement in art and cultural activities may contribute to preventing depressive symptoms among older adults. Promoting art and cultural engagement could be important to protect their mental health.


Depression , Aged , Depression/psychology , Female , Humans , Japan/epidemiology , Longitudinal Studies , Male
5.
J Epidemiol ; 32(9): 401-407, 2022 09 05.
Article En | MEDLINE | ID: mdl-33551389

BACKGROUND: Increasing the coverage of vaccinations recommended by the World Health Organization in the older adult population is an urgent issue, especially in the context of avoiding co-epidemics during the current coronavirus disease 2019 crisis. The aim of this study was to examine factors associated with the quality of perceived patient-physician communication and whether this variable was associated with increased odds of vaccination. METHODS: We used cross-sectional data from the Japan Gerontological Evaluation Study conducted from October 2016 to January 2017. The participants were 22,253 physically and cognitively independent individuals aged 65 or older living in 39 municipalities in Japan. Multilevel logit models were used to estimate the odds of vaccination. RESULTS: Among the participants, 40.0% and 58.8% had received pneumococcal and influenza vaccinations as per the recommended schedule, respectively. People with low educational levels were more likely to have a family physician but rate their experience in asking questions lower than those with higher educational levels. Having a family physician and high rating for physicians' listening attitude were positively associated with increased odds of pneumococcal and influenza vaccinations. High rating for patients' questioning attitude and shared decision-making, compared to an ambiguous attitude toward medical decision-making, were positively associated with increased odds of pneumococcal vaccination. CONCLUSION: The results suggest that promotion of having a family physician, better patient-physician communication, and shared decision-making may encourage older adults to undergo recommended vaccinations.


COVID-19 , Influenza Vaccines , Influenza, Human , Physicians , Aged , Communication , Cross-Sectional Studies , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Vaccination
6.
J Epidemiol Community Health ; 76(2): 182-189, 2022 02.
Article En | MEDLINE | ID: mdl-34341149

BACKGROUND: Little is known about the prospective association between community-level social capital and individual-level frailty onset. Therefore, this study aimed to examine the impact of community-level social capital on frailty onset among older adults using 3-year longitudinal data. METHODS: This prospective cohort study recruited non-institutionalised older adults from the Japan Gerontological Evaluation Study, established in 2013 and robust older adults were followed up for 3 years. We assessed three aspects of community-level social capital (civic participation, social cohesion and reciprocity), and employed a multilevel logistic regression analysis; frailty was evaluated using the Kihon Checklist questionnaire, which has been widely used as a screening tool for frailty in Japan. RESULTS: In total, 21 940 older adults (from 384 communities) who were robust at baseline (2013) completed the follow-up survey (2016). Participants' mean age (SD) was 71.8 (4.9) years, and 51.2% were female. In the follow-up period, frailty onset occurred in 622 participants (2.8%). Regarding community-level social capital variables, civic participation was inversely associated with frailty onset (OR=0.94, 95% CI 0.90 to 0.97, p=0.001), after adjusting for individual-level and community-level covariates. The potential intermediate factors of individual social relationships and health behaviours did not largely change the results. This association was found regardless of individual socioeconomic status. CONCLUSIONS: Living in a community with rich civic participation, such as engagement in social activities, was associated with lower frailty onset among older adults. Community development that fosters social participation is essential for frailty prevention.


Frailty , Social Capital , Aged , Female , Frailty/epidemiology , Humans , Japan/epidemiology , Longitudinal Studies , Prospective Studies , Social Participation
7.
Article En | MEDLINE | ID: mdl-33138333

We examined the association between objective and perceived neighborhood characteristics and self-reported leisure-time physical activity (PA) in older Japanese residents living in areas ranging from metropolitan to rural in 2016. Objective measures used were walkability and the numbers of parks/green spaces and sports facilities within 500 or 1000 m of subjects' homes, calculated using geographic information systems. Subjective measures were the subjects' perceptions of their neighborhoods, assessed using a structured questionnaire. All variables were divided into three groups, and the lowest tertile was used as the reference. We assessed the location and frequency of strolling or brisk walking, moderate-intensity PA, and vigorous-intensity PA (sports) using a self-reported questionnaire and defined as performing a certain type of PA 3-4 times/week as a habit. Living in a neighborhood in the highest tertile for walkability and number of parks/green spaces as well as perception of having good access to recreational facilities, observing others exercising and the presence of walkable sidewalks was associated with walking and sports habits (multivariable odds ratios (ORs): 1.33-2.46, all p < 0.05). Interestingly, objective measures of PA-friendly environmental features were inversely associated with moderate-intensity PA habits, potentially because moderate-intensity PA consisted predominantly of gardening. In conclusion, living in an environment supportive of PA, whether objectively or subjectively measured, is related to leisure-time PA habits among older Japanese adults.


Environment Design , Residence Characteristics , Walking , Aged , Aged, 80 and over , Cohort Studies , Cross-Sectional Studies , Exercise , Female , Humans , Male , Middle Aged , Surveys and Questionnaires
8.
Article En | MEDLINE | ID: mdl-30654459

Social support is important for the health of elderly populations. However, its longitudinal effect on incident dementia is unclear. We used the Aichi Gerontological Evaluation Study (AGES) project data to investigate the longitudinal effect of social support on dementia onset. Functionally independent older people at baseline (n = 14,088) in 10 municipalities were followed from 2003 to 2013 using National Long-term Care Insurance System data. Social support was assessed by the following support sources: co-residing family, family or relatives living apart, and friends or neighbors. Cumulative incidence of dementia was 14.6% and 18.7% for men and women, respectively. Cox proportional hazard models were employed by gender to investigate the association between social support and dementia onset adjusting for age, health status, health behaviors, subjective cognitive complaints, depression, and other socioeconomic factors. Gender differences were observed in the association between social support and incident dementia. Support from co-residing family members was protective among men, whereas among women, no effect of social support on dementia was observed. Among other social factors, community engagement was protective for women, while for men, being married was associated with lower incidence of dementia. The association between social support and dementia seems to differ by gender. When we design programs to promote social interactions among the elderly, we need to take into account such gender differences.


Dementia/epidemiology , Sex Characteristics , Social Support , Aged , Aged, 80 and over , Female , Follow-Up Studies , Friends , Health Behavior , Health Status , Humans , Incidence , Interpersonal Relations , Japan/epidemiology , Male , Proportional Hazards Models , Socioeconomic Factors
9.
Prev Med Rep ; 11: 282-289, 2018 Sep.
Article En | MEDLINE | ID: mdl-30116699

The possible effects of a neighborhood's built environment on physical activity have not been studied in Asian countries as much as in Western countries. The present study cross-sectionally examined the relationship between geographic information system (GIS) measured residence and worksite neighborhood walkability, and the number of parks/green spaces and sports facilities within a 1 km radius of home and workplace, with self-reported leisure-time habitual (3-4 times per week or more) walking and moderate-to-vigorous intensity habitual exercise among local government workers aged 18 to 64 years living in an urban-suburban area of Aichi, Japan in 2013. A single-level binomial regression model was used to estimate the multivariable odds ratios (ORs) and 95% confidence intervals (95% CIs). Of the 1959 male and 884 female participants, 288 (15%) and 141 (16%) reported habitual walking, respectively, and 18% and 17% reported habitual exercise, respectively. Compared with women who resided in neighborhood with a walkability index of 4-30, those living in an area with that of 35-40 were significantly more likely to engage in leisure-time habitual exercise (multivariable OR: 1.70, 95% CI: 1.08-2.68). Marginally significant positive associations were found between leisure-time habitual exercise and the residential neighborhood's number of parks/green spaces among women, as well as the number of sports facilities among men. In conclusion, a residential neighborhood environment characterized by higher walkability may contribute to the initiation or maintenance of moderate-to-vigorous intensity leisure-time exercise among working women living in an urban-suburban area of Japan.

11.
PLoS One ; 13(3): e0194919, 2018.
Article En | MEDLINE | ID: mdl-29590211

AIM: Long-term care systems may alleviate caregiver burdens, particularly for those with fewer resources. However, it remains unclear whether socioeconomic disparity in caregiver burdens exists under a public, universal long-term care insurance (LTCI) system. This study examined income-based inequalities in caregiving time and depressive symptoms in Japanese older family caregivers. We further compared inequality in depressive symptoms with that of non-caregivers to evaluate whether family caregiving exacerbates this disparity. METHODS: Data were obtained from a cross-sectional, nationwide survey conducted by the Japan Gerontological Evaluation Study in 2013. Participants were functionally independent older adults aged ≥65 years (N = 21,584). Depressive symptoms were assessed using the Geriatrics Depression Scale (GDS); caregiving hours per week, household income, and other covariates were also assessed. RESULTS: Family caregivers occupied 8.3% of the total. A Poisson regression model revealed that caregivers in lower income groups (compared to those in the highest) were 1.32 to 1.95 and 1.63 to 2.68 times more likely to engage in ≥36 and ≥72 hours/week of caregiving, respectively. As for the GDS (≥5), an excess risk was found in the caregivers in lower (compared to higher) income groups (adjusted prevalence ratio: 1.57-3.10). However, an interaction effect of income by caregiving role indicated no significant difference in inequality between caregivers and non-caregivers (p = .603). The excess risk for GDS (≥5) in the caregivers compared to non-caregivers was observed across income groups. CONCLUSIONS: Our findings revealed a possible disparity in family caregivers under the public LTCI system. Further studies should examine factors associated with longer caregiving hours in lower income households. Our findings also suggest the necessity for more efforts to alleviate depressive symptoms in family caregivers under the LTCI system regardless of income level, rather than exclusively supporting those with a low income.


Caregivers/psychology , Depressive Disorder/epidemiology , Family/psychology , Income , Insurance, Long-Term Care , Socioeconomic Factors , Stress, Psychological , Adaptation, Psychological , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Follow-Up Studies , Humans , Japan/epidemiology , Male , Middle Aged , Prognosis , Time Factors
12.
J Epidemiol Community Health ; 72(1): 7-12, 2018 Jan.
Article En | MEDLINE | ID: mdl-29089367

BACKGROUND: Social relationships consist of mutually related but distinct dimensions. It remains unclear how these domains independently contribute to incident dementia. This large-scale, prospective cohort study examines associations between the social relationship domains as well as their combinations and incident dementia among community-dwelling older adults. METHODS: We analysed data from 13 984 community-dwelling adults aged 65+ without long-term care needs living in Aichi prefecture in Japan. Incident dementia was assessed based on the Long-term Care Insurance records, followed for 3436 days from the baseline survey conducted in 2003. Three social relationships domains (social support, social networks and social activities) were further divided into a total of eight subdomains. A social relationship diversity score was calculated using the social relationship domains which were significantly related to incident dementia. RESULTS: A Cox proportional hazards model showed that being married, exchanging support with family members, having contact with friends, participating in community groups and engaging in paid work were related to a lower likelihood of developing incident dementia, controlling for covariates and other social relationship domains. The diversity scores, ranging from 0 to 5, were linearly associated with incident dementia (p<0.001), and those who scored highest were 46% less likely to develop incident dementia compared with those in the lowest category. CONCLUSIONS: Our findings revealed five social relationship subdomains which were negatively related to incident dementia, suggesting that dementia may potentially be prevented by enhancing these social relationships. Future studies should examine independent pathways between each social relationship domain and incident dementia.


Dementia/epidemiology , Interpersonal Relations , Marital Status , Social Support , Aged , Aged, 80 and over , Dementia/etiology , Dementia/psychology , Family , Female , Humans , Incidence , Male , Proportional Hazards Models , Prospective Studies , Risk Factors
13.
BMC Geriatr ; 17(1): 183, 2017 08 16.
Article En | MEDLINE | ID: mdl-28814289

BACKGROUND: Living arrangements of older adults have changed worldwide with increasing solitary and non-spouse households, which could affect social care systems. However, the relationship between these households and disability onset has remained unclear. We examined the relationship between living arrangements and the onset of basic activities of daily living disability in older adults, with a focus on gender differences and cohabitation status of those without a spouse. METHODS: Data from 6600 men and 6868 women aged 65 years or older without disability were obtained from the Aichi Gerontological Evaluation Study Project in Japan. Onset of disability was followed for 9.4 years. Disability was assessed based on Long-term Care Insurance System registration. A hierarchical Cox proportional hazards model was conducted to examine the risk of living alone and living only with non-spousal cohabitants compared to those living with spouses. RESULTS: Men living only with non-spousal cohabitants and those living alone were significantly more likely to develop disability after controlling for health and other covariates (hazard ratio = 1.38 and 1.45, respectively), while a significant difference was found only for women living alone (hazard ratio = 1.19). The risk of living with non-spousal cohabitants was marginally stronger in men, indicated by the interaction effect model (p = .08). A series of hierarchical analyses showed that social support exchange explained 24.4% and 15.8% of the excess risk of disability onset in men living alone and those living only with non-spousal cohabitants, respectively. A subsequent analysis also showed that support provision by older adults more greatly explained such excess risk than receiving support from others. CONCLUSIONS: Older men without spouses were more likely to develop disability onset regardless of cohabitants. Health professionals should consider programs that enhance social support exchange, particularly support provision by older adults who are at risk of disability.


Activities of Daily Living , Disabled Persons/statistics & numerical data , Family Characteristics , Residence Characteristics , Age of Onset , Aged , Cohort Studies , Female , Geriatric Assessment/methods , Humans , Insurance, Long-Term Care , Japan/epidemiology , Male , Needs Assessment , Proportional Hazards Models , Risk Assessment/methods , Risk Factors , Sex Factors , Social Support , Spouses/statistics & numerical data
14.
Article En | MEDLINE | ID: mdl-28671627

In Asian nations, family ties are considered important. However, it is not clear what happens among older people with no such ties. To investigate the association, we used longitudinal data from the Aichi Gerontological Evaluation Study (AGES) project. Functionally independent older people at baseline (N = 14,088) in 10 municipalities were followed from 2003 to 2013. Social ties were assessed by asking about their social support exchange with family, relatives, friends, or neighbors. Cox proportional hazard models were employed to investigate the association between social ties and the onset of functional disability adjusting for age, health status, and living arrangement. We found that social ties with co-residing family members, and those with friends or neighbors, independently protected functional health with hazard ratios of 0.81 and 0.85 among men. Among women, ties with friend or neighbors had a stronger effect on health compared to their male counterparts with a hazard ratio of 0.89. The fact that social ties with friends or neighbors are associated with a lower risk of functional decline, independent of family support, serves to underscore the importance of promoting social ties, especially among those lacking family ties.


Aging , Family , Friends , Residence Characteristics , Social Support , Aged , Asia , Female , Follow-Up Studies , Health Status , Humans , Male , Middle Aged , Proportional Hazards Models , Risk
15.
Nihon Koshu Eisei Zasshi ; 62(10): 596-608, 2015.
Article Ja | MEDLINE | ID: mdl-26607919

OBJECTIVES: Promoting social and leisure activity participation in older adults could be effective in preventing their health decline. However, gender or regional differences in those activities remain unclear despite the necessity of gender- or region-specific approaches to their promotion. This study examined gender and urban-rural differences in going-out, social, and leisure activities among community-dwelling older adults. METHODS: Data were obtained from the Japan Gerontological Evaluation Study (JAGES). Those analyzed were 103,621 people aged 65 or older who were functionally independent and lived in one of 31 municipalities. A total of seven activity variables were assessed with weekly going out, engagement in paid work, monthly and any frequency of engagement in group activities, monthly and any frequency of contact with friends, and having hobbies. We additionally assessed the contents of the group activities and hobbies. Gender, age groups (young-old: 65-74; old-old: 75 and over), and region groups, which were categorized as rural, urban, or metropolitan, were assessed along with education, depression, and other covariates. A chi-square test and multivariate logistic regression analysis were conducted to examine the age group-stratified differences in the going-out, social, and leisure activities among gender and region groups (P<.01). RESULTS: Multivariate logistic regression analysis showed that men were more likely to engage in weekly going out, paid work, and hobbies but less likely to engage in group activities and contact with friends, either monthly or at any frequency. Most activities were also found to differ significantly among the region groups. For instance, people in metropolitan areas were 2.3 times more likely to engage in weekly going out but were 0.4 (old-old group) or 0.5 times (young-old group) less likely to engage in contact with friends. Percentages of engagement in hobby- or sport-groups were over 20% in all gender and region groups; on the other hand, about 30% differences were found in the percentages of engagement in senior clubs or neighborhood associations between metropolitan and rural men. As for having hobbies, walking/jogging and gardening were popular across all gender and region groups, while the percentages of engagement in a variety of hobbies differed among gender and region groups. CONCLUSION: Our findings suggest 1) differences in the levels of social and leisure activities among gender and region groups and 2) both similarities and differences in the popular group activities or hobbies among gender and region groups. Activity promotion for older adults should be targeted considering these gender and region group characteristics.


Interpersonal Relations , Leisure Activities , Social Behavior , Aged , Female , Humans , Japan , Logistic Models , Male , Sex Factors
16.
Int J Environ Res Public Health ; 12(2): 1745-72, 2015 Feb 03.
Article En | MEDLINE | ID: mdl-25654774

The purpose of this study is to investigate healthcare access disparity that will cause delayed and unmet healthcare needs for the elderly, and to examine health inequality and healthcare cost burden for the elderly. To produce clear policy applications, this study adapts a modified PRECEDE-PROCEED model for framing theoretical and experimental approaches. Data were collected from a large collection of the Community Tracking Study Household Survey 2003-2004 of the USA. Reliability and construct validity are examined for internal consistency and estimation of disparity and inequality are analyzed by using probit/ols regressions. The results show that predisposing factors (e.g., attitude, beliefs, and perception by socio-demographic differences) are negatively associated with delayed healthcare. A 10% increase in enabling factors (e.g., availability of health insurance coverage, and usual sources of healthcare providers) are significantly associated with a 1% increase in healthcare financing factors. In addition, information through a socio-economic network and support system has a 5% impact on an access disparity. Income, health status, and health inequality are exogenously determined. Designing and implementing easy healthcare accessibility (healthcare system) and healthcare financing methods, and developing a socio-economic support network (including public health information) are essential in reducing delayed healthcare and health inequality.


Health Services Accessibility/statistics & numerical data , Health Services for the Aged/statistics & numerical data , Health Status Disparities , Healthcare Disparities/statistics & numerical data , Age Factors , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Health Care Surveys , Health Services Accessibility/economics , Health Services for the Aged/economics , Healthcare Disparities/economics , Humans , Male , Medicaid , Medicare , Needs Assessment , Reproducibility of Results , Socioeconomic Factors , United States
17.
Ind Health ; 51(5): 490-500, 2013.
Article En | MEDLINE | ID: mdl-23912205

Problem drinking is a serious public health problem in the workplace. However, few Japanese epidemiological studies have investigated the occupational characteristics of problem drinking. The purpose of this study is to clarify the occupational risk factors for problem drinking among a Japanese working population. We used data from a random-sampling survey about mental health and suicide, conducted among Hamamatsu City residents aged 15 to 79 yr old during May and June in 2008. The relation between occupational factors and problem drinking was analyzed with multiple logistic regression models stratified by gender. CAGE questionnaire was used to assess problem drinking. With regard to employment types, problem drinkers were more prevalent among self-employed women. With regard to occupational types, clerical and service professions had more problem drinkers of either sex, while administrative/managerial and sales professions had more women with such problem. With regard to company size, male problem drinkers were more prevalent in smaller companies than in larger ones. These results indicate that the prevalence of problem drinkers in the workplace depends on where one works. It is necessary to consider these characteristics to provide effective measures to address problem drinking in the workplace.


Alcoholism/epidemiology , Employment/statistics & numerical data , Occupations/statistics & numerical data , Adolescent , Adult , Aged , Female , Humans , Income/statistics & numerical data , Japan/epidemiology , Male , Middle Aged , Prevalence , Risk Factors , Sex Factors , Small Business/statistics & numerical data , Time Factors , Young Adult
18.
J Epidemiol ; 23(2): 132-8, 2013.
Article En | MEDLINE | ID: mdl-23419282

BACKGROUND: Diet is a modifiable factor that may affect sleep, but the associations of macronutrient intakes with insomnia are inconsistent. We investigated the associations of protein, fat, and carbohydrate intakes with insomnia symptoms. METHODS: In this cross-sectional analysis of 4435 non-shift workers, macronutrient intakes were assessed by the brief-type self-administered diet history questionnaire, which requires the recall of usual intakes of 58 foods during the preceding month. Presence of insomnia symptoms, including difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and poor quality of sleep (PQS) were self-reported. Logistic regression analysis was used to estimate odds ratios (ORs) and 95% CIs adjusted for demographic, psychological, and behavioral factors, as well as medical histories. RESULTS: Low protein intake (<16% vs ≥16% of total energy) was associated with DIS (OR 1.24, 95% CI 0.99-1.56) and PQS (OR 1.24, 95% CI 1.04-1.48), while high protein intake (≥19% vs <19% of total energy) was associated with DMS (OR 1.40, 95% CI 1.12-1.76). Low carbohydrate intake (<50% vs ≥50% of total energy) was associated with DMS (OR 1.19, 95% CI 0.97-1.45). CONCLUSIONS: Protein and carbohydrate intakes in the daily diet were associated with insomnia symptoms. The causality of these associations remains to be explained.


Diet/statistics & numerical data , Dietary Carbohydrates/adverse effects , Dietary Fats/adverse effects , Dietary Proteins/adverse effects , Energy Intake , Sleep Initiation and Maintenance Disorders/etiology , Adult , Cross-Sectional Studies , Diet Surveys , Dietary Carbohydrates/administration & dosage , Dietary Fats/administration & dosage , Dietary Proteins/administration & dosage , Employment/statistics & numerical data , Female , Humans , Japan/epidemiology , Male , Middle Aged , Risk Factors , Self Report , Sleep Initiation and Maintenance Disorders/epidemiology
19.
Disaster Med Public Health Prep ; 7(1): 55-64, 2013 Feb.
Article En | MEDLINE | ID: mdl-24618138

OBJECTIVE: Fatalities and injuries during an earthquake can be reduced by taking preemptive measures before-hand, and furniture anchoring is an important safety measure for all residents. This study sought to clarify the factors associated with furniture anchoring within the home. METHODS: A self-administered mail survey was completed from July to August 2010 by 3500 men and women between the ages of 20 and 69 years who were chosen at random from an official government resident registry of 2 cities in Japan. RESULTS: Of the 1729 valid responses, 37.1% reported furniture anchoring. An association with furniture anchoring was observed for having viewed earthquake intensity maps or damage predictions (odds ratio [OR] 1.92, 95% C1 1.54-2.39), expressing concern about a future earthquake (OR 2.07, 95% C1 1.36-3.15), feelings of urgency (OR 1.90, 95% CI 1.47-2.45), accuracy of the government disaster preparedness information (OR 1.68, 95% CI 1.17-2.42), knowledge of the meaning of emergency earthquake warnings (OR 1.67, 95% CI 1.12-2.48), and participation in voluntary disaster preparedness activities (OR 1.40, 95% C1 1.12-1.75). CONCLUSIONS: Furniture anchoring was found to be associated with risk awareness, risk perception, disaster preparedness information provided by government to residents, knowledge of earthquakes, participation in voluntary disaster preparedness activities, nonwooden structures, and marital status. An increase in furniture anchoring is important and can be achieved through education and training in daily life.


Disaster Planning , Earthquakes , Harm Reduction , Interior Design and Furnishings , Wounds and Injuries/prevention & control , Adult , Aged , Female , Humans , Japan , Male , Middle Aged , Risk Assessment , Surveys and Questionnaires
20.
Article En | MEDLINE | ID: mdl-23250842

Objective:  Fatalities and injuries during an earthquake can be reduced by taking preemptive measures beforehand, and furniture anchoring is an important safety measure for all residents. This study sought to clarify the factors associated with furniture anchoring within the home. Methods:  A self-administered mail survey was completed from July to August 2010 by 3500 men and women between the ages of 20 and 69 years who were chosen at random from an official government resident registry of 2 cities in Japan. Results:  Of the 1729 valid responses, 37.1% reported furniture anchoring. An association with furniture anchoring was observed for having viewed earthquake intensity maps or damage predictions (odds ratio [OR] 1.92, 95% CI 1.54-2.39), expressing concern about a future earthquake (OR 2.07, 95% CI 1.36-3.15), feelings of urgency (OR 1.90, 95% CI 1.47-2.45), accuracy of the government disaster preparedness information (OR 1.68, 95% CI 1.17-2.42), knowledge of the meaning of emergency earthquake warnings (OR 1.67, 95% CI 1.12-2.48), and participation in voluntary disaster preparedness activities (OR 1.40, 95% CI 1.12-1.75). Conclusions:  Furniture anchoring was found to be associated with risk awareness, risk perception, disaster preparedness information provided by government to residents, knowledge of earthquakes, participation in voluntary disaster preparedness activities, nonwooden structures, and marital status. An increase in furniture anchoring is important and can be achieved through education and training in daily life.

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