研究者業績

近藤 克則

コンドウ カツノリ  (Katsunori Kondo)

基本情報

所属
千葉大学 予防医学センター 特任教授 (名誉教授、グランドフェロー)
一般財団法人 医療経済研究・社会保険福祉協会 医療経済研究機構 研究部長 (Director of Research Department)
学位
博士(医学)(千葉大学)
博士(社会福祉学)(日本福祉大学)

J-GLOBAL ID
200901046026104368
researchmap会員ID
1000230928

外部リンク

1983年千葉大学医学部卒業.東京大学医学部付属病院リハビリテーション部医員, 船橋二和(ふたわ)病院リハビリテーション科科長などを経て, 1997年日本福祉大学助教授.University of Kent at Canterbury(イギリス)客員研究員(2000-2001),日本福祉大学教授を経て, 2014年4月から千葉大学教授,2016年4月から国立長寿医療研究センター老年学評価研究部長.「健康格差社会ー何が心と健康を蝕むのか」(医学書院,2005)で社会政策学会賞(奨励賞)受賞. 「健康格差縮小を目指した社会疫学研究」で,2020年「日本医師会医学賞」受賞


学歴

 1

論文

 695
  • 小嶋 雅代, 渡邉 良太, 安岡 実佳子, 竹内 研時, 斎藤 民, 寺部 健哉, 小嶋 俊久, 尾島 俊之, 武藤 剛, 大関 沙依, 近藤 克則
    Journal of Epidemiology 32(Suppl.1) 152-152 2022年1月  
  • Hao Wen, Zhao Wenjing, Kimura Takashi, Ukawa Shigekazu, Kadoya Ken, Kondo Katsunori, Tamakoshi Akiko
    Journal of Epidemiology 32(Suppl.1) 92-92 2022年1月  
  • 山元 絹美, 草間 太郎, 木内 桜, 近藤 克則, 小坂 健, 相田 潤
    Journal of Epidemiology 32(Suppl.1) 169-169 2022年1月  
  • 張 競文, 白井 こころ, 今野 弘規, 田中 麻理, 李 嘉き, 川内 はるな, 王 雨, 岡本 華奈, 近藤 克則, 北村 明彦, 磯 博康
    Journal of Epidemiology 32(Suppl.1) 112-112 2022年1月  
  • 辻 大士, 金森 悟, 渡邉 良太, 横山 芽衣子, 宮國 康弘, 斉藤 雅茂, 近藤 克則
    Journal of Epidemiology 32(Suppl.1) 93-93 2022年1月  
  • 玉田 雄大, 竹内 研時, 斉藤 雅茂, 山口 知香枝, 白井 こころ, 大平 哲也, 小嶋 雅代, 若井 建志, 近藤 克則
    Journal of Epidemiology 32(Suppl.1) 148-148 2022年1月  
  • 王 鶴群, 辻 大士, 井手 一茂, 中込 敦士, 奥園 桜子, 芦田 登代, Lingling, 近藤 克則
    Journal of Epidemiology 32(Suppl.1) 111-111 2022年1月  
  • Atsushi Nakagomi, Koichiro Shiba, Katsunori Kondo, Ichiro Kawachi
    Journal of applied gerontology : the official journal of the Southern Gerontological Society 41(1) 167-175 2022年1月  
    Evidence on the association between internet usage and incidence of depression remains mixed. We examined the associations between different categories of internet usage and developing clinical depression. We used data from the 2013 and 2016 waves of the Japan Gerontological Evaluation Study (JAGES) comprising 12,333 physically and cognitively independent adults aged ≥65 years. Participants were engaged in seven categories of internet usage: communication with friends/family, social media, information collection about health/medicine, searching for medical facilities, purchase of drugs and vitamins, shopping, and banking. We found that internet use for communication had a protective influence on the probability of developing clinical depression defined as the Geriatric Depression Scale scores ≥5 or self-reported diagnosed depression. Our findings support the role of online communication with friends/family in preventing clinical depression among older people. Online communication could be particularly useful in the COVID-19 crisis because many families are geographically dispersed and/or socially distanced.
  • 鄭 丞媛, 井上 祐介, 芳我 ちより, 近藤 克則
    Journal of Epidemiology 32(Suppl.1) 110-110 2022年1月  
  • 野口 泰司, 藤原 聡子, 鄭 丞媛, 井手 一茂, 斎藤 民, 近藤 克則, 尾島 俊之
    Journal of Epidemiology 32(Suppl.1) 149-149 2022年1月  
  • 芳我 ちより, 鄭 丞媛, 井上 祐介, 近藤 克則
    Journal of Epidemiology 32(Suppl.1) 167-167 2022年1月  
  • 田村 元樹, 高杉 友, 中村 美詠子, 柳 奈津代, 坂巻 弘之, 中込 敦士, 佐藤 豪竜, 近藤 克則, 尾島 俊之
    Journal of Epidemiology 32(Suppl.1) 109-109 2022年1月  
  • 高杉 友, 辻 大士, 大塚 理加, 宮國 康弘, 近藤 克則, 尾島 俊之
    Journal of Epidemiology 32(Suppl.1) 160-160 2022年1月  
  • 阿部 紀之, 井手 一茂, 辻 大士, 宮國 康弘, 櫻庭 唱子, 近藤 克則
    総合リハビリテーション 50(1) 61-67 2022年1月  
    <文献概要>[目的]千葉県松戸市が取り組む通いの場(元気応援くらぶ)事業またはその他の通いの場(グループ活動や会)への1年間参加による介護予防効果を検証すること.[方法]対象は2017年と2018年の日本老年学的評価研究の調査に回答した高齢者3,111名.目的変数を1年後の「要支援・要介護リスク尺度」3点以上悪化,説明変数を通いの場それぞれへの参加あり,参加なしの3群,調整変数を世帯構成,外出頻度,主観的健康感,主観的経済状況,手段的日常生活動作,要介護リスク点数としたポアソン回帰分析を行った.[結果]参加なし群(1,081名)と比べて元気応援くらぶ参加群(158名)の1年後の要介護リスク尺度3点以上悪化のincidence rate ratioは,75歳以上で0.54(95%信頼区間0.32〜0.90),女性で0.65(0.44〜0.97)であった.その他の社会参加者(1,748名)では有意な関連を認めなかった.[結語]狭義の通いの場に参加している後期高齢者と女性で,1年後の要介護リスク尺度3点以上の悪化は有意に少なく,介護予防効果が示唆された.
  • Anna Kinugawa, Taro Kusama, Takafumi Yamamoto, Sakura Kiuchi, Noriko Nakazawa, Katsunori Kondo, Ken Osaka, Jun Aida
    Appetite 168 105732-105732 2022年1月1日  
    Eating alone is reported to deteriorate health; however, the relationship between eating alone and poor dental health remains unclear. This cross-sectional study aimed to investigate the association between poor dental health and eating alone. Data of participants (n = 156,287) aged ≥65 years from the Japan Gerontological Evaluation Study were evaluated using logistic regression to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association between dental status, including prosthesis use, and eating status. Differences in these associations according to living status were also examined. The mean age of participants was 73.7 (SD = 6.0) years. The percentages of participants eating alone with 20 or more teeth, 10-19 teeth with dental prostheses, 0-9 teeth with dental prostheses, 10-19 teeth without dental prostheses, and 0-9 teeth without dental prostheses were 13.8%, 16.0%, 18.6%, 18.9%, and 27.0%, respectively. After adjusting for covariates, participants with 0-9 teeth without any dental prosthesis showed a significantly higher odds ratio for eating alone (OR = 1.81, 95% CI = 1.58-2.07) than those with 20 or more teeth. Among participants with poorer dental status, the probability of eating alone was higher in those living alone than in those living with others. Among older adults, poor dental status was significantly associated with eating alone, and this association was stronger among those living alone. Maintaining better dental status by using a dental prosthesis might reduce the risk of eating alone, especially for those living alone.
  • Koichiro Shiba, Adel Daoud, Shiho Kino, Daisuke Nishi, Katsunori Kondo, Ichiro Kawachi
    Psychiatry and clinical neurosciences 2021年12月22日  
    AIM: Understanding the differential mental health effects of traumatic experiences is important to identify particularly vulnerable subpopulations. We examined the heterogeneous associations between disaster-related traumatic experiences and postdisaster mental health, using a novel machine learning-based causal inference approach. METHODS: Data were from a prospective cohort study of Japanese older adults in an area severely affected by the 2011 Great East Japan Earthquake. The baseline survey was conducted 7 months before the disaster and the 2 follow-up surveys were conducted 2.5 and 5.5 years after (n = 1150 to n = 1644 depending on the exposure-outcome combinations). As disaster-related traumatic experiences, we assessed complete home loss and loss of loved ones. Using the generalized random forest algorithm, we estimated conditional average treatment effects (CATEs) of the disaster damages on postdisaster mental health outcomes to examine the heterogeneous associations by 51 predisaster characteristics of the individuals. RESULTS: We found that, even when there was no population average association between disaster-related trauma and subsequent mental health outcomes, some subgroups experienced severe impacts. We also identified and compared characteristics of the most and least vulnerable groups (ie, top versus bottom deciles of the estimated CATEs). While there were some unique patterns specific to each exposure-outcome combination, the most vulnerable group tended to be from lower socioeconomic backgrounds with preexisting depressive symptoms for many exposure-outcome combinations. CONCLUSIONS: We found considerable heterogeneity in the association between disaster-related traumatic experiences and subsequent mental health problems.
  • Atsuhide Takesue, Yoshimune Hiratsuka, Akira Inoue, Katsunori Kondo, Akira Murakami, Jun Aida
    BMC Geriatrics 21(1) 2021年12月1日  
    Background: While it has been recognized that visual impairment is associated with poor self-rated health (SRH), in addition to various negative health outcomes of visual impairment, the number of older adults with visual impairment is increasing due to population aging. As increasing evidence has been found for the effectiveness of social participation on good SRH, we examined whether there was an association between social participation and SRH and investigated whether the effect differed by visual status. Methods: Questionnaire data on self-reported visual status, social participation, socioeconomic status, and SRH were obtained in 2016. A total of 24,313 community-dwelling individuals aged 65 and over participated. We examined the association of social participation and SRH status among older adults with visual impairment. Stratified analysis and analysis with an interaction term between social participation and visual status were also conducted. Social participation was assessed by the number of participating groups (no participation, one, two, and three or more). Results: Overall visual impairment prevalence was 9.3% (95% CI: 8.9–9.7). Among those with and without visual impairment, prevalence of poor SRH was 38.4 and 13.1%, respectively. However, the association between social participation with SRH was similar, especially for those who participated in one or two groups. For people with (PR = 0.54) and without visual impairment (PR = 0.50), those who participated in two groups showed lower prevalence ratios for poor SRH compared to people without social participation. Conclusion: Social participation showed a beneficial association with SRH among older adults with visual impairment. Future interventions could focus on the potentially positive role of social participation on SRH among older adults with visual impairment.
  • 田村 元樹, 服部 真治, 辻 大士, 近藤 克則, 花里 真道, 坂巻 弘之
    日本公衆衛生雑誌 68(12) 899-913 2021年12月  査読有り
  • 斉藤 雅茂, 辻 大士, 藤田 欽也, 近藤 尚己, 相田 潤, 尾島 俊之, 近藤 克則
    日本公衆衛生雑誌 68(11) 743-752 2021年12月  査読有り
  • Atsushi Nakagomi, Koichiro Shiba, Takayuki Ueno, Katsunori Kondo, Ichiro Kawachi
    Preventive medicine 153 106757-106757 2021年12月  
    General health checks to detect cardiovascular risk factors form part of routine health care in many countries. Cardiovascular disease and dementia share a number of risk factors; however it remains unclear whether general health checks can reduce the incidence of dementia. We used longitudinal data from the Japan Gerontological Evaluation Study with up to 6.4 years follow-up (from 2010 to 2016). A total of 31,012 disability-free adults aged 65-74 were included. The outcome variable was dementia onset certified under the national long-term care insurance system. The treatment variable was defined as having health checks within the past 12 months prior to the baseline survey in 2010. After multiple imputation, we performed propensity score matching (PSM) to exclude off-support individuals who were the least likely to have health checks. We also performed inverse probability treatment weighting (IPTW) to estimate the effect of the treatment if everyone within the population was compliant to health checks. The hazard ratios for dementia onset among those reporting health checks within the previous year was 0.89 (95% confidence interval (CI): 0.78, 1.02) in the PSM analysis and 0.84 (95% CI: 0.75, 0.95) in the IPTW analysis. We then estimated the effect of health checks on 5-year incident dementia. The 5-year cumulative incidence difference based on the PSM analysis was -0.0046 (95%CI: -0.0101, 0.0009), while that based on the IPTW analysis was -0.0046 (95%CI, -0.0090, -0.0002). The PSM and IPTW approaches yielded similar findings that the incidence of dementia was lower among people having health checks.
  • Upul Cooray, Richard G Watt, Georgios Tsakos, Anja Heilmann, Masanori Hariyama, Takafumi Yamamoto, Isuruni Kuruppuarachchige, Katsunori Kondo, Ken Osaka, Jun Aida
    Social science & medicine (1982) 291 114486-114486 2021年12月  
    Prevalence of tooth loss has increased due to population aging. Tooth loss negatively affects the overall physical and social well-being of older adults. Understanding the role of socio-demographic and other predictors associated with tooth loss that are measured in non-clinical settings can be useful in community-level prevention. We used high-dimensional epidemiological data to investigate important factors in predicting tooth loss among older adults over a 6-year period of follow-up. Data was from participants of 2010 and 2016 waves of the Japan Gerontological Evaluation Study (JAGES). A total of 19,407 community-dwelling functionally independent older adults aged 65 and older were included in the analysis. Tooth loss was measured as moving from a higher number of teeth category at the baseline to a lower number of teeth category at the follow-up. Out of 119 potential predictors, age, sex, number of teeth, denture use, chewing difficulty, household income, employment, education, smoking, fruit and vegetable consumption, community participation, time since last health check-up, having a hobby, and feeling worthless were selected using Boruta algorithm. Within the 6-year follow-up, 3013 individuals (15.5%) reported incidence of tooth loss. People who experienced tooth loss were older (72.9 ± 5.2 vs 71.8 ± 4.7), and predominantly men (18.3% vs 13.1%). Extreme gradient boosting (XGBoost) machine learning prediction model had a mean accuracy of 90.5% (±0.9%). A visual analysis of machine learning predictions revealed that the prediction of tooth loss was mainly driven by demographic (older age), baseline oral health (having 10-19 teeth, wearing dentures), and socioeconomic (lower household income, manual occupations) variables. Predictors related to wide a range of determinants contribute towards tooth loss among older adults. In addition to oral health related and demographic factors, socioeconomic factors were important in predicting future tooth loss. Understanding the behaviour of these predictors can thus be useful in developing prevention strategies for tooth loss among older adults.
  • 井手 一茂, 渡邉 良太, 近藤 克則
    総合リハビリテーション 49(12) 1163-1168 2021年12月  
    <文献概要>はじめに 地域における介護予防の取り組みにおいて,通いの場をはじめとする地域活動が重要視されている.しかし,新型コロナウイルス感染症(COVID-19)の流行により,感染予防や感染への恐れから外出を自粛する高齢者や活動を制限された通いの場は多い.このような社会参加・交流,通いの場の活動制限が長引くことで,COVID-19による健康一次被害以外の健康二次被害(要介護リスク悪化など)が生じている.本稿では日本老年学的評価研究(Japan Gerontological Evaluation Study;JAGES)の知見を踏まえながら,介護予防施策の変遷,狭義と広義の通いの場の考え方,通いの場にかかわるエビデンス,COVID-19感染拡大による通いの場への影響と健康二次被害,通いの場の立ち上げや運営の進め方について紹介する.
  • Tomo Takasugi, Taishi Tsuji, Masamichi Hanazato, Yasuhiro Miyaguni, Toshiyuki Ojima, Katsunori Kondo
    BMC Geriatrics 21(1) 2021年12月  
    <title>Abstract</title><sec> <title>Background</title> As the understanding of the association between community-level education and dementia is insufficient, this study examined the contextual association of community-level prevalence of low educational attainment on the risk of dementia incidence. With this study, we further explored the potential differences in the aforementioned associations for urban and non-urban areas. </sec><sec> <title>Methods</title> We analyzed 6 years of prospective cohort data from the Japan Gerontological Evaluation Study, beginning with the baseline data collected between 2010 and 2012, for 51,186 physically and cognitively independent individuals aged ≥65 years (23,785 men and 27,401 women) from 346 communities in 16 municipalities across 7 prefectures. We assessed dementia incidence using available data from the long-term care insurance system in Japan. We dichotomized education years as ≤9 and ≥ 10 years and aggregated individual-level educational attainment as a community-level independent variable. Model 1 covariates were age and sex. Income, residential years, disease, alcohol, smoking, social isolation, and population density were added in Model 2. We conducted multiple imputation to address the missing data. We performed a two-level (community and individual) survival analysis to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). </sec><sec> <title>Results</title> The results indicate that the cumulative incidence of dementia during the follow-up period was 10.6%. The mean proportion with educational attainment of ≤9 years was 40.8% (range: 5.1–87.3%). Low community-level educational attainment was significantly associated with higher dementia incidence (HR: 1.04; 95% CI: 1.01–1.07), estimated by 10 percentage points of low educational attainment after adjusting for individual-level educational years and covariates. While the association was significant in non-urban areas (HR: 1.07; 1.02–1.13), there was no association in urban areas (HR: 1.03; 0.99–1.06). </sec><sec> <title>Conclusions</title> Older people living in communities with low educational attainment among their age demographic develop dementia more often compared with those living in areas with high educational attainment after adjusting for individual-level educational attainment and covariates; the association was pronounced in non-urban areas. Securing education for adolescents as a life course and population approach could thus be crucial in preventing dementia later in life among older people living in non-urban areas. </sec>
  • Mariko Kanamori, Masamichi Hanazato, Daisuke Takagi, Katsunori Kondo, Toshiyuki Ojima, Airi Amemiya, Naoki Kondo
    International Journal of Health Geographics 20(1) 2021年12月  
    <title>Abstract</title><sec> <title>Background</title> Rurality can reflect many aspects of the community, including community characteristics that may be associated with mental health. In this study, we focused on geographical units to address multiple layers of a rural environment. By evaluating rurality at both the municipality and neighborhood (i.e., a smaller unit within a municipality) levels in Japan, we aimed to elucidate the relationship between depression and rurality. To explore the mechanisms linking rurality and depression, we examined how the association between rurality and depression can be explained by community social capital according to geographical units. </sec><sec> <title>Methods</title> We used cross-sectional data from the 2016 wave of the Japan Gerontological Evaluation Study involving 144,822 respondents aged 65 years or older residing in 937 neighborhoods across 39 municipalities. The population density quintile for municipality-level rurality and the quintile for the time required to reach densely inhabited districts for neighborhood-level rurality were used. We calculated the prevalence ratios of depressive symptoms by gender using a three-level (individual, neighborhood, and municipality) Poisson regression. Community social capital was assessed using three components: civic participation, social cohesion, and reciprocity. </sec><sec> <title>Results</title> The prevalence of depressive symptoms was higher in municipalities with lower population density than those with the highest population density; the ratios were 1.22 (95% confidence intervals: 1.15, 1.30) for men and 1.22 (1.13, 1.31) for women. In contrast, when evaluating rurality at the neighborhood level, the prevalence of depressive symptoms was 0.9 times lower for men in rural areas; no such association was observed for women. In rural municipalities, community civic participation was associated with an increased risk of depressive symptoms. In rural neighborhoods, community social cohesion and reciprocity were linked to a lower risk of depressive symptoms. </sec><sec> <title>Conclusions</title> The association between rurality and depression varied according to geographical unit. In rural municipalities, the risk of depression may be higher for both men and women, and the presence of an environment conducive to civic participation may contribute to a higher risk of depression, as observed in this study. The risk of depression in men may be lower in rural neighborhoods in Japan, which may be related to high social cohesion and reciprocity. </sec>
  • Taishi Tsuji, Satoru Kanamori, Ryota Watanabe, Meiko Yokoyama, Yasuhiro Miyaguni, Masashige Saito, Katsunori Kondo
    Scientific Reports 11(1) 2021年12月  
    <title>Abstract</title>The current study investigated the relationship between the frequency of watching sports and depressive symptoms among older adults. This study used cross-sectional data from the Japan Gerontological Evaluation Study, a nationwide mail survey of 21,317 older adults. Depressive symptoms were defined as a Geriatric Depression Scale score of ≥ 5. Participants were queried regarding the average frequency at which they watched sports on-site and via TV/Internet over the past year. Among the 21,317 participants, 4559 (21.4%) had depressive symptoms, while 4808 (22.6%) and 16,576 (77.8%) watched sports on-site and via TV/Internet at least once a year, respectively. Older adults who watched sports on-site a few times/year (prevalence ratio, 0.70; 95% confidence interval, 0.65–0.74) or 1–3 times/month (0.66, 0.53–0.82) were less likely to have depressive symptoms compared to non-spectators after adjusting for frequency of playing sports, exercise activities, and other potential confounders. Meanwhile, a dose–response relationship was confirmed for watching via TV/Internet (prevalence ratio of 0.86, 0.79, and 0.71 for a few times/year, 1–3 times/month, and ≥ 1 time/week, respectively). This study suggested that watching sports on-site or via TV/Internet, regardless of whether they regularly engage in sports, may reduce the risk of depressive symptoms among older adults.
  • Hirotaka Kato, Rei Goto, Taishi Tsuji, Katsunori Kondo
    The European Journal of Health Economics 23(5) 847-861 2021年11月15日  
    <title>Abstract</title>Despite rapidly rising health expenditure associated with population aging, empirical evidence on the effects of cost-sharing on older people is still limited. This study estimated the effects of cost-sharing on the utilization of healthcare and health among older people, the most intensive users of healthcare. We employed a regression discontinuity design by exploiting a drastic reduction in the coinsurance rate from 30 to 10% at age 70 in Japan. We used large administrative claims data as well as income information at the individual level provided by a municipality. Using the claims data with 1,420,252 person-month observations for health expenditure, we found that reduced cost-sharing modestly increased outpatient expenditure, with an implied price elasticity of  – 0.07. When examining the effects of reduced cost-sharing by income, we found that the price elasticities for outpatient expenditure were almost zero,  – 0.08, and  – 0.11 for lower-, middle-, and higher-income individuals, respectively, suggesting that lower-income individuals do not have more elastic demand for outpatient care compared with other income groups. Using large-scale mail survey data with 3404 observations for self-reported health, we found that the cost-sharing reduction significantly improved self-reported health only among lower-income individuals, but drawing clear conclusions about health outcomes is difficult because of a lack of strong graphical evidence to support health improvement. Our results suggest that varying cost-sharing by income for older people (i.e., smaller cost-sharing for lower-income individuals and larger cost-sharing for higher-income individuals) may reduce health expenditure without compromising health.
  • 加藤 清人, 竹田 徳則, 林 尊弘, 平井 寛, 近藤 克則
    日本公衆衛生学会総会抄録集 80回 398-398 2021年11月  
  • 原田 真奈実, 相田 潤, 中澤 典子, 近藤 克則, 小坂 健
    日本公衆衛生学会総会抄録集 80回 264-264 2021年11月  
  • 高杉 友, 辻 大士, 大塚 理加, 宮國 康弘, 近藤 克則, 尾島 俊之
    日本公衆衛生学会総会抄録集 80回 269-269 2021年11月  
  • 王 鶴群, 辻 大士, 井手 一茂, 中込 敦士, LING LING, 近藤 克則
    日本公衆衛生学会総会抄録集 80回 243-243 2021年11月  
  • 辻 大士, 高木 大資, 近藤 尚己, 丸山 佳子, Ling Ling, 王 鶴群, 井手 一茂, 近藤 克則
    日本公衆衛生学会総会抄録集 80回 254-254 2021年11月  
  • 井手 一茂, 中込 敦士, 仕子 優樹, 塩谷 竜之介, 古賀 千絵, 長嶺 由衣子, 辻 大士, 近藤 尚己, 近藤 克則
    日本公衆衛生学会総会抄録集 80回 257-257 2021年11月  
  • 坂本 和則, 井手 一茂, 池田 登顕, 近藤 克則
    日本公衆衛生学会総会抄録集 80回 243-243 2021年11月  
  • 金森 悟, 甲斐 裕子, 山口 大輔, 辻 大士, 渡邉 良太, 近藤 克則
    日本公衆衛生学会総会抄録集 80回 370-370 2021年11月  
  • 田村 元樹, 高杉 友, 中村 美詠子, 柳 奈津代, 坂巻 弘之, 中込 敦士, 佐藤 豪竜, 近藤 克則, 尾島 俊之
    日本公衆衛生学会総会抄録集 80回 251-251 2021年11月  
  • 坂本 和則, 井手 一茂, 池田 登顕, 近藤 克則
    日本公衆衛生学会総会抄録集 80回 243-243 2021年11月  
  • 高杉 友, 辻 大士, 大塚 理加, 宮國 康弘, 近藤 克則, 尾島 俊之
    日本公衆衛生学会総会抄録集 80回 269-269 2021年11月  
  • Koichiro Shiba, Jacqueline M Torres, Adel Daoud, Kosuke Inoue, Satoru Kanamori, Taishi Tsuji, Masamitsu Kamada, Katsunori Kondo, Ichiro Kawachi
    Epidemiology (Cambridge, Mass.) 32(6) 886-895 2021年11月1日  
    BACKGROUND: Social participation has been suggested as a means to prevent depressive symptoms. However, it remains unclear whether a one-time boost suffices or whether participation needs to be sustained over time for long-term prevention. We estimated the impacts of alternative hypothetical interventions in social participation on subsequent depressive symptoms among older adults. METHODS: Data were from a nationwide prospective cohort study of Japanese older adults ≥65 years of age (n = 32,748). We analyzed social participation (1) as a baseline exposure from 2010 (approximating a one-time boost intervention) and (2) as a time-varying exposure from 2010 and 2013 (approximating a sustained intervention). We defined binary depressive symptoms in 2016 using the Geriatric Depression Scale. We used the doubly robust targeted maximum likelihood estimation to address time-dependent confounding. RESULTS: The magnitude of the association between sustained participation and the lower prevalence of depressive symptoms was larger than the association observed for baseline participation only (e.g., prevalence ratio [PR] for participation in any activity = 0.83 [95% confidence interval = 0.79, 0.88] vs. 0.90 [0.87, 0.94]). For activities with a lower proportion of consistent participation over time (e.g., senior clubs), there was little evidence of an association between baseline participation and subsequent depressive symptoms, while an association for sustained participation was evident (e.g., PR for senior clubs = 0.96 [0.90, 1.02] vs. 0.88 [0.79, 0.97]). Participation at baseline but withholding participation in 2013 was not associated with subsequent depressive symptoms. CONCLUSIONS: Sustained social participation may be more strongly associated with fewer depressive symptoms among older adults.
  • Koryu Sato, Naoki Kondo, Masamichi Hanazato, Taishi Tsuji, Katsunori Kondo
    The international journal of behavioral nutrition and physical activity 18(1) 140-140 2021年10月29日  
    BACKGROUND: The causal effect of physical activity on reducing dementia risk has been questioned due to the possibility of reverse causation. This study examined the potential causal effects of physical activity on reducing dementia risk using residency in a snowy area as an instrumental variable (IV) representing the physical activity of older adults. METHODS: We used cohort data from the Japan Gerontological Evaluation Study, a longitudinal cohort enrolling people aged 65 or older who were physically and cognitively independent in 2013; study participants were followed for an average of 5.7 years. Participants in the present study included 73,260 individuals living in 19 municipalities in Japan. Physical activity was measured by self-report questionnaires and the incidence of dementia was ascertained by linking participants to the public registries of long-term care insurance. IV estimation was obtained from a piecewise Cox proportional hazard model using a two-stage regression procedure. RESULTS: During the study period, we ascertained 8714 cases (11.9%) of dementia onset. In the IV analysis, we found that the frequency of physical activity per week was negatively associated with dementia risk, though the association weakened over time (Year 1: hazard ratio = 0.53, 95% confidence interval: 0.39-0.74; Year 4: 0.69, 0.53-0.90; Year 6: 0.85, 0.66-1.10). CONCLUSIONS: Our IV analysis indicated a potential causal effect of physical activity on reducing dementia risk that persisted for at least 4 years of follow-up. Thus, we conclude that physical activity should be recommended for older adults to reduce dementia risk.
  • Hazem Abbas, Jun Aida, Sakura Kiuchi, Katsunori Kondo, Ken Osaka
    Oral diseases 29(3) 1291-1298 2021年10月3日  
    OBJECTIVES: Little is known about the association between oral status and homebound status, and there is a possibility of a bidirectional relationship between them. In this exploratory prospective cohort study, we examined the association between four oral status measurements and being homebound bidirectionally. METHODS: We used 2010-2016 panel data gathered from the Japan Gerontological Evaluation Study. All functionally independent participants aged 65 years or older (n = 26,579) were included in this study. Multiple imputation and Poisson regression were used for analyses. We adjusted for age, sex, education, comorbidity, and depressive symptoms. RESULTS: In the fully adjusted model, the prevalence ratio (PR) of being homebound at follow-up was 1.42 for having <20 remaining teeth, 1.28 for having chewing difficulty, 0.99 for having choking experience, and 0.94 for having dry mouth at baseline. Reversely, being homebound at baseline predicted having chewing difficulty at follow-up (PR = 1.17), while no significant association was demonstrated with having <20 teeth (PR = 1.00), choking experience (PR = 1.06), and dry mouth (PR = 1.02). CONCLUSION: Chewing difficulty and having <20 remaining teeth predicted homebound status after 6 years. Reversely, homebound status at baseline only predicted having chewing difficulty at follow-up. These findings may help to determine the oral frailty assessment measures for older people.
  • Wen Hao, Wenjing Zhao, Takashi Kimura, Shigekazu Ukawa, Ken Kadoya, Katsunori Kondo, Akiko Tamakoshi
    BMC geriatrics 21(1) 523-523 2021年10月2日  
    BACKGROUND: Gait was proved to be strongly associated with global cognitive function and multiple cognitive domains; however, previous research usually concentrated on individual gait parameters. This study used wearable sensors to measure gait parameters in different aspects and comprehensively explored the association of gait with global cognitive function and cognitive domains. METHODS: The data of this cross-sectional study were obtained from 236 community-dwelling Japanese older adults (125 men and 111 women) aged 70-81 years. Gait was measured by asking participants to walk a 6-m course and back using the Physilog® sensors (GaiUp®, Switzerland). Global cognitive function and cognitive domains were evaluated by face-to-face interviews using the Japanese version of the Montreal Cognitive Assessment. Twenty gait parameters were summarized as independent gait factors using factor analysis. A generalized linear model and linear regression model were used to explore the relationship of gait with global cognitive function and cognitive domains adjusted for several confounding factors. RESULTS: Factor analysis yielded four gait factors: general cycle, initial contact, propulsion, and mid-swing. Among them, general cycle factor was significantly associated with global cognitive function (β = - 0.487, [- 0.890, - 0.085]) and executive function (P = 0.049); initial contact was associated with executive function (P = 0.017). CONCLUSION: General cycle of gait might be the better marker of global cognitive function and gait is most strongly associated with executive function. The longitudinal relationships should be examined in future cohort studies.
  • Atsushi Nakagomi, Koichiro Shiba, Katsunori Kondo, Ichiro Kawachi
    Aging & mental health 25(10) 1811-1820 2021年10月  
    OBJECTIVES: Widowhood is associated with increased risks of depression in the surviving spouse. We examined whether an increase in individual-level social capital mitigates the adverse impact of widowhood on depressive symptoms. METHODS: We used data from the 2013/2016 waves of the Japan Gerontological Evaluation Study of functionally independent adults aged 65 years or older (men: n = 20,853; women: n =16,858). Fixed-effects regression was applied to examine the potential buffering effects of changes in social capital on changes in depressive symptoms following widowhood among married people living with their spouse and/or others at baseline. RESULTS: Widowhood had a deleterious impact on depressive symptoms particularly among men who ended up living alone following their spouse's death. Fixed-effects models revealed that an increase in informal socializing and social participation might buffer the effects of spousal bereavement on depressive symptoms among men who became widowed during the first two years of follow-up and ended up living alone. DISCUSSION: An increase in structural social capital may mitigate the impact of spousal bereavement on depressive symptoms. However, the associations vary by gender, living arrangement, and time since widowhood. Intensive efforts should be directed toward connecting the vulnerable group, widowed men living alone, to sources of social capital.
  • 井手 一茂, 辻 大士, 渡邉 良太, 横山 芽衣子, 飯塚 玄明, 近藤 克則
    老年社会科学 43(3) 239-251 2021年10月  
    サロン、スポーツ、趣味、ボランティアグループ参加は、どの社会経済階層に多いのか明らかにすることを目的とした。2016年度の日本老年学的評価研究(JAGES)のデータを用い、38市町の65歳以上の高齢者20,972人を対象とした。目的変数は各グループへの参加有無とした。説明変数は、教育歴、等価所得、最長職、調整変数は、人口統計学的要因など計11要因とした。変数の欠損値は多重代入法で補完し、男女別にポアソン回帰分析を実施した。サロンはどの社会経済階層とも有意な関連を示さなかった。スポーツは、男性で低所得層の参加が少なく(出現割合比0.90)、趣味は、男女とも低学歴層の参加が少なかった(男0.92、女0.81)。最長職は、スポーツ・趣味で、管理職以外の社会経済階層が低い人たちの参加が少なかったが、ボランティアで参加が多かった。介護予防事業の評価では、社会経済階層に着目した評価も重要と考えられる。(著者抄録)
  • Koichiro Shiba, Adel Daoud, Hiroyuki Hikichi, Aki Yazawa, Jun Aida, Katsunori Kondo, Ichiro Kawachi
    Science advances 7(40) eabj2610 2021年10月  
    [Figure: see text].
  • 東馬場 要, 井手 一茂, 渡邉 良太, 飯塚 玄明, 近藤 克則
    総合リハビリテーション 49(9) 897-904 2021年9月  
    <文献概要>【背景】社会参加している高齢者は要介護認定リスクが低いとされるが,先行研究で検討されている社会参加の種類は限られている.本研究では,高齢者の社会参加の種類や数と要介護認定との関連を明らかにすることを目的とした.【方法】日本老年学的評価研究(Japan Gerontological Evaluation Study;JAGES)2013年度の自記式郵送調査に回答した地域在住高齢者90,889名を平均約3年間追跡した.説明変数を14種類の社会参加の種類,数とし,エンドポイントを追跡期間中の要介護認定発生とする生存時間分析を実施した.【結果】男女ともに就労,スポーツ,地域行事,環境美化,町内会,ボランティア,趣味,老人クラブ,女性のみ特技伝達,学習・教養,介護予防への参加者の要介護認定発生リスクが有意に低かった.また,男女とも非参加者に比べ社会参加の数が多い者ほど要介護認定発生リスクが有意に低かった.【結論】男女ともに効果が得られやすい8種類やより多くの種類への社会参加が介護予防に有用である可能性が示された.
  • Sae Ozeki, Kenji Takeuchi, Mikako Yasuoka, Koto Kamiji, Toshihisa Kojima, Yuko Waguri-Nagaya, Toshiyuki Ojima, Katsunori Kondo, Kenji Wakai, Masayo Kojima
    Archives of Gerontology and Geriatrics 96 104455-104455 2021年9月  
  • Taro Kusama, Noriko Nakazawa, Sakura Kiuchi, Katsunori Kondo, Ken Osaka, Jun Aida
    Journal of the American Geriatrics Society 69(9) 2498-2506 2021年9月  
    OBJECTIVES: Weight loss is a critical health issue in older adults. Oral function is essential for nutrient intake and can be restored using dental prosthetic treatments in patients with tooth loss. This study aimed to investigate the relationship between tooth loss and weight loss among the older adults and to evaluate the magnitude of its risk reduction by dental prosthetic treatment. DESIGN: Three-year follow-up longitudinal study based on a self-reported questionnaire. SETTING: Community-dwelling older adults in Japan. PARTICIPANTS: Adults aged 65 and older (n = 53,690). MEASUREMENTS: We used >10% weight loss during follow-up, the number of remaining teeth, and the use of dental prostheses as the outcome variable, exposure variable, and mediator, respectively. We fitted the logistic regression model including possible confounders and calculated the odds ratios (ORs) and 95% confidence intervals (95% CIs) of the controlled direct effect (CDE) at the level of use or nonuse of the dental prosthesis based on a causal mediation analysis framework. Additionally, we calculated the proportion eliminated by the dental prosthesis. RESULTS: The mean age of participants was 72.6 years (1 SD = 5.5), and 47.4% were males. About 5.8% (n = 3132) of them experienced >10% weight loss during the follow-up. Weight loss was observed in 6.8% of the participants with 0-19 remaining teeth and in 4.3% of them with ≥20 remaining teeth. The CDE of 0-19 remaining teeth was greater when no one used dental prosthesis (OR = 1.41; 95% CI = 1.26-1.59) compared with that when all participants used dental prosthesis (OR = 1.26; 95% CI = 1.08-1.46). This indicated that dental prosthesis decreased the risk of weight loss by 37.3%. CONCLUSION: Our study revealed that tooth loss increased the risk of clinically critical levels of weight loss among community-dwelling older adults. However, this risk was reduced by dental prosthetic treatment.
  • Mikako Yasuoka, Toshihisa Kojima, Yuko Waguri-Nagaya, Tami Saito, Nobunori Takahashi, Shuji Asai, Yasumori Sobue, Tsuyoshi Nishiume, Mochihito Suzuki, Hiroto Mitsui, Yohei Kawaguchi, Gen Kuroyanagi, Koto Kamiji, Miki Watanabe, Sadao Suzuki, Katsunori Kondo, Toshiyuki Ojima, Masayo Kojima
    Modern Rheumatology 2021年8月12日  
    <title>ABSTRACT</title> <sec> <title>Objectives</title> We aimed to examine the psychosocial characteristics of patients with rheumatoid arthritis (RA) by remission status and determine the impacts of social support on severity of depressive symptoms. </sec> <sec> <title>Methods</title> We enrolled RA patients aged 40–79 years who visited university hospitals’ outpatient clinics. Severity of depressive symptoms (Beck Depression Inventory-II), physical disability (Health Assessment Questionnaire), and support were evaluated. Furthermore, RA disease activity was evaluated by 28-point Disease Activity Score (DAS28) calculation. The independent impacts of instrumental and emotional social support on depressive symptoms by remission status defined as DAS28 score &amp;lt; 2.6 were estimated by multivariable regression analysis. </sec> <sec> <title>Results</title> This study included 360 RA patients. In the remission group, emotional support showed a statistically significant negative impact on depressive symptoms, whereas instrumental support had an extremely limited contribution to severity of depressive symptoms. In the non-remission group, instrumental support showed a negative tendency of impact on severity of depressive symptoms, whereas emotional support had a wide range of influence. </sec> <sec> <title>Conclusions</title> Favourable association between emotional support and depressive symptoms is confirmed only among RA patients in remission status. The influence of emotional support in non-remission patients and that of instrumental support regardless of remission status are inconclusive. </sec>
  • Taiji Noguchi, Chiyoe Murata, Takahiro Hayashi, Ryota Watanabe, Masashige Saito, Masayo Kojima, Katsunori Kondo, Tami Saito
    Journal of Epidemiology and Community Health 76(2) jech-2021 2021年8月2日  
    <sec><title>Background</title>Little is known about the prospective association between community-level social capital and individual-level frailty onset. Therefore, this study aimed to examine the impact of community-level social capital on frailty onset among older adults using 3-year longitudinal data. </sec><sec><title>Methods</title>This prospective cohort study recruited non-institutionalised older adults from the Japan Gerontological Evaluation Study, established in 2013 and robust older adults were followed up for 3 years. We assessed three aspects of community-level social capital (civic participation, social cohesion and reciprocity), and employed a multilevel logistic regression analysis; frailty was evaluated using the Kihon Checklist questionnaire, which has been widely used as a screening tool for frailty in Japan. </sec><sec><title>Results</title>In total, 21 940 older adults (from 384 communities) who were robust at baseline (2013) completed the follow-up survey (2016). Participants’ mean age (SD) was 71.8 (4.9) years, and 51.2% were female. In the follow-up period, frailty onset occurred in 622 participants (2.8%). Regarding community-level social capital variables, civic participation was inversely associated with frailty onset (OR=0.94, 95% CI 0.90 to 0.97, p=0.001), after adjusting for individual-level and community-level covariates. The potential intermediate factors of individual social relationships and health behaviours did not largely change the results. This association was found regardless of individual socioeconomic status. </sec><sec><title>Conclusions</title>Living in a community with rich civic participation, such as engagement in social activities, was associated with lower frailty onset among older adults. Community development that fosters social participation is essential for frailty prevention. </sec>
  • Yukako Tani, Takeo Fujiwara, Katsunori Kondo
    American journal of preventive medicine 61(2) 225-234 2021年8月  
    INTRODUCTION: This study investigated whether individual-level social capital modifies the association between adverse childhood experiences and dementia onset. METHODS: A 3-year follow-up (2013-2016) was conducted among participants who were physically and cognitively independent in the Japan Gerontological Evaluation Study. Dementia incidence for 16,821 participants was assessed through the public long-term care insurance system. Adverse childhood experiences before age 18 years and social capital were assessed using a self-report questionnaire at baseline in 2013. A total of 7 adverse childhood experiences were assessed: parental death, parental divorce, parental mental illness, family violence, physical abuse, psychological neglect, and psychological abuse. To assess social capital's mediating effect, 3 individual social capital items were measured (community trust, reciprocity, and attachment). The overall social capital score was categorized as low (<10th percentile), middle (10th-90th percentile), or high (>90th percentile). Data were analyzed in 2020. RESULTS: During the 3-year follow-up, 652 dementia cases occurred. Those with more adverse childhood experiences had a greater risk of dementia. Stratification by social capital score showed that the hazard ratio of ≥3 adverse childhood experiences (versus none) was 3.25 (95% CI=1.73, 6.10) among those with low social capital and 1.19 (95% CI=0.58, 2.43) among those with middle social capital. Among those with ≥3 adverse childhood experiences and high social capital, no dementia cases were observed. CONCLUSIONS: Among older adults in Japan, adverse childhood experiences were associated with increased dementia incidence only for those with low social capital.

MISC

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主要な書籍等出版物

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講演・口頭発表等

 233

共同研究・競争的資金等の研究課題

 62