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Tsuji T, Okada E, Saito M, Kanamori S, Miyaguni Y, Hanazato M, Kondo K, Ojima T. Community-level group sports participation and all-cause, cardiovascular disease, and cancer mortality: a 7-year longitudinal study. Int J Behav Nutr Phys Act 2024; 21:44. [PMID: 38659037 PMCID: PMC11040901 DOI: 10.1186/s12966-024-01592-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 04/05/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Community-level group sports participation is a structural aspect of social capital that can potentially impact individual health in a contextual manner. This study aimed to investigate contextual relationship between the community-level prevalence of group sports participation and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality in older adults. METHODS In this 7-year longitudinal cohort study, data from the Japan Gerontological Evaluation Study, a nationwide survey encompassing 43,088 functionally independent older adults residing in 311 communities, were used. Cause of death data were derived from the Japanese governmental agency, The Ministry of Health, Labour and Welfare, for secondary use. "Participation" was defined as engaging in group sports for one or more days per month. To analyze the data, a two-level survival analysis was employed, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. RESULTS Among the participants, 5,711 (13.3%) deaths were identified, with 1,311 related to CVD and 2,349 to cancer. The average group sports participation rate was 28.3% (range, 10.0-52.7%). After adjusting for individual-level group sports participation and potential confounders, a higher community-level group sports participation rate was found to be significantly associated with a lower risk of both all-cause mortality (HR: 0.89, 95% CI: 0.83-0.95) and cancer mortality (HR: 0.89, 95% CI: 0.81-0.98) for every 10% point increase in the participation rate. For CVD mortality, the association became less significant in the model adjusted for all covariates (HR: 0.94, 95% CI: 0.82-1.09). CONCLUSIONS Our findings support the existence of a preventive relationship between community-level group sports participation and the occurrence of all-cause and cancer mortality among older individuals. Promoting group sports within communities holds promise as an effective population-based strategy for extending life expectancy, regardless of individual participation in these groups.
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Affiliation(s)
- Taishi Tsuji
- Institute of Health and Sport Sciences, University of Tsukuba, 3-29-1 Otsuka, 112-0012, Bunkyo, Tokyo, Japan.
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage Ward, 263-8522, Chiba, Japan.
| | - Eisaku Okada
- Faculty of Social Policy & Administration, Hosei University, 4342, Aihara, 194-0298, Machida, Tokyo, Japan
| | - Masashige Saito
- Department of Social Welfare, Nihon Fukushi University, Okuda, Mihama-cho, 470-3295, Chita-gun, Aichi, Japan
- Center for Well-being and Society, Nihon Fukushi University, 5-22-35 Chiyoda, Naka Ward, 460-0012, Nagoya, Aichi, Japan
| | - Satoru Kanamori
- Teikyo University Graduate School of Public Health, 2-11-1 Kaga, 173-8605, Itabashi, Tokyo, Japan
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, 160-8402, Shinjuku, Tokyo, Japan
| | - Yasuhiro Miyaguni
- Department of Social Welfare, Nihon Fukushi University, Okuda, Mihama-cho, 470-3295, Chita-gun, Aichi, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, 474-8511, Obu, Aichi, Japan
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage Ward, 263-8522, Chiba, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-cho, Inage Ward, 263-8522, Chiba, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, 474-8511, Obu, Aichi, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo Ward, 431-3192, Hamamatsu, Shizuoka, Japan
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Tsuji T, Kanamori S, Watanabe R, Yokoyama M, Miyaguni Y, Saito M, Kondo K. Do changes in the frailty score differ by the type of group sports and exercises participated in? A 3-year longitudinal study. Eur Rev Aging Phys Act 2024; 21:8. [PMID: 38504171 PMCID: PMC10953207 DOI: 10.1186/s11556-024-00342-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 03/14/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Older adults who engage in group sports and exercises achieve greater health benefits than those who exercise by themselves. The benefits of group participation may vary depending on the type of sports/exercise they engage in. The present study aimed to identify the association between specific sports and exercise types performed in groups and evaluate the longitudinal changes in multidimensional frailty scores among community-dwelling older adults in Japan. METHODS We used 3-year follow-up data from the Japan Gerontological Evaluation Study and analyzed 33,746 men and 36,799 women aged ≥ 65 years. To elucidate the relationship between participation in 20 types of group sports/exercises in 2016 (baseline) and the change in frailty score (using the Kihon Checklist, KCL) from 2016 to 2019, we performed linear regression analyses through multivariate adjustments for age group, self-rated health, marital status, living alone, occupational status, years of education, alcohol drinking status, smoking status, equivalent income, and disease status using an inverse probability weighting method. P < 0.05 was considered statistically significant. RESULTS The mean change in KCL scores over 3 years was + 0.62 and + 0.61 points in men and women, respectively, implying the degree of frailty worsened. The sports/exercise types that significantly prevented increments in KCL scores for both sexes compared to non-participants were hiking (men: B, - 0.36; women: B, - 0.29), walking (men: B, - 0.26; women: B, - 0.24), tennis (men: B, - 0.23; women: B, - 0.24), ground golf (men: B, - 0.21; women: B, - 0.19), and weight exercises (men: B, - 0.19; women: B, - 0.16). CONCLUSION Participation in specific sports and exercise groups offer significant physical and psychological benefits for frailty prevention among older adults in Japan. The results of this study may offer substantive evidence to encourage older adults to participate in group activities for the prevention of multidimensional frailty. It will also help public health stakeholders to decide which type of sports and exercise groups to promote in a community.
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Affiliation(s)
- Taishi Tsuji
- Institute of Health and Sport Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo City, Tokyo, 112-0012, Japan.
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-Cho, Inage Ward, Chiba City, Chiba, 263-8522, Japan.
| | - Satoru Kanamori
- Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi City, Tokyo, 173-8605, Japan
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku City, Tokyo, 160-8402, Japan
| | - Ryota Watanabe
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-Cho, Inage Ward, Chiba City, Chiba, 263-8522, Japan
- Center for Well-Being and Society, Nihon Fukushi University, 5-22-35 Chiyoda, Naka Ward, Nagoya City, Aichi, 460-0012, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu City, Aichi, 474-8511, Japan
| | - Meiko Yokoyama
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-Cho, Inage Ward, Chiba City, Chiba, 263-8522, Japan
| | - Yasuhiro Miyaguni
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu City, Aichi, 474-8511, Japan
- Department of Social Welfare, Nihon Fukushi University, Okuda, Mihama-Cho, Aichi, Chita-Gun, 470-3295, Japan
| | - Masashige Saito
- Center for Well-Being and Society, Nihon Fukushi University, 5-22-35 Chiyoda, Naka Ward, Nagoya City, Aichi, 460-0012, Japan
- Department of Social Welfare, Nihon Fukushi University, Okuda, Mihama-Cho, Aichi, Chita-Gun, 470-3295, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoi-Cho, Inage Ward, Chiba City, Chiba, 263-8522, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu City, Aichi, 474-8511, Japan
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Kusama T, Takeuchi K, Kiuchi S, Aida J, Osaka K. Poor oral health and dementia risk under time-varying confounding: A cohort study based on marginal structural models. J Am Geriatr Soc 2024; 72:729-741. [PMID: 38064294 DOI: 10.1111/jgs.18707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/09/2023] [Accepted: 11/09/2023] [Indexed: 03/19/2024]
Abstract
BACKGROUND Bidirectional association between oral health, including tooth loss and oral hypofunction, and cognitive impairment can induce time-varying confounding in association with dementia. This study aimed to investigate the association between oral health and the development of dementia among older adults, considering cognitive impairment as a time-varying confounder. METHODS This nine-year follow-up cohort study targeted independent older adults aged ≥65 years who participated in the Japan Gerontological Evaluation Study. The exposure variables were self-reported poor oral health (≤19 remaining teeth, edentulousness, chewing difficulty, swallowing problems, and xerostomia), which were assessed in 2010 and 2013. The outcome variable was the incidence of dementia between 2013 and 2019, which was obtained from the municipalities' administrative database. Furthermore, in 2010 and 2013, we considered cognitive impairment as a time-varying confounder and treated it based on a marginal structural model (MSM), including possible baseline confounders. Oral health and cognitive impairment were assessed using the items of Kihon checklist. We employed a Cox proportional hazards model with a stabilized inverse probability weight and estimated hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Among 37,556 participants (mean age: 72.8 years [1 SD = 5.5], males: 46.8%), the dementia incidence rate was 2.2/100 person-year. The proportions of those with ≤19 remaining teeth, edentulousness, chewing difficulty, swallowing problems, and xerostomia were 61.3%, 11.0%, 24.4%, 14.7%, and 19.2%, respectively. From the regression analysis based on MSM, ≤19 remaining teeth (HR = 1.12, 95% CI = 1.03-1.23), edentulousness (HR = 1.20, 95% CI = 1.09-1.32), chewing difficulty (HR = 1.11, 95% CI = 1.02-1.21), and xerostomia (HR = 1.10, 95% CI = 1.01-1.20) were significantly associated with an increased risk of dementia; however, swallowing problems were not significantly associated with dementia onset (p > 0.05). CONCLUSIONS Even after considering time-varying confounding by cognitive function at baseline and follow-up, we observed significant associations between poor oral health and increased risk of dementia among older adults.
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Affiliation(s)
- Taro Kusama
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Kenji Takeuchi
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Sakura Kiuchi
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai, Miyagi, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Tokyo, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
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Kusama T, Takeuchi K, Kiuchi S, Tamada Y, Tabuchi T, Osaka K. Tooth loss mediates the association between smoking and an increased risk of dementia among older adults: The JAGES prospective cohort study. J Clin Periodontol 2024. [PMID: 38323671 DOI: 10.1111/jcpe.13959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
AIM Tooth loss has various causes; however, its cause-specific effects on health outcomes remain unclear. This study evaluated whether the association between past/current smoking and risk of dementia was mediated by tooth loss. MATERIALS AND METHODS This 9-year-follow-up prospective cohort study targeted adults aged ≥65 years. Dementia incidence during 2013-2019, smoking status (never, past/current) in 2010 and the number of remaining teeth (≤19, ≥20) in 2013 were the outcome, exposure and mediator, respectively. We used causal mediation analysis to fit the Cox proportional hazards model and estimated the hazard ratio (HR) and 95% confidence interval (CI) of the natural indirect effect (NIE) of smoking on dementia incidence through tooth loss and their mediated proportions. RESULTS Among 32,986 participants (mean age 72.6 years [1 SD = 5.4]; men 48.4%), the dementia incidence during follow-up was 2.11/100 person-years. Tooth loss significantly mediated the association between past/current smoking and dementia incidence; the NIE of fewer remaining teeth for past/current smokers compared to never smokers was HR = 1.03 (95% CI: 1.02-1.05), and the mediated proportion was 18.0%. CONCLUSIONS Tooth loss significantly mediates the association between past/current smoking and an increased risk of dementia among older adults.
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Affiliation(s)
- Taro Kusama
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kenji Takeuchi
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai, Japan
| | - Yudai Tamada
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Kino S, Ueno K, Nishioka D, Kondo N, Aida J. Prevalence of dental visits in older Japanese adults receiving public assistance. Community Dent Oral Epidemiol 2024; 52:68-75. [PMID: 37555616 DOI: 10.1111/cdoe.12902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/25/2023] [Accepted: 07/28/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVES Exemption from paying dental care costs among recipients of public assistance contributes to universal health care coverage. Although this system might reduce the financial barriers to dental care among patients, there are still several other barriers for public assistance recipients. Therefore, this study examined whether receiving public assistance was associated with a higher prevalence of dental visits for any reason, treatment and prevention. METHODS Data were obtained from 16 366 respondents from the 2019 wave of a nationwide cohort study on older adults in Japan. Poisson regression analyses with robust error variance were used to examine the associations between receiving public assistance and dental visits, adjusting for number of teeth, dental pain, periodontal conditions, age, sex, number of family members, education, equivalent household income, working status, instrumental activities of daily living, medical conditions, depressive symptoms, instrumental support and geographical variations. RESULTS More than half of the non-recipients of public assistance visited a dentist for some reason in the past 6 months. Meanwhile, only 37% of the recipients visited a dentist. In addition, almost half of the non-recipients had treatment visits, while only 34% of the recipients visited. Furthermore, 46% of the non-recipients had dental visits for prevention, while 32% of the recipients had preventive visits. In the fully adjusted models, compared to non-recipients, public assistance recipients were 24% (Prevalence Ratio [PR]: 0.76, 95% Confidence Intervals [CI]: 0.64, 0.90), 23% (PR: 0.77, 95% CI: 0.65, 0.92) and 21% (PR: 0.79, 95% CI: 0.65, 0.95) less likely to have dental visits for any reason, treatment, and prevention, respectively. CONCLUSIONS Although recipients were exempted from dental treatment fees, receiving public assistance was associated with a lower prevalence of dental visits for any reason, treatment and prevention. Future studies should identify the barriers to accessing dental care among public assistance recipients to improve dental visits.
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Affiliation(s)
- Shiho Kino
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Keiko Ueno
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Daisuke Nishioka
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Department of Medical Statistics, Research & Development Centre, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Department of Health and Social Behaviour, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives The University of Tokyo, Tokyo, Japan
- Japan Agency for Gerontological Evaluation Study (JAGES Agency), Tokyo, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Tamura M, Takasugi T, Nakamura M, Yanagi N, Nakagomi A, Sato K, Kondo K, Ojima T. Family Pharmacy and Medication Adherence Among Older Adults in Japan: A Cross-Sectional Study of JAGES 2019. J Gerontol B Psychol Sci Soc Sci 2023; 78:2122-2130. [PMID: 37837645 DOI: 10.1093/geronb/gbad147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Indexed: 10/16/2023] Open
Abstract
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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Affiliation(s)
- Motoki Tamura
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Tomo Takasugi
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Mieko Nakamura
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Natsuyo Yanagi
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Atsushi Nakagomi
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Koryu Sato
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Oubo, Aichi, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
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Wang H, Tsuji T, Ide K, Nakagomi A, Ling L, Kondo K. Does eating with others promote happiness among older adults living alone? A 3-year longitudinal study of the Japan gerontological evaluation study. Int J Geriatr Psychiatry 2023; 38:e6033. [PMID: 38038625 DOI: 10.1002/gps.6033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 11/18/2023] [Indexed: 12/02/2023]
Abstract
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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Affiliation(s)
- Hequn Wang
- Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Chiba, Japan
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Taishi Tsuji
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Faculty of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan
| | - Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Community General Support, Hasegawa Hospital, Chiba, Japan
| | - Atsushi Nakagomi
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Ling Ling
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
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Yamamoto-Kuramoto K, Kusama T, Kiuchi S, Kondo K, Osaka K, Takeuchi K, Aida J. Lower socio-economic status in adolescence is associated with poor oral health at an older age: Mediation by social and behavioural factors. Gerodontology 2023; 40:509-517. [PMID: 37035907 DOI: 10.1111/ger.12688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 04/11/2023]
Abstract
AIM To examine the mediators between lower socio-economic status (SES) in adolescence and oral health at an older age to uncover the underlying mechanisms of the association. METHODS Participants (n = 21 536) aged ≥65 years from the Japan Gerontological Evaluation Study were evaluated. The dependent variables were self-rated chewing difficulty and having ≤19 remaining teeth. The main independent variable was self-perceived SES in adolescence. The Karlson-Holm-Breen method was used for mediation analysis. RESULTS Mean age of the participants was 74.8 years (standard deviation = 6.4), and 51.5% were female. Overall, 5598 (26.0%) participants reported chewing difficulty and 9404 (43.7%) had ≤19 remaining teeth. Lower SES in adolescence was associated with a higher prevalence of chewing difficulty (odds ratio [OR] = 1.38, 95%confidence interval [CI] = 1.29-1.48; total effect). After controlling for mediators, OR for lower SES in adolescence was 1.22 (95%CI = 1.13-1.30; direct effect) and 1.13 (95%CI = 1.11-1.16; indirect effect). Mediators, prominently the number of teeth and income, explained 39.3% of the associations. Lower SES in adolescence increased the odds of ≤19 remaining teeth by OR = 1.23 (95% CI = 1.16-1.31; total effect). After controlling for mediators, the OR for lower SES in adolescence was 1.03 (95%CI = 0.97-1.10; direct effect) and 1.19 (95%CI = 1.16-1.23; indirect effect). Mediators, prominently educational attainment, explained 85.0% of the associations. CONCLUSIONS Lower SES in adolescence was associated with poor oral health at an older age through mediators. Approaches that consider social determinants from the beginning of the life course are required.
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Grants
- 21K19635 Japan Society for the Promotion of Science (JSPS) KAKENHI
- 19H03861 Japan Society for the Promotion of Science (JSPS) KAKENHI
- 19H03860 Japan Society for the Promotion of Science (JSPS) KAKENHI
- 15H01972 Japan Society for the Promotion of Science (JSPS) KAKENHI
- JP22lk0310087 Health Labour Sciences Research Grant
- JP21dk0110037 Health Labour Sciences Research Grant
- JP21lk0310073 Health Labour Sciences Research Grant
- JP20dk0110034 Health Labour Sciences Research Grant
- JP18le0110009 Health Labour Sciences Research Grant
- JP18ls0110002 Health Labour Sciences Research Grant
- JP18dk0110027 Health Labour Sciences Research Grant
- 22FA1010 Health Labour Sciences Research Grant
- 22FA2001 Health Labour Sciences Research Grant
- H30-Jyunkankinado-Ippan-004 Health Labour Sciences Research Grant
- 21DA1002 Health Labour Sciences Research Grant
- 19FA2001 Health Labour Sciences Research Grant
- 19FA1012 Health Labour Sciences Research Grant
- H28-Choju-Ippan-002 Health Labour Sciences Research Grant
- Japan Agency for Medical Research and Development (AMED) (JP18dk0110027, JP18ls0110002, JP18le0110009, JP20dk0110034, JP21lk0310073, JP21dk0110037, JP22lk0310087)
- Open Innovation Platform with Enterprises, Research Institute and Academia (OPERA, JPMJOP1831) from the Japan Science and Technology (JST)
- Innovative Research Program on Suicide Countermeasures (1-4)
- Sasakawa Sports Foundation
- Japan Health Promotion & Fitness Foundation
- Chiba Foundation for Health Promotion & Disease Prevention
- 19-2-06 8020 Research Grant for fiscal 2019 from the 8020 Promotion Foundation
- Meiji Yasuda Life Foundation of Health and Welfare
- Research Funding for Longevity Sciences from the National Center for Geriatrics and Gerontology (29-42, 30-22, 20-19, 21-20)
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Affiliation(s)
- Kinumi Yamamoto-Kuramoto
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Sakura Kiuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kenji Takeuchi
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
- Division of Statistics and Data Science, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Ide K, Nakagomi A, Tsuji T, Yamamoto T, Watanabe R, Yokoyama M, Shirai K, Kondo K, Shiba K. Participation in Community Gathering Places and Subsequent Health and Well-Being: An Outcome-Wide Analysis. Innov Aging 2023; 7:igad084. [PMID: 38106374 PMCID: PMC10724175 DOI: 10.1093/geroni/igad084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Indexed: 12/19/2023] Open
Abstract
Background and Objectives Evidence remains inadequate regarding the benefits of participation in community gathering places, which is Japan's primary strategy for preventing functional disability in older adults, in other domains of health and well-being. This longitudinal study examined the associations of participation in community gathering places with an array of subsequent health and well-being outcomes among older adults. Research Design and Methods We used 3-wave data (2013, 2016, and 2019) from Japan Gerontological Evaluation Study (n = 5 879 or 4 232 depending on the outcome). Our exposure was participation in community gathering places in 2016. We assessed 34 health/well-being outcomes in 2019 across 6 domains. We adjusted for pre-baseline covariates including prior outcome values in 2013. Results Compared with nonparticipation, participation in community gathering places was associated with some outcomes in the following 3 domains: physical/cognitive health (better higher-level functional capacity), social well-being (more frequent participation in hobby groups, senior citizens clubs, learning or cultural groups, and seeing more friends within a month), and prosocial/altruistic behaviors (more frequent participation in volunteering; after Bonferroni correction as p < .0015, .05/34). Discussion and Implications Evidence was mixed and more modest for the outcomes in three other domains, mental health, psychological well-being, and health behaviors. Promoting participation in community gathering places may not only fulfill its original goal (ie, preventing functional disability) but also enhance other domains of human well-being, potentially by increasing social interactions.
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Affiliation(s)
- Kazushige Ide
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Community General Support, Hasegawa Hospital, Chiba, Japan
| | - Atsushi Nakagomi
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Cardiology, Chiba University Hospital, Chiba, Japan
| | - Taishi Tsuji
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Institute of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan
| | - Takafumi Yamamoto
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Ryota Watanabe
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Center for Well-Being Society, Nihon Fukushi University, Aichi, Japan
| | - Meiko Yokoyama
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Koichiro Shiba
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
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Kino S, Stickley A, Arakawa Y, Saito M, Saito T, Kondo N. Social isolation, loneliness, and their correlates in older Japanese adults. Psychogeriatrics 2023; 23:475-486. [PMID: 36966745 DOI: 10.1111/psyg.12957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/07/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Loneliness and social isolation are elevated in older adults and associated with a range of detrimental outcomes. Despite this, there has been little research on these phenomena or on similarities and differences in their occurrence or combination in older Japanese adults. The current study aims to (i) determine what factors are associated with social isolation and loneliness among older adults in Japan; and (ii) describe the characteristics of individuals who are socially isolated but not lonely, as well as those who feel lonely but are not socially isolated. METHODS Data were analysed from 13 766 adults aged ≥65 years who participated in the 2019 wave of the Japan Gerontological Evaluation Study. Poisson regression analysis was used to examine associations. RESULTS Among older Japanese adults, the attributes of higher age, male gender, lower socioeconomic status, being a welfare recipient, and having depressive symptoms were associated with social isolation, while lower socioeconomic status, unemployment, welfare receipt, and poor physical and mental health were associated with loneliness. In addition, better educated, and mentally and physically healthy people were less likely to feel lonely even when socially isolated, while people who were not working and who had mental or physical health problems were more likely to feel lonely even if they were not socially isolated. DISCUSSION Our results indicate that in order to reduce unwanted social isolation and loneliness among older Japanese adults, in the first instance the focus should be on those individuals who are socioeconomically disadvantaged and unhealthy.
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Affiliation(s)
- Shiho Kino
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
| | - Andrew Stickley
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuki Arakawa
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
- Center for Well-being and Society, Nihon Fukushi University, Nagoya, Japan
| | - Tami Saito
- Department of Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
- Japan Agency for Gerontological Evaluation Study (JAGES Agency), Tokyo, Japan
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11
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Kojima K, Saito M, Miyaguni Y, Okada E, Ojima T. Oral function and cumulative long-term care costs among older Japanese adults: a prospective 6-year follow-up study of long care receipt data. BMJ Open 2023; 13:e066349. [PMID: 36787975 PMCID: PMC9930558 DOI: 10.1136/bmjopen-2022-066349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVES This study evaluated the relationship between status of oral function and related long-term care service costs. DESIGN This was a prospective 6-year follow-up study of previous survey data. SETTING The data were obtained from the Japan Gerontological Evaluation Study conducted between 2010 and 2011. PARTICIPANTS The participants were functionally independent older adults in 12 municipalities across Japan. INTERVENTIONS Care service benefit costs were tracked over 6 years using publicly available claims records (n=46 616) to monitor respondents' cumulative care costs. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome variable was the cumulative cost of long-term care insurance services during the follow-up period. We adjusted for the presence or absence of oral function problems, age, sex, physical function and socioeconomic and lifestyle background at the time of the baseline survey. RESULTS Tobit analysis revealed that, compared with those with no oral function problems, cumulative long-term care service benefit costs for those with one, two or three oral function problems were approximately US$4020, US$4775 and US$82 92, respectively, over 6 years. Compared with those with maintained oral function, there was a maximum difference of approximately US$8292 in long-term care service costs for those with oral function problems. With increase in number of oral function problems, there was a concomitant elevation in the cost of long-term care. CONCLUSIONS Oral function in older people was associated with cumulative long-term care insurance costs. The oral function of older people should be maintained to reduce future accumulated long-term care insurance costs. Compared with those with maintained oral function, there was a maximum difference of approximately US$8292 in long-term care service costs for those with oral function problems. The cost of long-term care was amplified as oral problems increased.
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Affiliation(s)
- Kaori Kojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
- Center for Well-Being and Society, Nihon Fukushi University, Nagoya, Japan
| | - Yasuhiro Miyaguni
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
- Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Eisaku Okada
- Center for Well-Being and Society, Nihon Fukushi University, Nagoya, Japan
- Faculty of Social Policy & Administration, Hosei University, Machida, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
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12
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Kino S, Stickley A, Nishioka D, Ueno K, Saito M, Ojima T, Kondo N. Suicidal ideation and suicide attempts among older recipients of public welfare assistance in Japan. J Epidemiol Community Health 2022; 76:jech-2022-218893. [PMID: 35858764 PMCID: PMC9484371 DOI: 10.1136/jech-2022-218893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/10/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The high suicide rate among older adults is an important public health issue. Financial insecurity has been linked to suicidal behaviour. Despite this, as yet, there has been little research on suicide-related behaviours among older recipients of public welfare. This study will examine if suicidal ideation and suicide attempts are more prevalent in older recipients of public welfare assistance in Japan. METHODS This cross-sectional study analysed data from 16 135 adults aged ≥65 years who participated in the 2019 wave of the Japan Gerontological Evaluation Study. Information was obtained on receiving public welfare assistance, lifetime suicidal ideation and attempts, and a variety of covariates. Poisson regression analysis with robust variance estimates was used to examine associations. RESULTS Suicidal ideation was reported by 4.8% of the participants, while the corresponding figure for attempted suicide was 2.2%. In fully adjusted analyses public welfare recipients had an almost 1.5 times higher prevalence of lifetime suicidal ideation (prevalence ratio, PR 1.47, 95% CI 1.02 to 2.13), and an almost two times higher prevalence of attempted suicide (PR 1.91, 95% CI 1.20 to 3.04) when compared with their counterparts not receiving public welfare assistance. CONCLUSION Older recipients of public welfare have a higher prevalence of suicidal behaviour in Japan. An urgent focus is now warranted on this vulnerable population to determine the specific factors underlying this association.
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Affiliation(s)
- Shiho Kino
- Department of Oral Health Promotion, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Bunkyo-ku, Tokyo, Japan
- Department of Social Epidemiology, Kyoto University, Kyoto, Japan
| | - Andrew Stickley
- Department of Social Epidemiology, Kyoto University, Kyoto, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Daisuke Nishioka
- Department of Social Epidemiology, Kyoto University, Kyoto, Japan
- Department of Medical Statistics, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Keiko Ueno
- Department of Social Epidemiology, Kyoto University, Kyoto, Japan
- Department of Health and Social Behavior, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Japan
- Center for Well-Being and Society, Nihon Fukushi University, Nagoya, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Kyoto University, Kyoto, Japan
- Department of Health and Social Behavior, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Japan Agency for Gerontological Evaluation Study (JAGES Agency), Taito-ku, Tokyo, Japan
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