Research Achievements - Original paper -
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Moderating role of alcohol tolerance in the association between excessive drinking and psychological distress: a cross-sectional study among agricultural workers in Japan.
Syohei Miyamoto, Fumiya Tanji, Suguru Iwano, Atushi Iwasawa, Hidenobu Ohta, Kyoichi Ono
BMC public health 25 ( 1 ) 2765 - 2765 2025.08 [Refereed]
Research paper (journal)
BACKGROUND: Excessive drinking is a known risk factor for psychological distress; however, the role of alcohol tolerance in this relationship remains unclear. This study examined the association between excessive drinking and psychological distress among agricultural workers in Japan by focusing on the potential moderating effect of alcohol tolerance. METHODS: A cross-sectional questionnaire survey was conducted among agricultural workers in City A, Akita Prefecture, Japan, between November 2024 and January 2025. Excessive drinking was defined as an alcohol use disorders identification test score ≥ 15, and psychological distress was assessed using the Kessler 6 scale (cut-off ≥ 13). Alcohol tolerance was determined based on self-reported facial flushing. Multivariate logistic regression analysis was performed to examine associations after adjusting for confounders. Stratified analyses were conducted to assess differences based on alcohol tolerance. RESULTS: Among the 169 participants, 15 (8.8%) reported psychological distress. Excessive drinking was significantly associated with psychological distress (odds ratio [OR] 6.41, 95% confidence interval [CI] 1.62-25.28, p < 0.001). Stratified analysis showed a significant association only among individuals with alcohol tolerance (OR 28.66, 95% CI 3.26-251.89, p < 0.001), whereas no significant association was observed among those without alcohol tolerance (OR 0.88, 95% CI 0.09-8.54, p = 0.91). CONCLUSIONS: Alcohol tolerance moderated the relationship between excessive drinking and psychological distress. These findings suggest that alcohol tolerance may be an important factor to consider when examining this association.
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Uneven Impact of Andropause Symptoms on Daily Life Domains in Employed Men: A Cross-Sectional Study.
Fumiya Tanji, Maiko Kawajiri, Hirohito Nanbu, Daisaku Nishimoto
Journal of occupational health 2025.07 [Refereed]
Research paper (journal)
OBJECTIVES: This study examined the extent to which the severity of andropause symptoms affects daily functioning, specifically in work, housework, outings, social relationships, and leisure activities, among employed Japanese men. METHODS: A cross-sectional internet-based survey was conducted in September 2024. Participants (N = 1,054), aged 20-69 years, completed the Aging Males' Symptoms scale to evaluate symptom severity. Impacts on daily life were assessed using a four-point scale. Multivariate logistic regression analyses estimated odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: After adjusting for relevant covariates, moderate and severe symptoms were significantly associated with greater difficulties in daily life. Compared to individuals with very mild symptoms, those with moderate symptoms had higher ORs for severe difficulties in work (OR = 7.2, 95% CI: 2.9-18.0), social relationships (OR = 17.7, 95% CI: 4.0-78.4), and housework (OR = 3.2, 95% CI: 1.2-9.0). Associations were stronger for severe symptoms: work (OR = 21.1, 95% CI: 8.0-55.5), social relationships (OR = 37.2, 95% CI: 7.9-174.3), and housework (OR = 8.5, 95% CI: 2.9-24.4). Severe symptoms were also linked to significant difficulties in outings (OR = 4.7, 95% CI: 1.8-12.4) and leisure (OR = 8.2, 95% CI: 3.0-22.5). CONCLUSIONS: Andropause symptoms significantly affect multiple areas of daily life, particularly work, social engagement, and household tasks. These findings underscore the importance of early recognition and intervention.
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Hirohito Nanbu, Fumiya Tanji, Maiko Kawajiri, Daisaku Nishimoto
Journal of Japan Academy of Nursing Science 45 99 - 109 2025.06 [Refereed]
Research paper (journal)
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Atsushi Iwasawa, Fumiya Tanji, Syohei Miyamoto, Kyoko Nomura
Scientific Reports ( Springer Science and Business Media LLC ) 15 ( 1 ) 2025.04 [Refereed]
Research paper (journal)
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Psychosocial Factors and Andropause Symptoms Among Japanese Men: An Internet-Based Cross-Sectional Study.
Fumiya Tanji, Hirohito Nanbu, Daisaku Nishimoto, Maiko Kawajiri
American journal of men's health 19 ( 1 ) 15579883241312836 - 15579883241312836 2025 [Refereed]
Research paper (journal)
This study aimed to investigate the relationship between psychosocial factors and andropause symptoms among Japanese men in an internet-based cross-sectional study. We conducted an internet-based cross-sectional study in 2024, named Japanese Men's health and Andropause Related Symptoms (J-MARS) study. Data on demographics, medical history, andropause symptoms, lifestyles (physical activity, insomnia, height, weight, and smoking and drinking habits), and psychological distress were collected from 1,489 men aged 20-69 years who participated in the J-MARS study. Andropause symptoms were measured using the Aging Males' Symptoms (AMS) rating scale, which was included in the analysis. We conducted a multivariate logistic regression analysis, and estimated odds ratios and 95% confidence intervals to examine the associated factors with severe andropause symptoms. Severe andropause symptoms according to the AMS score were noted in 125 men (8.4%). Severe andropause symptoms were associated with former smoking, current smoking, strength training (≥1.0 hr/day), probable insomnia, moderate psychological distress, and severe psychological distress. After excluding 289 participants with cardiovascular disease, cerebrovascular disease, cancer, or depression, severe andropause symptoms were associated with age, absence of a spouse, and suspected insomnia in addition to the above factors. Age, insomnia, and psychological distress were also significantly associated with all AMS subdomains (somatic, psychological, and sexual symptoms). Psychological stress, insomnia, and smoking habits are strongly associated with severe andropause symptoms. These findings may be useful for the prevention of andropause and for patient education.
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Association of Suicidal Ideation With Physical Health Conditions, Mental Health Conditions, and Multimorbidity and the Modifying Role of Emotional Social Support: A Cross-Sectional Study in Japan
Fumiya Tanji, Atsushi Iwasawa
Journal of Primary Care & Community Health 15 1 - 8 2024.09 [Refereed]
Research paper (journal)
INTRODUCTION: It is unclear whether the risk of suicide differs among individuals with only physical health condition, those with only mental health conditions, and those with both types of conditions (multimorbidity) and how emotional social support modifies these associations. This study aimed to examine differences in the association of suicidal ideation with the presence of only physical health conditions, only mental health conditions, and multimorbidity and the modifying role of emotional social support in these associations. METHODS: A cross-sectional survey was conducted between August and September 2023 in a Japanese rural town to collect data. The exposure variable was the health condition, and it was classified into 4 groups: disease-free, only physical health conditions, only mental health conditions, and multimorbidity. The outcome variable was suicidal ideation. The data collected were analyzed using multivariate logistic regression analysis and stratified analysis. RESULTS: Suicidal ideation was found to have a significant positive association with the presence of only mental health conditions and multimorbidity. These associations remained unchanged in the absence of emotional social support. However, the odds ratio for the only mental health conditions group decreased in the presence of emotional social support, while the odds ratio for the multimorbidity group remained significantly higher. CONCLUSIONS: Suicidal ideation is positively associated with the presence of only mental health conditions and multimorbidity, but emotional social support modifies only the association between suicidal ideation and the presence of only mental health conditions. These results suggest that it may be important to identify the type of social support one needs based on one's health condition to prevent suicide.
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Fumiya Tanji, Syohei Miyamoto, Atsushi Iwasawa, Hidenobu Ohta, Kyoichi Ono
Journal of Primary Care & Community Health ( SAGE Publications ) 14 2023.11 [Refereed]
Research paper (journal)
Introduction:
While there may be differences in the choice of suicide methods between attempters with and those without a history of psychiatric disorders, it is not clear whether these differences predict the actual degree of physical injury. The present study aimed to investigate the association between the history of psychiatric disorder and the degree of physical injury among suicide attempters in a Japanese rural area.
Methods:
We conducted a cross-sectional study analyzing secondary data of 806 suicide attempters from April 2012 to March 2022 obtained from a Japanese rural city. The exposure variable was a history of psychiatric disorders. The primary outcome was the degree of physical injury of suicide attempters: moderate and severe. We conducted a multivariate Poisson regression analysis to estimate the prevalence ratios (PRs) and 95% confidence intervals (CIs).
Results:
Among 806 suicide attempters, a significant negative association between the history of psychiatric disorder and the degree of physical injury was observed (PR = 0.40; 95% CI, 0.28-0.59). Those with and without psychiatric disorders were more likely to choose low- and severe-lethality suicide methods such as drug or psychotropic overdoses and hanging or deep wrist injuries, respectively ( P < .001).
Conclusions:
The present study highlights the importance of considering suicide attempters, both with and without psychiatric disorders, while formulating targeted suicide prevention strategies. -
The association between resilience and academic performance among nursing students: a cross-sectional study in Japan.
Fumiya Tanji, Hirohito Nanbu, Mayuko Ono, Noriko Abe, Junko Nitta
Journal of rural medicine : JRM 16 ( 4 ) 206 - 213 2021.10 [Refereed]
Research paper (journal)
Objective: Medical science students, especially nursing students, are more likely to experience academic stress; therefore, resilience helps them focus on their lessons attentively. However, the results of a few existing studies regarding how resilience impacts the academic performance of medical science students are incongruent. This study aimed to investigate whether resilience impacts the academic performance of Japanese nursing students. Methods: We conducted a cross-sectional, self-administered questionnaire survey from September to November 2020. A total of 229 undergraduate nursing students participated in this study; here, resilience was measured using the Bidimensional Resilience Scale, which includes innate factors (optimism, control, sociability, and vitality) and acquired factors (problem-solving, self-understanding, and understanding others). Academic performance was measured using the functional grade point average (f-GPA). Covariates were demographics, pre-entry academic performance levels, medical history, time spent walking, psychological distress, subjective economic status, and part-time jobs. Multivariate regression analyses were performed. Results: Among the 229 participants, the f-GPA mean (standard deviation) was 2.93 (0.46). Only vitality was significantly associated with a higher f-GPA after multiple imputations (β = 0.06; 95% confidence interval = 0.03-0.09; P<0.01). The Poisson regression analysis of 212 participants with all data indicated that vitality was associated with the fourth quartile f-GPA (prevalence ratio, 1.05; 95% confidence interval, 1.03-1.08; P<0.01). Conclusion: There was a significant association between the vitality of resilience components and academic performance among Japanese nursing students. This study suggests that an approach that develops resilience is necessary for the academic success of nursing students.
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Fumiya Tanji, Hirohito Nanbu, Susumu Fushimi, Kenichi Shibata, Rui Kondo
Journal of rural medicine : JRM ( Japanese Association of Rural Medicine ) 15 ( 4 ) 183 - 188 2020.10 [Refereed]
Research paper (journal)
Objective: Although it is well known that smoking is a risk factor for subarachnoid hemorrhage, the association between smoking and unruptured intracranial aneurysms remains unclear. The aim of the present study was to investigate whether smoking status was associated with unruptured intracranial aneurysms among Japanese brain health check-up examinees. Materials and Methods: We conducted a cross-sectional study of 1,496 adults (aged 26-90 years) undergoing brain health check-ups at a single community medical support hospital in Akita, Japan between 2009 and 2013. In Japan, people can discretionarily undergo a brain health check-up for early detection of unruptured intracranial aneurysms or subarachnoid hemorrhages. Participants responded to a questionnaire on lifestyle, such as smoking status, and were classified into three groups: never, former, and current smoker. The evaluation of unruptured intracranial aneurysms detected by magnetic resonance angiography was performed by an expert physician. Multiple logistic regression models were used to estimate the odds ratio for unruptured intracranial aneurysms. We performed statistical analyses by age, sex, and family history of stroke. Results: The number of participants with unruptured intracranial aneurysms was 43 (2.9%). The mean age (standard deviation) and proportion of males was 55.8 (9.5) years and 53.3%, respectively. The adjusted odds ratios (95% confidence intervals) for unruptured intracranial aneurysms of 1.21 (0.48-3.08) among former smokers and 2.88 (1.10-7.50) among current smokers were compared to those of never smokers (p-trend = 0.041). After stratifying by age, sex, and family history of stroke, no interactions were found. Conclusion: This cross-sectional study conducted in Japan showed that smoking was positively associated with unruptured intracranial aneurysms among brain health check-up examinees.
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Association between improved adherence to the Japanese diet and incident functional disability in older people: The Ohsaki Cohort 2006 Study.
Sanae Matsuyama, Shu Zhang, Yasutake Tomata, Saho Abe, Fumiya Tanji, Yumi Sugawara, Ichiro Tsuji
Clinical nutrition (Edinburgh, Scotland) 39 ( 7 ) 2238 - 2245 2020.07 [Refereed]
Research paper (journal)
BACKGROUND & AIMS: Although it has been reported that the Japanese dietary pattern is associated with a lower risk of incident functional disability among older people, the potential benefits of improving adherence to the Japanese diet remain unclear. The aim of the present study was to evaluate the association between 12-year change in adherence to the Japanese diet and the subsequent risk of incident functional disability in older people in Japan. METHODS: We analyzed 10-year follow-up data from a cohort study of 2923 Japanese older adults (age ≥65 years) in 2006. We collected dietary information using a validated 39-item food frequency questionnaire at two time points (1994 and 2006). Adherence to the Japanese diet (high intake of rice, miso soup, seaweeds, pickles, green and yellow vegetables, fish, green tea; low intake of beef and pork, and coffee) was assessed using the Japanese Diet Index (JDI), which ranges from 0 to 9. Participants were categorized into five groups according to changes in the JDI score at these two time points. Data on incident functional disability from December 2006 to November 2016 were retrieved from the public long-term care insurance database. The Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for incident functional disability. RESULTS: During 22,466 person-years of follow-up, 1093 cases of incident functional disability were documented. Compared with participants in the group with the largest decrease in the JDI score (≤-2), the multivariate-adjusted HR (95% CI) of incident functional disability was 0.77 (0.61-0.98) for those in the largest increase group (≥+2). CONCLUSIONS: Improved adherence to the Japanese diet was associated with a significantly lower risk of incident functional disability in older people in Japan.
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Contribution of systemic inflammation and nutritional status to the relationship between tooth loss and mortality in a community-dwelling older Japanese population: a mediation analysis of data from the Tsurugaya project.
Takako Hiratsuka, Takamasa Komiyama, Takashi Ohi, Fumiya Tanji, Yasutake Tomata, Ichiro Tsuji, Makoto Watanabe, Yoshinori Hattori
Clinical oral investigations 24 ( 6 ) 2071 - 2077 2020.06 [Refereed]
Research paper (journal)
OBJECTIVES: To assess whether systemic inflammation and nutritional status contribute to a relationship between tooth loss and mortality in community-dwelling older Japanese individuals using mediation analyses. MATERIALS AND METHODS: This longitudinal study targeted community-dwelling older Japanese individuals (N = 891). The exposure variable was the number of teeth (edentulous, 1-9, 10-19, ≥ 20), while the outcome was all-cause mortality from 2003 to 2016. Nutritional status and systemic inflammation were evaluated as mediators and based on serum albumin and high-sensitivity C-reactive protein levels, respectively. Covariates included age, sex, smoking, alcohol consumption, medical history, educational level, depressive symptoms, cognitive impairment, and physical function. The Cox proportional hazards model was applied to calculate hazard ratios (HRs) for the association between tooth loss and mortality and the contributions of systemic inflammation and nutritional status to this association. RESULTS: Edentulous participants (HR, 1.84; 95 % confidence interval [CI], 1.30-2.59) and those with 1-9 teeth (HR, 1.75; 95% CI, 1.28-2.40) groups exhibited a significantly higher risk of mortality than did those with ≥ 20 teeth. Mediation analyses showed that nutritional status contributed to the association between tooth loss and mortality in participants with 1-9 teeth, whereas systemic inflammation played no role in this association. CONCLUSIONS: Nutritional status may contribute to the association between tooth loss and mortality in community-dwelling older Japanese individuals with fewer remaining teeth. CLINICAL RELEVANCE: The data from this prospective cohort study help in elucidating parts of the biological mechanism underlying tooth loss and all-cause mortality in older individuals.
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Dental Status is Associated With Incident Functional Disability in Community-Dwelling Older Japanese: A Prospective Cohort Study Using Propensity Score Matching.
Takamasa Komiyama, Takashi Ohi, Yasutake Tomata, Fumiya Tanji, Ichiro Tsuji, Makoto Watanabe, Yoshinori Hattori
Journal of epidemiology 30 ( 2 ) 84 - 90 2020.02 [Refereed]
Research paper (journal)
BACKGROUND: A growing number of epidemiology studies have shown that poor oral health is associated with an increased incidence of functional disability. However, there are few studies in which the confounding bias is adjusted appropriately. In this study, we examined whether dental status is associated with functional disability in elderly Japanese using a 13-year prospective cohort study after elimination of confounding factors with propensity score matching. METHODS: Participants were community-dwelling Japanese aged 70 years or older who lived in the Tsurugaya district of Sendai (n = 838). The number of remaining teeth (over 20 teeth vs 0-19 teeth) was defined as the exposure variable. The outcome was the incidence of functional disability, defined as the first certification of long-term care insurance (LTCI) in Japan. The variables that were used to determine propensity score matching were age, sex, body mass index (BMI), medical history (stroke, hypertension, myocardial infarction, cancer, and diabetes), smoking, alcohol consumption, educational attainment, depression symptoms, cognitive impairment, physical function, social support, and marital status. RESULTS: As a result of the propensity score matching, 574 participants were selected. Participants with 0-19 teeth were more likely to develop functional disability than those with 20 or more teeth (hazard ratio 1.33; 95% confidence interval, 1.01-1.75). CONCLUSIONS: In this prospective cohort study targeting community-dwelling older adults in Japan, having less than 20 teeth was confirmed to be an independent risk factor for functional disability even after conducting propensity score matching. This study supports previous publications showing that oral health is associated with functional disability.
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The relationship between body mass index and disability-free survival in elderly Japanese: the Ohsaki Cohort 2006 Study.
Shu Zhang, Yasutake Tomata, Fumiya Tanji, Yumi Sugawara, Ichiro Tsuji
International journal of obesity (2005) 43 ( 11 ) 2254 - 2263 2019.11 [Refereed]
Research paper (journal)
BACKGROUND: The relationship between body mass index (BMI) and disability-free survival (DFS) remains unclear. METHODS: We conducted a 10-year prospective cohort study of 12,666 Japanese individuals aged ≥ 65 y. Information on BMI and lifestyle factors was collected via a questionnaire in 2006. Functional disability data were retrieved from the public Long-term Care Insurance database. Subjects were divided into seven groups according to BMI (<19, 19-21, 21-23, 23-25, 25-27, 27-29 and ≥29). Fiftieth percentile differences (PDs) and 95% confidence intervals (CIs) in the DFS period (differences of period until the first 50% of the composite outcome (disability or death) occurred in each of the BMI groups) were calculated using the Laplace regression model. RESULTS: There was a U-shaped relationship between BMI and the risk of incident composite outcome, with a BMI nadir of 25-27. Based on BMI 25-27 as a reference, the 50th PDs (95% CIs) (in months) in age at disability or death (median DFS) were -20.8 (-26.4, -15.2) (P < 0.001) months for BMI <19, -13.5 (-18.2, -8.7) (P < 0.001) months for BMI 19-21, -9.8 (-14.2, -5.4) (P < 0.001) months for BMI 21-23, -2.9 (-7.5, 1.7) (P = 0.21) months for BMI 23-25, -2.7 (-8.4, 2.9) (P = 0.34) months for BMI 27-29, and -11.5 (-19.6, -3.5) (P = 0.005) months for BMI ≥ 29. These relationships did not differ by sex. CONCLUSION: Older individuals with a BMI of <23 or ≥29 have a significantly shorter DFS period than those with a BMI of 25-27. It is suggested that the optimal BMI range for maximization of disability-free life expectancy in the elderly population is 23-29.
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Combined Healthy Lifestyle Behaviors and Disability-Free Survival: the Ohsaki Cohort 2006 Study.
Shu Zhang, Yasutake Tomata, Andrea Discacciati, Tatsui Otsuka, Yumi Sugawara, Fumiya Tanji, Ichiro Tsuji
Journal of general internal medicine 34 ( 9 ) 1724 - 1729 2019.09 [Refereed]
Research paper (journal)
BACKGROUND: Previous studies have suggested that a healthy lifestyle (HL) may prolong the years of life spent in good health. However, the impact of HL on disability-free survival (DFS) among the elderly is still uncertain. OBJECTIVE: To investigate the relationship between HL and DFS in the general elderly population. DESIGN: Prospective cohort study with a 10-year follow-up (2006-2016). PARTICIPANTS: 9910 community-dwelling elderly people (≥ 65 years). MAIN MEASURES: A HL index derived by summing the number of HL behaviors. Data on incident disability were retrieved from the public Long-term Care Insurance database. Multivariate-adjusted 50th percentile differences (PDs) in age at disability or death (months) and their 95% CIs were estimated with the Laplace regression model. KEY RESULTS: During the 10 years, 4562 disability or death events occurred. Participants who adhered to all three HL behaviors lived 17.1 (95% CI 12.7, 21.5) months longer without disability than those who adhered to zero or one. Each 1-point increase of the index score conferred 8.8 months additional life without disability. The tendency for the 50th PDs to increase with a higher HL index score did not differ according to age (< 75 or ≥ 75 years), sex, or the presence of chronic conditions (none, or ≥ 1 chronic condition). CONCLUSIONS: A combination of HL behaviors may substantially increase DFS, even for late-elderly (≥ 75 years), or elderly people with chronic conditions.
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The association between emotional and instrumental social support and risk of suicide death: A population-based cohort study.
Tatsui Otsuka, Yasutake Tomata, Shu Zhang, Fumiya Tanji, Yumi Sugawara, Ichiro Tsuji
Journal of psychiatric research 114 141 - 146 2019.07 [Refereed]
Research paper (journal)
Suicide is an important public health issue and previous studies have suggested that social support can one preventive factor. However, the association between emotional and instrumental social support and suicide death has not been investigated in detail. The purpose of this study was to investigate the association between each type of social support and suicide death based on a population-based cohort study. We analyzed follow-up data for 47,223 subjects (aged ≥40 y) participating in a community-based, prospective cohort study. At the baseline, the subjects were asked five questions about social support. The end point of the study was suicide mortality, based on data from the National Vital Statistics. The Cox model was used to estimate the multivariate-adjusted hazard ratios of suicide death. In addition, stratified analysis was conducted to test the interaction of each type of social support with gender (male/female) and age (<65/≥65 y) separately. Among 320,880 person-years of follow-up, 90 cases of suicide death were documented. There were significant association between instrumental social support and lower risk of suicide death, and the hazard ratio was 0.60 (95% CI: 0.38-0.94). Emotional social support was also associated with a lower risk of suicide death, but not to a significant degree, and the hazard ratio was 0.70 (95% CI: 0.42-1.17). It is suggested that instrumental social support was significantly associated with a lower risk of suicide death, and emotional social support tended to be associated with a lower risk of suicide death.
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Randomised controlled trial of a financial incentive for increasing the number of daily walking steps: study protocol.
Yasutake Tomata, Fumiya Tanji, Dieta Nurrika, Yingxu Liu, Saho Abe, Koichi Matsumoto, Shu Zhang, Yumika Kotaki, Sanae Matsuyama, Yukai Lu, Yumi Sugawara, Shino Bando, Teiichiro Yamazaki, Tatsui Otsuka, Toshimasa Sone, Ichiro Tsuji
BMJ open 9 ( 6 ) e026086 2019.06 [Refereed]
Research paper (journal)
INTRODUCTION: Physical activity is one of the major modifiable factors for promotion of public health. Although it has been reported that financial incentives would be effective for promoting health behaviours such as smoking cessation or attendance for cancer screening, few randomised controlled trials (RCTs) have examined the effect of financial incentives for increasing the number of daily steps among individuals in a community setting. The aim of this study is to investigate the effects of financial incentives for increasing the number of daily steps among community-dwelling adults in Japan. METHODS AND ANALYSIS: This study will be a two-arm, parallel-group RCT. We will recruit community-dwelling adults who are physically inactive in a suburban area (Nakayama) of Sendai city, Japan, using leaflets and posters. Participants that meet the inclusion criteria will be randomly allocated to an intervention group or a waitlist control group. The intervention group will be offered a financial incentive (a chance to get shopping points) if participants increase their daily steps from their baseline. The primary outcome will be the average increase in the number of daily steps (at 4-6 weeks and 7-9 weeks) relative to the average number of daily steps at the baseline (1-3 weeks). For the sample size calculation, we assumed that the difference of primary outcome would be 1302 steps. ETHICS AND DISSEMINATION: This study has been ethically approved by the research ethics committee of Tohoku University Graduate School of Medicine, Japan (No. 2018-1-171). The results will be submitted and published in a peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER: UMIN000033276; Pre-results.
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Joint impact of seven risk factors on incident dementia in elderly Japanese: the Ohsaki Cohort 2006 Study.
Yumika Kotaki, Yasutake Tomata, Fumiya Tanji, Shu Zhang, Yumi Sugawara, Ichiro Tsuji
Journal of neurology 266 ( 5 ) 1222 - 1229 2019.05 [Refereed]
Research paper (journal)
BACKGROUND: This cohort study estimated the population attributable fraction (PAF) of seven combined major risk factors for incident dementia. METHODS: We conducted a cohort study of 8563 community-dwelling individuals aged ≥ 65 years. In a baseline survey (2006), we collected data on major seven risk factors: diabetes mellitus, hypertension, obesity, physical inactivity, severe psychological distress, smoking, and low educational attainment. The total number of risk factors was applied as an exposure variable. Subjects were categorized into four groups according to the total number of risk factors they possessed (0, 1, 2, ≥ 3 risk factors). Data on incident dementia were retrieved from the public Long-term Care Insurance database. Hazard ratios (HRs) and 95% confidence interval (95% CI) were estimated using the Cox proportional regression model. We also calculated the PAF using HRs and the prevalences in our cohort data. RESULTS: The number of cases of incident dementia was 577 (6.7%). A dose-response relationship between the total number of risk factors and incident dementia was observed; in comparison with no risk factors (reference), the age- and sex-adjusted HRs (95% CIs) were 1.25 (0.92-1.70) for one risk factor, 1.59 (1.18-2.15) for two, and 2.21 (1.62-3.01) for three or more (P trend < 0.001). If subjects had adhered to none of the risk factors, the PAF would have been 32.2%. If subjects had improved toward one better category, the PAF would have been 23.0%. CONCLUSION: Our findings suggest that reducing the combined number of risk factors would contribute significantly to reducing the incidence of dementia.
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Preventive Effect of Oral Self-Care on Pneumonia Death among the Elderly with Tooth Loss: The Ohsaki Cohort 2006 Study.
Kaoru Manabe, Fumiya Tanji, Yasutake Tomata, Shu Zhang, Ichiro Tsuji
The Tohoku journal of experimental medicine 247 ( 4 ) 251 - 257 2019.04 [Refereed]
Research paper (journal)
Tooth loss is a risk factor for pneumonia mortality, but it is unclear whether oral care negates excess mortality due to pneumonia among community-dwelling elderly with tooth loss. The purpose of this study was to examine the influence of oral care on the association between the number of remaining teeth and the risk of pneumonia death. We analyzed for 18,098 individuals (aged ≥ 65 years) participating in a prospective cohort study. In a 2006 baseline survey, the following data were collected: the number of remaining teeth, oral care, history of disease, smoking, alcohol drinking, education level and so forth. We also obtained data on dates and causes of death between 2006 and 2014. The primary outcome was mortality due to pneumonia. Compared with those having ≥ 20 teeth, the risk of pneumonia mortality was increased among participants having 10-19 or 0-9 teeth; the multivariate hazard ratios (HRs) (95% confidence intervals [CI]) were 1.45 (1.03-2.04) and 1.38 (1.01-1.87), respectively. Among those having 0-9 teeth, a significantly increased risk of mortality due to pneumonia was disappeared for those who brushed their teeth ≥ 2 times per day, for those with visiting a dentist, and for those with use of denture, whereas the risk persisted among those who brushed their teeth ≤ 2 times per day, for those without visiting a dentist, and for those without use of denture. Tooth-brushing, visiting a dentist or use of denture may negate the increased risk of pneumonia death among the elderly with tooth loss.
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Moving from prefabricated temporary housing to public reconstruction housing and social isolation after the Great East Japan Earthquake: a longitudinal study using propensity score matching.
Takuya Sekiguchi, Yoshihiro Hagiwara, Yumi Sugawara, Yasutake Tomata, Fumiya Tanji, Yutaka Yabe, Eiji Itoi, Ichiro Tsuji
BMJ open 9 ( 3 ) e026354 2019.03 [Refereed]
Research paper (journal)
OBJECTIVES: After the Great East Japan Earthquake (GEJE) of 2011, many survivors have been forced to live in prefabricated temporary housing, which is uncomfortable and insufficiently durable for permanent living. Public reconstruction housing has been built to improve their living conditions; however, those moving have to rebuild personal relationships and adapt to a new environment. This study examined whether survivors moving to public reconstruction housing became more socially isolated than those remaining in prefabricated temporary housing. DESIGN, SETTING AND PARTICIPANTS: Self-report questionnaire data collected in 2015 (4 years after the GEJE) were used as the baseline for follow-up surveys in 2016 and 2017, as many survivors moved from prefabricated temporary housing to public reconstruction housing from 2015. We analysed longitudinal data from 393 survivors, distinguishing those who moved to public reconstruction housing during the 5th year after the disaster from those who remained in prefabricated temporary housing. Participants were assessed using the Lubben Social Network Scale-6 (LSNS-6) in all three surveys, with social isolation defined by a score of <12/30. To reduce the effect of selection bias, propensity score analysis was performed (178 of 393 participants were retained). We used a generalised estimated equation to evaluate the association between moving from prefabricated temporary housing to public reconstruction housing and changes in social isolation over 2 years. RESULTS: LSNS-6 scores of the reconstruction housing group were worse than those of the prefabricated housing group between 4 and 6 years after the GEJE (P=0.006). Over the same period, social isolation worsened in the reconstruction housing group but improved in the prefabricated housing group (P=0.002). CONCLUSIONS: Social isolation should be monitored while supporting survivors who moved to public reconstruction housing, and further longitudinal research is needed to clarify the risk of social isolation.
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Weight change since age 20 and incident risk of obesity-related cancer in Japan: a pooled analysis of the Miyagi Cohort Study and the Ohsaki Cohort Study.
Mano Wakamatsu, Yumi Sugawara, Shu Zhang, Fumiya Tanji, Yasutake Tomata, Ichiro Tsuji
International journal of cancer 144 ( 5 ) 967 - 980 2019.03 [Refereed]
Research paper (journal)
It is unclear whether weight change during adulthood affects the risk of obesity-related cancers such as those of the esophagus, colorectum, pancreas, breast, endometrium, and kidney among Japanese, where obesity is less frequent and less severe. We examined the association between weight change during adulthood and the risk of obesity-related cancer among Japanese by conducting a pooled analysis of two prospective studies of residents in Miyagi Prefecture, Japan. A total of 78,743 persons (40,422 women and 38,321 men) aged 40-79 years participated in the Miyagi Cohort Study in 1990 and in the Ohsaki Cohort Study in 1994. Weight change since age 20 was divided into four categories (weight loss; stable weight; moderate weight gain; high weight gain). Cox proportional hazards regression analysis was used to estimate the multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) for obesity-related cancer incidence. During 1,057,899 person-years of follow up, 4,467 cases of obesity-related cancer (women; 1,916 cases, men; 2,551cases) were identified. In women, compared to the stable weight, weight gain was associated with an increased risk of obesity-related cancer (moderate weight gain; HRs = 1.10, 95%CIs: 0.97-1.26, high weight gain; HRs = 1.29, 95%CIs: 1.14-1.47). The results indicate that weight gain since age 20 was associated with a significantly increased risk of obesity-related cancer among Japanese women. By contrast, in men, our study found that weight change is not associated with the incidence of obesity-related cancer.