Oral Status and Dementia Onset: Mediation of Nutritional and Social Factors

Some modifiable risk factors for dementia are closely related to oral health. Although eating and speaking abilities are fundamental oral functions, limited studies have focused on the effect of malnutrition and lack of social interaction between oral health and dementia. We investigated the mediating effects of nutritional and social factors on the association between the number of teeth and the incidence of dementia. This 6-y cohort study used data from the Japan Gerontological Evaluation Study targeting older adults aged 65 y and above. The number of teeth (exposure) and covariates in 2010 (baseline survey), mediators (weight loss, vegetable and fruit intake, homeboundness, social network) in 2013, and the onset of dementia (outcome) between 2013 and 2016 were obtained. The Karlson-Holm-Breen mediation method was applied. A total of 35,744 participants were included (54.0% women). The mean age at baseline was 73.1 ± 5.5 y for men and 73.2 ± 5.5 y for women. A total of 1,776 participants (5.0%) had dementia during the follow-up period. There was a significant total effect of the number of teeth on the onset of dementia (hazard ratio, 1.14; 95% CI, 1.01-1.28). Controlling for nutritional and social mediators, the effect of the number of teeth was reduced to 1.10 (95% CI, 0.98-1.25), leaving an indirect effect of 1.03 (95% CI, 1.02-1.04). In the sex-stratified analysis, the proportion mediated by weight loss was 6.35% for men and 4.07% for women. The proportions mediated by vegetable and fruit intake and homeboundness were 4.44% and 4.83% for men and 8.45% and 0.93% for women, respectively. Furthermore, the proportion mediated by social networks was 13.79% for men and 4.00% for women. Tooth loss was associated with the onset of dementia. Nutritional and social factors partially mediated this association.

Simulating the impacts of interregional mobility restriction on the spatial spread of COVID-19 in Japan

A spatial susceptible-exposed-infectious-recovered (SEIR) model is developed to analyze the effects of restricting interregional mobility on the spatial spread of the coronavirus disease 2019 (COVID-19) infection in Japan. National and local governments have requested that residents refrain from traveling between prefectures during the state of emergency. However, the extent to which restricting interregional mobility prevents infection expansion is unclear. The spatial SEIR model describes the spatial spread pattern of COVID-19 infection when people commute or travel to a prefecture in the daytime and return to their residential prefecture at night. It is assumed that people are exposed to an infection risk during their daytime activities. The spatial spread of COVID-19 infection is simulated by integrating interregional mobility data. According to the simulation results, interregional mobility restrictions can prevent the geographical expansion of the infection. On the other hand, in urban prefectures with many infectious individuals, residents are exposed to higher infection risk when their interregional mobility is restricted. The simulation results also show that interregional mobility restrictions play a limited role in reducing the total number of infected individuals in Japan, suggesting that other non-pharmaceutical interventions should be implemented to reduce the epidemic size.

Establishment of an Adult Medaka Fatty Liver Model by Administration of a Gubra-Amylin-Nonalcoholic Steatohepatitis Diet Containing High Levels of Palmitic Acid and Fructose

Among lifestyle-related diseases, fatty liver is the most common liver disease. To date, mammalian models have been used to develop methods for inhibiting fatty liver progression; however, new, more efficient models are expected. This study investigated the creation of a new model to produce fatty liver more efficiently than the high-fat diet medaka model that has been used to date. We compared the GAN (Gubra-Amylin nonalcoholic steatohepatitis) diet, which has been used in recent years to induce fatty liver in mice, and the high-fat diet (HFD). Following administration of the diets for three months, enlarged livers and pronounced fat accumulation was noted. The GAN group had large fat vacuoles and lesions, including ballooning, compared to the HFD group. The GAN group had a higher incidence of lesions. When fenofibrate was administered to the fatty liver model created via GAN administration and liver steatosis was assessed, a reduction in liver fat deposition was observed, and this model was shown to be useful in drug evaluations involving fatty liver. The medaka fatty liver model administered with GAN will be useful in future fatty liver research.

Impact of various intensities and frequencies of non-occupational physical activity on the risk of dementia among physically independent older adults: the Japan Gerontological Evaluation Study

OBJECTIVES

The aim of this study was to investigate the association between different intensities and frequencies of non-occupational physical activity (PA) and the risk of dementia among Japanese older adults.

STUDY DESIGN

This was a prospective cohort study.

METHODS

A total of 2194 participants aged ≥65 years from the Japan Gerontological Evaluation Study were followed up between 2010 and 2016. The standardised dementia scale of the long-term care insurance system was used to identify incident dementia, whereas non-occupational PA (<2 or ≥2 times/week on each intensity: light, moderate and vigorous) was assessed using a questionnaire. Cox regression was used to compute the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident dementia.

RESULTS

After adjustment for sociodemographic and medical characteristics, the following frequencies and intensities of non-occupational PA, compared with no non-occupational PA at all, were associated with a reduced risk of dementia: light PA ≥2 times/week (HR = 0.61, 95% CI: 0.38-0.97), moderate PA <2 times/week (HR = 0.46, 95% CI: 0.28-0.76), moderate PA ≥2 times/week (HR = 0.57, 95% CI: 0.36-0.91), vigorous PA <2 times/week (HR = 0.40, 95% CI: 0.21-0.74) and vigorous PA ≥2 times/week (HR = 0.29, 95% CI: 0.15-0.57). In the sex-specific analysis, moderate PA <2 times/week and vigorous PA ≥2 times/week were associated with a reduced risk of dementia in men, whereas light and moderate PA ≥2 times/week and all frequencies of vigorous PA were associated with a reduced risk of dementia in women.

CONCLUSIONS

Practicing non-occupational PA was associated with a reduced risk of dementia among Japanese older adults.

Past infections are associated with low levels of anti-citrullinated protein autoantibodies in rheumatoid arthritis

Background : Rheumatoid arthritis (RA), an autoimmune disease of unknown etiology, is believed to occur as the result of actions of genetic and environmental factors. In this study, we examined the relation of past histories about infectious diseases with the levels anti-citrullinated protein autoantibodies (ACPA) in RA. Methods : Results of a questionnaire about histories of infectious diseases were obtained from 85 patients with RA, and were analyzed. Results : Significantly lower level of ACPA was detected in patients with the history of tonsillitis, otitis media or urinary cystitis than in those without it. There was no difference in the level of ACPA in RA patients between with and without cold / influenza, rubella, chickenpox, herpes labialis or herpes zoster. When RA patients were divided into two groups, high-level and low-level ACPA, multiple logistic regression analysis revealed that the history of otitis media was a significantly independent factor for the low level of ACPA. There was no significant relation between the level of rheumatoid factor and histories of infectious diseases. Conclusion : This study clarified that the past history of otitis media is associated with the low level of ACPA in RA. J. Med. Invest. 67 : 182-188, February, 2020.

High Jc and low anisotropy of hydrogen doped NdFeAsO superconducting thin film

The recent realisations of hydrogen doped LnFeAsO (Ln = Nd and Sm) superconducting epitaxial thin films call for further investigation of their structural and electrical transport properties. Here, we report on the microstructure of a NdFeAs(O,H) epitaxial thin film and its temperature, field, and orientation dependencies of the resistivity and the critical current density Jc. The superconducting transition temperature Tc is comparable to NdFeAs(O,F). Transmission electron microscopy investigation supported that hydrogen is homogenously substituted for oxygen. A high self-field Jc of over 10 MA/cm2 was recorded at 5 K, which is likely to be caused by a short London penetration depth. The anisotropic Ginzburg-Landau scaling for the angle dependence of Jc yielded temperature-dependent scaling parameters γJ that decreased from 1.6 at 30 K to 1.3 at 5 K. This is opposite to the behaviour of NdFeAs(O,F). Additionally, γJ of NdFeAs(O,H) is smaller than that of NdFeAs(O,F). Our results indicate that heavily electron doping by means of hydrogen substitution for oxygen in LnFeAsO is highly beneficial for achieving high Jc with low anisotropy without compromising Tc, which is favourable for high-field magnet applications.

ACE2, TMPRSS2, and Furin expression in the nose and olfactory bulb in mice and humans

No abstract available.

Greenspace and depression in Japanese Older Adults considering physical activities: JAGES study

Introduction

Older adult's depression is a public health problem. In recent years, exposure to local greenspace is beneficial to mental health via increased physical activity in people. However, few studies approach the relationship between greenspace and depression while simultaneously considering the frequency, time, and the number of types of physical activity, and large-scale surveys targeting the older adults.

Methods

Cross-sectional data conducted in 2016 by the Japan Gerontological Evaluation Study was used. The analysis included older adults aged 65 and over who did not require care or assistance, and a total of 126,878 people in 881 School districts. The explanatory variable is the percentage of the greenspace of the area, and the greenspace data used is data created from satellite photographs acquired by observation satellites of the Japan Aerospace Exploration Agency. The objective variable was depression (Geriatric Depression Scale 5 points or more). The analysis method was a multi-level logistic regression analysis. Physical activity was the number of sports-related hobbies, the frequency of participation in sports meetings, and walking time in daily life. Other factors such as personal attributes, population density of residential areas, and local climate were also considered.

Results

Depression in the survey was 20.4%. The abundance of greenspace was still associated with depression, considering all physical activity. The odds ratio of depression in areas with more greenspace was 0.92 (95% CI 0.87 - 0.98) compared to areas with less greenspace.

Conclusions

It became clear that areas with many greenspace were still associated with low depression, even considering the frequency, time and number of physical activities. It is conceivable that the healing effect of seeing greenspace, the reduction of air pollution and noise, etc. are related to the lack of depression without going through physical activity.

Key messages

In Japan, older adults are less depressed when there are many local greenspace. It became clear that areas with many greenspace were still associated with low depression, even considering physical activities.

Detection of the Metastable Ice Phase during Water Crystallization

BACKGROUND

Under atmospheric pressure, the identifiable phases of ice crystals are hexagonal (stable) and cubic (metastable).

OBJECTIVE

This study aimed to test the hypothesis that water crystallizes into the cubic phase at the beginning and then changes to the hexagonal phase.

MATERIALS AND METHODS

Aqueous solutions of 40% (w/w) and 50% (w/w) glucose, and 40% (w/w) ammonium hydrogen sulfate, as well as emulsified water, were investigated.

RESULTS

The cubic-to-hexagonal ice phase transition was detected in 40% (w/w) glucose solution within a 1 s integration interval, whereas the cubic ice formed in 50% (w/w) glucose solution did not transition to the hexagonal phase. The cubic phase was also confirmed in the 40% (w/w) ammonium hydrogen sulfate solution, but not in emulsified water.

CONCLUSION

The cubic-to-hexagonal ice phase transition was detected in three aqueous solutions tested upon freezing. It was not possible to clearly capture the transition process in emulsified water under the study condition.

Elder abuse and depressive symptoms: Which is cause and effect? Bidirectional longitudinal studies

Background

Elder abuse is a serious public health concern that increases the risks of negative health outcomes globally. It is well known that abuse in older adults is associated with depression; however, longitudinal studies investigating the causal relationship between these events are scarce. Because the cause precedes the result over time, the temporal relationships between abuse and depression should be verified from each direction. This longitudinal study therefore investigated and clarified whether depression causes or results from elder abuse among older Japanese adults.

Methods

Two longitudinal analyses were conducted using data derived from the Japan Gerontological Evaluation Study. The data were collected in 2010 and 2013 through a mail survey of 1737 people (983 females, 754 males) across Japan.

Results

Of those who did not experience abuse in 2010, 38 (5.0%) males and 53 (5.4%) females newly experienced abuse in 2013. Among respondents who did not have depressive symptoms in 2010, 60 (8.0%) males and 61 (6.2%) females newly reported depressive symptoms in 2013. After adjusting for demographic factors in analysis 1, people who experienced abuse were 2.28-fold (95% confidence interval [CI] = 1.68-3.09) more likely to have depressive symptoms 3 years later than those who were not abused. In analysis 2, respondents who had mild or severe depression in 2010 were 2.23-fold (95% CI = 1.61-3.10) more likely to have experienced abuse after 3 years than those who did not have depression.

Conclusions

After adjusting for several demographic factors, the results showed that abuse can lead to depression and that depression can be a cause of abuse. Therefore, preventing abuse should be considered from both directions.

Key messages

Elder abuse could be a cause for depressive symptoms. Depressive symptoms could be a cause of elder abuse.

Association between accessibility to elementary school and depression in older Adults: JAGES Study

Background

The connection in a local community has diluted in an aging society, and the importance of intergenerational exchange has increased for older adults' health. Some positive effects of intergenerational exchange have reported. For example, a reciprocal intergenerational exchange contributes to better mental health in later life. However, there is little evidence of the relationship between neighborhood environments causing intergenerational exchange and the health status of older adults. This study investigated the association between geographical accessibility to elementary school, enhancing intergenerational exchange, and depression in older adults.

Methods

The data were retrieved from the Japan Gerontological Evaluation Study (JAGES) 2016, a population-based study of independently living people ≥65 years old. The dependent variable is depression evaluated by the Geriatric Depression Scale (GDS≥5). The geographical accessibility to elementary School is the distance between the representative points of their residences and the nearest elementary school. Logistic regression analysis calculates the odds ratio to determine the association between depression and accessibility to elementary school and compare models to examine the effect of intermediate factors.

Results

Overall, 20.4% of the participants had depression. Compared with the longest distance from elementary school (≥950m), the odds ratio was 0.91 (95% CI = 0.86, 0.96) for the nearest category (&lt;330m), 0.91 (95% CI = 0.87, 0.96) for the second-nearest (330-490m) and 0.94 (95% CI = 0.89, 0.99) for the third (490-670m) in model 1. After adjusting for intermediate factors, the odds ratio was 0.94 for the first and second-nearest groups.

Conclusions

Geographical accessibility to elementary school was associated with decreased depression for older adults. The result indicates that older adults' daily meetings with children around elementary schools can result in a positive effect on their mental health.

Key messages

Geographical accessibility to elementary school was associated with decreased depression for older adults. The neighborhood design enhancing intergenerational exchange might be useful for age-friendly cities.

Effect of Copayment on Dental Visits: A Regression Discontinuity Analysis

Despite their prevalence and burdens, oral diseases are neglected in universal health coverage. In Japan, a 30% copayment (out of pocket) by the user and a 70% contribution by Japan’s universal health insurance (JUHI) are required for dental and medical services. From the age of 70 y, an additional 10% is offered by JUHI (copayment, 20%; JUHI, 80%). This study aimed to investigate the effect of cost on dental service use among older adults under the current JUHI system. A regression discontinuity quasi-experimental method was used to investigate the causal effect of the JUHI discount policy on dental visits based on cross-sectional data. Data were derived from the 2016 Japan Gerontological Evaluation Study. This analysis contained 7,161 participants who used JUHI, were aged 68 to 73 y, and responded to questions regarding past dental visits. Analyses were controlled for age, sex, number of teeth, and equalized household income. Mean ± SD age was 72.1 ± 0.79 y for the discount-eligible group and 68.9 ± 0.78 y for the noneligible group. During the past 12 mo, significantly more discount-eligible participants had visited dental services than noneligible participants (66.0% vs. 62.1% for treatment visits, 57.7% vs. 53.1% for checkups). After controlling for covariates, the effect of discount eligibility was significant on dental treatment visits (odds ratio [OR], 1.36; 95% CI, 1.32 to 1.40) and dental checkups (OR, 1.49; 95% CI, 1.44 to 1.54) in the regression discontinuity analysis. Similar findings were observed in triangular kernel-weighted models (OR, 1.38 [95% CI, 1.34 to 1.44]; OR, 1.52 [95% CI, 1.47 to 1.56], respectively). JUHI copayment discount policy increases oral health service utilization among older Japanese. The price elasticity for dental checkup visits appears to be higher than for dental treatment visits. Hence, reforming the universal health coverage system to improve the affordability of relatively inexpensive preventive care could increase dental service utilization in Japan.

Effect of Small Focus on Electron Heating and Proton Acceleration in Ultrarelativistic Laser-Solid Interactions

Acceleration of particles from the interaction of ultraintense laser pulses up to 5×10^{21}  W cm^{-2} with thin foils is investigated experimentally. The electron beam parameters varied with decreasing spot size, not just laser intensity, resulting in reduced temperatures and divergence. In particular, the temperature saturated due to insufficient acceleration length in the tightly focused spot. These dependencies affected the sheath-accelerated protons, which showed poorer spot-size scaling than widely used scaling laws. It is therefore shown that maximizing laser intensity by using very small foci has reducing returns for some applications.

Commissioning of high current H+/D+ ion beams for the prototype accelerator of the International Fusion Materials Irradiation Facility

The Linear IFMIF (International Fusion Materials Irradiation Facility) Prototype Accelerator (LIPAc) is aiming at demonstrating the low energy section of a 40 MeV/125 mA IFMIF deuteron accelerator up to 9 MeV with a full beam current in cw operation. For such a high-power beam, the LIPAc injector is required to produce a 100 keV D⁺ beam with 140 mA and match it for injection into the Radio Frequency Quadrupole (RFQ) accelerator. The injector is designed by CEA-Saclay based on the high intensity light ion source (SILHI). In 2019, the commissioning of the RFQ to demonstrate the D⁺ beam acceleration at a low duty cycle (0.1%) was conducted. A nominal beam current of 125 mA D⁺ beam was accelerated up to 5 MeV through the RFQ successfully. The LIPAc injector fully satisfied the requirements for RFQ beam commissioning at the pulse mode.

Development of a dynamic blood vessel phantom for evaluation of moving images

In coronary angiography (CAG) and percutaneous coronary intervention (PCI), it is important for radiological technologists to optimize the balance between radiation dose and image quality for physicians to be able to perform CAG and PCI most effectively. Evaluation of image processing is necessary to ensure that technologists can optimally adjust image quality for clinical use to the extent that physicians require. However, few phantoms are available for evaluating fluoroscopic image processing, and this makes it necessary to adjust image quality in clinical settings while utilizing the image processing according to the manufacturer’s recommendations. In this study, we developed a dynamic phantom that mimics a pulsating coronary artery for use in image quality analysis of moving images. We also examined whether processed images (image lag) can be physically analyzed. Two issues require special attention in creating a new phantom: establishing the exact position of the simulated blood vessel in the phantom, and providing good reproducibility. The study used the rotational motion of a disk to generate images, with a circular simulated blood vessel on the rotating acrylic disk, with the center of the simulated blood vessel shifted from the center of the acrylic disk. This enabled the reproduction of translational motion of the simulated blood vessel. As a result, because this phantom has signals and afterimages at the same position (of a simulated blood vessel), a quantitative evaluation of the afterimages became possible. In the evaluation of the image processing with the angiograph, it was shown that evaluations of image lag which are typically performed in clinical settings can be performed with the dynamic blood vessel phantom.

Direct comparison of dithienosilole and dithienogermole as π-conjugated linkers in photosensitizers for dye-sensitized solar cells

Dithienosilole (DTS) and dithienogermole (DTG) are useful building units of π-conjugated organic materials. In the present work, donor-π-acceptor (D-π-A) dyes with bis(dihexyloxyphenyl)aminophenyl, DTS or DTG, and pyridine or cyanoacrylic acid as the donor (D), the π-conjugated linker (π), and the acceptor (A) units, respectively, were prepared and their optical properties were investigated. The D-π-A dyes exhibited strong absorption in the visible region, indicating efficient intramolecular donor-acceptor interaction. The addition of trifluoroacetic acid to solutions of pyridine-containing dyes led to red-shifts of the absorption bands as a result of pyridinium salt formation. Similar red-shifts were observed for cyanoacrylic acid dyes, which were due to the enhanced formation of neutral dyes relative to the separated ion pairs. The D-π-A dyes, however, showed similar absorption spectra when attached to the TiO2 surface, indicating that the dye-TiO2 electronic interaction was rather weak. In contrast to the finding that these dyes exhibited similar optical properties regardless of the π-linker (i.e., DTS or DTG), dye-sensitized solar cells (DSSCs) based on DTG-containing dyes exhibited superior performance compared to those based on DTS-containing dyes. Electrochemical impedance spectroscopy measurements supported the higher performance of the DSSCs with DTG-containing dyes.

Medical costs associated with childhood maltreatment history among Japanese older people

Background

Childhood maltreatment can have a significant impact on health across the life course, but its impact on health care costs in later life is unknown in Japan. This study aims to assess additional medical costs of Japanese older people with childhood maltreatment history.

Methods

Data from the Japan Gerontological Evaluation Study (JAGES) 2013, a population-based cohort of independent people aged 65 years or older across Japan were used and linked uniquely with the database of health insurance claims for residents of a city with more than 1.5 million citizens, aged 75 years or younger (N = 978). Average annual medical costs for April 2012 and March 2013 and April 2013 and March 2014 were calculated and compared between those who experienced childhood maltreatment and those who did not, using generalized linear models.

Results

4.5% of our sample witnessed their father physically abusing their mother, 1.9% were physically abused, 10.6% were emotionally neglected, and 5.7% were emotionally abused in their childhood. Average medical costs of those with any childhood maltreatment (N = 176, 18.0% of the sample) were significantly higher than those without maltreatment (549,468JPY vs. 413,013JPY (1USD is equivalent to 110JPY); p = 0.007). When examining the effect of each type of maltreatment, average costs of those with emotional neglect were higher than the counterpart (573,481JPY vs. 412,082JPY; p = 0.008). Average costs of those who experienced physical abuse were also higher than those who did not (726,254JPY vs 431,106JPY; p = 0.035). The effect of any childhood maltreatment remained statistically significant after older adults’ age and gender were controlled (p = 0.03).

Conclusions

Our findings suggest that childhood maltreatment is strongly associated with additional medical costs among older Japanese. If it was truly causal, it can be estimated that additional medical costs associated with childhood maltreatment can be more than 333 billion JPY per year nationwide.

Key messages

Average annual medical costs of older adults with any childhood maltreatment history were significantly 116,098 JPY greater than those with no maltreatment history. As for each type of childhood maltreatment, emotional neglect tends to increase medical costs in late adulthood.