Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
29 巻 , 2 号
選択された号の論文の6件中1~6を表示しています
Original Article
  • Tin Tin Su, Meram Azzani, Adeoye Philip Adewale, Nithiah Thangiah, Ros ...
    2019 年 29 巻 2 号 p. 43-49
    発行日: 2019/02/05
    公開日: 2019/02/05
    [早期公開] 公開日: 2018/06/30
    ジャーナル オープンアクセス

    Background: The aim of this research is to assess the level of physical activity (PA) in relation to different socio-economic factors and to examine the effect of the recommended level of PA on the domains of quality of life (QoL) among residents of low-income housing in the metropolitan area of Kuala Lumpur, Malaysia.

    Methods: This was a cross-sectional study that included 680 respondents from community housing projects. Reported PA was assessed using the Global Physical Activity Questionnaire (GPAQ) short form version 2. The SF-12v2 was administered to assess the health-related QoL (HRQoL) among the study population. Respondents were grouped into “active” and “insufficient” groups according to reported weekly PA level. One-way analysis of variance, analysis of co-variance, and multiple linear regression were used in the analysis.

    Results: Overall, 17.6% (95% CI, 14.3–20.9) of the respondents did not achieve the recommended levels of PA (≥600 metabolic equivalent [MET]-minutes week−1). Level of achieving recommended PA was higher among younger participants, females, members belonging to nuclear families, and in self-employed participants. The group that fulfilled recommended PA levels (active) has higher levels of QoL in all domains except physical functioning.

    Conclusions: Almost one out of five low-income urban residents were physically inactive. In addition, individuals who attained recommended PA levels had better scores on some domains of HRQOL than those who did not. Our findings call for tailor-made public health interventions to improve PA levels among the general population and particularly for low-income residents.

  • Airi Amemiya, Takeo Fujiwara
    2019 年 29 巻 2 号 p. 50-56
    発行日: 2019/02/05
    公開日: 2019/02/05
    [早期公開] 公開日: 2018/06/30
    ジャーナル オープンアクセス

    Background: The respiratory tract of children in low-income families is more likely to be exposed to toxins, which may lead to poor lung function. The purpose of this study was to elucidate the impact of low household income on lung function among children and adolescents in Japan.

    Methods: We analyzed a population-based sample of 1,224 children aged 5 to 17 years old from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE). Forced expiratory volume in 1 s (FEV1) and in 6 s (FEV6) was measured. Annual household income and other potential covariates were assessed through a questionnaire. Low household income was defined as less than 3 million yen (approximately 27,000 United States dollars [USD]) per year. Multivariate regression analysis was used to adjust for potential covariates.

    Results: We observed statistically significantly lower FEV1:FEV6 ratio with children in lowest-income families compared with those in highest-income families, after adjusting for child’s age and sex (coefficient = −0.082; 95% confidence interval [CI], −0.131 to −0.034). After adjusting for other covariates, including parental smoking status and parental diagnosis of asthma, a similar trend remained (coefficient = −0.054; 95% CI, −0.109 to 0.001).

    Conclusions: Children in low-income families showed significantly lower lung function than those in high-income families. Prevention and early intervention are necessary to help the development of lung function among children living in low-income families.

  • Hitomi Fujita, Akihiro Hosono, Kiyoshi Shibata, Shoko Tsujimura, Kyoko ...
    2019 年 29 巻 2 号 p. 57-60
    発行日: 2019/02/05
    公開日: 2019/02/05
    [早期公開] 公開日: 2018/09/22
    ジャーナル オープンアクセス

    Background: It is known that physical activity affects glucose metabolism. However, there have been no reports on the influence of physical activity earlier in life on subsequent glucose metabolism. Therefore, we analyzed the influence of physical activity in earlier decades of life on insulin resistance in middle aged and older residents in Japan.

    Methods: The subjects were 6,883 residents of Okazaki City between the ages of 40 and 79 years who underwent physical examinations at the Okazaki City Medical Association Public Health Center from April 2007 through August 2011. They gave informed consent for participation in the study. Data on individual characteristics were collected via a questionnaire and from the health examination records. Fasting blood glucose and insulin levels were used to calculate the homeostatic model assessment of insulin resistance (HOMA-IR). HOMA-IR >1.6 was considered to indicate insulin resistance for the purpose of logistic regression models.

    Results: The study sample included 3,683 men and 3,200 women for whom complete information was available. For those who exercised regularly throughout their teens to their 30s–40s, the odds ratio for having insulin resistance was 0.75 (95% confidence interval [CI], 0.58–0.96) for men and 0.76 (95% CI, 0.58–0.99) for women after adjusting for other variables, including age, body mass index, and present physical activity. A linear trend was also observed in both men and women.

    Conclusions: Subjects who have exercised regularly in the early decades of life are less likely to have insulin resistance later in life.

  • Kenichi Mori, Keiko Wada, Kie Konishi, Yuko Goto, Fumi Mizuta, Sachi K ...
    2019 年 29 巻 2 号 p. 61-64
    発行日: 2019/02/05
    公開日: 2019/02/05
    [早期公開] 公開日: 2018/06/23
    ジャーナル オープンアクセス

    Background: Cedar pollinosis is one of the most prevalent forms of seasonal allergic reaction in Japan. Only one prospective study has examined the association between cedar pollinosis and mortality. Using a symptom-based questionnaire on cedar pollinosis, we investigated the association of cedar pollinosis with all-cause and cause-specific mortality.

    Methods: Data came from the Takayama Study, which recruited residents aged ≥35 years in 1992 from Takayama city in Gifu Prefecture, Japan. The current study used information on cedar pollinosis that was obtained from the second survey in 2002. A total of 12,471 persons who were 45–80 years old and had no history of cancer, coronary heart disease, or stroke responded to a questionnaire asking about four symptoms related to cedar pollinosis. Mortality and migration data were obtained throughout the follow-up period up to March 2013. Cox proportional hazard models were used to examine the relation between cedar pollinosis and mortality.

    Results: A total of 1,276 persons died during follow-up period. Among these, there were 504 neoplasm, 278 cardiovascular, and 181 respiratory deaths. After adjusting for potential confounders, cedar pollinosis was associated with significantly lower all-cause mortality (hazard ratio [HR] 0.79; 95% confidence interval [CI], 0.65–0.95) and respiratory mortality (HR 0.38; 95% CI, 0.18–0.82). There was no significant association between cedar pollinosis and mortality due to neoplasm or cardiovascular disease.

    Conclusions: We found an inverse association between cedar pollinosis and the risk of all-cause and respiratory mortality. Further research is needed to elucidate the association between cedar pollinosis and mortality.

  • Junko Saito, Naoki Kondo, Masashige Saito, Daisuke Takagi, Yukako Tani ...
    2019 年 29 巻 2 号 p. 65-72
    発行日: 2019/02/05
    公開日: 2019/02/05
    [早期公開] 公開日: 2018/06/23
    ジャーナル オープンアクセス

    Background: We explored the distinct trajectories of functional decline among older adults in Japan, and evaluated whether the frequency of outings, an important indicator of social activity, predicts the identified trajectories.

    Methods: We analyzed data on 2,364 adults aged 65 years or older from the Japan Aichi Gerontological Evaluation Study. Participants were initially independent and later developed functional disability during a 31-month follow-up period. We used the level of long-term care needs certified in the public health insurance system as a proxy of functional ability and linked the fully tracked data of changes in the care levels to the baseline data. A low frequency of outings was defined as leaving one’s home less than once per week at baseline. We applied a growth mixture model to identify trajectories in functional decline by sex and then examined the association between the frequency of outings and the identified trajectories using multinomial logistic regression analysis.

    Results: Three distinct trajectories were identified: “slowly declining” (64.3% of men and 79.7% of women), “persistently disabled” (4.5% and 3.7%, respectively), and “rapidly declining” (31.3% and 16.6%, respectively). Men with fewer outings had 2.14 times greater odds (95% confidence interval, 1.03–4.41) of being persistently disabled. The association between outing frequency and functional decline trajectory was less clear statistically among women.

    Conclusions: While the majority of older adults showed a slow functional decline, some showed persistent moderate disability. Providing more opportunities to go out or assistance in that regard may be important for preventing persistent disability, and such needs might be greater among men.

Study Profile
  • Satoshi Seino, Akihiko Kitamura, Yui Tomine, Izumi Tanaka, Mariko Nish ...
    2019 年 29 巻 2 号 p. 73-81
    発行日: 2019/02/05
    公開日: 2019/02/05
    [早期公開] 公開日: 2018/06/30
    ジャーナル オープンアクセス

    Background: Preventing and reducing frailty is an important challenge for Japan in the next decade, especially in metropolitan areas. We launched a community-wide intervention trial (the Ota Genki Senior Project) in 2016 to develop effective community-based strategies for frailty prevention in metropolitan areas. This report describes the study design and baseline survey.

    Methods: This study is a community-wide intervention trial that integrates participatory action research into a cluster non-randomized controlled trial for adults aged 65 years or older living in Ota City, Tokyo. We allocated 3 of 18 districts to an intervention group and the other 15 to a control group. Using a mailed self-administered questionnaire, we conducted a baseline survey of 15,500 residents (8,000 and 7,500 in the intervention and control groups, respectively) from July through August 2016. In addition to socioeconomic status and lifestyle variables, we assessed frailty status (primary outcome) and physical, nutritional, and psychosocial variables (secondary outcomes). Based on the baseline findings, an intervention to improve outcomes will be implemented as participatory action research. Follow-up surveys will be conducted in the same manner as the baseline survey.

    Results: A total of 11,925 questionnaires were returned (76.9% response rate; 6,105 [76.3%] and 5,820 [77.6%] in the intervention and control groups, respectively), and 11,701 were included in the analysis (mean age, 74.3 [standard deviation, 5.5] years; 48.5% were men).

    Conclusions: This study is expected to contribute to development of a prototype of a community-wide frailty prevention strategy, especially in metropolitan areas in Japan. Trial registration: UMIN Clinical Trials Registry (UMIN000026515).

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