Papers

Many countries have been increasing their state pension age. Nonetheless, there is little consensus on whether retirement affects the risk of cardiovascular disease.

Using a causal inference approach, Mr. Sato and colleagues found a 2.2%-point decrease in the risk of heart disease and a 3.0%-point decrease in physical inactivity among retirees, compared with workers.
Policymakers need to consider the benefits of raising the state pension age and allowing older people to continue working versus the costs from the potential risk of expensive medical conditions such as cardiovascular disease.

This research has been published in International Journal of Epidemiology, one of top journals in the field of epidemiology.

In addtion, the results of this study were covered by various media outlets.

Article: Sato K, Noguchi H, Inoue K, Kawachi I, Kondo N. Retirement and cardiovascular disease: a longitudinal study in 35 countries. Int J Epidemiol. 2023 May 8 Int J Epidemiol. 2023 May 8: dyad058.

DOI: https://doi.org/10.1093/ije/dyad058

The research group led by Associate Professor Inoue, Professor Susan Athey of Stanford University, and Associate Professor Yusuke Tsugawa of the University of California, Los Angeles, has proposed the potential usefulness of the “high-benefit approach,” a next-generation personalized medicine strategy for hypertension treatment, by applying advanced machine learning models to the treatment of hypertension.

This research established a new concept focusing on individual treatment effects. It demonstrated its usefulness, and it is expected to become a basis for the next generation of personalized medicine applying machine learning.

Kosuke Inoue, Susan Athey, Yusuke Tsugawa (2023). Machine-learning-based high-benefit approach versus conventional high-risk approach in blood pressure management. International Journal of Epidemiology.

DOI: https://doi.org/10.1093/ije/dyad037

Please click on the following link for the press release and more information.
Press release: https://www.kyoto-u.ac.jp/ja/research-news/2023-04-05
Kyoto University School of Public Health: http://sph.med.kyoto-u.ac.jp/news/7016/

The research group led by Associate Professor Inoue and Associate Professor Yusuke Tsugawa of the University of California, Los Angeles (UCLA), using U.S. National Health and Nutrition Examination Survey data, has found that achieving 8,000 steps per day, even just one or two days a week has a positive impact on health.

Using accelerometer-measured step count information, the study examined the risk of mortality associated with walking more than 8,000 steps per day for 0, 1-2, and 3-7 days. The Findings, those who walked at least 8,000 degrees, even one or two days per week, showed a reduction in mortality risk almost equal to those who regularly walked three or more days per week.

The results of this study suggest that achieving the target number of steps, even one or two days per week, may have a sufficiently positive impact on health.

Kosuke Inoue, Yusuke Tsugawa, Elizabeth Rose Mayeda, Beate Ritz (2023). Association of Daily Step Patterns With Mortality in US Adults. JAMA Network Open, 6(3):e235174.

DOI: https://doi.org/10.1001/jamanetworkopen.2023.5174

Please click on the following link for the press release and more information.

Press release: https://www.kyoto-u.ac.jp/ja/research-news/2023-03-30

Kyoto University School of Public Health: http://sph.med.kyoto-u.ac.jp/news/6979/

A research group including Assistant Professor Inoue, Assistant Professor Tatsuhiko Naito of Osaka University Graduate School of Medicine (at the time of the research/now a postdoctoral fellow at Mount Sinai School of Medicine), Professor Yukinori Okada (Team leader, RIKEN Center for Integrative Medical Sciences Laboratory for Systems Genetics / Professor of Department of Genome Informatics, Graduate School of Medicine, The University of Tokyo), and Lecturer Kenji Oki of Hiroshima University(Department of Molecular and Internal Medicine, Graduate School of Biomedical & Health Science), has conducted a genome-wide association study of primary aldosteronism, and the results were published in Circulation.

Tatsuhiko Naito, Kosuke Inoue, Kyuto Sonehara, Ryuta Baba, Takaya Kodama, Yu Otagaki, Akira Okada, Kiyotaka Itcho, Kazuhiro Kobuke, Shinji Kishimoto, Kenichi Yamamoto, BioBank Japan, Takayuki Morisaki, Yukihito Higashi, Nobuyuki Hinata, Koji Arihiro, Noboru Hattori, Yukinori Okada, Kenji Oki .Genetic Risk of Primary Aldosteronism and Its Contribution to Hypertension: A Cross-Ancestry Meta-Analysis of Genome-Wide Association Study.Circulation,21 February 2023

DOI:10.1161/CIRCULATIONAHA.122.062349

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A paper in joint research with Associate Professor Midori Matsushima at the University of Tsukuba has been published online in the Journal of Biosocial Science.

A research group led by Associate Professor Midori Matsushima, Humanities and Social Sciences, University of Tsukuba, and Professor Naoki Kondo examined the association between the COVID-19 pandemic and pregnancy postponement.

This study analyzed data on 768 women with the intention to become pregnant from The Japan COVID-19 and Society Internet Survey (JACSIS) conducted in 2020 and 2021, and found that approximately 20% of the women postponed pregnancy. Furthermore, the reason for this was not fear or anxiety about COVID-19 infection, but rather reduced income and anxiety towards future household finances due to the COVID-19, and the impact of this was particularly strong in 2021.

The results of this study showed that social factors affect the pregnancy decisions of those who wish to become pregnant, suggesting that it is important to promote the elimination of economic insecurity even after this pandemic is over.

Midori Matsushima, Hiroyuki Yamada, Naoki Kondo, Yuki Arakawa, Takahiro Tabuchi. Impact of the COVID-19 pandemic on pregnancy postponement – evidence from Japan. Journal of Biosocial Science,11 January 2023.

DOI: https://doi.org/10.1017/S0021932022000451

Abstract

Japan has faced a decline in fertility since the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to investigate the rate of pregnancy postponement and its contributing factors, with a particular focus on economic- and COVID-19 infection-related indicators. This study used data from 768 observations of married women aged 18 to 50 years with pregnancy intentions. The data were obtained from two rounds of a large web-based survey conducted by the Japan COVID-19 and Society Internet Survey (JACSIS) in 2020 and 2021. A generalised estimating equation (GEE) model was employed, as well as Poisson regression models for sub-sample analysis divided by year to estimate the year differential magnitude of the contributing factors’ impacts. Approximately 20% of married women with childbearing intentions postponed their childbearing. The analyses revealed that declining income and anxiety about future household finances were significantly related to delayed childbearing, while fear of COVID-19 and infection rate were not. Additionally, the adverse effects of unfavourable economic conditions were stronger in 2021. Notably, age did not influence the decision of pregnancy postponement. Older women postponed pregnancy just as much as younger women. In conclusion, this study revealed that the COVID-19 pandemic, particularly its related adverse economic conditions, contributed to Japan’s current baby bust. Considering that advanced maternal age is already common in Japan, this decreased fertility may result in the long-term negative consequence of further population decline.

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Assistant Professor Maho Haseda’s paper has been published in the Health & Place.

Haseda M, Takagi D, Stickley A, Kondo K, & Kondo N. (2022). Effectiveness of a community organizing intervention on mortality and its equity among older residents in Japan: A JAGES quasi-experimental study. Health & place, 74, 102764.

https://doi.org/10.1016/j.healthplace.2022.102764

Abstract
Interventions that involve key aspects of community organizing, such as quantitative community assessments and organizational partnership support for the community, may promote residents’ health. We evaluated the effectiveness of this form of intervention on mortality and its variability across individual-level household equivalized income tertiles, comparing 52,858 residents aged 65 and above in 12 intervention municipalities to 39,006 residents in nine control municipalities in Japan. During 1,166 days of follow-up, the adjusted hazard ratio for cumulative mortality among men in the intervention municipalities was 0.92 (95% confidence interval: 0.86, 0.99) compared to those in the control group, with similar results being observed across all income levels. Active utilization of data to evaluate communities and building intersectoral partnerships might lower older male residents’ mortality risk, regardless of their income status.

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Assistant Professor Koryu Sato’s paper has been published in the Health & Place.

Sato, K., Kondo, N., Kondo, K. Pre-pandemic individual- and community-level social capital and depressive symptoms during COVID-19: A longitudinal study of Japanese older adults in 2019-21. Health & Place, 74; 102772 (2022).

https://doi.org/10.1016/j.healthplace.2022.102772

Abstract
During a pandemic, it is important to know whether social capital can mitigate the risk of mental disorders, given the restrictions on social interactions. However, evidence using longitudinal data is scarce. This study examined the association between pre-pandemic social capital and depressive symptoms during COVID-19 among older adults. We used longitudinal data from the Japan Gerontological Evaluation Study (JAGES), including 8291 participants aged 65 or older who were physically and cognitively independent and not depressed at baseline. We conducted baseline and follow-up mail surveys in ten municipalities in Japan from November 2019 to January 2020 (pre-pandemic period) and from November 2020 to February 2021 (pandemic period), respectively. We measured depressive symptoms using the 15-item Geriatric Depression Scale. Social capital was measured with three validated subscales, namely, civic participation, social cohesion, and reciprocity. We performed a multilevel logistic regression analysis to examine the association. A total of 1089 (13.1%) participants newly developed depressive symptoms during the pandemic. The logistic regression showed that pre-pandemic individual-level social cohesion (odds ratio = 0.79, 95% confidence interval: 0.73 to 0.86) and reciprocity (0.89, 0.82 to 0.96) and community-level reciprocity (0.93, 0.88 to 0.98) were negatively associated with the odds of depressive symptoms. Even after adjusting for declines in social capital during the pandemic, the observed associations of pre-pandemic social capital remained. Fostering social cohesion and reciprocity may increase resilience to mental disorders during a pandemic of infectious disease.

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