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BACKGROUND: In-person religious service attendance has been linked to favorable health and well-being outcomes. However, little research has examined whether online religious participation improves these outcomes, especially when in-person attendance is suspended. METHODS: Using longitudinal data of 8951 UK adults, this study prospectively examined the association between frequency of online religious participation during the stringent lockdown in the UK (23 March -13 May 2020) and 21 indicators of psychological well-being, social well-being, pro-social/altruistic behaviors, psychological distress, and health behaviors. All analyses adjusted for baseline socio-demographic characteristics, pre-pandemic in-person religious service attendance, and prior values of the outcome variables whenever data were available. Bonferroni correction was used to correct for multiple testing. RESULTS: Individuals with online religious participation of ≥1/week (v. those with no participation at all) during the lockdown had a lower prevalence of thoughts of self-harm in week 20 (odds ratio 0.24; 95% CI 0.09-0.62). Online religious participation of <1/week (v. no participation) was associated with higher life satisfaction (standardized ß = 0.25; 0.11-0.39) and happiness (standardized ß = 0.25; 0.08-0.42). However, there was little evidence for the associations between online religious participation and all other outcomes (e.g. depressive symptoms and anxiety). CONCLUSIONS: There was evidence that online religious participation during the lockdown was associated with some subsequent health and well-being outcomes. Future studies should examine mechanisms underlying the inconsistent results for online v. in-person religious service attendance and also use data from non-pandemic situations.
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COVID-19 , Humanos , Adulto , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Ansiedade/epidemiologia , Reino UnidoRESUMO
OBJECTIVE: Living a happy life is an essential issue for old adults. However, how eating with others contributes to happiness and whether this association is different by living arrangements or not is unknown. The current study examined the relationship between the frequency of eating with others and happiness among older adults according to their living arrangements using 3-year longitudinal data. METHODS: The analyzed sample comprised 18,727 people (10,920 males and 7807 females) with low happiness (0-7 points on score of 0-10 points) from Japan Gerontological Evaluation Study (JAGES) in 2016. Our exposure was the frequency of eating with others: rarely, a few times a year, a few times a month, and a few times a week or more. We performed Modified Poisson Regression to examine the association between the frequency of eating with others and high happiness (8-10 points) in 2019 stratified by living arrangement (living alone/with others). RESULTS: A total of 4352 (23.2%) people showed high happiness in 2019. After adjusting for age, sex, marital status, education, household income, social participation, illnesses under treatment, and depressive symptoms in 2016, the cumulative incidence ratio (CIR) for high happiness in 2019 among people living alone was more significant, that is, 1.28 (95% confidence intervals: 0.88-1.87), 1.50 (1.05-2.14), and 1.82 (1.26-2.63), than 1.28 (1.11-1.48), 1.30 (1.12-1.50), and 1.33 (1.16-1.52) among people living with others for those who ate with others a few times a year, a few times a month, and a few times a week or more compared to those who rarely ate with others, respectively. The interaction between the frequency of eating with others and living arrangements was statistically significant. The trend test showed that higher frequency of eating with others was significantly associated with high happiness. CONCLUSIONS: Eating with others was associated with improved happiness among older adults, with such an association being stronger among people living alone.
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Felicidade , Ambiente Domiciliar , Masculino , Feminino , Humanos , Idoso , Estudos Longitudinais , Japão/epidemiologia , Participação SocialRESUMO
BACKGROUND: Although remote communication technologies have been widely used to maintain connections with others against interpersonal contact restrictions and exacerbated loneliness during the COVID-19 pandemic, it is unclear whether and what types of remote communication technologies are effective in mitigating loneliness. OBJECTIVE: This study aimed to investigate the association between remote communication and loneliness when face-to-face meetings with others were strongly prohibited and whether this association varied across types of communication tools, age, and gender. METHODS: We used cross-sectional data from the Japan COVID-19 and Society Internet Survey conducted from August to September 2020. From registered panelists of the research agency, 28,000 randomly sampled participants completed the survey on the website. We created 2 study cohorts who stopped meeting with family members living apart and friends during the pandemic. We categorized whether participants had technology-based remote communication (voice calling, text messaging, and video calling) with family and friends. Loneliness was assessed using the 3-item University of California, Los Angeles Loneliness Scale. We used a modified Poisson regression model to investigate the association between loneliness and remote communication with family members living apart or friends. We also conducted subgroup analyses based on age and gender. RESULTS: A total of 4483 participants stopped meeting with family members living apart, and 6783 participants stopped meeting with friends during the COVID-19 pandemic. Remote communication with family members living apart did not show an association with loneliness, whereas remote communication with friends was associated with a low prevalence of loneliness (family: adjusted prevalence ratio [aPR]=0.89, 95% CI 0.74-1.08; P=.24 and friends: aPR=0.82, 95% CI 0.73-0.91; P<.001). From analyses by tools, voice calling was associated with low loneliness (family: aPR=0.88, 95% CI 0.78-0.98; P=.03 and friends: aPR=0.87, 95% CI 0.80-0.95; P=.003). Similarly, text messaging was associated with low loneliness (family: aPR=0.82, 95% CI 0.69-0.97; P=.02 and friends: aPR=0.81, 95% CI 0.73-0.89; P<.001). However, we did not find an association between video calling and loneliness (family: aPR=0.88, 95% CI 0.75-1.02; P=.09 and friends: aPR=0.94, 95% CI 0.85-1.04; P=.25). Text messaging with friends was associated with low loneliness regardless of age, whereas voice calling with family or friends was associated with low loneliness only among participants aged ≥65 years. An association between remote communication with friends and low loneliness was found regardless of the type of remote communication tool among men, whereas it was found only for text messaging with friends among women. CONCLUSIONS: In this cross-sectional study of adults in Japan, remote communication, especially via voice calling and text messaging, was associated with low loneliness. Promoting remote communication may reduce loneliness when face-to-face contact is restricted, which should be the subject of future research.
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COVID-19 , Pandemias , Adulto , Masculino , Feminino , Humanos , Idoso , Estudos Transversais , COVID-19/epidemiologia , Solidão , ComunicaçãoRESUMO
ObjectiveãMutsuzawa town, Chiba Prefecture, relocated a "health-supportive" roadside station in 2019. The underlying hypothesis is that older people who use the roadside station will have better self-rated health than those who do not use it. We aimed to verify whether roadside station use was associated with a decrease in poor self-rated health.MethodãThis was a longitudinal study that compared and evaluated the roadside station use and non-use groups using three-wave panel data before and after relocation of the roadside station in September 2019. To obtain three-wave panel data, self-administered questionnaires were mailed three times: in July 2018 (FY 2018) before the station was relocated and in November 2020 (FY 2020) and January 2022 (FY 2021) after the relocation in 2019. The dependent variable was poor self-rated health in FY 2021, and the independent variable was use of the roadside station as of FY 2020. Covariates included basic characteristics from FY 2018, as well as going out, social participation, and interacting on social networks in FY 2018 and FY 2020. A multivariate analysis was conducted using multiple imputation to complete missing values for the Crude model, which included the basic attributes of FY 2018 (Model 1); going out, social participation, and interacting on social networks in FY 2018 (Model 2); and going out, social participation, and interacting on social networks in FY 2020 (Model 3). The cumulative incidence rate ratio (CIRR), 95% confidence intervals, and P-values were calculated using a modified Poisson regression analysis for each model.ResultsãOf the 576 participants, 344 (59.8%) were roadside station users. The multivariate analysis adjusted for basic attributes revealed that the number of people with poor self-rated health in the user group was significantly lower than that in the non-user group, with a CIRR of 0.67 (95% confidence interval: 0.45-0.99, P=0.043). However, the adjusted model showed a CIRR of 0.71 (95% confidence interval: 0.48-1.06, P=0.096) for going out, social participation, and interacting on social networks in FY2020 after the roadside station opened.ConclusionãFindings of this study revealed that, after adjusting for confounding factors prior to relocation of the roadside station, the number of people with poor self-rated health decreased in the user group. Thus, such commercial facilities as roadside stations, which give users an opportunity to go out and meet people, can provide a "naturally healthy" environment.
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Participação Social , Humanos , Idoso , Estudos Longitudinais , Inquéritos e QuestionáriosRESUMO
ObjectiveãIn Japan, measures to prevent frailty among older adults have been implemented. Promotion of social participation is a key measure, but few longitudinal studies have examined the relationship between the types and number of social participation and frailty onset. In this study, we aimed to clarify the relationship between the types and number of social participation and frailty onset using longitudinal data from a large sample of older adults in municipalities in Japan.MethodsãWe used the 2016 and 2019 panel survey data from the Japan Gerontological Evaluation Study (JAGES). The analysis included 59,545 individuals from 28 municipalities who responded to the JAGES survey in both 2016 (at baseline) and 2019 (at follow-up). We excluded individuals who were dependent on activities of daily living at baseline and non-responders, and those who were frail or with no information about frailty. The dependent variable was frailty onset (≥8 out of 25 points on the basic checklist) at follow-up, and the independent variables were the types and number of types of social participation at baseline. We included 11 variables as potential confounders. We used multiple imputations to complete the missing values and used modified Poisson regression to examine the association between social participation and risk of frailty onset.ResultsãOf the 59,545 participants, 6,431 (10.8%) were frail onset at follow-up. After multiple imputations (minimum 64,212, maximum 64,287), the risk of frailty onset at follow-up was lower for eight types of social participation, excluding senior citizens' clubs, (nursing care [risk ratio; 0.91], paid work [0.90], volunteer groups [0.87], neighborhood associations [0.87], learning or cultural groups [0.87], activities intended to teach skills or pass experiences to others [0.85], hobby groups [0.81], and sports groups or clubs [0.80]; P<0.05), than no social participation. Additionally, individuals who participated in more types of social participation were at a lower risk of frailty than those with no social participation (P for trend <0.001).ConclusionsãThe risk of frailty onset was lower among individuals who participated in eight types of social participation at baseline and among those who participated in more types of social participation than those with no social participation. The results suggest that social participation is a useful measure to prevent frailty for extending healthy life expectancy.
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Fragilidade , Participação Social , Humanos , Idoso , Atividades Cotidianas , Fragilidade/epidemiologia , Estudos Longitudinais , JapãoRESUMO
General health checks to detect cardiovascular risk factors form part of routine health care in many countries. Cardiovascular disease and dementia share a number of risk factors; however it remains unclear whether general health checks can reduce the incidence of dementia. We used longitudinal data from the Japan Gerontological Evaluation Study with up to 6.4 years follow-up (from 2010 to 2016). A total of 31,012 disability-free adults aged 65-74 were included. The outcome variable was dementia onset certified under the national long-term care insurance system. The treatment variable was defined as having health checks within the past 12 months prior to the baseline survey in 2010. After multiple imputation, we performed propensity score matching (PSM) to exclude off-support individuals who were the least likely to have health checks. We also performed inverse probability treatment weighting (IPTW) to estimate the effect of the treatment if everyone within the population was compliant to health checks. The hazard ratios for dementia onset among those reporting health checks within the previous year was 0.89 (95% confidence interval (CI): 0.78, 1.02) in the PSM analysis and 0.84 (95% CI: 0.75, 0.95) in the IPTW analysis. We then estimated the effect of health checks on 5-year incident dementia. The 5-year cumulative incidence difference based on the PSM analysis was -0.0046 (95%CI: -0.0101, 0.0009), while that based on the IPTW analysis was -0.0046 (95%CI, -0.0090, -0.0002). The PSM and IPTW approaches yielded similar findings that the incidence of dementia was lower among people having health checks.
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Demência , Vida Independente , Idoso , Demência/diagnóstico , Demência/epidemiologia , Seguimentos , Humanos , Incidência , Japão/epidemiologiaRESUMO
OBJECTIVES: Widowhood is associated with increased risks of depression in the surviving spouse. We examined whether an increase in individual-level social capital mitigates the adverse impact of widowhood on depressive symptoms. METHODS: We used data from the 2013/2016 waves of the Japan Gerontological Evaluation Study of functionally independent adults aged 65 years or older (men: n = 20,853; women: n =16,858). Fixed-effects regression was applied to examine the potential buffering effects of changes in social capital on changes in depressive symptoms following widowhood among married people living with their spouse and/or others at baseline. RESULTS: Widowhood had a deleterious impact on depressive symptoms particularly among men who ended up living alone following their spouse's death. Fixed-effects models revealed that an increase in informal socializing and social participation might buffer the effects of spousal bereavement on depressive symptoms among men who became widowed during the first two years of follow-up and ended up living alone. DISCUSSION: An increase in structural social capital may mitigate the impact of spousal bereavement on depressive symptoms. However, the associations vary by gender, living arrangement, and time since widowhood. Intensive efforts should be directed toward connecting the vulnerable group, widowed men living alone, to sources of social capital.
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Luto , Capital Social , Viuvez , Depressão/epidemiologia , Feminino , Humanos , Masculino , CônjugesRESUMO
We investigated age-related change in the contribution of stroke volume (SV) to central PP (cPP). Eighty seven adult subjects who were free of vasoactive agents were included. Subjects were divided into three age groups: young (20-39 years, n = 26), middle (40-49 years, n = 29), and old (≥50 years, n = 32). SV was calculated by Doppler echocardiography. Hemodynamic indices were measured using a brachial cuff-based oscillometric method. The brachial and cPP showed a small decline from the young group to the middle group and a greater rise after 50 years old. SV significantly and positively correlated with brachial (r = 0.53, p < 0.01) and cPP (r = 0.57, p < 0.01) in the young group. In the middle group, the association of SV with brachial pulse pressure was significant (r = 0.38, p = 0.04) and that with cPP was bordering significant (r = 0.34, p = 0.07). No significant association was found between SV and PP in the old group. In conclusion, the contribution of SV to cPP decreases with age. Age-related changes in the determinants of cPP should be considered when investigating the clinical value of cPP.
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Pressão Sanguínea , Volume Sistólico , Adulto , Fatores Etários , Ecocardiografia Doppler , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
The aim of this study was to investigate the association of aortic pulsatility assessed by a non-invasive brachial cuff-based method with coronary atherosclerosis. In total, 139 patients undergoing coronary angiography were included in this cross-sectional study. Aortic blood pressure (BP) indices were recorded invasively by a fluid-filled catheter and non-invasively by a brachial cuff-based oscillometric device. Fractional pulse pressure (FPP) was defined as pulse pressure (PP)/mean BP and pulsatility index (PI) as PP/diastolic BP. Aortic FPP and PI in coronary artery disease (CAD) patients were significantly higher than in non-CAD patients in both invasive and non-invasive methods. Multivariate logistic regression analysis demonstrated that non-invasively measured aortic FPP and PI were associated with CAD risk in patients aged ≥70 years [aortic FPP per 0.1 odds ratio (OR) = 1.66, 95% confidence interval (CI) 1.05-2.64; aortic PI per 0.1 OR =1.39, 95% CI 1.02-1.88; all p < 0.05], but were not associated with CAD risk in patients aged <70 years. In linear regression analysis, non-invasively measured aortic FPP and PI correlated with SYNTAX and Gensini scores only in patients aged ≥70 years. Aortic FPP and PI measured non-invasively by a brachial cuff-based oscillometric device were associated with coronary atherosclerosis in elderly patients.
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Doença da Artéria Coronariana , Hipertensão , Idoso , Aorta , Pressão Sanguínea , Angiografia Coronária , Estudos Transversais , HumanosRESUMO
Importance: There are limited data on whether the vulnerabilities and impacts of social isolation vary across populations. Objective: To explore the association between social isolation and mortality due to all causes, cardiovascular diseases (CVD), and malignant neoplasms focusing on heterogeneity by sociodemographic factors. Design, Setting, and Participants: This cohort study used a moderator-wide approach to examine the heterogeneity in the association of social isolation with all-cause, CVD, and malignant neoplasm mortality using baseline data from the Japan Gerontological Evaluation Study in 2010 and 2011. Eligible participants were adults aged 65 years or older without heart disease, stroke, cancer, or impaired activity of daily living across 12 Japanese municipalities. Follow-up continued until December 31, 2017, identifying 6-year all-cause, cardiovascular disease (CVD), and malignant neoplasm mortality. Logistic regression assessed effect modification by age, gender, education, income, population density, marital status, and employment on mortality associations. Data analysis was performed from September 13, 2023, to March 17, 2024. Exposure: Social isolation, determined by a 3-item scale (scores of 2 or 3 indicating isolation) was the primary exposure variable. Main Outcomes and Measures: Six-year all-cause, CVD, and malignant neoplasms mortality. Results: This study included 37â¯604 older adults, with a mean (SD) age of 73.5 (5.9) years (21â¯073 women [56.0%]). A total of 10â¯094 participants (26.8%) were classified as experiencing social isolation. Social isolation was associated with increased all-cause (odds ratio [OR], 1.20 [95% CI, 1.09-1.32]), CVD (OR, 1.22 [95% CI, 0.98-1.52]), and malignant neoplasm mortality (OR, 1.14 [95% CI, 1.01-1.28]). Stratified analysis showed associations of social isolation with all-cause and malignant neoplasm mortality among people with high income (highest tertile all cause: OR, 1.27 [95% CI, 1.06-1.53]; malignant neoplasm: OR, 1.27 [95% CI, 1.02-1.60]), living in areas with high population density (highest tertile all cause: OR, 1.47 [95% CI, 1.26-1.72]; malignant neoplasm: OR, 1.38 [95% CI, 1.11-1.70]), not married (all cause: OR, 1.33 [95% CI, 1.15-1.53]; malignant neoplasm: OR, 1.25 [95% CI, 1.02-1.52]), and retirees (all cause: OR, 1.27 [95% CI, 1.14-1.43]; malignant neoplasm: OR, 1.27 [95% CI, 1.10-1.48]). Formal testing for effect modification indicated modification by population density and employment for all-cause mortality and by household income and employment for neoplasm mortality. Conclusions and Relevance: Social isolation was associated with increased risks of all-cause, CVD, and malignant neoplasm mortality, with associations varying across populations. This study fills an important gap in research on social isolation, emphasizing its varied associations across demographic and socioeconomic groups.
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Doenças Cardiovasculares , Neoplasias , Isolamento Social , Humanos , Isolamento Social/psicologia , Feminino , Masculino , Idoso , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/psicologia , Neoplasias/mortalidade , Neoplasias/psicologia , Japão/epidemiologia , Idoso de 80 Anos ou mais , Estudos de Coortes , Causas de Morte , Fatores Sociodemográficos , Mortalidade , Fatores SocioeconômicosRESUMO
Despite the acknowledged relationship between the usual (preferred) walking speed (UWS) and health, there is currently no practical method available to reliably and accurately detect slight changes in UWS. This study aimed to explore whether either of the following two phenomena occurs during continuous daily walking in various periods: (a) Similarity between the most frequent cadences in the two periods. (b) The occurrence of the most frequent cadence in at least one of the two periods during the other period, with a frequency close to that of the most frequent cadence. In August 2021, invitations to participate in the study were extended via email to participants that took part in the Japan COVID-19 and Society Internet Surveys (JACSIS). A mobile phone application that collected step data during continuous walking was provided to the participants, and data were collected from December 1, 2021, to January 31, 2022. While 1022 participants installed the phone application, only 505 had measurement data for ten days or more in each of the two months of the study duration. The cadence during continuous walking was automatically measured daily from 05:00 to 21:00. Most participants exhibited at least one of the phenomena mentioned above, confirming a common, notably frequent, invariant cadence over time. Overall, this method allows for the identification of minor reductions and lower bounds of decline in UWS. This study illustrates the potential for tracking a decreasing trend in UWS. Early detection of a downward trend permits individuals to take timely remedial action, as recovery is relatively easy, and the confirmation of even a slight recovery bolsters recovery motivation.
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Internet use influences social interactions in society. However, there is no consensus on whether and what kind of Internet use increases face-to-face communication (FFC). This study investigated the mode of Internet use that increases FFC among older adults after three years. Participants were 8734 adults aged 65 or older who responded to the Japan Gerontological Evaluation Study (JAGES) surveys in 2016 and 2019. The exposures were the purposes of Internet use in 2016. The outcome was the frequency of FFC with friends or acquaintances in 2019. The confounders included 13 demographic, socioeconomic, and psychological variables. We performed modified Poisson regression analyses and found that Internet use for communication in 2016 increased FFC in 2019, especially for low-frequency FFC in 2016. Internet-based non-FFC may help promote FFC and prevent social isolation among older adults who are less likely to interact with others.
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There is inconsistent evidence on the association between community-level social capital and the health or well-being of older adults. This study examined the association between community-level social capital and multidimensional health and well-being outcomes using an outcome-wide approach. We used data from the Japan Gerontological Evaluation Study, a nationwide cohort study of Japanese older adults (analytic samples: 47,227 for outcomes obtained from the long-term care insurance registry and 34,183 for other outcomes). We assessed three aspects of school-district-level community social capital in 2016 (civic participation, social cohesion, and reciprocity) and 41 subsequent health and well-being outcomes through 2019. We performed either a modified multilevel Poisson regression or a multilevel logistic regression analysis. We adjusted for pre-baseline characteristics, prior outcome values, and individual-level social capital from the 2013 wave. Even after Bonferroni correction, we found that community-level social capital was associated with some subsequent social well-being and physical/cognitive health. For example, community-level reciprocity was associated with a higher prevalence of taking a social role (Prevalence ratio [PR] = 1.03, 95% confidence interval [CI] = 1.02, 1.04) and undergoing health screening (PR = 1.03, 95% CI: 1.01, 1.04). There was modest evidence that community-level civic participation was associated with a higher competency of intellectual activity (PR = 1.01, 95% CI: 1.01, 1.02) and community-level social cohesion was associated with a reduced onset of functional disability (PR = 0.94, 95% CI: 0.90, 0.98). Community-level social capital may promote social well-being and some physical/cognitive health outcomes.
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BACKGROUND: Prior studies have underscored the importance of studying volunteering in the East Asian context. However, no study has conducted a holistic assessment of the relationship between volunteering and the multidimensional health and well-being outcomes of East Asian populations using a strong study design for causal inference. To address this gap, this study examined the associations between volunteer group participation and the subsequent health and well-being of Japanese older adults. METHODS: Three waves of data (2013, 2016, and 2019), obtained from the Japan Gerontological Evaluation Study-a nationwide cohort study of physically and cognitively independent older adults, aged ≥ 65 years, in Japan-were utilized. Exposure was evaluated as the frequency of volunteer group participation: ≥ 1/week, 1 - 3 times a month, a few times a year, and none (2016). As outcomes, 40 indicators of health and well-being were assessed across seven domains (2019): physical/cognitive health, health behaviors, mental health, subjective well-being, social well-being, pro-social/altruistic behaviors, and cognitive social capital. We included 47,318 respondents for four outcomes (death, dementia, and functional disability [any level and level 2 or greater]) and 34,187 respondents for the 36 other outcomes. RESULTS: More frequent volunteering (≥ 1/week) was associated with higher social well-being outcomes, more frequent pro-social/altruistic behaviors and outings, and fewer depressive symptoms, even after considering multiple testing. CONCLUSION: Throughout the three-year follow-ups, volunteer group participation was beneficial for depressive symptoms, social well-being, and other proximal outcomes.
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Evidence of video call on preventing late-life depression during the COVID-19 pandemic is limited. We examined the associations of social contact (in-person, voice call, and video call) with incidence of depressive symptoms and evaluated whether specific factors (particularly, age and change in the frequency of in-person contact) affect these associations. We used longitudinal data from the 2019 and 2020 waves of the Japan Gerontological Evaluation Study, including 10,523 participants aged ≥65 years in 10 municipalities. Depressive symptoms were measured by the 15-item Geriatric Depression Scale (GDS-15) score ≥5 in main analysis, and GDS-15 score ≥4, 10, or continuous variable in sensitivity analyses. Social contact represented frequency changes before and during the pandemic: non-contact (reference), decreased-contact, maintained-contact, and increased-contact. We employed modified Poisson regression analysis. Compared to non-contact of video call, the association of increased-contact of video call with depressive symptoms was insignificant in main analysis (GDS-15 ≥ 5: risk ratio (RR) = 0.89, 95% confidence interval (CI): 0.79-1.01), whereas significant in sensitivity analyses (GDS-15 ≥ 4: RR = 0.89, 95% CI: 0.82-0.98; GDS-15 ≥ 10: RR = 0.71, 95% CI: 0.53-0.97; GDS-15 = continuous variable: Β = -0.17, 95% CI: -0.33 to -0.002). In-person contact was significantly associated with lower incidence of depressive symptoms (non-contact: reference; maintained-contact: RR = 0.92, 95% CI: 0.85-0.99; increased-contact: RR = 0.84, 95% CI: 0.77-0.91), whereas voice call was not. Age and change in the frequency of in-person contact did not show significant effect modifications on the associations of video call with incidence of depressive symptoms after Bonferroni correction for multiple testing. In conclusion, this study suggests that the evidence supporting video call as a way to protect against depressive symptoms among older adults during the pandemic appears weak compared to the evidence for in-person contact.
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COVID-19 , Humanos , Idoso , COVID-19/epidemiologia , Estudos Longitudinais , Pandemias , Japão/epidemiologia , Depressão/etiologia , Depressão/complicaçõesRESUMO
BACKGROUND: Social isolation has become a serious public health issue. However, most previous studies examine the relationship between social isolation and a single outcome. We aimed to conduct holistic assessments to understand the multidimensional impacts of social isolation on health and well-being. METHODS: We used the three-wave data (2013, 2016, and 2019) obtained from the Japan Gerontological Evaluation Study. Our exposure, obtained from the 2016 survey, was the Social Isolation Index (SII) comprising five components: no partner, poor interaction with children, poor interaction with relatives, poor interaction with friends, and no social participation). We assessed 36 health and well-being outcomes across six dimensions obtained from the 2019 survey: physical/cognitive health, health behaviours, mental health, subjective well-being, social isolation, and cognitive social capital. Pre-exposure characteristics and prior outcome levels in 2013 were adjusted. We included 47,318 respondents for 4 outcomes (death, dementia, and functional disability) and 34,187 respondents for 32 other outcomes. The Bonferroni correction was used to correct for multiple tests. RESULTS: The total SII scores were associated with a wide range of health and well-being outcomes across the six dimensions. Specifically, we found a robust association between an SII score of four or greater with mortality (Odds ratio: 1.89; 95% CI: 1.46-2.43). Among the five components of the SII, poor interaction with friends and no social participation showed robust associations with a wide range of health and well-being. We also found some robust evidence regarding effect modification by gender and age in the associations between the components of the SII and health and well-being. CONCLUSIONS: Social isolation, specifically social interaction with friends and social participation, may affect a wide range of health and well-being among older adults.
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Isolamento Social , Participação Social , Criança , Humanos , Idoso , Isolamento Social/psicologia , Saúde Mental , Inquéritos e Questionários , Amigos/psicologia , Estudos LongitudinaisRESUMO
OBJECTIVES: Poor medication adherence among older adults is a global concern as it causes adverse drug interactions and inappropriate dosing. This study aimed to assess the association between family pharmacy and medication adherence among older adults. METHODS: The Japan Gerontological Evaluation Study was a cross-sectional study of 18,792 people aged ≥65 years living in 61 municipalities in 25 prefectures who participated in a survey conducted in 2019 and did not require long-term care. Self-reported questionnaires were administered to evaluate whether the participants "always received medicines from the same pharmacy" and whether they had unused medicines. Modified Poisson regression was used to examine the association after adjusting for confounders. RESULTS: Unused medicines were present in 89.9% of the "have group" (individuals who always received their medicines from the same pharmacy). This group had a lower prevalence of unused medicines (prevalence ratio [PR] = 0.87, 95% confidence interval [CI]: 0.82-0.92) than the "none group" (individuals who did not always receive their medicines from the same pharmacy). In the stratified analysis by education level, the prevalence of unused medicines was lower among those with low levels of education (≤9 years: PR = 0.82, 95% CI: 0.71-0.96; 10-12 years: PR = 0.81, 95% CI: 0.74-0.88). DISCUSSION: Older adults who "always received medicines from the same pharmacy" had a lower prevalence of unused medicines, especially those with low levels of education. Thus, "always receiving medicines from the same pharmacy" may be effective in reducing the proportion of unused medicines and improving medication adherence.
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Farmácia , Humanos , Idoso , Estudos Transversais , Japão , Inquéritos e Questionários , Adesão à MedicaçãoRESUMO
BACKGROUND: Individual-level social capital prevents cognitive decline. However, a few studies have focused on the effects of community-level social capital on dementia. Therefore, we investigated the association between community-level social capital and dementia onset based on longitudinal study data on older adults in Japan. METHODS: We used longitudinal data from the Japan Gerontological Evaluation Study, obtained over nine years (2010-2019). In total, 35,921 physically and cognitively independent individuals (16,848 males and 19,073 females) aged ≥65 years and nested within 308 communities in seven municipalities participated in the study. Dementia onset was assessed using the public long-term care insurance registration. Social capital was assessed using three dimensions: civic participation, social cohesion, and reciprocity. We performed a two-level multilevel survival analysis stratified by sex, calculated hazard ratios (HRs), and 95% confidence intervals (CIs). RESULTS: During the follow-up, 6245 (17.4%) dementia onset cases were identified. The cumulative incidence of dementia was 16.2% in males and 18.4% in females. After adjusting for covariates, individual-level civic participation was associated with a lower incidence of dementia in both males and females (HR, 0.84; 95% CI, 0.77-0.92; HR, 0.78; 95% CI, 0.73-0.84). Community-level civic participation and social cohesion were associated with a lower incidence of dementia among females (HR, 0.96; 95% CI, 0.93-0.99; HR, 0.93; 95% CI, 0.88-0.98) and cross-level interaction on social cohesion among females (HR, 0.95; 95% CI, 0.90-0.99). CONCLUSIONS: Living in a community with high civic participation and social cohesion is associated with a lower incidence of dementia among older females. Therefore, promoting civic participation and social cohesion in the community may be a useful population-based strategy to delay or prevent the onset of dementia.
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Demência , Capital Social , Masculino , Feminino , Humanos , Idoso , Relações Interpessoais , Participação Social/psicologia , Estudos Longitudinais , Japão/epidemiologia , Demência/epidemiologiaRESUMO
PURPOSE: A growing body of evidence suggests that oral health is associated with a wide range of health outcomes; however, opinions tend to vary because of inconsistent findings. This study aimed to simultaneously examine the association between oral health status and multiple health and well-being indicators using outcome-wide epidemiology. METHODS: Data were obtained from the Japan Gerontological Evaluation Study. Oral health status was categorized as: ≥20 teeth, 10-19 teeth with dental prosthesis, 0-9 teeth with prosthesis, 10-19 teeth without prosthesis, and 0-9 teeth without prosthesis. We examined the associations between oral health status in 2013 and 35 health and well-being outcomes in 2019, including physical/cognitive health, psychological distress, subjective health, social well-being, prosocial/altruistic behaviors, and health behaviors, using two databases (n=32,827 and 15,905). RESULTS: Compared to individuals with ≥20 teeth, those with <20 teeth had a 10-33% higher risk of mortality and a 7-10% higher risk of functional disability six years later. Additionally, individuals with fewer than 20 teeth tended to go out less frequently and eat fewer vegetables and fruits. Furthermore, individuals with 0-9 teeth without a prosthesis were more likely to have severe functional disability (risk ratio (RR):1.17, 95% confidence interval (CI):1.05-1.31), engage in fewer intellectual activities (standardized difference: 0.17, 95% CI: 0.10-0.24), and feel more hopeless (RR: 1.21, 95% CI: 1.04-1.41). CONCLUSIONS: The prevention of tooth loss and prosthodontic treatment may be associated with reduced mortality and functional disability, as well as maintenance of intellectual ability, frequency of going out, and improvements in dietary lifestyle.
RESUMO
The effect of prehospital factors on favorable neurological outcomes remains unclear in patients with witnessed out-of-hospital cardiac arrest (OHCA) and a shockable rhythm. We developed a decision tree model for these patients by using prehospital factors. Using a nationwide OHCA registry database between 2005 and 2020, we retrospectively analyzed a cohort of 1,930,273 patients, of whom 86,495 with witnessed OHCA and an initial shockable rhythm were included. The primary endpoint was defined as favorable neurological survival (cerebral performance category score of 1 or 2 at 1 month). A decision tree model was developed from randomly selected 77,845 patients (development cohort) and validated in 8650 patients (validation cohort). In the development cohort, the presence of prehospital return of spontaneous circulation was the best predictor of favorable neurological survival, followed by the absence of adrenaline administration and age. The patients were categorized into 9 groups with probabilities of favorable neurological survival ranging from 5.7 to 70.8% (areas under the receiver operating characteristic curve of 0.851 and 0.844 in the development and validation cohorts, respectively). Our model is potentially helpful in stratifying the probability of favorable neurological survival in patients with witnessed OHCA and an initial shockable rhythm.