1
|
Inomata S, Lu Y, Matsuyama S, Murakami Y, Tsuji I. Association between education and disability-free life expectancy among Japanese older people: The Ohsaki Cohort 2006 study. Arch Gerontol Geriatr 2024; 125:105466. [PMID: 38749086 DOI: 10.1016/j.archger.2024.105466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/28/2024] [Accepted: 04/29/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Higher education level is associated with longer disability-free life expectancy (DFLE). However, evidence is scarce regarding factors that can contribute to eliminating inequality in DFLE according to education level. This study aimed to clarify the association between education and DFLE and estimate whether DFLE in people with lower education may increase to the same level as that in people with higher education through social participation. METHODS We analyzed data from 13,849 Japanese people aged 65 years and older who participated in a 13-year prospective study. At baseline, we collected information on education levels (low, middle, or high) and social participation. DFLE was defined as the average duration people expect to live without disability. To calculate DFLE for each education level group, the multistate life table method was employed using a Markov model. RESULTS At the age of 65 years, DFLE (95 % confidence interval [CI]) in women with low education was 21.3 years (20.8-21.8) without social participation and 24.3 (23.8-24.9) with social participation. In the middle education group, DFLE was 22.1 (21.6-22.6) without social participation and 25.0 (24.6-25.5) with social participation. In the high education group, DFLE was 22.1 (21.5-22.8) without social participation and 25.5 (25.0-26.0) with social participation. Similar results were found for men. CONCLUSIONS DFLE in people with low or middle education with social participation was almost the same as that in those with high education with social participation, suggesting the possibility that disparities in DFLE by education level could be offset by promoting social participation in older adults.
Collapse
Affiliation(s)
- Shiori Inomata
- Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yukai Lu
- Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sanae Matsuyama
- Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshitaka Murakami
- Department of Medical Statistics, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan.
| |
Collapse
|
2
|
Chan JKN, Correll CU, Wong CSM, Chu RST, Fung VSC, Wong GHS, Lei JHC, Chang WC. Life expectancy and years of potential life lost in people with mental disorders: a systematic review and meta-analysis. EClinicalMedicine 2023; 65:102294. [PMID: 37965432 PMCID: PMC10641487 DOI: 10.1016/j.eclinm.2023.102294] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 11/16/2023] Open
Abstract
Background Mental disorders are associated with premature mortality. There is increasing research examining life expectancy and years-of-potential-life-lost (YPLL) to quantify the disease impact on survival in people with mental disorders. We aimed to systematically synthesize studies to estimate life expectancy and YPLL in people with any and specific mental disorders across a broad spectrum of diagnoses. Methods In this systematic review and meta-analysis, we searched Embase, MEDLINE, PsychINFO, WOS from inception to July 31, 2023, for published studies reporting life expectancy and/or YPLL for mental disorders. Criteria for study inclusion were: patients of all ages with any mental disorders; reported data on life expectancy and/or YPLL of a mental-disorder cohort relative to the general population or a comparison group without mental disorders; and cohort studies. We excluded non-cohort studies, publications containing non-peer-reviewed data or those restricted to population subgroups. Survival estimates, i.e., life expectancy and YPLL, were pooled (based on summary data extracted from the included studies) using random-effects models. Subgroup analyses and random-effects meta-regression analyses were performed to explore sources of heterogeneity. Risk-of-bias assessment was evaluated using the Newcastle-Ottawa Scale. This study is registered with PROSPERO (CRD42022321190). Findings Of 35,865 studies identified in our research, 109 studies from 24 countries or regions including 12,171,909 patients with mental disorders were eligible for analysis (54 for life expectancy and 109 for YPLL). Pooled life expectancy for mental disorders was 63.85 years (95% CI 62.63-65.06; I2 = 100.0%), and pooled YPLL was 14.66 years (95% CI 13.88-15.98; I2 = 100.0%). Disorder-stratified analyses revealed that substance-use disorders had the shortest life expectancy (57.07 years [95% CI 54.47-59.67]), while neurotic disorders had the longest lifespan (69.51 years [95% CI 67.26-71.76]). Substance-use disorders exhibited the greatest YPLL (20.38 years [95% CI 18.65-22.11]), followed by eating disorders (16.64 years [95% CI 7.45-25.82]), schizophrenia-spectrum disorders (15.37 years [95% CI 14.18-16.55]), and personality disorders (15.35 years [95% CI 12.80-17.89]). YPLLs attributable to natural and unnatural deaths in mental disorders were 4.38 years (95% CI 3.15-5.61) and 8.11 years (95% CI 6.10-10.13; suicide: 8.31 years [95% CI 6.43-10.19]), respectively. Stratified analyses by study period suggested that the longevity gap persisted over time. Significant cross-study heterogeneity was observed. Interpretation Mental disorders are associated with substantially reduced life expectancy, which is transdiagnostic in nature, encompassing a wide range of diagnoses. Implementation of comprehensive and multilevel intervention approaches is urgently needed to rectify lifespan inequalities for people with mental disorders. Funding None.
Collapse
Affiliation(s)
- Joe Kwun Nam Chan
- LKS Faculty of Medicine, Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - Christoph U. Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Child and Adolescent Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Corine Sau Man Wong
- LKS Faculty of Medicine, School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Ryan Sai Ting Chu
- LKS Faculty of Medicine, Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - Vivian Shi Cheng Fung
- LKS Faculty of Medicine, Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - Gabbie Hou Sem Wong
- LKS Faculty of Medicine, Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - Janet Hiu Ching Lei
- LKS Faculty of Medicine, Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - Wing Chung Chang
- LKS Faculty of Medicine, Department of Psychiatry, The University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
3
|
Effect of social participation on the association between frailty and disability. Arch Gerontol Geriatr 2023; 110:104989. [PMID: 36905805 DOI: 10.1016/j.archger.2023.104989] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/27/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVES To examine whether social participation affects the association between frailty and disability. METHODS A baseline survey conducted from December 1 to 15, 2006, included 11,992 participants who were classified based on the Kihon Checklist into three categories and based on the number of activities in which they socially participated into four categories. The study outcome, incident functional disability, was defined as in Long-Term Care Insurance certification. A Cox proportional hazards model was used to calculate hazard ratios (HRs) for incident functional disability according to frailty and social participation categories. Combination analysis was performed between the nine groups using the above-mentioned Cox proportional hazards model. RESULTS During the 13-year follow-up (107,170 person-years), 5,732 incident cases of functional disability were certified. Compared with the robust group, the other groups had significantly higher incident functional disability. However, the HRs for those participating in social activities were lower than that for those not participating in any activity [1.52 (pre-frail + none group); 1.31 (pre-frail + one activity group); 1.42 (pre-frail + two activities group); 1.37 (pre-frail + three activities group); 2.35 (frail + none group); 1.87 (frail + one activity group); 1.85 (frail + two activities group); and 1.71 (frail + three activities group)]. CONCLUSIONS The risk of functional disability for those participating in social activities was lower than that for those not participating in any activity, irrespective of being pre-frail or frail. Comprehensive social systems for disability prevention need to focus on social participation in frail older adults.
Collapse
|
4
|
Yamato M, Matsuyama S, Murakami Y, Aida J, Lu Y, Sugawara Y, Tsuji I. Association between the number of remaining teeth and disability-free life expectancy, and the impact of oral self-care in older Japanese adults: a prospective cohort study. BMC Geriatr 2022; 22:820. [PMID: 36280835 PMCID: PMC9590145 DOI: 10.1186/s12877-022-03541-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/13/2022] [Indexed: 11/24/2022] Open
Abstract
Background Tooth loss has been reportedly associated with shorter disability-free life expectancy (DFLE). However, no study has explored whether oral self-care offsets reduction in DFLE. The present study aimed to assess the association between oral self-care and DFLE in older individuals with tooth loss. Methods Data on the 13-year follow-up from a cohort study of 14,206 older Japanese adults aged ≥ 65 years in 2006 were analyzed. Information on the number of remaining teeth was collected using a questionnaire, and the participants were then categorized into three groups (0–9, 10–19, and ≥ 20 teeth). Additionally, “0–9” and “10–19” groups were divided into two subgroups based on whether they practiced oral self-care. DFLE was defined as the average number of years a person could expect to live without disability, and was calculated by the multistate life table method based on a Markov model. Results DFLE (95% confidence interval) was 19.0 years (18.7–19.4) for 0–9 teeth, 20.1 (19.7–20.5) for 10–19 teeth, and 21.6 (21.2–21.9) for ≥ 20 teeth for men. For women, DFLE was 22.6 (22.3–22.9), 23.5 (23.1–23.8), and 24.7 (24.3–25.1), respectively. Practicing oral self-care was associated with longer DFLE, by 1.6–1.9 years with brushing ≥ 2 times a day in people with 0–9 and 10–19 teeth, and by 3.0–3.1 years with the use of dentures in those with 0–9 teeth. Conclusions Practicing oral self-care is associated with an increase in DFLE in older people with tooth loss. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03541-2.
Collapse
Affiliation(s)
- Maya Yamato
- grid.69566.3a0000 0001 2248 6943Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Sanae Matsuyama
- grid.69566.3a0000 0001 2248 6943Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Yoshitaka Murakami
- grid.265050.40000 0000 9290 9879Department of Medical Statistics, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Jun Aida
- grid.265073.50000 0001 1014 9130Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yukai Lu
- grid.69566.3a0000 0001 2248 6943Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Yumi Sugawara
- grid.69566.3a0000 0001 2248 6943Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Ichiro Tsuji
- grid.69566.3a0000 0001 2248 6943Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| |
Collapse
|
5
|
Du M, Dai W, Liu J, Tao J. Less Social Participation Is Associated With a Higher Risk of Depressive Symptoms Among Chinese Older Adults: A Community-Based Longitudinal Prospective Cohort Study. Front Public Health 2022; 10:781771. [PMID: 35223728 PMCID: PMC8863664 DOI: 10.3389/fpubh.2022.781771] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE We aimed to examine the association between social participation and depressive symptoms among Chinese older people aged 65 years or above to supplement limited studies in China on this topic. METHODS This community-based longitudinal prospective cohort study used the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, baseline in 2014 and a follow-up in 2018). Depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale. Social participation was assessed using a composite index by considering the frequency for the two types of social activity: organized social activities and informal activities. Pearson's χ2 test was used to correlate the characteristics of participants with social participation or depressive symptoms. Log-binomial regression models were used to assess the association between social participation and the risk of depressive symptoms. RESULTS The incidence of depressive symptoms was 28.8% among 2,200 participants in 2018 after a 4-year follow-up. Participants with no social participation (32.6%), organized social activities (30.6%), or informal social activities (31.2%) were more likely to have depressive symptoms. After the adjustment of demographic factors, socioeconomic status, lifestyle habits, and health status, in comparison with older people who often engaged in social participation, organized social activities, and informal social activities, the risk of depressive symptoms was 45% [adjusted risk ratio (aRR): 1.45, 95% CI: 1.16-1.82], 42% (aRR: 1.45, 95% CI: 1.02-2.00), and 29% (aRR: 1.29, 95% CI: 1.02-1.99) higher among older people with no social participation and who never engaged in organized social activities and informal social activities, respectively. CONCLUSIONS This study showed that the lack of social participation, including organized social activities and informal social activities, was associated with a higher risk of depressive symptoms after 4 years among older adults in China. Our findings shed lights into the feasibility of promoting social participation to reduce the risk of depressive symptoms and promote longevity and healthy aging among older adults.
Collapse
Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wanwei Dai
- Peking University Third Hospital, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Institute for Global Health and Development, Peking University, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| |
Collapse
|