| 1. |
Honda T, Ohara T, Yoshida D, Shibata M, Ishida Y, Furuta Y, Oishi E, Hirakawa Y, Sakata S, Hata J, Nakao T, Ninomiya T, Development of a dementia prediction model for primary care: The Hisayama Study. , Alzheimer’s Dement (Amst), 10.1002/dad2.12221., 13, e12221, 2021.05, Introduction: We aimed to develop a risk prediction model for incident dementia using predictors that are available in primary-care settings.
Methods: A total of 795 subjects aged 65 years or over were prospectively followed-up from 1988 to 2012. A Cox proportional-hazards regression was used to develop a multivariable prediction model. The developed model was translated into a simplified scoring system based on the beta-coefficient. The discrimination of the model was assessed by Harrell's C statistic, and the calibration was assessed by a calibration plot.
Results: During the follow-up period, 364 subjects developed dementia. In the multivariable model, age, female sex, low education, leanness, hypertension, diabetes, history of stroke, current smoking, and sedentariness were selected as predictors. The developed model and simplified score showed good discrimination and calibration.
Discussion: The developed risk prediction model is feasible and practically useful in primary-care settings to identify individuals at high risk for future dementia.
Keywords: dementia; general population; primary prevention; prospective study; risk prediction model.. |
| 2. |
Takanori Honda, Yoichiro Hirakawa, Jun Hata, Sanmei Chen, Mao Shibata, Satoko Sakata, Yoshihiko Furuta, Mayu Higashioka, Emi Oishi, Takanari Kitazono, Toshiharu Ninomiya, Active commuting, commuting modes and the risk of diabetes: 14-year follow-up data from the Hisayama study., Journal of diabetes investigation, 10.1111/jdi.13844, 2022.05, AIMS/INTRODUCTION: We aimed to investigate the association of active commuting (cycling or walking to work), as well as the association of the individual commuting modes, with the risk of diabetes in a prospective cohort of community-dwelling adults in Japan. MATERIAL AND METHODS: A total of 1,270 residents aged 40-79 years were followed up for a median of 14 years. Active commuting was defined as either cycling or walking to work. A Cox proportional hazards model was used to examine the association of active commuting with the risk of diabetes. Associations for different forms of active commuting (cycling, walking and mixed modes of cycling or walking with non-active components) were also examined. RESULTS: During the follow-up period, 191 participants developed diabetes. Active commuting was associated with a lower risk of diabetes than non-active commuting after adjustment for potential confounders (hazard ratio [HR] 0.54, 95% confidence interval [CI] 0.31-0.92). With regard to the commuting modes, the risk of diabetes was significantly lower in individuals who commuted by cycling alone (HR 0.46, 95% CI 0.22-0.98), and tended to be lower in individuals who commuted by walking alone (HR 0.14, 95% CI 0.02-1.02) compared with that in individuals with non-active commuting. Meanwhile, no significant associations were observed for the mixed mode of walking and non-active commuting (HR 1.69, 95% CI 0.77-3.71). CONCLUSIONS: Active commuting, particularly that consisting exclusively of cycling or walking, was associated with a reduced risk of diabetes. Our findings support a public health policy that promotes the choice of active commuting for the prevention of diabetes.. |
| 3. |
Yasuyoshi Washio, Satoko Sakata, Satoru Fukuyama, Takanori Honda, Keiko Kan-O, Mao Shibata, Jun Hata, Hiromasa Inoue, Takanari Kitazono, Koichiro Matsumoto, Toshiharu Ninomiya, Risks of Mortality and Airflow Limitation in Japanese with Preserved Ratio Impaired Spirometry., American journal of respiratory and critical care medicine, 10.1164/rccm.202110-2302OC, 2022.05, RATIONALE: Several Western studies have reported that participants with preserved ratio impaired spirometry (PRISm) have higher risks of airflow limitation (AFL) and death. However, evidence in East Asian populations is limited. OBJECTIVES: To investigate the relation between PRISm and the risks of death and incident AFL in a Japanese population. METHODS: A total of 3,032 community-dwelling Japanese participants aged ≥40 years were followed up for a median of 5.3 years by annual spirometry examinations. Participants were classified into lung function categories at baseline as follows: normal spirometry (forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ≥0.70 and FEV1 ≥80% predicted), PRISm (≥0.70 and <80%), AFL Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1 (<0.70 and ≥80%), and AFL GOLD 2-4 (<0.70 and <80%). Hazard ratios (HRs) and their 95% confidence intervals (CIs) were computed using a Cox proportional hazard model. MEASUREMENTS AND MAIN RESULTS: During the follow-up period, 131 participants died, 22 of whom died from cardiovascular disease, and 218 participants developed AFL. When examining the prognosis of each baseline pulmonary function category, participants with PRISm had higher risks of all-cause death (HR 2.20 [95%CI: 1.35 to 3.59]) and cardiovascular death (HR 4.07 [1.07 to 15.42]) than those with normal spirometry after adjusting for confounders. Moreover, the multivariable-adjusted risk of incident AFL was greater in participants with PRISm than in those with normal spirometry (HR 2.48 [1.83 to 3.36]). CONCLUSIONS: PRISm was associated with higher risks of all-cause and cardiovascular death and a greater risk of the development of AFL in a Japanese community. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).. |
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Fungai Mbengo, Maggie Zgambo, Ebenezer Afrifa-Yamoah, Fatch Welcome Kalembo, Takanori Honda, Yoko Shimpuku, Sanmei Chen, Systematic review protocol of the effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth globally., BMJ open, 10.1136/bmjopen-2021-056929, 12, 5, e056929, 2022.05, INTRODUCTION: Human immunodeficiency virus (HIV) prevention interventions focused at reducing risky sexual behaviours are an important strategy for preventing HIV infection among youth (15-24 years) who continue to be vulnerable to the disease. This systematic review aims to synthesise current global evidence on the effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth in the last decade. METHODS AND ANALYSIS: MEDLINE/PubMed, EMBASE, PsychINFO, ProQuest Central, CINAHL and Web of Science databases, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform and reference lists of included studies and systematic reviews on effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth will be searched for articles published from August 2011 to August 2021. Eligible studies will be longitudinal studies including randomised controlled trials and quasi-experimental studies that examined the effectiveness of HIV prevention interventions among youth populations (15-24 years) with risky sexual behaviour as a primary or secondary outcome. Study selection and quality assessment will be undertaken independently by three reviewers and disagreements will be resolved through consensus. Data analysis will be undertaken using RevMan software V.5.3.3. A random effects meta-analysis will be conducted to report heterogeneous data where statistical pooling is achievable. We will use I2 statistics to test for heterogeneity. Where appropriate, a funnel plot will be generated to assess publication bias. Where statistical pooling is unachievable, the findings will be reported in a narrative form, together with tables and figures to assist in data presentation if required. Reporting of the systematic review will be informed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. ETHICS AND DISSEMINATION: Ethical approval is not required. Findings of the systematic review will be published in a peer-reviewed journal. The findings will be of interest to researchers, healthcare practitioners and policymakers. PROSPERO REGISTRATION NUMBER: CRD42021271774.. |
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Tomoyuki Ohara, Jun Hata, Masashi Tanaka, Takanori Honda, Hajime Yamakage, Takayuki Inoue, Yoichiro Hirakawa, Toru Kusakabe, Mao Shibata, Takanari Kitazono, Tomohiro Nakao, Noriko Satoh-Asahara, Toshiharu Ninomiya, Association of daily sleep duration with the incident dementia by serum soluble TREM2 in a community., Journal of the American Geriatrics Society, 10.1111/jgs.17634, 70, 4, 1147-1156, 2022.04, BACKGROUND: Little is known about the influence of serum level of soluble triggering receptor expressed on myeloid cells 2 (sTREM2), which is a soluble type of an innate immune receptor expressed on the microglia, on the association of the daily sleep duration with the risk of dementia. METHODS: A total of 1230 Japanese community-residents aged 60 and older without dementia were followed prospectively for 10 years (2002-2012). Serum sTREM2 levels were divided into two groups using the median value (334.8 pg/ml). Self-reported daily sleep duration was grouped into three categories of <5.0, 5.0-7.9, and ≥8.0 h. A Cox proportional hazards model was used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) of daily sleep duration on the risk of dementia according to serum sTREM2 levels. RESULTS: During the follow-up, 262 subjects developed dementia. In subjects with low serum sTREM2 levels, subjects with ≥8.0 h of daily sleep had a significantly greater risk of dementia (multivariable-adjusted HR 2.05 [95% CI 1.32-3.19]) than those with 5.0-7.9 h of daily sleep, but those with <5.0 h did not. In contrast, the risk of dementia increased significantly in subjects with both <5.0 (1.95 [1.03-3.68]) and ≥8.0 h of daily sleep (1.48 [1.06-2.07]) in the subjects with high serum sTREM2 levels. CONCLUSIONS: The influence of daily sleep duration on risk of dementia differed according to serum sTREM2 levels in the older Japanese population. Short daily sleep may be associated with greater risk of dementia only in subjects with a high serum sTREM2 level.. |
| 6. |
Masako Asada, Mao Shibata, Naoki Hirabayashi, Tomoyuki Ohara, Yoshihiko Furuta, Taro Nakazawa, Takanori Honda, Jun Hata, Masako Hosoi, Nobuyuki Sudo, Ken Yamaura, Toshiharu Ninomiya, Association between chronic low back pain and regional brain atrophy in a Japanese older population: the Hisayama Study., Pain, 10.1097/j.pain.0000000000002612, 2022.03, ABSTRACT: Chronic low back pain (CLBP) is the leading cause of years lived with disability. Recently, it has been reported that CLBP is associated with alterations in the central nervous system. The present study aimed to investigate the association between CLBP and regional brain atrophy in an older Japanese population. A total of 1106 community-dwelling participants aged ≥65 years underwent brain magnetic resonance imaging scans and a health examination in 2017 to 2018. We used the FreeSurfer software for the analysis of brain magnetic resonance imaging. Chronic pain was defined as subjective pain for ≥3 months. Participants were divided into 3 groups according to the presence or absence of chronic pain and the body part that mainly suffered from pain: a "no chronic pain (NCP)" group (n = 541), "CLBP" group (n = 189), and "chronic pain in body parts other than the lower back (OCP)" group (n = 376). The brain volumes of the ventrolateral and dorsolateral prefrontal cortex, the posterior cingulate gyrus, and the amygdala were significantly lower in the CLBP group than in the NCP group after adjustment for sociodemographic, physical, and lifestyle factors and depressive symptoms. In addition, the left superior frontal gyrus was identified as a significant cluster by the Query, Design, Estimate, Contrast interface. There were no significant differences in the brain volumes of pain-related regions between the NCP and the OCP groups. The present study suggests that CLBP is associated with lower brain volumes of pain-related regions in a general older population of Japanese.. |
| 7. |
Yasumi Kimura, Daigo Yoshida, Tomoyuki Ohara, Jun Hata, Takanori Honda, Yoichiro Hirakawa, Mao Shibata, Emi Oishi, Satoko Sakata, Yoshihiko Furuta, Sanmei Chen, Kazuhiro Uchida, Tomohiro Nakao, Takanari Kitazono, Toshiharu Ninomiya, Long-term association of vegetable and fruit intake with risk of dementia in Japanese older adults: the Hisayama study., BMC geriatrics, 10.1186/s12877-022-02939-2, 22, 1, 257-257, 2022.03, BACKGROUND: Several prospective Western studies have reported an inverse association of vegetable and fruit intake with dementia risk. However, there is limited epidemiologic evidence in Asians. This study investigated the association of intakes of vegetables, fruits, and their nutrients on the risk of incident dementia and its subtypes in a Japanese community. METHODS: A total of 1071 participants (452 men and 619 women) aged ≥60 years without dementia at baseline were prospectively followed up for 24 years. Intakes of vegetables, fruits, and nutrients were evaluated using a 70-item semiquantitative food frequency questionnaire at baseline and were categorized into quartiles separately by gender. The outcome measure was the development of dementia and its subtypes-namely, Alzheimer's disease (AD) and vascular dementia (VaD). The risk estimates of incident dementia were computed using a Cox proportional hazards model. RESULTS: During the long-term follow-up period, 464 subjects developed dementia, of whom 286 had AD and 144 had VaD. Higher vegetable intake was associated gradually with lower risk of developing dementia and AD (both P-trend < 0.05), but not VaD, after adjusting for confounders. Subjects allocated the highest quartile of vegetable intake had 27 and 31% lower risk of dementia and AD, respectively, than those with the lowest quartile. The risk of dementia decreased significantly with higher intakes of vitamin A, riboflavin, vitamin C, magnesium, calcium, and potassium (all P-trend < 0.05). Subjects with higher total dietary fiber intake tended to be at decreased risk for total dementia (P-trend = 0.07). Meanwhile, there were no significant associations between fruit intake and the risk of dementia and its subtypes. CONCLUSION: Higher intakes of vegetables and their constituent nutrients were associated with a lower risk of dementia in Japanese older adults. A diet rich in vegetables may be beneficial in reducing the dementia risk in Asians.. |
| 8. |
Sanmei Chen, Tao Chen, Takanori Honda, Yu Nofuji, Hiro Kishimoto, Kenji Narazaki, Associations of Objectively-Measured Sedentary Time and Patterns with Cognitive Function in Non-Demented Japanese Older Adults: A Cross-Sectional Study., International journal of environmental research and public health, 10.3390/ijerph19041999, 19, 4, 2022.02, This study aimed to investigate the cross-sectional associations of objectively-measured sedentary time and patterns with cognitive function in Japanese older adults. A total of 1681 non-demented community-dwelling older adults (aged 73 ± 6, 62.1% women) were included. Total sedentary time, prolonged sedentary time (accumulated in ≥30 min bouts) and mean sedentary bout length were assessed using a tri-axial accelerometer. Global and domain-specific cognitive functions were measured using the Montreal Cognitive Assessment. The average of total sedentary time and prolonged sedentary time were 462 ± 125 and 186 ± 111 min/day, respectively. Greater prolonged sedentary time, but not total sedentary time, was significantly associated with poorer performance in the orientation domain even after controlling for moderate-to-vigorous physical activity (p for trend = 0.002). A significant inverse association was also observed between mean sedentary bout length and the orientation domain (p for trend = 0.009). No significant associations were observed for global cognitive function or other cognitive domains. Sedentary time accumulated in prolonged bouts, but not total sedentary time, was inversely associated with orientation ability among older adults. Our results encourage further researches to confirm the role of prolonged sedentary time in changes to cognitive domains over time among older adults.. |
| 9. |
Haruki Momma, Ryoko Kawakami, Takanori Honda, Susumu S Sawada, Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies., British journal of sports medicine, 10.1136/bjsports-2021-105061, 2022.02, OBJECTIVE: To quantify the associations between muscle-strengthening activities and the risk of non-communicable diseases and mortality in adults independent of aerobic activities. DESIGN: Systematic review and meta-analysis of prospective cohort studies. DATA SOURCES: MEDLINE and Embase were searched from inception to June 2021 and the reference lists of all related articles were reviewed. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Prospective cohort studies that examined the association between muscle-strengthening activities and health outcomes in adults aged ≥18 years without severe health conditions. RESULTS: Sixteen studies met the eligibility criteria. Muscle-strengthening activities were associated with a 10-17% lower risk of all-cause mortality, cardiovascular disease (CVD), total cancer, diabetes and lung cancer. No association was found between muscle-strengthening activities and the risk of some site-specific cancers (colon, kidney, bladder and pancreatic cancers). J-shaped associations with the maximum risk reduction (approximately 10-20%) at approximately 30-60 min/week of muscle-strengthening activities were found for all-cause mortality, CVD and total cancer, whereas an L-shaped association showing a large risk reduction at up to 60 min/week of muscle-strengthening activities was observed for diabetes. Combined muscle-strengthening and aerobic activities (versus none) were associated with a lower risk of all-cause, CVD and total cancer mortality. CONCLUSION: Muscle-strengthening activities were inversely associated with the risk of all-cause mortality and major non-communicable diseases including CVD, total cancer, diabetes and lung cancer; however, the influence of a higher volume of muscle-strengthening activities on all-cause mortality, CVD and total cancer is unclear when considering the observed J-shaped associations. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020219808.. |
| 10. |
Emi Oishi, Jun Hata, Takanori Honda, Satoko Sakata, Sanmei Chen, Yoichiro Hirakawa, Daigo Yoshida, Mao Shibata, Tomoyuki Ohara, Yoshihiko Furuta, Takanari Kitazono, Toshiharu Ninomiya, Development of a risk prediction model for incident hypertension in Japanese individuals: the Hisayama Study., Hypertension research : official journal of the Japanese Society of Hypertension, 10.1038/s41440-021-00673-7, 44, 9, 1221-1229, 2021.09, The identification of individuals at high risk of developing hypertension can be of great value to improve the efficiency of primary prevention strategies for hypertension. The objective of this study was to develop a risk prediction model for incident hypertension based on prospective longitudinal data from a general Japanese population. A total of 982 subjects aged 40-59 years without hypertension at baseline were followed up for 10 years (2002-12) for the incidence of hypertension. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg, diastolic blood pressure (DBP) ≥ 90 mmHg, or the use of antihypertensive agents. The risk prediction model was developed using a Cox proportional hazards model. A simple risk scoring system was also established based on the developed model. During the follow-up period (median 10 years, interquartile range 5-10 years), 302 subjects (120 men and 182 women) developed new-onset hypertension. The risk prediction model for hypertension consisted of age, sex, SBP, DBP, use of glucose-lowering agents, body mass index (BMI), parental history of hypertension, moderate-to-high alcohol intake, and the interaction between age and BMI. The developed model demonstrated good discrimination (Harrell's C statistic=0.812 [95% confidence interval, 0.791-0.834]; optimism-corrected C statistic based on 200 bootstrap samples=0.804) and calibration (Greenwood-Nam-D'Agostino χ2 statistic=12.2). This risk prediction model is a useful guide for estimating an individual's absolute risk for hypertension and could facilitate the management of Japanese individuals at high risk of developing hypertension in the future.. |
| 11. |
Tao Chen, Takanori Honda, Sanmei Chen, Hiro Kishimoto, Shuzo Kumagai, Kenji Narazaki, Potential utility of physical function measures to improve the risk prediction of functional disability in community-dwelling older Japanese adults: a prospective study., BMC geriatrics, 10.1186/s12877-021-02415-3, 21, 1, 476-476, 2021.09, BACKGROUND: While gait speed, one-leg standing balance, and handgrip strength have been shown to be independent predictors for functional disability, it is unclear whether such simple measures of physical function contribute to improved risk prediction of functional disability in older adults. METHODS: A total of 1,591 adults aged ≥ 65 years and without functional disability at baseline were followed up for up to 7.9 years. Functional disability was identified using the database of Japan's Long-term Care Insurance System. Maximum gait speed, one-leg standing time, and handgrip strength were measured at baseline. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association of physical function and functional disability incidence. The incremental predictive value of each physical function measure for risk prediction was quantified using the difference in overall C-statistic, category-free net reclassification improvement (NRI), and integrated discrimination improvement (IDI) index. RESULTS: During follow-up (median: 7.8 years), functional disability was identified in 384 participants. All of the physical function measures were inversely associated with the risk of functional disability, independent of potential confounding factors. The multivariable adjusted HRs (95 % CIs) for functional disability per one standard deviation increment of maximum gait speed, one-leg-standing time, and hand grip strength were 0.73 (0.65-0.83), 0.68 (0.59-0.79), and 0.72 (0.59-0.86), respectively. Incorporation of each of maximum gait speed, one-leg-stand time, and hand grip strength into a basic model with other risk factors significantly improved C-statistic from 0.770 (95 % CIs, 0.751-0.794) to 0.778 (0.759-0.803), 0.782 (0.760-0.805), and 0.775 (0.756-0.800), respectively (all p < 0.05). A model including all three measures had the highest C-statistic of 0.787 (0.765-0.810). The improvements in risk prediction were also confirmed by category-free NRI and IDI index. CONCLUSIONS: Adding any of the three measures to a basic model with other known risk factors significantly improved the prediction of functional disability and addition of all three measures provided further improvement of the prediction in older Japanese adults. These data provide robust evidence to support the practical utility of incorporating these simple physical function measures into functional disability risk prediction tools.. |
| 12. |
Masahito Yoshinari, Yoichiro Hirakawa, Jun Hata, Mayu Higashioka, Takanori Honda, Daigo Yoshida, Naoko Mukai, Udai Nakamura, Takanari Kitazono, Toshiharu Ninomiya, Comparison of the contributions of impaired beta cell function and insulin resistance to the development of type 2 diabetes in a Japanese community: the Hisayama Study., Diabetologia, 10.1007/s00125-021-05459-7, 64, 8, 1775-1784, 2021.08, AIMS/HYPOTHESIS: Our aim was to compare the contributions of impaired beta cell function (IBF) and insulin resistance with the development of type 2 diabetes in a Japanese community. METHODS: A total of 2094 residents aged 40-79 years without diabetes underwent a health examination including a 75 g OGTT in 2007. Participants were divided into four groups according to the presence or absence of IBF (insulinogenic index/HOMA-IR ≤28.5) and insulin resistance (HOMA-IR ≥1.61) and were followed up for 7 years (2007-2014). Cox's proportional hazards model was used to estimate HRs and 95% CIs for type 2 diabetes. The population attributable fractions (PAFs) due to IBF, insulin resistance, and their combination were calculated. RESULTS: At baseline, the prevalence of isolated IBF, isolated insulin resistance, and both IBF and insulin resistance were 5.4%, 24.1% and 9.5%, respectively. During the follow-up period, 272 participants developed type 2 diabetes. The multivariable-adjusted HRs (95% CI) and PAFs (95% CI) for type 2 diabetes were 6.3 (4.3, 9.2) and 13.3% (8.7, 17.7) in the participants with isolated IBF, 1.9 (1.3, 2.7) and 10.5% (4.0, 16.6) in those with isolated insulin resistance, and 8.0 (5.7, 11.4) and 29.3% (23.0, 35.1) in those with both IBF and insulin resistance, respectively, compared with the participants without either. CONCLUSIONS/INTERPRETATION: The present study suggests that the combination of IBF and insulin resistance makes the main contribution to the development of type 2 diabetes in Japanese communities.. |
| 13. |
Kimitaka Nakamura, Daigo Yoshida, Takanori Honda, Jun Hata, Mao Shibata, Yoichiro Hirakawa, Yoshihiko Furuta, Hiro Kishimoto, Tomoyuki Ohara, Takanari Kitazono, Yasuharu Nakashima, Toshiharu Ninomiya, Prevalence and Mortality of Sarcopenia in a Community-dwelling Older Japanese Population: The Hisayama Study., Journal of epidemiology, 10.2188/jea.JE20190289, 31, 5, 320-327, 2021.05, BACKGROUND: The prevalence of sarcopenia defined using the Asian Working Group for Sarcopenia (AWGS) criteria in Asian communities has not been fully addressed. Moreover, few studies have addressed the influence of sarcopenia on mortality. METHODS: A total of 1,371 and 1,597 residents aged 65 years or older participated in health surveys in 2012 and 2017. Sarcopenia was determined using the AWGS definition. Factors associated with the presence of sarcopenia were assessed using a logistic regression model in participants in the 2012 survey. Subjects in the 2012 survey were followed-up prospectively for a median of 4.3 years. Mortality risk for subjects with sarcopenia was examined using the Cox proportional hazards model. RESULTS: The crude prevalence of sarcopenia was 7.4% and 6.6% in participants at the 2012 and 2017 surveys, respectively; there was no significant difference between surveys (P = 0.44). The prevalence of sarcopenia increased significantly with age in both sexes (both P for trend <0.001). Subjects with sarcopenia were more likely to exercise less regularly, to intake less total energy, and to exhibit a disability in activity of daily living than those without. The multivariable-adjusted hazard ratio for all-cause mortality was 2.20 (95% confidence interval, 1.25-3.85) in subjects with sarcopenia, compared to those without. CONCLUSIONS: Approximately 7% of older subjects had sarcopenia in a community-dwelling older Japanese population. Moreover, subjects with sarcopenia had an increased mortality risk. Our findings suggest that a public health strategy for sarcopenia is needed to extend healthy life expectancy.. |
| 14. |
Takaya Sasaki, Emi Oishi, Takuya Nagata, Satoko Sakata, Sanmei Chen, Yoshihiko Furuta, Takanori Honda, Daigo Yoshida, Jun Hata, Nobuo Tsuboi, Takanari Kitazono, Takashi Yokoo, Toshiharu Ninomiya, N-Terminal Pro-B-Type Natriuretic Peptide and Incident CKD., Kidney international reports, 10.1016/j.ekir.2021.01.006, 6, 4, 976-985, 2021.04, Introduction: Serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels have been associated with the progression of kidney impairment among patients with chronic kidney disease (CKD), but only a few studies have investigated the association between serum NT-proBNP levels and incident CKD in general populations. Methods: A total of 2486 Japanese community-dwelling residents ≥40 years of age without CKD at baseline were followed up by repeated annual health examinations for 10 years. Participants were divided into 4 groups according to serum NT-proBNP levels. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2 or the presence of proteinuria. Cox proportional hazards models were used to estimate hazard ratios (HRs) for risk of CKD. Linear mixed models were used to compare changes in eGFR. Results: During the follow-up period, 800 participants developed CKD. The multivariable-adjusted HRs (95% confidence intervals [CIs]) for developing CKD were 1.00 (reference), 1.32 (1.11-1.57), 1.40 (1.10-1.78), and 1.94 (1.38-2.73) for serum NT-proBNP levels of <55, 55-124, 125-299, and ≥300 pg/ml, respectively (P for trend <0.001). The decline of eGFR during the follow-up was significantly more rapid among participants with higher serum NT-proBNP levels (P for trend <0.001). Adding serum NT-proBNP to the model composed of known risk factors for CKD improved the predictive ability for developing CKD. Conclusions: Higher serum NT-proBNP levels were associated with greater risks of developing CKD and greater decline in eGFR. Serum NT-proBNP could be a useful biomarker for assessing the future risk of CKD in a general Japanese population.. |
| 15. |
Keisuke Yamasaki, Jun Hata, Tomomi Ide, Takuya Nagata, Satoko Sakata, Daigo Yoshida, Takanori Honda, Yoichiro Hirakawa, Toshiaki Nakano, Takanari Kitazono, Hiroyuki Tsutsui, Toshiharu Ninomiya, Urinary N-terminal pro-B-type natriuretic peptide as a biomarker for cardiovascular events in a general Japanese population: the Hisayama Study., Environmental health and preventive medicine, 10.1186/s12199-021-00970-0, 26, 1, 47-47, 2021.04, BACKGROUND: Epidemiological evidence has shown that serum N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations, a diagnostic biomarker for heart failure, are positively associated with cardiovascular risk. Since NT-proBNP in serum is excreted in urine, it is hypothesized that urinary NT-proBNP concentrations are correlated with serum concentrations and linked with cardiovascular risk in the general population. METHODS: A total of 3060 community-dwelling residents aged ≥ 40 years without history of cardiovascular disease (CVD) were followed up for a median of 8.3 years (2007-2015). Serum and urinary concentrations of NT-proBNP at baseline were compared. The hazard ratios (HRs) and their 95% confidence intervals (CIs) for the association between NT-proBNP concentrations and the risk of developing CVD were computed using the Cox proportional hazards model. RESULTS: The median values (interquartile ranges) of serum and urinary NT-proBNP concentrations at baseline were 56 (32-104) pg/mL and 20 (18-25) pg/mL, respectively. There was a strong quadratic correlation between the serum and urinary concentrations of NT-proBNP (coefficient of determination [R2] = 0.72): urinary concentrations of 20, 27, and 43 pg/mL were equivalent to serum concentrations of 55, 125, and 300 pg/mL, respectively. During the follow-up period, 170 subjects developed CVD. The age- and sex-adjusted risk of CVD increased significantly with higher urinary NT-proBNP levels (P for trend < 0.001). This association remained significant after adjustment for traditional cardiovascular risk factors (P for trend = 0.009). The multivariable-adjusted risk of developing CVD almost doubled in subjects with urinary NT-proBNP of ≥ 43 pg/mL as compared to those with urinary NT-proBNP of ≤ 19 pg/mL (HR 2.07, 95% CI 1.20-3.56). CONCLUSIONS: The present study demonstrated that urinary NT-proBNP concentrations were well-correlated with serum concentrations and were positively associated with cardiovascular risk. Given that urine sampling is noninvasive and does not require specially trained personnel, urinary NT-proBNP concentrations have the potential to be an easy and useful biomarker for detecting people at higher cardiovascular risk.. |
| 16. |
Kimitaka Nakamura, Daigo Yoshida, Takanori Honda, Jun Hata, Mao Shibata, Yoichiro Hirakawa, Yoshihiko Furuta, Hiro Kishimoto, Tomoyuki Ohara, Sanmei Chen, Takanari Kitazono, Yasuharu Nakashima, Toshiharu Ninomiya, Midlife and late-life diabetes and sarcopenia in a general older Japanese population: the Hisayama Study., Journal of diabetes investigation, 10.1111/jdi.13550, 2021.03, AIMS/INTRODUCTION: To investigate the association between midlife or late-life diabetes and the development of sarcopenia in an older Japanese population. MATERIALS AND METHODS: A total of 824 Japanese residents aged 65 to 84 years without sarcopenia were followed up from 2012 to 2017. Sarcopenia was determined following the Asian Working Group for Sarcopenia definition. The time of diabetes diagnosis was classified as midlife or late-life diabetes by the age at first diagnosis of diabetes (<65 or ≥65 years) based on annual health checkups data over the past 24 years. The duration of diabetes was categorized into 3 groups of <10, 10-15, and >15 years. The odds ratios of incident sarcopenia according to the diabetic status were estimated using a logistic regression analysis. RESULTS: During follow-up, 47 subjects developed sarcopenia. The multivariable-adjusted odds ratio for incident sarcopenia was significantly greater in subjects with diabetes at baseline than in those without it (odds ratio 2.51, 95% confidence interval 1.26-5.00). Subjects with midlife diabetes had a significantly greater risk of incident sarcopenia, whereas no significant association between late-life diabetes and incident sarcopenia was observed. With a longer duration of diabetes, the risk of incident sarcopenia increased significantly (p for trend = 0.002). CONCLUSIONS: The present study suggests that midlife diabetes and a longer duration of diabetes are significant risk factors for incident sarcopenia in the older population. Preventing diabetes in midlife may reduce the risk of the development of sarcopenia in later life.. |
| 17. |
Jun Hata, Takuya Nagata, Satoko Sakata, Emi Oishi, Yoshihiko Furuta, Yoichiro Hirakawa, Takanori Honda, Daigo Yoshida, Takanari Kitazono, Toshiharu Ninomiya, Risk Prediction Model for Incident Atrial Fibrillation in a General Japanese Population - The Hisayama Study., Circulation journal : official journal of the Japanese Circulation Society, 10.1253/circj.CJ-20-0794, 2021.02, BACKGROUND: The risk prediction of incident atrial fibrillation (AF) is useful to prevent AF and its complications. The aim of this study is to develop a new risk prediction model for incident AF using the prospective longitudinal data from a general Japanese population.Methods and Results:A total of 2,442 community-dwelling AF-free residents aged ≥40 years were followed up from 1988 to 2012 (46,422 person-years). The development of AF was confirmed by a standard 12-lead electrocardiogram at repeated health examinations and by medical records at clinics or hospitals. The risk prediction model for incident AF was developed using a Cox proportional hazards model. During the follow up, 230 AF events were confirmed. Age, sex, systolic blood pressure, waist circumference, estimated glomerular filtration rate, abnormal cardiac murmur, high R-wave amplitude, and arrhythmia other than AF were selected for inclusion in the model. This model showed good discrimination (Harrell's c statistics: 0.785) and calibration (Greenwood-Nam-D'Agostino test: P=0.87) for AF risk at 10 years. CONCLUSIONS: The new risk prediction model showed good performance on the individual risk assessment of the future onset of AF in a general Japanese population. As this model included commonly used clinical parameters, it may be useful for determining the requirements for the careful evaluation of AF, such as frequent electrocardiogram examinations in clinical settings, and subsequent reductions in the risk of AF-related complications.. |
| 18. |
Takanori Honda, Yuki Ishida, Masaaki Oda, Kenichi Noguchi, Sanmei Chen, Satoko Sakata, Emi Oishi, Yoshihiko Furuta, Daigo Yoshida, Yoichiro Hirakawa, Jun Hata, Takanari Kitazono, Toshiharu Ninomiya, Changes in Body Weight and Concurrent Changes in Cardiovascular Risk Profiles in Community Residents in Japan: the Hisayama Study., Journal of atherosclerosis and thrombosis, 10.5551/jat.59394, 2021.01, AIM: We investigated the influence of weight change on concurrent changes in predicted cardiovascular disease (CVD) risk and individual CVD risk factors over time. METHODS: A total of 2,140 community-dwellers aged 40-74 years participated in both 2002 and 2007 health examinations. Obesity was defined as body mass index ≥ 25 kg/m2. Weight trajectories were classified as: "stable obese" (obese at both examinations), "obese to nonobese" (obese in 2002 but nonobese in 2007), "nonobese to obese" (nonobese in 2002 but obese in 2007), or "stable nonobese" (nonobese at both examinations). We compared changes in the model-predicted risk for CVD and individual CVD risk factors across weight-change categories. RESULTS: The predicted risk for CVD increased during 5 years in all groups; the increment in the predicted risk for CVD was smallest in the obese to nonobese participants and steepest in the nonobese to obese subjects. Compared with the stable obese participants, the obese to nonobese participants had greater favorable changes in waist circumferences, blood pressure, fasting plasma glucose, serum high-density lipoprotein cholesterol, serum triglycerides, and liver enzymes. For all these parameters, opposite trends were observed when comparing the nonobese to obese participants with the stable nonobese group. CONCLUSIONS: We demonstrated the favorable association of losing weight in obese people and avoiding excessive weight gain in nonobese people with global risk of future CVD and individual CVD risk factors in a real-world setting. The findings could improve behavioral lifestyle interventions that provide information on the health consequences of weight change at health checkups.. |
| 19. |
Tao Chen, Takanori Honda, Sanmei Chen, Kenji Narazaki, Shuzo Kumagai, Corrigendum to: Dose-Response Association Between Accelerometer-Assessed Physical Activity and Incidence of Functional Disability in Older Japanese Adults: A 6-Year Prospective Study., The journals of gerontology. Series A, Biological sciences and medical sciences, 10.1093/gerona/glaa231, 76, 1, 176-176, 2021.01. |
| 20. |
Tomoyuki Ohara, Daigo Yoshida, Jun Hata, Mao Shibata, Takanori Honda, Yoshihiko Furuta, Naoki Hirabayashi, Takanari Kitazono, Tomohiro Nakao, Toshiharu Ninomiya, Current status of the certification of long-term care insurance among individuals with dementia in a Japanese community: The Hisayama Study., Psychiatry and clinical neurosciences, 10.1111/pcn.13204, 2021.01. |
| 21. |
Takanori Honda, Sanmei Chen, Jun Hata, Daigo Yoshida, Yoichiro Hirakawa, Yoshihiko Furuta, Mao Shibata, Satoko Sakata, Takanari Kitazono, Toshiharu Ninomiya, Development and Validation of a Risk Prediction Model for Atherosclerotic Cardiovascular Disease in Japanese Adults: The Hisayama Study., Journal of atherosclerosis and thrombosis, 10.5551/jat.61960, 2021.01, AIM: To develop and validate a new risk prediction model for predicting the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) in Japanese adults. METHODS: A total of 2,454 participants aged 40-84 years without a history of cardiovascular disease (CVD) were prospectively followed up for 24 years. An incident ASCVD event was defined as the first occurrence of coronary heart disease or atherothrombotic brain infarction. A Cox proportional hazards regression model was used to construct the prediction model. In addition, a simplified scoring system was translated from the developed prediction model. The model performance was evaluated using Harrell's C statistics, a calibration plot with the Greenwood-Nam-D'Agostino test, and a bootstrap validation procedure. RESULTS: During a median of a 24-year follow-up, 270 participants experienced the first ASCVD event. The predictors of the ASCVD events in the multivariable Cox model included age, sex, systolic blood pressure, diabetes, serum high-density lipoprotein cholesterol, serum low-density lipoprotein cholesterol, proteinuria, smoking habits, and regular exercise. The developed models exhibited good discrimination with negligible evidence of overfitting (Harrell's C statistics: 0.786 for the multivariable model and 0.789 for the simplified score) and good calibrations (the Greenwood-Nam-D'Agostino test: P=0.29 for the multivariable model, 0.52 for the simplified score). CONCLUSION: We constructed a risk prediction model for the development of ASCVD in Japanese adults. This prediction model exhibits great potential as a tool for predicting the risk of ASCVD in clinical practice by enabling the identification of specific risk factors for ASCVD in individual patients.. |
| 22. |
Mayu Higashioka, Satoko Sakata, Takanori Honda, Jun Hata, Mao Shibata, Daigo Yoshida, Kenichi Goto, Takanari Kitazono, Haruhiko Osawa, Toshiharu Ninomiya, The Association of Small Dense Low-Density Lipoprotein Cholesterol and Coronary Heart Disease in Subjects at High Cardiovascular Risk., Journal of atherosclerosis and thrombosis, 10.5551/jat.55350, 28, 1, 79-89, 2021.01, AIM: The present study aims to investigate the association between serum small dense low-density lipoprotein (sdLDL) cholesterol level and the development of coronary heart disease (CHD) in subjects at high cardiovascular risk. METHODS: A total of 3,080 participants without prior cardiovascular disease (CVD), aged ≥ 40 years, were followed up for a median of 8.3 years, which were divided into two groups, those with serum sdLDL cholesterol levels of ＜35 mg/dL or ≥ 35 mg/dL. Then, subjects were stratified by the status of diabetes, CVD-related comorbidities (defined as the presence of diabetes, chronic kidney disease, or peripheral artery disease), and the CVD risk assessment according to the Japan Atherosclerosis Society Guidelines. The hazard ratios (HRs) and 95% confidence intervals (CIs) were computed using a Cox proportional hazards model. RESULTS: During the follow-up, 79 subjects developed CHD. The risk for incident CHD was higher in subjects with serum sdLDL cholesterol of ≥ 35 mg/dL than those with sdLDL cholesterol of ＜35 mg/dL (HR 2.09, 95%CI 1.26-3.45) after adjusting for traditional risk factors. In the subgroup analyses, the multivariable-adjusted HR for incident CHD increased significantly in those with serum sdLDL cholesterol of ≥ 35 mg/dL among subjects with diabetes (HR 2.76, 95%CI 1.09-7.01), subjects with CVD-related comorbidities (HR 2.60, 95%CI 1.21-5.58), and high-risk category defined as the presence of CVD-related comorbidities or a Suita score of ≥ 56 points (HR 1.93, 95%CI 1.02-3.65). CONCLUSIONS: Elevated serum sdLDL cholesterol was associated with the development of CHD even in subjects at high cardiovascular risk.. |
| 23. |
Takuya Nagata, Jun Hata, Satoko Sakata, Emi Oishi, Takanori Honda, Yoshihiko Furuta, Tomoyuki Ohara, Daigo Yoshida, Yoichiro Hirakawa, Mao Shibata, Tomomi Ide, Takanari Kitazono, Hiroyuki Tsutsui, Toshiharu Ninomiya, Serum N-terminal pro-B-type natriuretic peptide as a predictor for future development of atrial fibrillation in a general population: the Hisayama Study., International journal of cardiology, 10.1016/j.ijcard.2020.06.018, 320, 90-96, 2020.12, BACKGROUND: Biomarkers for predicting future development of atrial fibrillation (AF) have not been fully established in general populations. The aim of this study was to assess the predictive ability of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) for the development of AF. METHODS AND RESULTS: A total of 3126 community-dwelling Japanese subjects aged ≥ 40 years without a history of AF in 2002 were followed up for a median of 10.2 years. Serum NT-proBNP levels at baseline were divided into four categories (≤ 54, 55-124, 125-299, and ≥ 300 pg/mL) according to the current guidelines and prior reports. The hazard ratios for the development of AF were estimated using a Cox proportional hazards model. During the follow-up period, 153 subjects developed new-onset AF. The age- and sex-adjusted cumulative incidence of AF increased significantly with higher serum NT-proBNP levels (p < 0.001 for trend). The association remained significant after adjustment for known risk factors for AF and cardiovascular disease (hazard ratio [95% confidence interval]: ≤ 54 pg/mL: 1.00 [reference]; 55-124 pg/mL: 1.72 [1.00-2.97]; 125-299 pg/mL: 3.95 [2.23-6.98]; ≥ 300 pg/mL: 8.51 [4.48-16.17]; p < 0.001 for trend). Furthermore, incorporation of serum NT-proBNP levels into the model consisting of known risk factors for AF and cardiovascular disease significantly improved the predictive ability for developing AF (Harrell's c-statistics: 0.828 to 0.844, p = 0.01; continuous net reclassification improvement: 0.41, p < 0.001; integrated discrimination improvement: 0.031, p < 0.001). CONCLUSIONS: Serum NT-proBNP levels can be a risk biomarker for predicting future development of AF in a general Japanese population.. |
| 24. |
Yuki Ishida, Daigo Yoshida, Takanori Honda, Yoichiro Hirakawa, Mao Shibata, Satoko Sakata, Yoshihiko Furuta, Emi Oishi, Jun Hata, Takanari Kitazono, Toshiharu Ninomiya, Influence of the Accumulation of Unhealthy Eating Habits on Obesity in a General Japanese Population: The Hisayama Study., Nutrients, 10.3390/nu12103160, 12, 10, 2020.10, Few studies have examined the association between the accumulation of unhealthy eating habits and the likelihood of obesity or central obesity in a general Japanese population. We examined this association in a sample of 1906 community-dwelling Japanese subjects (age: 40-74 years) who participated in a health check-up in 2014. A face-to-face questionnaire interview was conducted to collect information about three unhealthy eating habits, i.e., snacking, eating quickly, and eating late-evening meals. Obesity was defined as body mass index ≥25 kg/m2 and central obesity was defined as waist circumference ≥90 cm in men and ≥80 cm in women. The odds ratios (OR) were estimated by using a logistic regression analysis. Subjects with any one of the three eating habits had a significantly higher likelihood of obesity than those without that habit after adjusting for confounding factors. The multivariable-adjusted OR for obesity increased linearly with an increase in the number of accumulated unhealthy eating habits (p for trend < 0.001). Similar associations were observed for central obesity. Our findings suggest that modifying each unhealthy eating habit and avoiding an accumulation of multiple unhealthy eating habits might be important to reduce the likelihood of obesity.. |
| 25. |
Tao Chen, Takanori Honda, Sanmei Chen, Kenji Narazaki, Shuzo Kumagai, Anne Newman, Dose–Response Association Between Accelerometer-Assessed Physical Activity and Incidence of Functional Disability in Older Japanese Adults: A 6-Year Prospective Study, The Journals of Gerontology: Series A, 10.1093/gerona/glaa046, 75, 9, 1763-1770, 2020.09, BACKGROUND: It is unknown whether moderate-to-vigorous physical activity (MVPA) in bouts of <10 minutes protects against disability risks or if only 10 minutes bouts of MVPA is critical. Additionally, it is unclear whether light physical activity (LPA) or its accumulation patterns is associated with functional disability. METHODS: A total of 1,678 adults aged ≥65 years and without functional disability at baseline were followed up for 6 years. Functional disability was identified using the database of Japan's Long-term Care Insurance System. Physical activity was measured using a tri-axial accelerometer secured to the waist. RESULTS: Functional disability was identified in 274 participants (16.3%). When examined as quartiles, higher levels of all MVPA measures were dose-dependently associated with lower risk of functional disability. Associations of MVPA in ≥10 and <10 minutes bouts remained significant in a mutually adjusted model. Neither total LPA nor LPA in bout of ≥10 minutes, but LPA in bouts of <10 minutes was associated with functional disability. Analyses using restricted cubic spline functions showed that associations of all MVPA measures and LPA in bouts of <10 minutes with functional disability were linear (p for nonlinear >.05). The hazard ratios (HRs; 95% confidence interval [CI]) for functional disability per 10 minutes increment of total MVPA and LPA in bout of <10 minutes were 0.86 (0.81-0.92) and 0.96 (0.93-0.99), respectively. CONCLUSIONS: Higher MVPA, regardless accumulation patterns, or LPA in bouts of <10 minutes was associated with lower risk of functional disability in a linear dose-response manner in older adults.. |
| 26. |
Daigo Yoshida, Tomoyuki Ohara, Jun Hata, Mao Shibata, Yoichiro Hirakawa, Takanori Honda, Yoshihiko Furuta, Emi Oishi, Satoko Sakata, Shigenobu Kanba, Takanari Kitazono, Toshiharu Ninomiya, Lifetime cumulative incidence of dementia in a community-dwelling elderly population in Japan., Neurology, 10.1212/WNL.0000000000009917, 95, 5, e508-e518, 2020.08, OBJECTIVE: To estimate the lifetime cumulative incidence of dementia and its subtypes from a community-dwelling elderly population in Japan. METHODS: A total of 1,193 community-dwelling Japanese individuals without dementia, aged 60 years or older, were followed up prospectively for 17 years. The cumulative incidence of dementia was estimated based on a death- and dementia-free survival function and the hazard functions of dementia at each year, which were computed by using a Weibull proportional hazards model. The lifetime risk of dementia was defined as the cumulative incidence of dementia at the point in time when the survival probability of the population was estimated to be less than 0.5%. RESULTS: During the follow-up, 350 participants experienced some type of dementia; among them, 191 participants developed Alzheimer disease (AD) and 117 developed vascular dementia (VaD). The lifetime risk of dementia was 55% (95% confidence interval, 49%-60%). Women had an approximately 1.5 times greater lifetime risk of dementia than men (65% [57%-72%] vs 41% [33%-49%]). The lifetime risks of developing AD and VaD were 42% (35%-50%) and 16% (12%-21%) in women vs 20% (7%-34%) and 18% (13%-23%) in men, respectively. CONCLUSION: Lifetime risk of all dementia for Japanese elderly was substantial at approximately 50% or higher. This study suggests that the lifetime burden attributable to dementia in contemporary Japanese communities is immense.. |
| 27. |
Yoichiro Hirakawa, Jun Hata, Masahito Yoshinari, Mayu Higashioka, Daigo Yoshida, Mao Shibata, Takanori Honda, Satoko Sakata, Hiroyuki Kato, Takanori Teramoto, Hideki Maki, Shozo Nishimoto, Takanari Kitazono, Toshiharu Ninomiya, 30-minute postload plasma glucose levels during an oral glucose tolerance test predict the risk of future type 2 diabetes: the Hisayama Study., BMJ open diabetes research & care, 10.1136/bmjdrc-2019-001156, 8, 1, 2020.07, INTRODUCTION: To investigate the associations of 30 min postload plasma glucose (30 mPG) levels during an oral glucose tolerance test (OGTT) with the risk of future diabetes in a general Japanese population. RESEARCH DESIGN AND METHODS: A total of 2957 Japanese community-dwelling residents without diabetes, aged 40-79 years, participated in the examinations in 2007 and 2008 (participation rate, 77.1%). Among them, 2162 subjects who received 75 g OGTT in a fasting state with measurements of plasma glucose level at 0, 30, and 120 min were followed up for 7 years (2007-2014). Cox's proportional hazards model was used to estimate HRs and their 95% CIs of each index for the development of type 2 diabetes using continuous variables and quartiles with adjustment for traditional risk factors. The influence of 30 mPG on the predictive ability was estimated with Harrell's C-statistics, integrated discrimination improvement (IDI), and the continuous net reclassification index (cNRI). RESULTS: During follow-up, 275 subjects experienced type 2 diabetes. Elevated 30 mPG levels were significantly associated with increased risk of developing diabetes (p<0.01 for trend): the multivariable-adjusted HR was 8.41 (95% CI 4.97 to 14.24) for the highest versus the lowest quartile, and 2.26 (2.04 to 2.52) per 1 SD increase. This association was attenuated but remained significant after further adjustment for fasting and 2-hour postload plasma glucose levels. Incorporation of 30 mPG into the model including traditional risk factors with fasting and 2-hour postload plasma glucose levels for diabetes improved the predictive ability of type 2 diabetes (improvement in Harrell's C-statistics values: from 0.828 to 0.839, p<0.01; IDI: 0.016, p<0.01; cNRI: 0.103, p=0.37). CONCLUSIONS: Elevated 30 mPG levels were associated with increased risk of diabetes, and inclusion of 30 mPG levels significantly improved the predictive ability for future diabetes, suggesting that 30 mPG may be useful for identifying high-risk populations for type 2 diabetes.. |
| 28. |
Satoko Sakata, Jun Hata, Takanori Honda, Yoichiro Hirakawa, Emi Oishi, Mao Shibata, Daigo Yoshida, Kenichi Goto, Takanari Kitazono, Toshiharu Ninomiya, Serum uric acid levels and cardiovascular mortality in a general Japanese population
the Hisayama Study, Hypertension Research, 10.1038/s41440-019-0390-8, 43, 6, 560-568, 2020.06, Studies on the association between serum uric acid levels and the risk of cardiovascular disease have yielded inconsistent results. We investigated the association of serum uric acid levels with cardiovascular disease mortality in a Japanese community. A total of 2633 community-dwelling Japanese people aged ≥40 years without a history of cardiovascular disease were followed up for 19 years. Serum uric acid levels were categorized into quintiles (Q1, lowest; Q5, highest). The hazard ratios for mortality from cardiovascular disease, stroke, and coronary heart disease were computed using a Cox proportional hazards model. During the follow-up, 235 subjects died from cardiovascular disease (including 84 from stroke and 53 from coronary heart disease). Risks for cardiovascular disease mortality were higher in both the Q1 and Q5 groups than in the Q3 group after adjustment for confounding factors (Q1, hazard ratio 1.50 [95% confidence interval 0.94–2.39]; Q2, 1.06 [0.66–1.72]; Q3, 1.00 [reference]; Q4, 1.44 [0.93–2.23]; and Q5, 1.89 [1.23–2.91]). A similar U-shaped association was observed for stroke mortality (Q1, 3.26 [1.29–8.25]; Q2, 2.21 [0.85–5.73]; Q3, 1.00 [reference]; Q4, 2.65 [1.07–6.58]; and Q5, 3.77 [1.54–9.24]), while coronary heart disease mortality was increased only in the Q5 group (Q1, 1.27 [0.46–3.50]; Q2, 0.85 [0.29–2.48]; Q3, 1.00 [reference]; Q4, 1.57 [0.63–3.92]; and Q5, 2.53 [1.03–6.18]). Elevated serum uric acid was suggested to be a significant risk factor for stroke or coronary heart disease mortality in a Japanese community. Conversely, the excess risk of stroke mortality in individuals with lower serum uric acid levels may indicate a possible cerebroprotective role of uric acid.. |
| 29. |
Sanmei Chen, Takanori Honda, Tomoyuki Ohara, Jun Hata, Yoichiro Hirakawa, Daigo Yoshida, Mao Shibata, Satoko Sakata, Emi Oishi, Yoshihiko Furuta, Takanari Kitazono, Toshiharu Ninomiya, Serum homocysteine and risk of dementia in Japan, Journal of Neurology, Neurosurgery and Psychiatry, 10.1136/jnnp-2019-322366, 91, 5, 540-546, 2020.05, Objective To examine the association between serum total homocysteine levels (tHcy) and dementia risk. Methods A total of 1588 Japanese adults aged ≥60 years without dementia were prospectively followed from 2002 to 2012. Cox proportional hazards models and restricted cubic splines were used to estimate the HRs of tHcy levels on the risk of dementia. Results During the follow-up, 372 subjects developed all-cause dementia; 247 had Alzheimer's disease (AD) and 98 had vascular dementia (VaD). Compared with the lowest tHcy quintile (≤6.4 μmol/L), the multivariable-adjusted HRs (95% CI) of the highest quintile (≥11.5 μmol/L) were 2.28 (1.51-3.43) for all-cause dementia, 1.96 (1.19-3.24) for AD and 2.51 (1.14-5.51) for VaD. In restricted cubic splines, the risk of all-cause dementia steadily increased between approximately 8-15 μmol/L and plateaued thereafter, with a similar non-linear shape observed for AD and VaD (all p for non-linearity ≤0.02). In stratified analyses by the most recognised genetic polymorphism affecting tHcy concentrations (methylenetetrahydrofolate reductase C677T), the positive association of tHcy with all-cause dementia persisted in both non-carriers and carriers of the risk allele, and even tended to be stronger in the former (p for heterogeneity=0.07). Conclusion High serum tHcy levels are associated with an elevated risk of dementia, AD and VaD in a non-linear manner, such that an exposure-response association is present only within a relatively high range of tHcy levels. Non-genetic factors affecting serum tHcy concentrations may play important roles in tHcy-dementia associations irrespective of the genetic susceptibility for raised tHcy.. |
| 30. |
Tomoyuki Ohara, Yoshihiko Furuta, Naoki Hirabayashi, Jun Hata, Yoichiro Hirakawa, Takanori Honda, Daigo Yoshida, Mao Shibata, Takanari Kitazono, Toshiharu Ninomiya, Elevated serum glycated albumin and glycated albumin : hemoglobin A1c ratio were associated with hippocampal atrophy in a general elderly population of Japanese: The Hisayama Study., Journal of diabetes investigation, 10.1111/jdi.13220, 2020.01, AIMS/INTRODUCTION: To investigate the association of alternative glycemic measures - namely, serum glycated albumin (GA), hemoglobin A1c (HbA1c ) and the GA : HbA1c ratio - with global brain and hippocampal atrophy in a general elderly Japanese population. MATERIALS AND METHODS: A total of 1,278 Japanese individuals aged ≥65 years in a community participated in brain magnetic resonance imaging scanning and screening examination of health status in 2012. We measured total brain volume (TBV), hippocampal volume (HV) and intracranial volume (ICV) using the data from the magnetic resonance imaging examination. The association of each glycemic measure with the ratios of TBV : ICV (an indicator of global brain atrophy) and HV : ICV (an indicator of hippocampal atrophy) was examined by analysis of covariance. RESULTS: The mean values of the TBV : ICV and HV : ICV ratios decreased significantly with elevating serum GA levels and GA : HbA1c ratio levels (all P for trend < 0.05), but not with higher HbA1c levels, after adjusting for age, sex, low education, systolic blood pressure, antihypertensive medication, diabetes mellitus, serum total cholesterol, electrocardiogram abnormalities, body mass index, smoking habits, alcohol drinking habits and regular exercise. These significant associations were still observed in the sensitivity analysis after excluding individuals with mild cognitive impairment and dementia. In addition, increased serum GA levels and the GA : HbA1c ratio levels, but not HbA1c , were closely associated with lower mean values of the TBV : ICV and HV : ICV ratios, irrespective of the presence or absence of diabetes mellitus. CONCLUSIONS: The present study suggests that higher serum GA and higher GA : HbA1c ratio are significantly associated with global brain and hippocampal atrophy.. |
| 31. |
S. Chen, T. Honda, Kenji Narazaki, T. Chen, H. Kishimoto, Shuzo Kumagai, Physical Frailty and Risk of Needing Long-Term Care in Community-Dwelling Older Adults
A 6-Year Prospective Study in Japan, Journal of Nutrition, Health and Aging, 10.1007/s12603-019-1242-6, 23, 9, 856-861, 2019.11, Objective: To examine the association between physical frailty and risk of needing long-term care, and compare the predictive value and clinical usefulness of a simple frailty scale (FRAIL) with that of the original Cardiovascular Health Study (CHS) criteria. Design and Setting: A 6-year prospective cohort study of community-dwelling older adults in a west Japanese suburban town. Participants: 1,554 older adults aged 65 years and over who were initially free of long-term care needs at baseline. Measurements: Physical frailty was defined by the CHS criteria and the FRAIL scale. The onset of needing long-term care was ascertained using national records of certification of long-term care needs. Cox proportional hazard models were used to estimate the association between physical frailty and risk of needing long-term care. Decision curve analysis was performed to compare the clinical usefulness of the two physical frailty criteria. Results: During a median follow-up of 5.8 years, 244 were ascertained as needing long-term care. Baseline physical frailty was significantly associated with elevated risk of needing long-term care, with a multivariable-adjusted hazard ratio (HR) of 2.00 (95% confidence interval [CI], 1.32–3.02) for being frail and 1.50 (95% CI, 1.10–2.03) for being pre-frail as defined by the CHS criteria, compared with being robust (p for trend = 0.001). Similar results were found for physical frailty defined by the FRAIL scale, with a multivariable-adjusted HR (95% CIs) of 2.11 (1.25–3.56) for being frail and 1.73 (1.28–2.35) for being pre-frail vs. being robust (p for trend < 0.001). The two physical frailty criteria had similar net benefits in identifying individuals at high risk for needing long-term care. Conclusions: Physical frailty is significantly associated with an increased risk of needing long-term care in community-dwelling older adults in Japan. Compared with the original CHS criteria, the simple FRAIL scale has comparable predictive value and clinical usefulness for identifying individuals at risk for needing long-term care.. |
| 32. |
Masako Asada, Emi Oishi, Satoko Sakata, Jun Hata, Daigo Yoshida, Takanori Honda, Yoshihiko Furuta, Mao Shibata, Kosuke Suzuki, Hiroshi Watanabe, Norihito Murayama, Takanari Kitazono, Ken Yamaura, Toshiharu Ninomiya, Serum Lipopolysaccharide-Binding Protein Levels and the Incidence of Cardiovascular Disease in a General Japanese Population
The Hisayama Study, Journal of the American Heart Association, 10.1161/JAHA.119.013628, 8, 21, 2019.11, Background: Epidemiological studies have reported a link between serum LBP (lipopolysaccharide-binding protein) levels and lifestyle-related diseases. However, there have been no longitudinal studies investigating the association of serum LBP levels and the incidence of cardiovascular disease (CVD) in general populations. Methods and Results: A total of 2568 community-dwelling Japanese individuals 40 years and older without prior CVD were followed for 10 years (2002–2012). Serum LBP levels were divided into quartiles (quartile 1: 2.20–9.68 μg/mL; quartile 2: 9.69–10.93 μg/mL; quartile 3: 10.94–12.40 μg/mL; quartile 4: 12.41–24.34 μg/mL). The hazard ratios (HRs) and their 95% CIs for the incidence of CVD were computed using a Cox proportional hazards model. During the follow-up period, 180 individuals developed CVD. The age- and sex-adjusted cumulative incidence of CVD increased significantly with higher serum LBP levels (P for trend=0.005). Individuals with higher serum LBP levels had a significantly greater risk of the development of CVD after adjusting for conventional cardiovascular risk factors (quartile 1: HR, 1.00 [reference]; quartile 2: HR, 1.04 [95% CI, 0.60–1.78]; quartile 3: HR, 1.52 [95% CI, 0.92–2.51]; and quartile 4: HR, 1.90 [95% CI, 1.17–3.09]; P for trend=0.01). This association remained significant after additional adjustment for homeostasis model assessment of insulin resistance (P for trend=0.01). However, when additional adjustment was made for high-sensitivity C-reactive protein, the association was attenuated to the nonsignificant level (P for trend=0.08). Conclusions: The present findings suggest that higher serum LBP levels are associated with increased risk of the development of CVD in the general Japanese population. Low-grade endotoxemia may contribute to the pathogenesis of CVD through chronic systemic inflammation.. |
| 33. |
Takanori Honda, Tomoyuki Ohara, Masakazu Shinohara, Jun Hata, Ryuji Toh, Daigo Yoshida, Mao Shibata, Tatsuro Ishida, Yoichiro Hirakawa, Yasuhiro Irino, Satoko Sakata, Kazuhiro Uchida, Takanari Kitazono, Shigenobu Kanba, Ken Ichi Hirata, Toshiharu Ninomiya, Serum elaidic acid concentration and risk of dementia
The Hisayama Study, Neurology, 10.1212/WNL.0000000000008464, 93, 22, e2053-e2064, 2019.11, OBJECTIVE: The associations between trans fatty acids and dementia have been unclear. We investigated the prospective association between serum elaidic acid (trans 18:1 n-9) levels, as an objective biomarker for industrial trans fat, and incident dementia and its subtypes. METHODS: In total, 1,628 Japanese community residents aged 60 and older without dementia were followed prospectively from when they underwent a screening examination in 2002-2003 to November 2012 (median 10.3 years, interquartile range 7.2-10.4 years). Serum elaidic acid levels were measured using gas chromatography/mass spectrometry and divided into quartiles. The Cox proportional hazards model was used to estimate the hazard ratios for all-cause dementia, Alzheimer disease (AD), and vascular dementia by serum elaidic acid levels. RESULTS: During the follow-up, 377 participants developed some type of dementia (247 AD, 102 vascular dementia). Higher serum elaidic acid levels were significantly associated with greater risk of developing all-cause dementia (p for trend = 0.003) and AD (p for trend = 0.02) after adjustment for traditional risk factors. These associations remained significant after adjustment for dietary factors, including total energy intake and intakes of saturated and polyunsaturated fatty acids (both p for trend <0.05). No significant associations were found between serum elaidic acid levels and vascular dementia. CONCLUSIONS: The findings suggest that higher serum elaidic acid is a possible risk factor for the development of all-cause dementia and AD in later life. Public health policy to reduce industrially produced trans fatty acids may assist in the primary prevention of dementia.. |
| 34. |
Serum Lipopolysaccharide-Binding Protein Levels and the Incidence of Cardiovascular Disease in a General Japanese Population: The Hisayama Study.. |
| 35. |
Small Dense Low-Density Lipoprotein Cholesterol and the Risk of Coronary Heart Disease in a Japanese Community.. |
| 36. |
Serum elaidic acid concentration and risk of dementia: The Hisayama study.. |
| 37. |
Takuya Nagata, Tomoyuki Ohara, Jun Hata, Satoko Sakata, Yoshihiko Furuta, Daigo Yoshida, Takanori Honda, Yoichiro Hirakawa, Tomomi Ide, Shigenobu Kanba, Takanari Kitazono, Hiroyuki Tsutsui, Toshiharu Ninomiya, NT-proBNP and Risk of Dementia in a General Japanese Elderly Population
The Hisayama Study, Journal of the American Heart Association, 10.1161/JAHA.118.011652, 8, 17, e011652, 2019.09, Background Epidemiological evidence implies a link between heart disease and dementia. However, few prospective studies have assessed the association between serum NT-proBNP (N-terminal pro-B-type natriuretic peptide) levels and dementia. Methods and Results A total of 1635 community-dwelling Japanese elderly aged ≥60 years without dementia (57% women, mean age±SD 70.8±7.7 years) were followed up for 10 years. Serum NT-proBNP levels were divided into 4 categories (≤54, 55-124, 125-299, and ≥300 pg/mL). The hazard ratios were estimated using a Cox proportional hazards model. During the follow-up period, 377 subjects developed all-cause dementia, 247 Alzheimer disease, and 102 vascular dementia. The age- and sex-adjusted incidence of all-cause dementia was 31.5 per 1000 person-years and increased significantly with higher serum NT-proBNP levels, being 16.4, 32.0, 35.7, and 45.5, respectively (P for trend <0.01). Subjects with serum NT-proBNP levels of ≥300 pg/mL had a significantly higher risk of all-cause dementia (hazard ratio=2.46, 95% CI 1.63-3.71) than those with serum NT-proBNP levels of ≤54 pg/mL after adjusting for confounders. Similar risks were observed for Alzheimer disease and vascular dementia. Incorporation of the serum NT-proBNP level into a model with known risk factors for dementia significantly improved the predictive ability for incident dementia (c-statistics 0.780-0.787, P=0.02; net reclassification improvement 0.189, P=0.001; integrated discrimination improvement 0.011, P=0.003). Conclusions Higher serum NT-proBNP levels were significantly associated with an increased risk of dementia. Serum NT-proBNP could be a novel biomarker for predicting future risk of dementia in the general elderly population.. |
| 38. |
The ratios of serum eicosapentaenoic acid to arachidonic acid and docosahexaenoic acid to arachidonic acid were inversely associated with serum resistin levels: the Hisayama Study.. |
| 39. |
Hata J, Ohara T, Katakura Y, Shmizu K, Yamashita S, Yoshida D, Honda T, Hirakawa Y, Shibata M, Sakata S, Kitazono T, Kuhara S, Ninomiya T, Association Between Serum β-alanine and Risk of Dementia: the Hisayama Study., American Jouranl of Epidemiology, d10.1093/aje/kwz116., 2019.05. |
| 40. |
Ninomiya T, Kanzaki N, Hirakawa Y, Yoshinari M, Higashioka M, Honda T, Shibata M, Sakata S, Yoshida D, Teramoto T, Takemoto S, Nishimoto S, Hata J, Kitazono T, Serum Ethylamine Levels as an Indicator of l-Theanine Consumption and the Risk of Type 2 Diabetes in a General Japanese Population: The Hisayama Study, Diabetes Care, 2019.05. |
| 41. |
Association Between Serum β-alanine and Risk of Dementia: the Hisayama Study.. |
| 42. |
Dairy consumption and risk of functional disability in an elderly Japanese population: the Hisayama Study.. |
| 43. |
Serum Ethylamine Levels as an Indicator of l-Theanine Consumption and the Risk of Type 2 Diabetes in a General Japanese Population: The Hisayama Study.. |
| 44. |
Yonemoto K, Honda T, Kishimoto H, Yoshida D, Hata J, Mukai N, Shibata M, Hirakawa Y, Ninomiya T, Kumagai S, Longitudinal Changes of Physical Activity and Sedentary Time in the Middle-Aged and Older Japanese Population: The Hisayama Study, Journal of Physical Activity and Health, 10.1123/jpah.2017-0701, 66, 165-171, 2019.02. |
| 45. |
Ohara T, Hata J, Tanaka M, Honda T, Yamakage H, Yoshida D, Inoue T, Hirakawa Y, Kusakabe T, Shibata M, Teraoka T, Kitazono T, Kanba S, Satoh-Asahara N, Ninomiya T, Serum Soluble Triggering Receptor Expressed on Myeloid Cells 2 as a Biomarker for Incident Dementia: The Hisayama Study, Annals of Neurology, 10.1002/ana.25385, 16, 47-58, 2019.01, OBJECTIVE:
To investigate the association between serum soluble triggering receptor expressed on myeloid cells 2 (sTREM2), a soluble type of an innate immune receptor expressed on the microglia, and the risk of dementia.
METHODS:
A total of 1,349 Japanese community residents aged 60 and older without dementia were followed prospectively for 10 years (2002-2012). Serum sTREM2 levels were quantified by using an enzyme-linked immunosorbent assay and divided into quartiles. Cox proportional hazards model was used to estimate the hazard ratios (HRs) of serum sTREM2 levels on the risk of dementia.
RESULTS:
During the follow-up, 300 subjects developed all-cause dementia; 193 had Alzheimer's disease (AD), and 85 had vascular dementia (VaD). The age- and sex-adjusted incidences of all-cause dementia, AD, and VaD elevated significantly with higher serum sTREM2 levels (all p for trend < 0.012). These associations were not altered after adjustment for confounding factors, including high-sensitive C-reactive protein. Subjects with the highest quartile of serum sTREM2 levels had significantly higher multivariable-adjusted risks of developing all-cause dementia, AD, and VaD than those with the lowest quartile (HR = 2.03, 95% confidence interval [CI] = 1.39-2.97, p < 0.001 for all-cause dementia; HR = 1.62, 95% CI = 1.02-2.55, p = 0.04 for AD; HR = 2.85, 95% CI = 1.35-6.02, p = 0.006 for VaD). No significant heterogeneity in the association of serum sTREM2 levels with the development of dementia was observed among the other risk factor subgroups (all p for heterogeneity > 0.11).
INTERPRETATION:
The present findings suggest a significant association between increased serum sTREM2 levels and the risk of developing all-cause dementia, AD, and VaD in the general elderly Japanese population.. |
| 46. |
Yoshida D, Ohara T, Hata J, Shibata M, Hirakawa Y, Honda T, Uchida K, Takasugi S, Kitazono T, Kiyohara Y, Ninomiya T, Dairy consumption and risk of functional disability in an elderly Japanese population: the Hisayama Study, American Journal of Clinical Nutrition, 10.1093/ajcn/nqz040., 109, 1661-1671, 2019.01. |
| 47. |
Mayu Higashioka, Yoichiro Hirakawa, Ryoichi Kawamura, Takanori Honda, Jun Hata, Daigo Yoshida, Yasunori Takata, Takanari Kitazono, Haruhiko Osawa, Toshiharu Ninomiya, Ratios of serum eicosapentaenoic acid to arachidonic acid and docosahexaenoic acid to arachidonic acid were inversely associated with serum resistin levels
The Hisayama Study, Journal of Diabetes Investigation, 10.1111/jdi.13129, 2019.01, Aims/Introduction: Resistin is an adipocyte-derived polypeptide that leads to the progression of insulin resistance and subsequent atherosclerosis. Some studies have reported an association between self-reported intake of n−3 polyunsaturated fatty acids (PUFAs) and serum resistin levels. However, no studies have investigated the association between the ratio of serum levels of n−3 to serum n−6 PUFAs and the serum resistin concentration in the general population. Materials and Methods: We carried out a cross-sectional study of 3,200 community-dwelling Japanese individuals aged ≥40 years in 2002–2003. The ratios of serum eicosapentaenoic acid or docosahexaenoic acid to arachidonic acid (AA) were categorized into quartiles. The associations of serum eicosapentaenoic acid/AA and docosahexaenoic acid/AA with the serum resistin concentration were assessed using linear regression models with adjustment for potential confounding factors. Results: The geometric mean of serum resistin was 10.3 ng/mL. The age- and sex-adjusted geometric mean of serum resistin decreased significantly with increased levels of serum eicosapentaenoic acid/AA (quartile 1: 11.3 ng/mL; quartile 2: 10.6 ng/mL; quartile 3: 10.3 ng/mL; quartile 4: 9.3 ng/mL; P for trend <0.001). A similar association was observed for serum docosahexaenoic acid/AA (quartile 1: 11.1 ng/mL; quartile 2: 10.6 ng/mL; quartile 3: 10.1 ng/mL; quartile 4: 9.7 ng/mL; P for trend <0.001). An adjustment for potential confounding factors did not change these associations. Conclusions: Higher ratios of serum n−3 to n−6 PUFAs were associated with lower serum resistin levels. Consumption of a large amount of n−3 PUFAs might have desirable effects on resistin-mediated diseases.. |
| 48. |
Serum Soluble Triggering Receptor Expressed on Myeloid Cells 2 as a Biomarker for Incident Dementia: The Hisayama Study.. |
| 49. |
Hatabe Y, Shibata M, Ohara T, Oishi E, Yoshida D, Honda T, Hata J, Kanba S, Kitazono T, Ninomiya T., Decline in handgrip strength from midlife to late-life is associated with dementia in a Japanese community: the Hisayama Study, Journal of Epidemiology, 10.2188/jea.JE20180137, 2018.12. |
| 50. |
A potential novel pathological implication of serum soluble triggering receptor expressed on myeloid cell 2 in insulin resistance in a general Japanese population: The Hisayama study.. |
| 51. |
Development and validation of modified risk prediction models for cardiovascular disease and its subtypes: The Hisayama Study.. |
| 52. |
Objectively measured sedentary time and diabetes mellitus in a general Japanese population: The Hisayama Study.. |
| 53. |
Ohara T, Honda T, Hata J, Yoshida D, Mukai N, Hirakawa Y, Shibata M, Kishimoto H, Kitazono T, Kanba S, Ninomiya T, Association Between Daily Sleep Duration and Risk of Dementia and Mortality in a Japanese Community, Journal of the American Geriatrics Society, 10.1111/jgs.15446, 146, 1911-1918, 2018.10. |
| 54. |
Tanaka M, Honda T, Yamakage H, Hata J, Yoshida D, Hirakawa Y, Shibata M, Inoue T, Kusakabe T, Satoh-Asahara N, Ninomiya T, A potential novel pathological implication of serum soluble triggering receptor expressed on myeloid cell 2 in insulin resistance in a general Japanese population: The Hisayama study, Diabetes Research and Clinical Practice, 10.1016/j.diabres.2018.10.007, 10, 225-232, 2018.10. |
| 55. |
Honda T, Kishimoto H, Mukai N, Hata J, Yoshida D, Hirakawa Y, Shibata M, Ohara T, Kumagai S, Ninomiya T, Objectively measured sedentary time and diabetes mellitus in a general Japanese population: The Hisayama Study, Journal of Diabetes Investigation, 10.1111/jdi.12968, 279, 809-816, 2018.10. |
| 56. |
Honda T, Yoshida D, Hata J, Hirakawa Y, Ishida Y, Shibata M, Sakata S, Kitazono T, Ninomiya Toshiharu, Development and validation of modified risk prediction models for cardiovascular disease and its subtypes: The Hisayama Study, Atherosclerosis, 10.1016/j.atherosclerosis.2018.10.014, 85, 38-44, 2018.10, Background and aims:
Predicting cardiovascular events is of practical benefit for disease prevention. The aim of this study was to develop and evaluate an updated risk prediction model for cardiovascular diseases and its subtypes.
Methods:
A total of 2,462 community residents aged 40-84 were followed up for 24 years. A Cox’s proportional hazards regression model was used to develop risk prediction models for cardiovascular diseases, and separately for stroke and coronary heart diseases. The risk assessment ability of the developed model was evaluated, and a bootstrapping method was used for internal validation. The predicted risk was translated into a simplified scoring system. A decision curve analysis was used to evaluate clinical usefulness.
Results:
The multivariable model for cardiovascular diseases included age, sex, systolic blood pressure, hemoglobin A1c, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, smoking habits, and regular exercise as predictors. The models for stroke and for coronary heart diseases incorporated both shared and unique variables. The developed models showed good discrimination with little evidence of overfitting (optimism-corrected Harrell’s C statistics 0.726-0.777) and calibrations (Hosmer-Lemeshow test, p = 0.44 – 0.90). The decision curve analysis revealed that the predicted risk-based decision-making would have higher net benefit than either a CVD intervention strategy for all individuals or no individuals.
Conclusions:
The developed risk prediction models showed a good performance and satisfactory internal validity, which may help in understanding individual risk and setting personalized goals, and in promoting risk stratification in public health strategies for CVD prevention.. |
| 57. |
Association Between Daily Sleep Duration and Risk of Dementia and Mortality in a Japanese Community.. |
| 58. |
Patterns and Levels of Sedentary Behavior and Physical Activity in a General Japanese Population: The Hisayama Study.. |
| 59. |
Ahmad Basri Nadzirah, 本田 貴紀, 陳 三妹, Supartini Atin, 平野(小原) 裕子, 一宮 厚, 熊谷 秋三, 日本の大学一年生に見られる自殺願望 : SOCおよび親や親しい友人との関係との関連性, 健康支援 = Japanese journal of health promotion, 19, 2, 157-165, 2017.09. |
| 60. |
Takanori Honda, Sanmei Chen, Koji Yonemoto, Hiro Kishimoto, Tao Chen, Kenji Narazaki, Yuka Haeuchi, Shuzo Kumagai, Sedentary bout durations and metabolic syndrome among working adults: a prospective cohort study, BMC PUBLIC HEALTH, 10.1186/s12889-016-3570-3, 16, 888, 2016.08, Background: This study aimed to examine the associations between time spent in prolonged and non-prolonged sedentary bouts and the development of metabolic syndrome.
Methods: We used data from a prospective study of Japanese workers. Baseline examination was conducted between 2010 and 2011. A total of 430 office workers (58 women) aged 40-64 years without metabolic syndrome were followed up by annual health checkups until 2014. Metabolic syndrome was defined as having >= 3 out of 5 diagnostic criteria from the Joint Interim Statement 2009 definition. Sedentary time was assessed using a tri-axial accelerometer. Time spent in total, prolonged (accumulated >= 30 min) and non-prolonged sedentary bouts (accumulated < 30 min) was calculated. Cox proportional hazards models were used to estimate the risk of developing metabolic syndrome.
Results: During a median follow-up of 3 years, 83 participants developed metabolic syndrome. After adjustment for age, sex, education, smoking, and family income, positive associations were observed between time spent in prolonged sedentary bouts and the development of metabolic syndrome. After additional adjustment for moderate-to-vigorous physical activity, those in the three highest quartiles of time spent in prolonged sedentary bouts showed higher risk of metabolic syndrome compared to the lowest quartile group, with adjusted hazard ratios (95 % confidence intervals) of 2.72 (1.30 - 5.73), 2.42 (1.11 - 5.50), and 2.85 (1.31 - 6.18), respectively. No associations were seen for time spent in total and non-prolonged sedentary bouts.
Conclusions: Sedentary behavior accumulated in a prolonged manner was associated with an increased risk of metabolic syndrome. In devising public health recommendations for the prevention of metabolic disease, the avoidance of prolonged uninterrupted periods of sedentary behavior should be considered.. |
| 61. |
Sanmei Chen, Takanori Honda, Kenji Narazaki, Tao Chen, Yu Nofuji, Shuzo Kumagai, Global cognitive performance and frailty in non-demented community-dwelling older adults: Findings from the Sasaguri Genkimon Study, GERIATRICS & GERONTOLOGY INTERNATIONAL, 10.1111/ggi.12546, 16, 6, 729-736, 2016.06, AimTo investigate the associations of global cognitive performance with frailty and pre-frailty in non-demented community-dwelling older adults.
MethodA cross-sectional study was carried out using data from the baseline survey of the Sasaguri Genkimon Study in 2011. The study sample consisted of 1565 older adults with complete data and no evidence of dementia. Global cognitive performance was evaluated using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Frailty state was defined using the Cardiovascular Health Study criteria, based on five components: unintentional weight loss, low grip strength, exhaustion, low gait speed and low physical activity.
ResultsTotal MoCA and MMSE scores, and their domain-specific scores decreased across the non-frail, pre-frail and frail groups. Poorer total MoCA and MMSE scores, as well as their domain-specific scores, were associated with the greater likelihood of being frail, but not with pre-frailty after full adjustment. The strength of the association with frailty was greater for total MoCA score than for total MMSE score. Domain-specific scores for visuospatial abilities and attention domains in both of the MoCA and MMSE were consistently associated with the likelihood of pre-frailty and frailty, even after being mutually adjusted for all domains.
ConclusionsThe MoCA performance is more strongly associated with the odds of frailty than the MMSE performance in the relatively functional and non-demented older adult population. The present findings could contribute to further exploration of possible common pathways that can be targeted in the prevention and management for both of these two conditions.. |
| 62. |
Tao Chen, Kenji Narazaki, Yuka Haeuchi, Sanmei Chen, Takanori Honda, Shuzo Kumagai, Associations of Sedentary Time and Breaks in Sedentary Time With Disability in Instrumental Activities of Daily Living in Community-Dwelling Older Adults, JOURNAL OF PHYSICAL ACTIVITY & HEALTH, 10.1123/jpah.2015-0090, 13, 3, 303-309, 2016.03, Background: This cross-sectional study was performed to examine associations of objectively measured sedentary time (ST) and breaks in sedentary time (BST) with instrumental activities of daily living (IADL) disability in Japanese community-dwelling older adults. Methods: The sample comprised 1634 older adults (mean age: 73.3 y, men: 38.4%). Sedentary behavior was measured using a triaxial accelerometer. Disability was defined as inability in at least 1 of the IADL tasks using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Results: After adjusting for potential confounders and moderate-to-vigorous physical activity (MVPA), longer ST was significantly associated with higher likelihood of IADL disability, whereas a greater number of BST was associated with lower likelihood of IADL disability. ST and BST remained statistically significant after mutual adjustment with odds ratio of 1.30 (95% confidence interval [CI)], 1.00-1.70) and 0.80 (95% CI, 0.65-0.99), respectively. Conclusions: This study first demonstrated that shorter ST and more BST were associated with lower risk of IADL disability independent of MVPA and that the association for ST was independent of BST and vice versa. These findings suggest not only total ST but also the manner in which it is accumulated may contribute to the maintenance of functional independence in older adults.. |
| 63. |
Tao Chen, Kenji Narazaki, Takanori Honda, Sanmei Chen, Yuki Haeuchi, Yu Y. Nofuji, Eri Matsuo, Shuzo Kumagai, Tri-Axial Accelerometer-Determined Daily Physical Activity and Sedentary Behavior of Suburban Community-Dwelling Older Japanese Adults, JOURNAL OF SPORTS SCIENCE AND MEDICINE, 14, 3, 507-514, 2015.09, Knowledge regarding accelerometer-derived physical activity (PA) and sedentary behavior (SED) levels is scarce for Japanese older adults. The aims of this study were therefore to 1) describe levels of PA and SED in Japanese community-dwelling older adults, using tri-axial accelerometer; 2) examine the variation of PA and SED with respect to sex, age, and body mass index (BMI). Participants of this study were from the baseline survey of the Sasaguri Genkimon Study, who were 65 years or older and not certified as those requiring long-term care. PA was assessed objectively for seven consecutive days using tri-axial accelerometer. A total of 1,739 participants (median age: 72 years, men: 38.0%) with valid PA data were included. Overall, participants in the present study spent 54.5% of their waking time being sedentary and 45.5% being active, of which 5.4% was moderate-to-vigorous physical activity (MVPA). Women accumulated more minutes of light physical activity (LPA) and MVPA compared with men. In contrast, men spent more time being sedentary. Mean steps per day did not differ between sexes. Furthermore, participants with higher BMI (BMI >= 25) had lower PA levels, and longer SED compared with those with lower BMI (BMI <25). PA levels were lower and SED was longer with age. The present study is the first to demonstrate that the levels of PA and SED differed by sex, age, and BMI in Japanese community-dwelling older adults. In particular, women were more active compared with men, providing unique insight into the current level of PA in older adults. Data presented in the study will enable further investigation of additional determinants of PA and SED in order to develop effective population-based intervention strategies to promote PA and reduce prolonged SED in the Japanese population and possibly other rapidly aging societies.. |
| 64. |
Chen Sanmei, Honda Takanori, Narazaki Kenji, Chen Tao, Nofuji Yu, Haeuchi Yuka, Kumagai Shuzo, Combination of the clock drawing test with frailty phenotype for the prediction of incident disability in two-year follow-up among nondemented community-dwelling older adults, Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 10.1016/j.jalz.2015.06.1634, 11, 7, 732-733, 2015.07. |
| 65. |
Chen Tao, Narazaki Kenji, Haeuchi Yuka, Chen Sanmei, Honda Takanori, Kumagai Shuzo, Associations of Light Physical Activity and Sedentary Time with IADL Disability in Community-dwelling Older Adults, MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, 10.1249/01.mss.0000478849.57611.42, 47, 5, 774, 2015.05. |
| 66. |
Sanmei Chen, Takanori Honda, Tao Chen, Kenji Narazaki, Yuka Haeuchi, Atin Supartini, Shuzo Kumagai, Screening for frailty phenotype with objectively-measured physical activity in a west Japanese suburban community: evidence from the Sasaguri Genkimon Study, BMC GERIATRICS, 10.1186/s12877-015-0037-9, 15, 36, 2015.04, Background: The low physical activity domain of the frailty phenotype has been assessed with various self-reported questionnaires, which are prone to possible recall bias and a lack of diagnostic accuracy. The primary purpose of this study was to define the low physical activity domain of the frailty phenotype using accelerometer-based measurement and to evaluate the internal construct validity among older community-dwellers. Secondly, we examined potential correlates of frailty in this population.
Methods: We conducted a cross-sectional study of 1,527 community-dwelling older men and women aged 65 and over. Data were drawn from the baseline survey of the Sasaguri Genkimon Study, a cohort study carried out in a west Japanese suburban community. Frailty phenotypes were defined by the following five components: unintentional weight loss, low grip strength, exhaustion, slow gait speed, and low physical activity. Of these criteria, physical activity was objectively measured with a tri-axial accelerometer. To confirm our measure's internal validity, we performed a latent class analysis (LCA) to assess whether the five components could aggregate statistically into a syndrome. We examined the correlates of frailty using multiple stepwise logistic regression models.
Results: The estimated prevalence of frailty was 9.3% (95% confidence intervals, CI, 8.4-11.2); 43.9% were pre-frail (95% CI, 41.5-46.4). The percentage of low physical activity was 19.5%. Objectively-assessed physical activity and other components aggregated statistically into a syndrome. Overall, increased age, poorer self-perceived health, depressive and anxiety symptoms, not consuming alcohol, no engagement in social activities, and cognitive impairment were associated with increased odds of frailty status, independent of co-morbidities.
Conclusions: This study confirmed the internal construct validity of the frailty phenotype that defined the low energy expenditure domain with the objective measurement of physical activity. Accelerometry may potentially standardize the measurement of low physical activity and improve the diagnostic accuracy of the frailty phenotype criteria in primary care setting. The potential role of factors associated with frailty merits further studies to explore their clinical application.. |
| 67. |
Takanori Honda, Sanmei Chen, Hiro Kishimoto, Kenji Narazaki, Shuzo Kumagai, Identifying associations between sedentary time and cardio-metabolic risk factors in working adults using objective and subjective measures: a cross-sectional analysis, BMC PUBLIC HEALTH, 10.1186/1471-2458-14-1307, 14, 1307, 2014.12, Background: Sedentary behavior has been reported to be associated with metabolic and vascular health independent of moderate-to-vigorous physical activity (MVPA). In order to select appropriate options to measure sedentary behavior in practice and research settings, it is worthwhile to characterize the extent to which objective and subjective measures of sedentary behavior quantify adverse health risks in the same population. This cross-sectional analysis compared accelerometer-derived and self-reported sedentary time to identify their association with cardio-metabolic risk factors.
Methods: Cross-sectional analysis was conducted using data from 661 Japanese workers (145 women) aged 20-64 years. Participants wore a tri-axial accelerometer device for 10 consecutive days and completed the Japan Atherosclerosis Longitudinal Study Physical Activity Questionnaire. Data on body mass index, waist circumference, resting blood pressure, triglycerides, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, total: HDL cholesterol ratio, blood glucose, and glycosylated hemoglobin (HbA1c) were obtained from annual health examinations.
Results: Both accelerometer-derived and self-reported sedentary time were deleteriously associated with triglycerides, HDL-cholesterol, total: HDL ratio, and HbA1c after adjustment for potential confounders including MVPA. There were no significant differences in regression coefficients between the two measures. Thus, the magnitude of the associations of both measures with cardio-metabolic risk factors was similar, despite poor agreement between them. Occupational sedentary time was correlated with both measures of total sedentary time, and more consistently associated with cardio-metabolic risk factors than sedentary leisure time.
Conclusions: Both accelerometer and self-report measurements are similarly associated with cardio-metabolic risk factors in a Japanese working adult population. Subjective and objective measures of sedentary behaviors appear to capture different aspects of behaviors. Further efforts to establish data processing methods integrating objective and subjective measures are needed to more effectively assess sedentary time's relationship to health outcomes.. |
| 68. |
Kenji Narazaki, Eri Matsuo, Takanori Honda, Yu Nofuji, Koji Yonemoto, Shuzo Kumagai, Physical Fitness Measures As Potential Markers of Low Cognitive Function in Japanese Community-Dwelling Older Adults without Apparent Cognitive Problems, JOURNAL OF SPORTS SCIENCE AND MEDICINE, 13, 3, 590-596, 2014.09, Detecting signs of cognitive impairment as early as possible is one of the most urgent challenges in preventive care of dementia. It has still been unclear whether physical fitness measures can serve as markers of low cognitive function, a sign of cognitive impairment, in older people free from dementia. The aim of the present study was to examine an association between each of five physical fitness measures and global cognition in Japanese community-dwelling older adults without apparent cognitive problems. The baseline research of the Sasaguri Genkimon Study was conducted from May to August 2011 in Sasaguri town, Fukuoka, Japan. Of the 2,629 baseline subjects who were aged 65 years or older and not certified as individuals requiring nursing care by the town, 1,552 participants without apparent cognitive problems (Mini-Mental State Examination score >= 24) were involved in the present study (59.0% of the baseline subjects, median age: 72 years, men: 40.1%). Global cognitive function was measured by the Japanese version of the Montreal Cognitive Assessment. Handgrip strength, leg strength, sit-to-stand rate, gait speed, and one-leg stand time were examined as physical fitness measures. In multiple linear regression analyses, each of the five physical fitness measures was positively associated with the Montreal Cognitive Assessment score after adjusting for age and sex (p < 0.001). These associations were preserved after additional adjustment for years of formal education, body mass index, and other confounding factors (p < 0.001). The present study first demonstrated the associations between multiple aspects of physical fitness and global cognitive function in Japanese community-dwelling older people without apparent cognitive problems. These results suggest that each of the physical fitness measures has a potential as a single marker of low cognitive function in older populations free from dementia and thereby can be useful in community-based preventive care of dementia.. |
| 69. |
Association between Tri-axial Accelerometer-derived Sedentary Time and Obesity in a Japanese Community-dwelling Older Population. |
