Highlights
hot_paper

Journal of Epidemiology


Volume 29, Issue 11 (November 2019)

1) Older Adult Males Who Worked at Small-Sized Workplaces Have an Increased Risk of Decline in Instrumental Activities of Daily Living: A Community-Based Prospective Study
● Although late-life working as well as paid work before old age are associated with functional capacity in older age, the association between old-age working, middle-aged occupation, and functional capacity in old age is unknown.
● Our results demonstrate that workplace size for the longest held job independently predicts a decline in instrumental activities of daily living (IADL) among older adult males.
● Our findings could not be fully explained by other work history including working status later in life and other socio-economic status including educational background.
● Not only promoting late-life working, but also providing workers employed at small workplaces with sufficient occupational health services, may be effective in preventing IADL decline in old age.

2) Association of Free Sugar Intake Estimated Using a Newly-Developed Food Composition Database With Lifestyles and Parental Characteristics Among Japanese Children Aged 3–6 Years: DONGuRI Study
● A food composition database was newly developed for sugars in 2222 Japanese foods.
● Mean free sugar intake was 7.8% of energy intake in Japanese children aged 3-6 years.
● Prevalence of excessive free sugar intake (≥10% of energy intake) was 21.7%.
● Longer screen time was most strongly associated with excessive free sugar intake.
● Age, sleeping duration, and maternal job were also associated with free sugar intake.

3) Cross-Sectional Association Between Types of Leisure Activities and Self-rated Health According to Gender and Work Status Among Older Japanese Adults
● In older men and non-working women, sports activities were significantly associated with positive SRH.
● In non-working older adults, regardless of gender, cooking was associated with positive SRH.
● In working men and non-working women, musical activities were associated with positive SRH.
● In working men, technology usage was associated with positive SRH.
● In non-working women, TV watching was associated with a lower prevalence of positive SRH.

4)Determining the Optimal Number of Wearing-Days Given a Fixed Number of Accelerometers in Population-Level Study
● We determined the optimal number of accelerometer wearing days and sample size.
● A single wearing day is optimal for estimation of population PA level.
● Optimal wearing day is 1-2 to estimate association between PA and an outcome.

5) Study Profile
Study Profile: The Japan “Society and New Tobacco” Internet Survey (JASTIS): A Longitudinal Internet Cohort Study of Heat-Not-Burn Tobacco Products, Electronic Cigarettes, and Conventional Tobacco Products in Japan
● A longitudinal internet study investigates new tobacco products in Japan since 2015.
● Socio-demographic, health and tobacco-related factors were collected annually.
● The study focused on new products such as e-cigarettes and heat-not-burn tobacco.

Volume 29, Issue 10 (October 2019)

1) Community Social Capital and Depressive Symptoms Among Older People in Japan: A Multilevel Longitudinal Study
● We examined the effects of community social capital on late-life depressive symptoms in Japan.
● Previously validated scales in relation to civic participation, social cohesion and reciprocity were used.
● Community civic participation showed protective effects against the onset of depressive symptoms.
● The results were robust in both two- and three-wave longitudinal panel analyses.

2) Frequency of Balanced-Meal Consumption and Frailty in Community-Dwelling Older Japanese: A Cross-Sectional Study
● Balanced-meal consumption among older Japanese was examined in a cross-sectional study.
● A lower frequency of balanced-meal consumption was associated with frailty prevalence.
● Balanced-meal consumption may decrease the risks of prefrailty and frailty.

3) Household Income Relationship With Health Services Utilization and Healthcare Expenditures in People Aged 75 Years or Older in Japan: A Population-Based Study Using Medical and Long-term Care Insurance Claims Data
● Health services utilization was evaluated in older people according to income.
● LTC insurance premiums categories were used to categorize participants.
● Older people with lower income had fewer consultations with physicians.
● Older people with lower income had an increased use of inpatient services.
● The income categorization may be a proxy for socioeconomic status.

4)The Relative Association of Collective Efficacy in School and Neighborhood Contexts With Adolescent Alcohol Use
● The relative associations of collective efficacy in neighborhood and high schools with adolescent alcohol use were examined.
● The associations between school collective efficacy and adolescent low alcohol use may be stronger than the neighborhood collective efficacy.
● School collective efficacy may be important to prevent adolescent drinking.

5)Does the Type of Temporary Housing Make a Difference in Social Participation and Health for Evacuees of the Great East Japan Earthquake and Tsunami? A Cross-Sectional Study
● From the largest survey relating to the Great East Japan Earthquake, health of the survivors in prefabricated- and rented-housing were compared.
● Social participation was associated with good physical and mental health condition of disaster evacuees.
● However, because the residents of prefabricated housing had more frequent opportunities for participation, they received a larger health benefit.
● Providing opportunity for social participation may be a practical intervention option to maintain evacuees’ health.

6)Statistical Data
Regional Differences in Colorectal Cancer Mortality Between 2000 and 2013 in Republic of Korea
● Colorectal cancer (CRC) mortality trends in Republic of Korea by region were described using a Joinpoint regression model in both sex.
● Visualization of CRC mortality changes by 16 metropolitan cities and provinces in both sexes were also analyzed between 2000-2004 and 2009-2013.
● Changes in CRC mortality varied across 16 metropolitan cities and provinces in men, while no significant change patterns were shown in women.
● The east side of South Korea had the least progress in mortality reduction in men from 2000-2004 to 2009-2013.

Volume 29, Issue 9 (September 2019)

1) Body Mass Index and Risks of Incident Ischemic Stroke Subtypes: The Japan Public Health Center-Based Prospective (JPHC) Study
● Cumulative average BMI that is regarded to capture the average level of exposure over long-term was related to ischemic stroke subtype incidence.
● There were approximately two-fold excess risk of lacunar and large-artery occlusive strokes in women for BMI≥30 kg/m2 compared to BMI 23- <25 kg/m2.
● There were approximately two-fold excess risk of cardioembolic stroke in both sexes for BMI≥30 kg/m2 compared to BMI 23- <25 kg/m2.

2) Objectively-Assessed Patterns and Reported Domains of Sedentary Behavior Among Japanese Older Adults
● Older adults can spend nearly 60% of their time sedentary.
● About 45% of total sitting was accumulated by prolonged bouts.
● TV viewing and PC use were the major contributors of prolonged sitting.
● Men, those who are older and overweight/obese may be at-risk subgroups.

3) Severity of Nausea and Vomiting in Singleton and Twin Pregnancies in Relation to Fetal Sex: The Japan Environment and Children’s Study (JECS)
● Both fetal sex and number of fetuses are associated with severity of NVP.
● Women with female singleton pregnancies have increased odds for severe NVP.
● Women with twin pregnancies also have increased odds for severe NVP.
● Women with both female twin pregnancies have the highest risk for severe NVP.

4)Trends in Small-Cell Lung Cancer Survival in 1993–2006 Based on Population-Based Cancer Registry Data in Japan
● Survival of patients with small cell lung cancer between 1993 and 2006 were investigated, using population-based cancer registry data in Japan.
● Relative survival of patients with small cell lung cancer between 1999 and 2006 was better than that between 1993 and 1998.
● The improvement of survival was observed among both patients with limited disease and extensive disease small cell lung cancer.

5)Nationwide Survey of Pediatric Inpatients With Hand, Foot, and Mouth Disease, Herpangina, and Associated Complications During an Epidemic Period in Japan: Estimated Number of Hospitalized Patients and Factors Associated With Severe Cases
● Nationwide survey of pediatric inpatients with hand, foot and mouth disease, herpangina, and associated complications was conducted in Japan 2010.
● Number of inpatients was estimated and factors associated with severe cases were explored.
● Estimated number of pediatric inpatients during epidemic period was about 2,900.
● Younger age was a factor associated with severe cases.
● Suggestive factors associated with severe cases was hyperglycemia.

Volume 29, Issue 8 (August 2019)

1) Case-Control Study of Rotavirus Vaccine Effectiveness Compared to Test-Negative Controls or Hospital Controls
● Rotavirus vaccines are effective against rotavirus gastroenteritis (vaccine effectiveness >80%).
● Vaccine effectiveness estimated using test-negative controls and hospital controls was similar.
● Test-negative controls are a valid alternative to hospital controls.

2) Psychiatric Admissions and Length of Stay During Fiscal Years 2014 and 2015 in Japan: A Retrospective Cohort Study Using a Nationwide Claims Database
● Over 25,000 new psychiatric admissions per month in Japan.
● Seasonal trend in the number of admissions with a peak in summer.
● Overall 90-day discharge rate was 64%.
● Discharge rates varied by type of hospital fee and by hospital.

3) Socioeconomic Disparity in the Prevalence of Objectively Evaluated Diabetes Among Older Japanese Adults: JAGES Cross-Sectional Data in 2010
● This is the first study to clarify the income disparity in diabetes prevalence utilizing the large-scale data of Japanese older adults.
● A low-income group was statistically significantly associated with high diabetes prevalence compared to the high-income group. However, the study showed no significant association between educational attainment, longest occupation and diabetes prevalence.
● The health disparity was only observed among women, but not men.
● Further longitudinal studies should monitor the socioeconomic disparity in diabetes prevalence and incidence. Moreover, the effective public health intervention should be considered by the implementation research.

4)Unilateral Mastication Evaluated Using Asymmetric Functional Tooth Units as a Risk Indicator for Hearing Loss
● Previous studies reported hearing ability can be reduced by unilateral mastication.
● Little evidence reported of these association using large-scale epidemiologic data.
● Unilateral mastication was estimated from individual functional tooth units.
● Hearing threshold increased with the unilateral mastication level.
● Further studies including various confounding factors are needed.

5)Factors Associated With Intention of Future Pregnancy Among Women Affected by the Fukushima Nuclear Accident: Analysis of Fukushima Health Management Survey Data From 2012 to 2014
● Pregnancy intention among Fukushima mothers was analyzed using data from the Fukushima Health Management Survey.
● Mothers’ concern about radiation was associated with lower pregnancy intention, especially among primiparas.
● Providing quality obstetrical and mental health care and parenting support are the keys to maintaining the temporal increase in fertility.

6) Study Profile
The LEAD (Lung, Heart, Social, Body) Study: Objectives, Methodology, and External Validity of the Population-Based Cohort Study
● LEAD results to better characterize chronic respiratory diseases.
● LEAD minimizes the recall bias for undiagnosed or self-reported co-morbidities.
● LEAD additionally screens for cardiovascular diseases, metabolic diseases, and mental diseases.
● LEAD will provide a framework for lung health, age and multi-morbidity.
● LEAD will understand genetic risk factors influencing lung function development.

Volume 29, Issue 7 (July 2019)

1) The Differential Effects of Age on the Association Between Childhood Socioeconomic Disadvantage and Subjective Symptoms of Dementia Among Older Japanese People
● Lower childhood socioeconomic status (SES) was associated with subjective symptoms of dementia among older Japanese people.
● There was a significant interaction between childhood SES and age on subjective dementia symptoms, indicating an effect modification of age.
● The association between childhood SES and subjective dementia symptoms was stronger for participants aged ≥75 years than for those aged 65–74 years.
● The differential association by age may stem from the shaping of early experiences by the social and historical context.

2) Prevalence of Congenital Anomalies in the Japan Environment and Children’s Study
● Describing prevalence of 61 congenital anomalies and evaluating the validity within the Japan Environment and Children study (JECS).
● The prevalence was estimated on the basis of all pregnancies in the cohort, including all cases of spontaneous abortion and medical termination of pregnancy.
● At least 90.5% of the congenital anomalies reported in the transcription forms were confirmed after re-evaluation of the corresponding medical and insurance records.

3) Trends in Lipids and Lipoproteins Among Adults in Northwestern Xinjiang, China, From 1998 Through 2015
● This is the first report on secular trends in serum lipids in low income northwestern Xinjiang, mainly comprised of Han, Kazakh and Mongolian ethnicity.
● From 1998-2000 to 2007-2008 and to 2015, there was a declining trend in the prevalence of dyslipidemia. Mean LDL-C was decreased during the same period.
● The prevalence of dyslipidemia was closely related with male gender, Mongolian ethnicity, hypertension, obesity, elevated FBG, smoking, and drinking.

4) Geographical Variation in Psychiatric Admissions Among Recipients of Public Assistance
● Large geographic variations existed in the number of psychiatric admissions.
● The number of public assistance recipients per population explained this variation.
● Psychiatric bed availability was also associated with this variation.
● Similar associations were observed among old and new long-stay patients.

5)The Hekinan Children’s Study: Design and Profile of Participants at Baseline
● The Hekinan Children’s Study enrolled 3,141 first-year students at elementary schools.
● This cohort aims to investigate primarily the associations between lifestyle and environmental factors and some surrogate markers of chronic diseases.
● The validity of a food frequency questionnaire developed to assess children’s dietary intakes in this cohort was tested.

Volume 29, Issue 6 (June 2019)

1) Association of Alcohol Consumption With Fat Deposition in a Community-Based Sample of Japanese Men: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA)
● This is the first population-based study in Asia evaluating association between alcohol consumption and VAT/SAT.
● Higher alcohol consumption is associated with greater VAT, but not with SAT.
● Our findings confirm the associations even in leaner populations.
● Not like previous studies, former drinkers are excluded from the analysis.

2) Long-term Body Weight Gain After Maturity is Associated With the Incidence of Chronic Kidney Disease (CKD), Independent of Current Body Weight, in Middle-aged and Older Men
● This study retrospectively investigated the influence of long-term body weight gain after adulthood on the incidence of CKD in middle-aged and older men.
● The cumulative incidence of CKD was significantly higher among the normal body weight participants with a body weight gain of ≥10 kg since age of twenty years, compared with other groups.
● The present study suggested that the long-term body weight gain after adulthood in normal body weight participants may be related to the incidence of CKD, independent of the current body weight.

3) Psychological Stress, Family Environment, and Constipation in Japanese Children: The Toyama Birth Cohort Study
● We examined associated factors of constipation in 7,998 elementary school children.
● In total, 312 children (3.9%) experienced constipation. (Boys 2.8%: Girls 5.1 %).
● Conventional risk factors like diet and exercise were associated with constipation.
● Mental stress was as strongly associated with constipation as conventional factors.
● Infrequent interaction with parents was also associated with constipation.

4) Additive Effect of Physical Activity and Sedentary Time on Depressive Symptoms in Rural Japanese Adults: A Cross-Sectional Study
● Of all rural residents, 22.5% met the recommended level of physical activity.
● Physical activity and sedentary time additively contribute to depressive symptoms.
● If physical activity is less than the guidelines, less sedentary time is important.

5) Associations of Daily Walking Time With Pneumonia Mortality Among Elderly Individuals With or Without a Medical History of Myocardial Infarction or Stroke: Findings From the Japan Collaborative Cohort Study
● Pneumonia is one of the leading causes of death in developed countries.
● Elderly individuals often have underlying chronic diseases that may prevent them from walking and increase their risk of contracting pneumonia.
● Regular walking may reduce the risk of pneumonia mortality in elderly individuals with or without cardiovascular history.

6) Short Communication
Historical Changes in Histological Diagnosis of Lung Cancer
● Availability of histological diagnosis between periods was evaluated.
● Diagnoses of adenocarcinoma and squamous cell carcinoma were reliable over time.
● Small cell carcinoma tended to be diagnosed as other types prior to the 1980s.
● Influence of diagnostic classification change was different by histological type.

Volume 29, Issue 5 (May 2019)

1) Induced Abortion, Birth Control Methods, and Breast Cancer Risk: A Case-Control Study in China
● We conducted a case-control study to evaluate effect of common birth control methods and induced abortion on breast cancer.
● Having a history of medical abortions, ≧3 surgical abortions, or both medical and surgical abortions was associated with an increased risk of breast cancer in postmenopausal women.
● Premenopausal women who had used IUDs for more than 20 years tended to have a lower breast cancer risk than other age-matched premenopausal women.
● Both premenopausal and postmenopausal women who had <20 years exposure to IUDs and those who had used two or more birth control methods (with the exception of women who used IUDs for more than 20 years) tended to have much higher breast cancer risk.

2) Smoking, Alcohol Consumption, and Risks for Biliary Tract Cancer and Intrahepatic Bile Duct Cancer
● We evaluated the association of smoking and alcohol with BTC and IHBDC risks.
● Smoking was associated with an increased risk of IHBDC in male regular drinkers.
● A non-significant increase of IHBDC risk associated with alcohol was found in men.
● Neither smoking nor alcohol consumption was associated with BTC risk in men.

3) The Effect of Maternal Age at the First Childbirth on Gestational Age and Birth Weight: The Japan Environment and Children’s Study (JECS)
● In Japan, the prevalence of advanced maternal age pregnancy is increasing.
● Older maternal age (>30 years) at the first childbirth is a risk factor for PTB, LBW, and SGA.
● These data aid in proper counseling of advanced age women in the first-time pregnancy.

4) Does Cigarette Smoking Increase Traffic Accident Death During 20 Years Follow-up in Japan? The Ibaraki Prefectural Health Study
● We studied an association between smoking and traffic accident death.
● Male smokers had marginally significantly higher risk of traffic accident death.
● Among women, because of a few traffic accident death, no association was observed.

5) Cholangiocarcinoma Trends, Incidence, and Relative Survival in Khon Kaen, Thailand From 1989 Through 2013: A Population-Based Cancer Registry Study
● Incidence rates of CCA in Khon Kaen province, Thailand have decreased in the last 10 to 12 years.
● The declining incidence of CCA parallels a decline in Opisthorchis viverrini infection rates.
● The projected incidence of CCA in this area should be stable over the next 10 years albeit higher than the world rate.
● Survival of cholangiocarcinoma (CCA) is poor.

Volume 29, Issue 4 (April 2019)

1) Trends and Correlates of High-Risk Alcohol Consumption and Types of Alcoholic Beverages in Middle-Aged Korean Adults: Results From the HEXA-G Study
● The prevalence and amount of alcohol consumption remain high and have not changed in men, whereas they were low but have increased in women.
● In both men and women, the contribution of beer and Makgeolli to total amount of alcohol consumption has increased which was inversely associated with age.
● Education level is negatively associated with high-risk drinking and positively associated with consumption of strong spirits and wine.
● Smoking is the most influential factor in high-risk drinking and consumption of Soju and strong spirits, which have higher alcohol content than other beverages.
● Regular exercise and stress are associated with high-risk drinking and all types of alcoholic beverages, except Soju.

2) Associations of Overweight, Obesity, and Underweight With High Serum Total Cholesterol Level Over 30 Years Among the Japanese Elderly: NIPPON DATA 80, 90, and 2010
● We examined the trend of association between overweight, obesity and underweight and high TC 1980 to 2010.
● Although a positive association between overweight/obesity and high TC was observed in 1980, it was gradually weakened.
● Whereas underweight was inversely associated with high TC in 1980, it was also gradually weakened among women but not men.

3) Physical Fitness Tests and Type 2 Diabetes Among Japanese: A Longitudinal Study From the Niigata Wellness Study
● Grip strength was negatively associated with the risk of type 2 diabetes.
● Balance ability was also negatively associated with the risk of type 2 diabetes.
● These relation were confirmed even when 1-year lagged covariates were used.

4) Optimal Criteria and Diagnostic Ability of Serum Pepsinogen Values for Helicobacter pylori Infection
● Sample sizes were 1097 for CLIA and 1260 for LA methods.
● Criteria by PG II and PG I/PG II ratio were determined for H. pylori infection.
● Criteria were different for CLIA and for LA methods.
● More than 95% sensitivity and more than 70% specificity were obtained.
● The criteria can be used practically for diagnosis of H. pylori infection.

5) E-Cigarette Use in a Country With Prevalent Tobacco Smoking: A Population-Based Study in Taiwan
● Very few studies have examined e-cigarette use in Asian countries, where tobacco smoking is highly prevalent and e-cigarettes are usually not (or less) regulated.
● Characteristics of tobacco users can be better understood by dividing tobacco product use groups into exclusive e-cigarette use, exclusive cigarette use, and dual use.
● Compared to users of exclusive cigarettes, users of exclusive e-cigarettes had a younger age and a greater likelihood of alcohol use.

6) Association Between Maternal Serum Folate Concentrations in the First Trimester and the Risk of Birth Defects: The Hokkaido Study of Environment and Children’s Health
● Median serum folate level of first-trimester pregnancies in Japan was 16.5 nmol/L.
● Serum folate deficiency level in the same population was 0.7%.
● Three hundred fifty-eight of 14,596 infants had birth defects.
● No association between maternal serum folate levels and birth defects was observed.

Volume 29, Issue 3 (March 2019)

1) Special Article
The Circulatory Risk in Communities Study (CIRCS): A Long-Term Epidemiological Study for Lifestyle-Related Disease Among Japanese Men and Women Living in Communities
● The Circulatory Risk in Communities Study (CIRCS) is an ongoing community-based dynamic cohort study of lifestyle-related disease, involving approximately 12,000 adults from 5 communities of Japan.
● The most notable features of this half century-long study is its aim to develop community-based prevention programs through the identification of profiles and underlying factors for cardiovascular disease.

2) Social Capital and Dietary Intakes Following the 2011 Great East Japan Earthquake and Tsunami
● Low social capital was associated with poor dietary intake among women.
● Poor dietary intake was found in divorced, widowed, and, unmarried survivors.
● An age <65 years was associated with poor dietary intake.
● Residents of Rikuzentakata demonstrated relatively good dietary intake.

3) Prevalence and Correlates of Dyslipidemia Among Men and Women in Palau: Findings of the Palau STEPS Survey 2011–2013
● This is the first population-based survey in Palau for dyslipidemia which is a major risk factor of NCDs.
● We examined lipid profiles in Palau via the Palau National STEPS conducted between 2011 and 2013.
● Lower proportion of hypercholesterolemia was shown in Palauan population thought high proportions of high BMI value and obesity.
● Palauan men showed a lower mean value of cholesterol than non-Palauan men; and Palauan women showed a higher mean value of triglycerides than non-Palauan women.
● The blood lipids varied by age, ethnicity and living area.

4) The Prospective Association Between Plasma Concentrations of Cellular Growth Factors and Risk of Heart Failure Mortality in Japanese Population
● Limited evidence on relation of serum insulin-like growth factors and heart failure.
● We ran a nested case-control study following subjects aged 40-79 years for 9 years.
● Serum IGF-I, IGF-II, IGF-BP3 and TGF-β1 measured in 88 cases and 88 controls.
● SD increment of serum IGF-II associated with almost half risk reduction of heart failure.

5) Impact of Comorbidities on Survival in Gastric, Colorectal, and Lung Cancer Patients
● We examined the impact of comorbidities on overall survival in cancer patients.
● Cox proportional hazards models were developed to adjust for other covariates.
● The presence of comorbidities was associated with poorer survival.
● Comorbidities are an independent negative prognostic factor in cancer patients.

6) Effects of Omitting Non-confounding Predictors From General Relative-Risk Models for Binary Outcomes
● We assessed effects of omitting non-confounding variables from general relative-risk models for binary outcomes.
● Bias and precision were qualitatively similar to those with logistic regression.
● Bias and precision somewhat exceeded those with logistic regression in relation to the size of the actual relative risk.
● General relative-risk models can be used without much added concern over omitted variables.

Volume 29, Issue 2 (February 2019)

1) Physical Activity and Health-Related Quality of Life Among Low-Income Adults in Metropolitan Kuala Lumpur
● Physical activity (PA) could be a cost-effective method to improve health and QoL.
● One out of five low income urban residents in Malaysia were physically inactive.
● Individuals who attained recommended PA level had better scores of QoL.
● It is a promising possibility to use PA intervention to improve mental health.

2) Association of Low Family Income With Lung Function Among Children and Adolescents: Results of the J-SHINE Study
● A population-based sample of 1224 children in and around Tokyo was analyzed.
● Children in low-income families showed significantly lower lung function.
● Early intervention for lung function is necessary among children living in poverty.

3) Physical Activity Earlier in Life Is Inversely Associated With Insulin Resistance Among Adults in Japan
● Continued physical activity earlier in life had an inversive association on the insulin resistance after middle age.
● This association for insulin resistance was observed even if the influence of BMI is excluded.
● All results had significant impact on insulin resistance among both men and women.

4) Cedar Pollinosis and Mortality: A Population-Based Prospective Cohort Study in Japan
● This cohort study examined the association of cedar pollinosis with mortality.
● We used a validated symptom-based questionnaire on cedar pollinosis.
● Cedar pollinosis was inversely associated with all-cause and respiratory mortality.
● No association was found between cedar pollinosis and death from cancer or CVD.

5) Exploring 2.5-Year Trajectories of Functional Decline in Older Adults by Applying a Growth Mixture Model and Frequency of Outings as a Predictor: A 2010–2013 JAGES Longitudinal Study
● Three distinct trajectories of functional decline were identified in older Japanese men and women.
● The majority of older Japanese showed a trajectory of slow functional decline from the first occurrence.
● Men with fewer outings at baseline were more likely to belong to persistently disabled trajectory rather than slowly declining trajectory.

6) Study Profile
A Community-Wide Intervention Trial for Preventing and Reducing Frailty Among Older Adults Living in Metropolitan Areas: Design and Baseline Survey for a Study Integrating Participatory Action Research With a Cluster Trial
● A community-wide intervention to postpone frailty was launched in Ota City, Tokyo.
● Baseline survey of 15,500 residents was conducted (76.9% response rate).
● Interventions based on the results are conducted as participatory action research.
● A community-wide frailty prevention strategy will be developed for metropolises.

Volume 29, Issue 1 (January 2019)

1) Review Article
Contribution of Diabetes to the Incidence and Prevalence of Comorbid Conditions (Cancer, Periodontal Disease, Fracture, Impaired Cognitive Function, and Depression): A Systematic Review of Epidemiological Studies in Japanese Populations
● We reviewed literatures about the link between diabetes and complications in Japan.
● We focused on cancer, periodontitis, fracture, dementia, and depression.
● There was scant evidence about the effect of diabetes on these conditions in Japan.
● The needs for future studies were suggested.

2) Changes in Smoking Status and Mortality From All Causes and Lung Cancer: A Longitudinal Analysis of a Population-based Study in Japan
● The analysis considered the longitudinal changes of smoking status during follow-up.
● The risk of mortality for former smokers become higher by using updated information.
● The risk of mortality for ill new quitters is higher than did continuous smokers.

3) Birth Anomalies in Monozygotic and Dizygotic Twins: Results From the California Twin Registry
● The first US twin study explored heritable/parental factors in 9 birth anomalies.
● Prevalence of birth anomalies in California twins declined slightly from 1957-1982.
● Excess concordance comparing MZ to DZ were found for clubfoot and strabismus.
● Parental smoking increased the risk of spina bifida and strabismus.

4) Number of Teeth, Oral Self-care, Eating Speed, and Metabolic Syndrome in an Aged Japanese Population
● Elderly people have <20 teeth are at high risk of metabolic syndrome (MetS).
● Elderly people who are eating fast are at high risk of MetS.
● Elderly men using secondary oral hygiene products daily are at low risk of MetS.
● Combination of having few teeth and eating fast may enhance the risk of MetS.

5) Short communication
Subjective Household Economic Status and Obesity in Toddlers: A Cross-Sectional Study of Daycare Centers in Japan
● A new device is available for self-monitoring urinary Na/K ratio.
● Our trial comparted urinary Na/K ratio between users of the device and non-users.
● Those who used the device were likely to have larger reduction in urinary Na/K ratio.
● With an education for improving dietary habit, there may be a much larger reduction.