Journal of Epidemiology
Online ISSN : 1349-9092
Print ISSN : 0917-5040
ISSN-L : 0917-5040
Volume 29 , Issue 7
Showing 1-5 articles out of 5 articles from the selected issue
Original Article
  • Hiroshi Murayama, Mika Sugiyama, Hiroki Inagaki, Chiaki Ura, Fumiko Mi ...
    2019 Volume 29 Issue 7 Pages 241-246
    Published: July 05, 2019
    Released: July 05, 2019
    [Advance publication] Released: October 20, 2018

    Background: Despite increasing evidence of an association between childhood socioeconomic disadvantage and cognitive outcomes, such as dementia and cognitive decline, in Western countries, there are no studies on this association from non-Western societies. We investigated the relationship between childhood socioeconomic status (SES) and subjective symptoms of dementia among community-dwelling older Japanese people and examined age and sex variations in this association.

    Methods: Data were derived from a cross-sectional survey for all community-dwelling individuals aged 65 years and over in Adachi, Tokyo (n = 132,005). We assessed subjective dementia symptoms using a self-administered dementia checklist, which was validated by comparison with the Clinical Dementia Rating scale.

    Results: Data from 75,358 questionnaires were analyzed. After adjusting for potential covariates, lower childhood SES was associated with greater likelihood of subjective dementia symptoms. We found a significant interaction between childhood SES and age on subjective dementia symptoms but no interaction between childhood SES and sex. Age-stratified analysis indicated that the association between lower childhood SES and subjective dementia symptoms was stronger in the ≥75 years subgroup than in the 65–74 years subgroup, indicating an effect modification of age on this association.

    Conclusions: Our findings suggested that low SES in childhood might have a long-term influence on dementia symptoms in late life and that this influence varied by age. This differential association might be explained by the social and historical context in Japan (ie, World War II, postwar chaos, and high economic growth) that has shaped participants’ early experiences.

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  • Hidetoshi Mezawa, Ai Tomotaki, Kiwako Yamamoto-Hanada, Kazue Ishitsuka ...
    2019 Volume 29 Issue 7 Pages 247-256
    Published: July 05, 2019
    Released: July 05, 2019
    [Advance publication] Released: September 22, 2018

    Background: The aims of the present report were to estimate the prevalence of congenital anomalies (CAs) among infants in Japan using data from the Japan Environment and Children’s Study (JECS) and to evaluate the validity of CA classification within JECS.

    Methods: Data on CAs were collected at delivery and at age 1 month from the medical records of 101,825 infants at 15 regional centers. The analyses focused on 61 CAs, selected on the basis of reported associations with environmental exposure. Prevalence per 10,000 pregnancies (including miscarriages, stillbirths, and live births) was stratified according to four reporting patterns (at delivery, at age 1 month, at either, and at both). To evaluate the accuracy of observed CA prevalence, the medical records of 179 cases from a single JECS regional center underwent independent, retrospective re-evaluation.

    Results: The prevalence of major CAs in four reporting patterns (at delivery, at age 1 month, at either, and at both) was 2.4, 2.6, 3.5, and 1.4 for myelomeningocele/spina bifida; 4.3, 4.2, 5.3, and 3.2 for cleft palate; 18.1, 17.4, 19.5, and 15.1 for cleft lip with or without cleft palate; 73.4, 100.3, 120.8, and 52.8 for congenital heart disease; and 10.5, 14.1, 15.0, and 9.6 for Down’s syndrome, respectively. In the subsample re-evaluation, CA diagnoses were confirmed for 92.7%, 93.3%, 90.5%, and 97.8% of cases in the four reporting patterns (at delivery, at age 1 month, at either, and at both), respectively.

    Conclusions: The present report generated reliable data concerning the prevalence of major CAs in JECS.

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  • Ling Zhou, Xin Zhao, Mulalibieke Heizhati, Suofeiya Abulikemu, Delian ...
    2019 Volume 29 Issue 7 Pages 257-263
    Published: July 05, 2019
    Released: July 05, 2019
    [Advance publication] Released: December 22, 2018

    Background: To examine trends in serum lipids in population in Northwestern Xinjiang between 1998 and 2015 and to provide clues for future prevention.

    Methods: We enrolled 5,142 adults aged ≥30 years from seven independent cross-sectional studies conducted in 1998–2000, 2007–2008, and 2015. Blood lipid profiles, such as total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured.

    Results: The mean age was 48.5 years in 1998–2000, 47.9 years in 2007–2008, and 53.7 years in 2015. There was a declining trend in the prevalence of dyslipidemia among adults in northwestern Xinjiang. Mean LDL-C decreased during the same period, while mean HDL-C showed the opposite trend. Mean TC was 4.79 mmol/L in 1998–2000, 5.17 mmol/L in 2007–2008, and 4.59 mmol/L in 2015. The trend of mean TG was similar to that of TC. The prevalence of dyslipidemia was closely related with male gender, Mongolian ethnicity, hypertension, obesity, elevated fasting blood glucose, smoking, and drinking.

    Conclusion: Between 1998 and 2015, favorable trends in lipid levels have occurred among adults of Northwestern Xinjiang. However, further efforts are needed.

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  • Yasuyuki Okumura, Nobuo Sakata, Hisateru Tachimori, Tadashi Takeshima
    2019 Volume 29 Issue 7 Pages 264-271
    Published: July 05, 2019
    Released: July 05, 2019
    [Advance publication] Released: September 22, 2018

    Background: Understanding the area-specific resource use of inpatient psychiatric care is essential for the efficient use of the public assistance system. This study aimed to assess the geographical variation in psychiatric admissions and to identify the prefecture-level determinants of psychiatric admissions among recipients of public assistance in Japan.

    Methods: We identified all recipients of public assistance who were hospitalized in a psychiatric ward in May 2014, 2015, or 2016 using the Fact-finding Survey on Medical Assistance. The age- and sex-standardized number of psychiatric admissions was calculated for each of the 47 prefectures, using direct and indirect standardization methods.

    Results: A total of 46,559 psychiatric inpatients were identified in May 2016. The number of psychiatric admissions per 100,000 population was 36.6. We found a 7.1-fold difference between the prefectures with the highest (Nagasaki) and lowest (Nagano) numbers of admissions. The method of decomposing explained variance in the multiple regression model showed that the number of psychiatric beds per 100,000 population and the number of recipients of public assistance per 1,000 population were the most important determinants of the number of psychiatric admissions (R2 = 28% and R2 = 23%, respectively). The sensitivity analyses, using medical cost as the outcome and data from different survey years and subgroups, showed similar findings.

    Conclusions: We identified a large geographical variation in the number and total medical cost of psychiatric admissions among recipients of public assistance. Our findings should encourage policy makers to assess the rationale for this variation and consider strategies for reducing it.

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  • Chisato Nagata, Keiko Wada, Yukari Sahashi, Takashi Tamura, Kie Konish ...
    2019 Volume 29 Issue 7 Pages 272-277
    Published: July 05, 2019
    Released: July 05, 2019
    [Advance publication] Released: October 20, 2018

    Background: The early life environment is now recognized as a key factor contributing to susceptibility to certain diseases in later life.

    Methods: We initiated a cohort study among school children in 2011 to primarily investigate the associations between lifestyle and environmental factors and some surrogate markers of chronic diseases, such as cardiometabolic risk factors (ie, obesity, high blood pressure, high blood glucose, insulin, or lipids) and cancer risk factors (ie, height and age at menarche). A baseline questionnaire asked for information, including demographic variables, medical history and use of medication, dietary habits, physical activity, sleep habits, and behavioral and emotional problems of children. Follow-up surveys are planned for the fourth grade of elementary school and the first grade of junior high school. At these follow-up surveys, fasting blood samples will be obtained to measure cardiometabolic markers. We also checked the validity of a food frequency questionnaire, which was originally created for 6-year-olds but was modified for use in older children.

    Results: A total of 3,141 first-year students at elementary schools in Hekinan City, Aichi Prefecture, participated in the study. The response rate was 87.4%. The means of age and body mass index were 6.99 (standard deviation, 0.28) years and 15.3 (standard deviation, 1.7) kg/m2, respectively, in the 3,067 Japanese children (1,639 boys and 1,428 girls).

    Conclusions: This cohort will reveal determinants of cardiometabolic risk factors and cancer risk factors during childhood.

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