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Background Perceived social support (SS) is a key determinant of successful aging; however, its evolution with age and dynamic association with psychological distress (PD) are largely unexplored. Methods We used longitudinal data from nine-wave social surveys conducted in Japan from 2013 to 2022 to track 181,126 observations from 22,419 individuals born between 1946 and 1955. We divided perceived SS into support from family members and from others, and defined PD as a Kessler 6 score (range: 0–24) ≥ 13. We conducted systematic equation modeling to examine how the evolution of SS is associated with PD after controlling for time-invariant individual attributes. Results The prevalence of PD among those who received SS was 2.6% for men and 3.7% for women, which was considerably lower than the 6.5% and 11.4% among those who did not receive SS, respectively. Individuals tended to lose support from family members as they aged but received more support from others, thereby largely sustaining the overall SS. Of the adverse effects of losing support from family members on PD, 53.1% (standard error [SE]: 9.6%) and 55.8% (SE: 6.4%) were moderated by support from others among men and women, respectively. Conclusion These results suggest that most middle-aged and young-old Japanese individuals respond smoothly to declining support from family members by increasing their reliance on support from others.

Background: Although the feasibility of randomized trials for investigating the long-term association between oral health and cognitive decline is low, deriving causal inferences from observational data is challenging. We aimed to investigate the association between poor oral status and subjective cognitive complaints (SCC) using fixed-effects model to eliminate the confounding effect of unobserved time-invariant factors.Methods: We used data from Japan Gerontological Evaluation Study (JAGES) which was conducted in 2010, 2013, and 2016. β regression coefficients and 95% confidence intervals [CIs] were calculated using fixed-effects models to determine the effect of deteriorating oral status on developing SCC. Onset of SCC was evaluated using the Kihon Checklist-Cognitive function score. Four oral status variables were used: awareness of swallowing difficulty, decline in masticatory function, dry mouth, and number of teeth.Results: We included 13,594 participants (55.8% women) without SCC at baseline. The mean age was 72.4 (standard deviation [SD], 5.1) years for men and 72.4 (SD, 4.9) years for women. Within the 6-year follow-up, 26.6% of men and 24.9% of women developed SCC. The probability of developing SCC was significantly higher when participants acquired swallowing difficulty (β = 0.088; 95% CI, 0.065–0.111 for men and β = 0.077; 95% CI, 0.057–0.097 for women), decline in masticatory function (β = 0.039; 95% CI, 0.021–0.057 for men and β = 0.030; 95% CI, 0.013–0.046 for women), dry mouth (β = 0.026; 95% CI, 0.005–0.048 for men and β = 0.064; 95% CI, 0.045–0.083 for women), and tooth loss (β = 0.043; 95% CI, 0.001–0.085 for men and β = 0.058; 95% CI, 0.015–0.102 for women).Conclusion: The findings suggest that good oral health needs to be maintained to prevent the development of SCC, which increases the risk for future dementia.

Background: The trend of the diffusion of heated tobacco products (HTPs) is a great concern because HTPs have become available worldwide. This study examined the sociodemographic characteristics of HTPs users in Japan, where HTPs were first launched. Methods: This cross-sectional study used data from an online survey conducted in 2017. A total of 4,926 participants, aged 20–69 years, were included. The dependent variable was the type of tobacco products used. The independent variables were age and equivalent income. Two analyses estimated the odds ratios (ORs) for 1) being smokers compared to “non-smokers,” and 2) being “HTP smokers” compared to “only combustible cigarette smokers.” Analyses were stratified by sex. Educational attainment and occupation were also used in the sensitivity analyses. Results: The percentages of “non-smokers,” “only combustible cigarette smokers,” and “HTP smokers” were 82.8%, 14.2%, and 3.0%, respectively. When compared to the oldest participants (aged 60–69), the youngest participants (aged 20–29) tended to be “HTP smokers” (OR 7.90; 95% confidence interval [CI], 3.09–20.22 for men and OR 9.28; 95% CI, 2.14–40.28 for women). Compared to participants with the lowest incomes (<2 million), those with the highest incomes (≥4 million) tended to use HTPs (OR 2.93; 95% CI, 1.56–5.49 in men and OR 1.82; 95% CI, 0.73–4.54 in women). These trends were consistent when analyses included only smokers. There were consistent results in other SES measurements, including educational attainment and occupation. Conclusions: Younger or more affluent people tended to use HTPs, although smoking rates among these populations were generally lower. New tobacco control efforts are required.

Social participation (SP) is known to have a favorable impact on an individual’s health. This study examined whether residing in a neighborhood with a high SP level would be predictive of delayed deterioration in health outcomes, even after controlling for individual SP. With the 14-wave longitudinal data of 32,388 individuals (15,749 men and 16,639 women) aged 50–59 years residing in 2,477 neighborhoods in 2005, we used multilevel Cox proportional hazards models to examine the impact of neighborhood SP on the onset of problems in activities of daily living (ADL), poor self-rated health, and psychological distress. Residing in a neighborhood with high SP levels modestly postponed the onset of health problems in individuals. The hazard ratio (HR) of ADL problems in response to residing in a neighborhood with above-average SP levels was 0.92 (95% confidence interval [CI]: 0.85–0.99) and 0.93 (95% CI: 0.87–1.00) for men and women, respectively, even after controlling for an individual’s SP and other attributes. The results for other health outcomes showed a similar pattern. These findings suggest that high neighborhood SP has a favorable impact on health among middle-aged adults, independent of individual SP. Policy measures to enhance and promote neighborhood SP are thus needed in terms of public health.

Background: Although the majority of survivors of the huge Great East Japan Earthquake and Tsunami evacuated to two types of temporary housings, prefabricated housing and rented housing, health effects of these different environments were unclear. We examined whether prevalent social participation in prefabricated housing brought larger health benefits than in rented housing using the largest health survey data of the disaster survivors. Methods: This cross-sectional study used a 2012 survey by the Miyagi Prefectural Government, in which almost all of evacuees were targeted (response rate: 61.6%). Self-rated health (SRH) and psychological distress measured via K6 score were the dependent variables, and social participation was the independent variable. Odds ratios of the social participation on health variables were estimated using logistic regression models. To assess the contribution of social participation, the population attributable fraction (PAF) was estimated. Results: The participants lived in prefabricated and rented housing numbered 19,726 and 28,270, respectively. Participants in prefabricated housing had poorer SRH and K6 than those in rented housing. The proportions of participants engaging in social participation of prefabricated and rented housing were 38.2% and 15.4%, respectively. The absence of social participation was significantly associated with poor SRH and K6 among participants in both housing types. The PAFs of social participation with good SRH were 39.5% in prefabricated housing and 14.4% in rented housing. For K6, the PAFs were 47.1% and 19.5% in prefabricated and rented housing, respectively. Conclusion: Compared to the residents in rented housing, residents in prefabricated housing had more frequent opportunities for social participation, which was associated with larger health benefits.

The adverse impact of caregiving on caregivers’ mental health and the positive impact of social participation (SP) on health are both well understood. This study examined the moderating effect of SP on the association between family caregiving and caregivers’ psychological distress (PD). We used longitudinal data from 27,869 individuals born between 1946 and 1955 collected from a 14-wave nationwide survey, which was conducted from 2005 to 2018. We estimated dynamic panel data models, which could control for an individual’s time-invariant attributes in a dynamic framework, to examine how SP moderated the association between informal caregiving and a caregiver’s PD (defined by a Kessler score of 13 or higher). We observed that the onset of caregiving increased the probability of PD by 2.1% (95% confidence interval [CI]: 1.5%–2.6%) and 1.0% (95% CI: 0.5%–1.6%) for women and men, respectively, compared to 3.4% and 2.8% as the prevalence of PD for women and men, respectively. SP moderated the association between caregiving and a caregiver’s PD by 55.8% (95% CI: 31.9%–79.8%) and 73.5% (95% CI: 36.1%–110.9%) for women and men, respectively. In addition, the moderating effect of SP on a caregiver’s PD increased as the caregiver’s age advanced especially in women. These results suggest the need to keep family caregivers from being socially isolated, especially as they get older.

Aims/hypothesis The aims of the study were to evaluate the association between type 2 diabetes and the risk of death from any cancer and specific cancers in East and South Asians. Methods Pooled analyses were conducted of 19 prospective population-based cohorts included in the Asia Cohort Consortium, comprising data from 658,611 East Asians and 112,686 South Asians. HRs were used to compare individuals with diabetes at baseline with those without diabetes for the risk of death from any cancer and from site-specific cancers, including cancers of the oesophagus, stomach, colorectum, colon, rectum, liver, bile duct, pancreas, lung, breast, endometrium, cervix, ovary, prostate, bladder, kidney and thyroid, as well as lymphoma and leukaemia. Results During a mean follow-up of 12.7 years, 37,343 cancer deaths (36,667 in East Asians and 676 in South Asians) were identified. Baseline diabetes status was statistically significantly associated with an increased risk of death from any cancer (HR 1.26; 95% CI 1.21, 1.31). Significant positive associations with diabetes were observed for cancers of the colorectum (HR 1.41; 95% CI 1.26, 1.57), liver (HR 2.05; 95% CI 1.77, 2.38), bile duct (HR 1.41; 95% CI 1.04, 1.92), gallbladder (HR 1.33; 95% CI 1.10, 1.61), pancreas (HR 1.53; 95% CI 1.32, 1.77), breast (HR 1.72; 95% CI 1.34, 2.19), endometrium (HR 2.73; 95% CI 1.53, 4.85), ovary (HR 1.60; 95% CI 1.06, 2.42), prostate (HR 1.41; 95% CI 1.09, 1.82), kidney (HR 1.84; 95% CI 1.28, 2.64) and thyroid (HR 1.99; 95% CI 1.03, 3.86), as well as lymphoma (HR 1.39; 95% CI 1.04, 1.86). Diabetes was not statistically significantly associated with the risk of death from leukaemia and cancers of the bladder, cervix, oesophagus, stomach and lung. Conclusions/interpretation Diabetes was associated with a 26% increased risk of death from any cancer in Asians. The pattern of associations with specific cancers suggests the need for better control (prevention, detection, management) of the growing epidemic of diabetes (as well as obesity), in order to reduce cancer mortality.

Social participation (SP) is often argued to have a favorable impact on health outcomes. This study examines whether and to what extent social participation can reduce and postpone the need for long-term care (LTC) among middle-aged and older adults in Japan. We used longitudinal data of 17,454 individuals born from 1946 to 1955, obtained from a 17-wave nationwide panel survey conducted from 2005 to 2021 in Japan. We examined (1) whether SP at baseline (2005) was associated with a lower risk of having LTC needs in the last wave (2021) using logistic regression models and (2) whether SP at baseline postponed the onset of these needs using Cox proportional hazards models, both controlling for baseline covariates. The results of different SP activities were compared. Participating in one or more SP activities in 2005 was associated with lower needs for LTC in 2021, with an odds ratio of 0.69 (95% confidence interval [CI], 0.49–0.96), and postponed their onset, with a hazard ratio of 0.71 (95% CI, 0.65–0.78). However, these favorable features of SP were observed only for leisure activities, and no satisfaction with SP activities had a limited association with LTC needs. The results suggest that SP can be associated with a lower risk of LTC needs and postpone their onset; however, these favorable features are limited to leisure activities, and satisfaction with SP activities is needed to enhance them.

Introduction Introducing a primary care physician ( Kakaritsuke-I : KI) system to improve the efficiency of the health care system has been controversial in Japan. This study aimed to determine the relevance of KI to an individual’s health behavioral intentions. Methods We used data from a nationwide, population-based internet survey ( N  = 5,234) to conduct a cross-sectional regression analysis. Additionally, we used a propensity score matching method to mitigate the potential endogenous biases inherent in the decision to have a KI. Results KI was positively associated with various behavioral intentions. For example, the probabilities of intending to eat a well-balanced diet and engaging in moderate exercise were 12.8 (95% confidence interval [CI]:9.5–16.1) percentage points and 7.2 (95% CI: 3.9–10.4) percentage points higher, respectively, among those with a KI than among those without a KI. A KI equally increased the likelihood of getting vaccinated against coronavirus (in November 2021) by 7.5 (95% CI: 5.2–9.8) percentage points. Conclusions Although further analysis is needed to examine the effect of KI on health, the results of this study suggest the potential benefits of policy measures to promote the KI system.

Background Low back pain is an important public health issue across the world. However, it is unclear whether socioeconomic status (SES) is associated with low back pain. This study determines an association between SES and low back pain among older people. Methods We used cross-sectional data derived from the year 2013 across 30 Japanese municipalities. The survey was conducted between October 2013 to December 2013. Functionally independent community-dwelling older adults aged 65 and above ( n  = 26,037) were eligible for the study. Multilevel Poisson regression analysis with a robust variance estimator was used to examine the association between SES and low back pain. Self-reported low back pain in the past year was used as a dependent variable. Educational attainment, past occupation, equivalized household income, wealth, and subjective economic situation represented SES and were separately analyzed as independent variables, adjusted for covariates including age and sex. Results The prevalence of low back pain was 63.4%. Overall, lower SES were more likely to suffer from low back pain compared with that for the highest. First, as for the educational attainment, the prevalence ratio (PR) (95% credible interval (CI)) for the lowest level was 1.07 (1.02–1.12). Second, as for the past occupation, the PR (95% CI) for the blue-collared workers compared with professionals was 1.06 (1.01–1.11). Third, as for the equalized household income, the PRs (95% CI) for lower middle and the lowest income levels were 1.08 (1.02–1.13) and 1.16 (1.10–1.23), respectively. Fourth, as for the wealth, the PRs (95% CI) for lower middle and the lowest wealth levels were 1.11 (1.04–1.19) and 1.18 (1.11–1.27), respectively. Fifth, as for the subjective economic situation, the PRs (95% CI) for lower middle and the lowest financial conditions were 1.18 (1.10–1.26) and 1.32 (1.22–1.44), respectively. Conclusions Significant socioeconomic inequalities were observed in low back pain among older individuals in Japan. Policymakers and clinicians must understand the nature of these inequalities.