Language：Japanese   Publisher：日本公衆衛生学会  

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BACKGROUND: Several studies have shown that social isolation is a risk factor for cognitive decline and dementia; however, its neurological mechanisms are not fully understood. Using longitudinal data, this study examined the effects of social isolation on hippocampal and total gray matter volumes in community-dwelling older Japanese individuals. METHODS: Data were obtained from the Neuron to Environmental Impact Across Generations (NEIGE) Study conducted in Tokamachi City (Niigata Prefecture, Japan), including 279 community-dwelling persons aged 65-84 years who underwent brain magnetic resonance imaging in 2017 and 2021 (male: 47.6 %; mean age: 73.0 years). We investigated two dimensions of social isolation: poor social networks and solitary living. RESULTS: Multiple regression analysis with inverse probability weighting showed that individuals with a social contact frequency of <1 time/week had a greater decrease in hippocampal volume than those with a contact frequency of more than or equal to 4 times/week, whereas those who lived alone tended to have a smaller decrease in hippocampal volume than those who lived with others. We found no association between the frequency of social contact, living alone, and total gray matter volume. Furthermore, there was no interaction between sex and age for any of the outcomes. CONCLUSION: Our longitudinal analysis suggested that the relationship between social isolation and dementia onset may be mediated by hippocampal atrophy; however, the direction of the influence depends on the isolation type. These findings are expected to contribute to the elucidation of the social mechanisms underlying dementia onset.

DOI： 10.1016/j.archger.2024.105642

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: It is well known that low educational attainment is associated with cognitive function decline in older age. Childhood book availability may help to preserve cognitive function in older adults with low education. The study objective was to examine the association between childhood book availability and cognitive function among older adults with low educational attainment, and to investigate the mediating effect of the volume of reading-related brain regions (e.g., superior temporal cortex). METHODS: A cross-sectional study of community-dwelling older Japanese adults aged 65-84 years was conducted (n = 474). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Childhood book availability was assessed using a retrospective questionnaire. Brain region volume was measured using magnetic resonance imaging. Multivariate regression modeling and structural equation modeling were used for analysis. RESULTS: Both high educational attainment and childhood book availability were independently associated with high MMSE score. Stratification of educational level showed that childhood book availability was positively associated with MMSE score among participants with low educational attainment (coefficient = 1.48, 95% confidence interval [CI]: 0.31 to 2.66), but not among those with moderate or high educational attainment (coefficient = -0.01, 95% CI: -1.44 to 1.42 and -1.21, 95% CI: -3.85 to 1.42, respectively). Among participants with low educational attainment, left superior temporal cortex volume mediated the association between childhood book availability and MMSE score. DISCUSSION: The availability of books in childhood helps to preserve cognitive function in older adults with low education via left superior temporal cortex volume. Further research is needed to replicate these findings.

DOI： 10.1093/geronb/gbae052

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Low socioeconomic position (SEP) has been linked to an increased risk of dementia. However, little is known about the association between SEP trajectory and regional brain volumes related to dementia. METHODS: A random sample of community-dwelling older adults (n = 428, age = 73.1 ± 5.5) living in Tokamachi City (Niigata Prefecture, Japan) without medical histories of dementia, Parkinson's disease, and depression who underwent automated assessment of brain volumes on magnetic resonance imaging and responded to a self-administered questionnaire survey in 2017. We measured SEP in childhood (household SEP at age 15), young adulthood (education), mid-adulthood (the longest occupation), and late adulthood (current wealth), and further performed group-based trajectory analysis to identify lifetime trajectory patterns on SEP. Multivariate regression models were employed to investigate the association between SEP trajectories and 4 regional brain volumes related to the development of Alzheimer's disease (ie, entorhinal cortex, hippocampus, amygdala, and the parahippocampus), the most common type of dementia. RESULTS: We found 3 distinct SEP trajectories (stable middle class [68%], downward [23%], and upward [9%]). Compared to those who experienced stable middle class, older adults who experienced the upward SEP mobility had significantly larger hippocampus (β: 213.2, 95% confidence interval: 14.7, 411.8). On the other hand, older adults who experienced downward SEP mobility showed no significant differences in any of the 4 brain structural volumes. CONCLUSIONS: Our findings indicate that upward life-course SEP mobility is associated with larger volumes of hippocampus in old age. SEP trajectory may offer us a useful lens to enhance our understanding of the etiology of dementia.

DOI： 10.1093/gerona/glad269

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Background

Internet use has both positive and negative effects on mental health. However, few studies have examined the association between internet use and mental health among older adults in developing countries. This study aimed to investigate the association between Internet use and depressive symptoms among older adults in two regions of Myanmar.

Methods

Data based on a visit to 1,200 older adults in urban and rural Myanmar were obtained through stratified random sampling using the cross-sectional baseline survey of the longitudinal study titled “Healthy and Active Aging in Myanmar.”

Our analysis included 1,186 participants. The dependent variable was depressive symptoms, and the 15-item version of the Geriatric Depression Scale (GDS) was used as a continuous variable; the higher the score, the more likely a person was to be depressed. Internet use (one of the questions about household property ownership) was used as an independent variable. After confirming the absence of multicollinearity, we adjusted for age, gender, educational background, activities of daily living, residential area, and frequency of meeting friends, and stratified by subjective economic status (above or below average). We also examined the interaction between internet use and subjective economic status. A linear regression analysis was performed.

Results

Among the 1,186 participants included in the analysis (women: 59.5%; median age: 68 years old), 202 (17.0%) were Internet users (95% Confidential Interval [CI]: 0.15, 0.19), and they had significantly lower GDS scores than the participants who did not use the Internet (B: -1.59, 95% CI: -2.04, -1.13).GDS showed a negative association with Internet use even in the multivariate analysis (B: -0.95, 95% CI: -1.41, -0.50). However, the interaction term for GDS between Internet use and subjective economic status was not significantly associated (B: 0.43, 95% CI: -1.11, 1.98).

Conclusions

Internet use and depressive symptoms were associated especially among the older adults. However, there were no significant interaction between Internet use and subjective economic status for GDS.

DOI： 10.1186/s12877-024-04729-4

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Other Link： https://link.springer.com/article/10.1186/s12877-024-04729-4/fulltext.html

Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.jmii.2024.01.001

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Parechovirus-A (PeV-A) causes emerging infection in children, and clinical presentation depends on genotype. The virus has been investigated mainly in developed countries; however, data from developing countries, especially in Asia, are sparse. This study investigated whether PeV-A circulated in children in Myanmar. This retrospective study evaluated PeV-A in nasopharyngeal samples from children aged 1 month to 12 years who were hospitalized with acute lower respiratory infection at Yankin Children Hospital, Yangon, Myanmar, during the period from May 2017 to April 2019. Real-time polymerase chain reaction (PCR) was used to detect PeV-A, and PCR-positive samples were used for genotyping and phylogenetic analysis. In total, 11/570 (1.9%) of samples were positive for PeV-A; 7 were successfully genotyped by sequencing the VP3/VP1 region, as follows: PeV-A1 (n = 4), PeV-A5 (n = 1), PeV-A6 (n = 1), and PeV-A14 (n = 1). Median age was 10.0 months (interquartile range 4.0-12.0 months), and other respiratory viruses were detected in all cases. Phylogenetic analysis showed that all detected PeV-A1 strains were in clade 1 A, which was a minor clade worldwide. Four PeV-A genotypes were detected in Myanmar. The clinical impact of PeV-A in children should be evaluated in future studies.

DOI： 10.1002/jmv.28964

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Language：Japanese   Publisher：(一社)日本骨粗鬆症学会  

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PURPOSE: Visual impairment is a possible cause of physical frailty. Reduced physical activity (PA) may be involved in the pathway from visual impairment to physical frailty, although the association between vision and objectively measured PA among older adults remains unclear. This study examined the sex-specific association of subjective vision with intensity-specific PA and bout-specific sedentary behavior (SB) among community-dwelling, older Japanese adults. STUDY DESIGN: Cross-sectional study METHODS: This study used data from the Neuron to Environmental Impact across Generations study analyzing older adults (527 participants, aged 65-84 years) living in rural areas of Niigata Prefecture, Japan. Subjective vision was assessed by use of a questionnaire. Intensity-specific PA (light-intensity PA and moderate-to-vigorous PA [MVPA]), bout-specific SB, and daily step count were objectively evaluated by use of an accelerometer. The association of subjective vison with PA and SB, stratified by sex, was analyzed by means of general regression analyses, with adjustment for covariates. RESULTS: The data of 512 participants (men: 46.9%; with poor subjective vision: 22.9%) were analyzed. Poor subjective vision was significantly associated with log MVPA (partial regression coefficient = -0.261, P = .013) and log steps (partial regression coefficient = -0.164; P = .021) among women, whereas a tendency of an association was observed with prolonged SB time among men (partial regression coefficient: 39.1; P = .073). CONCLUSION: Older Japanese women with poor subjective vision performed less MVPA and had fewer step counts than those of participants with good subjective vision, and men with poor subjective vision had longer prolonged SB, which may all accelerate the process to physical frailty.

DOI： 10.1007/s10384-023-00977-w

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Publishing type：Research paper (scientific journal)   Publisher：BMJ  

Objectives

This study aims to investigate whether there is a differential association between socioeconomic status (SES) and adherence to hypertension medication among older adults in rural and urban areas in Myanmar and assess what type of SES is associated with a difference.

Design

Cross-sectional study using baseline data from the Japan Gerontological Evaluation Study in Myanmar prospective cohort study. A multistage random sampling method was applied in each region.

Setting

An urban and a rural area in Myanmar.

Participants

A total of 1200 older adults over 60 years old in Myanmar were randomly selected in 2018 (600 each from rural and urban areas). Of them, 573 had hypertension and were eligible for the analysis (urban: 317, rural: 256).

Outcome

Adherence to hypertension medication (yes/no) is the outcome of interest. Three types of SES (wealth, education and current employment status) were the independent variables.

Results

We found that 21.5% of urban residents and 48.4% of rural residents were non-adherent in the study population. Poisson regression modelling stratified by area was performed to estimate the prevalence ratios (PRs) of not following treatment instructions. Demographic information and complications of hypertension were adjusted for in all models as possible confounders. In terms of SES, middle level of wealth compared with low level was significantly associated with poor adherence (PR 2.68, 95% CI 1.28 to 5.59) in the urban area, but education and employment status did not show similar associations. Lower education compared with middle/high school or higher was significantly associated with poor adherence in the rural area (no school: PR 3.22, 1.37–7.58; monastic: 3.42, 1.16–5.07; primary school: 2.41, 1.18–4.95), but wealth and income did not show similar associations.

Conclusions

SES and adherence to hypertension medication were differently associated among older adults in rural and urban areas in Myanmar. To ensure healthcare access to hypertension treatment for every citizen, the differential association between SES and adherence in urban/rural areas needs to be recognised.

DOI： 10.1136/bmjopen-2022-065370

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Language：English   Publishing type：Research paper (scientific journal)  

People have a preference for, and feel better in, beautiful natural environments. However, there are no epidemiological studies on the association between neighborhood beauty and neuroimaging measures. We aimed to determine association between neighborhood beauty and regional brain volume. Participants were 476 community-dwelling older adults from the Neuron to Environmental Impact across Generations (NEIGE) study. Subjective neighborhood beauty was assessed through participants' perception of beautiful scenery within 1 km of their home. Objective measures of neighborhood indicators (green spaces, blue spaces, and plant diversity) within 1 km of participants' homes were obtained using a geographic information system. Volumes of brain regions associated with experience of beauty were measured using magnetic resonance imaging. We estimated associations between neighborhood beauty and regional brain volume using linear regression. Of the participants, 42% rated their neighborhoods as very beautiful, and 17% rated them as not at all beautiful. Higher subjective neighborhood beauty was associated with larger bilateral medial orbitofrontal cortex and insula volumes (all p for trend &lt; 0.01). Brain volume was not associated with objective neighborhood measures. Subjective neighborhood beauty was associated with brain regions related to rewards and decision making, suggesting that these brain regions underpin the perception of neighborhood beauty.

DOI： 10.3390/ijerph20010679

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Recently, several studies reported that pneumonia might increase the risk of cognitive decline and dementia due to increased frailty. OBJECTIVES: This study aims to examine the association between a history of pneumonia and subsequent dementia risk. METHODS: Participants were 9952 aged 65 years or older Japanese men and women from the Japan Gerontological Evaluation Study prospective cohort study, followed up from 2013 to 2019. Dementia was identified by public long-term care insurance registration. A history of pneumonia contracted 1 year before the baseline questionnaire in 2013. A cox regression model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for dementia risk, adjusted for potential confounding variables. We conducted competing risk analyses using a cause-specific hazard model. RESULTS: During the follow-up period of 6 years, 939 persons developed dementia. There was no association between having a prior history of pneumonia with dementia risk (HR 1.20, 95% CI:0.81-1.78). However, we observed an increased risk of dementia in persons with pre-frailty and frailty; the multivariable HR (95% CI) was 1.75 (1.48-2.07) and 2.42 (2.00-2.93) for pre-frailty and frailty, respectively. When pneumonia and frailty were combined, the risk of dementia was the highest for the persons with a history of pneumonia and frailty; the multivariable HR (95% CI) was 2.30 (1.47-3.62). The multivariable HR (95% CI) for those without pneumonia with frailty was 1.95 (1.66-2.28). Meanwhile, the multivariable HR (95% CI) for those with pneumonia without frailty was 1.64 (0.68-3.99). CONCLUSION: Our findings imply that a prior history of pre-frailty and frailty with or without pneumonia, but not a history of pneumonia per se, was associated with an increased risk of dementia among population-based-cohort of older Japanese people.

DOI： 10.1002/gps.5825

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Language：Japanese   Publisher：(一社)日本骨粗鬆症学会  

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Language：English   Publishing type：Research paper (scientific journal)  

Providing appropriate immunization information during the perinatal period is important for improving immunization rates among infants and children; however, the distribution of immunization information by healthcare workers (HCWs) is not standardized in Japan. We investigated HCWs' attitudes toward childhood immunization and factors related to vaccine hesitancy. We conducted a cross-sectional descriptive survey of HCWs involved in childhood immunization in Niigata City, Japan, from November 2017 to January 2018. We assessed contextual, individual and group, and vaccine/vaccination-specific influences. Of 290 HCWs, 139 (47.9%) returned completed questionnaires. Most HCWs (87/139, 64.9%) reported providing immunization information verbally to parents; 51/87 (58.6%) spent fewer than five minutes doing so. Pediatricians provided vaccines based on the parents' best interest, whereas public health nurses and midwives emphasized government policy. Nurses had greater hesitancy related to personal perceptions and social/peer factors than pediatricians (p &lt; 0.001). Nurses were significantly more likely than pediatricians to suggest that children receive more shots than necessary (p &lt; 0.01). Nurses tended to have more negative attitudes toward vaccination and little awareness of immunization promotion compared to pediatricians. Thus, all HCWs involved in childhood immunization should receive sufficient information to provide timely and appropriate immunization to infants and children.

DOI： 10.3390/vaccines10071055

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: We investigated the association between tooth loss and structural brain volume and its mediating effect on the association between tooth loss and cognitive function in older Japanese. METHODS: A cross-sectional study was conducted by using the data of 494 randomly sampled community-dwelling individuals aged 65-84 years living in Tokamachi City, Japan. Total brain volume (TBV), gray matter volume (GMV), white matter volume (WMV), and hippocampal volume (HV) were measured with magnetic resonance imaging. The association of self-reported number of teeth (≥20, 1-19, and 0) with cognitive function assessed with the Japanese version of the Quick Mild Cognitive Impairment screen and structural brain volume was examined. Causal mediation analysis was performed to evaluate the mediating effect of structural brain volume. Age, sex, socioeconomic status, health behavior, comorbid conditions, and total intracranial volume were adjusted. RESULTS: Respondents with no teeth showed lower cognitive function (coefficient = -4.01; 95% confidence interval [CI]: -7.19, -0.82), lower TBV (coefficient = -10.34; 95% CI: -22.84, 2.17), and lower GMV (coefficient = -6.92; 95% CI: -14.84, 0.99) than those with ≥20 teeth (P for trends were 0.003, 0.035, and 0.047, respectively). The number of teeth was not significantly associated with WMV or HV. GMV showed a significant mediating effect on the association between the number of teeth and cognitive function (coefficient = -0.38; 95% CI: -1.14, -0.002, corresponding to 9.0% of the total effect), whereas TBV did not. CONCLUSIONS: GMV was suggested to mediate the relationship between tooth loss and lower cognitive function.

DOI： 10.1016/j.jagp.2022.06.005

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BACKGROUND: Homebound status is one of the most important risk factors associated with functional decline and long-term care in older adults. Studies show that neighborhood built environment and community social capital may be related to homebound status. This study aimed to clarify the association between homebound status for community-dwelling older adults and community environment-including social capital and neighborhood built environment-in rural and urban areas. METHODS: We surveyed people aged 65 years and older residing in three municipalities of Niigata Prefecture, Japan, who were not certified as requiring long-term care. The dependent variable was homebound status; explanatory variables were community-level social capital and neighborhood built environment. Covariates were age, sex, household, marital status, socioeconomic status, instrumental activities of daily living, the Geriatric Depression Scale-15, self-rated health, number of diseases under care, and individual social capital. The association between community social capital or neighborhood built environment and homebound status, stratified by rural/urban areas, was investigated using multilevel logistic regression analysis. RESULTS: Among older adults (n = 18,099), the homebound status prevalence rate was 6.9% in rural areas and 4.2% in urban areas. The multilevel analysis showed that, in rural areas, fewer older adults were homebound in communities with higher civic participation and with suitable parks or pavements for walking and exercising. However, no significant association was found between community social capital or neighborhood built environment and homebound status for urban older adults. CONCLUSION: Community social capital and neighborhood built environment were significantly associated with homebound status in older adults in rural areas.

DOI： 10.2188/jea.JE20200154

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Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

Few studies have examined whether objective or subjective economic status (ES) has a greater association with the happiness of older adults, despite concerns regarding the growing economic cost of morbidity and their functional dependence in developing countries with aging populations. Thus, this study examined whether objective/subjective ES was associated with happiness in older adults in two Myanmar regions. A multistage random sampling procedure and face-to-face interviews were conducted in the urban and rural areas of Myanmar. The happiness of 1200 participants aged &gt;60 years was evaluated using a single happiness score ranging from 0 (very unhappy) to 10 (very happy). The wealth index, used as an objective ES, was calculated from 17 household asset items, such as radio, washing machines, and television. Subjective ES was assessed by asking “Which of the following best describes your current financial situation in light of general economic conditions?” Responses ranged from “very difficult” to “very comfortable”. Both low objective and subjective ES were negatively associated with happiness, after adjusting for confounding variables and stratification by region (urban and rural areas). Although objective and subjective ES had similar associations with happiness in urban areas, subjective ES had a stronger association in rural areas.

DOI： 10.3390/ijerph19063216

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Language：Japanese   Publisher：(公財)日本眼科学会  

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Language：Japanese   Publisher：(公財)日本眼科学会  

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: There is no consensus regarding the impact of population density on the transmission of respiratory viral infections such as COVID-19 and seasonal influenza. Our study aimed to determine the correlation between population density and the incidence and duration of COVID-19 transmission. METHODS: Publicly available data for confirmed COVID-19 cases in Japan, from January 2020 through November 2021, were retrospectively collected. The average numbers of seasonal influenza cases reported in the national database from 2013-2014 through 2019-2020 were identified. Using data for COVID-19 and seasonal influenza population density and incidence rates (age-adjusted), the Pearson's correlation coefficient was determined. RESULTS: A significant positive correlation between log population density and length of outbreak period was observed for COVID-19 (r = 0.734; p < 0.001) but not for seasonal influenza. Additionally, a significant linear correlation was observed between population density and age-adjusted incidence rate for COVID-19 (r = 0.692; p < 0.001) but not for seasonal influenza. CONCLUSIONS: In Japan, areas with high population density experienced a prolonged and more intense COVID-19 outbreak compared with areas with low population density. This was not observed with seasonal influenza, suggesting that public health measures against COVID-19 should be tailored according to population density.

DOI： 10.1016/j.ijregi.2022.01.003

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BACKGROUND: Adverse childhood experiences (ACEs) can affect later-life health outcomes via brain structural differences. However, there is no sufficient empirical evidence about whether brain morphological differences remain until old ages. OBJECTIVE: We examined the association between ACEs and brain volumes among older individuals. PARTICIPANTS AND SETTING: Residents aged 65-84 years in Tokamachi City, Japan, were randomly recruited, and 491 participants were included in the analysis. METHODS: ACEs were assessed with a self-reported questionnaire. The volumes of seven brain regions of interests were evaluated via structural magnetic resonance imaging. RESULTS: In total, 143 (27.1%) participants experienced one ACE and 33 (6.7%) two or more ACEs. Participants with two or more ACEs had a larger anterior cingulate cortex volume (B = 0.346, 95% confidence interval [CI] = 0.04 to 0.66) and smaller hippocampal (B = -0.287, 95% CI = -0.58 to 0.001) and amygdala (B = -0.313, 95% CI = -0.59 to -0.03) volumes. Interestingly, we observed a distinct association between deprivation and threat. That is, deprivation was associated with a smaller amygdala volume (B = -0.164, 95% CI = -0.32 to -0.01) and threat with a larger anterior cingulate cortex volume (B = 0.401, 95% CI = 0.11 to 0.70). CONCLUSIONS: ACEs were associated with the volumes of brain regions such as anterior cingulate cortex, hippocampus, and amygdala, which are responsible for emotion and self-regulation in older population. The effect of ACEs on the amygdala was commonly driven by deprivation experiences and that on the anterior cingulate cortex by threat.

DOI： 10.1016/j.chiabu.2021.105456

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OBJECTIVES: Having gratitude is associated with reduced social isolation and depression, which are risk factors for dementia. However, it is unknown whether gratitude is directly associated with cognitive function. This study aimed to determine associations between gratitude and cognitive function and to elucidate the underlying biological mechanism by testing the mediating role of brain regions among healthy older people. METHODS: We used cross-sectional data from the 2017 Neuron to Environmental Impact across Generations (NEIGE) study of community-dwelling older adults aged ≥ 65 years (n = 478). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Levels of gratitude were assessed using the two-items of Gratitude Questionnaire. Volumes of brain regions associated with emotional processing and social interaction were measured by magnetic resonance imaging. Linear regression models and structural equation models were used to examine associations between level of gratitude, brain volume, and cognitive function. RESULTS: The mean gratitude score was 6.3 (SD=0.9) and the mean MMSE score was 27.1 (SD=2.5). Regression analysis showed that higher levels of gratitude were associated with better cognitive function (coefficient=0.25, 95% CI: 0.01, 0.49), adjusting for age, sex, education, marital status, and depressive symptoms. Higher levels of gratitude were associated with larger volumes of right amygdala and left fusiform gyrus. Structural equation model analysis showed that amygdala volumes mediated the association between gratitude and cognitive function. CONCLUSION: Higher levels of gratitude were positively associated with cognitive function, partially mediated through the amygdala, which is involved in processing emotion and memory.

DOI： 10.1016/j.archger.2022.104645

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BACKGROUND: Childhood maltreatment can impede gratitude, yet little is known about the older population and its moderators. The aim of this study is to clarify the association between childhood maltreatment and levels of gratitude of the older population, and the moderating effect of social ties on the association. METHODS: We analyzed the data of 524 community-dwelling older adults aged 65-84 years without functional disabilities in Tokamachi City, Niigata, Japan, collected for the Neuron to Environmental Impact across Generations (NEIGE) study in 2017. Using a questionnaire, the participants rated three types of childhood maltreatment before the age of 18 (physical abuse, emotional neglect, and psychological abuse), level of gratitude, and social ties. RESULTS: We found an inverse association between emotional neglect and gratitude. Furthermore, emotional neglect was inversely associated with gratitude only for those with lower levels of social ties. CONCLUSIONS: Promoting social ties may mitigate the adverse impact of emotional neglect on the level of gratitude.

DOI： 10.3390/ijerph182111082

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Language：Japanese   Publisher：日本運動疫学会  

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Language：Japanese   Publisher：日本運動疫学会  

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Non-pharmaceutical interventions (NPIs), such as sanitary measures and travel restrictions, aimed at controlling the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may affect the transmission dynamics of human respiratory syncytial virus (HRSV). We aimed to quantify the contribution of the sales of hand hygiene products and the number of international and domestic airline passenger arrivals on HRSV epidemic in Japan. METHODS: The monthly number of HRSV cases per sentinel site (HRSV activity) in 2020 was compared with the average of the corresponding period in the previous 6 years (from January 2014 to December 2020) using a monthly paired t-test. A generalized linear gamma regression model was used to regress the time-series of the monthly HRSV activity against NPI indicators, including sale of hand hygiene products and the number of domestic and international airline passengers, while controlling for meteorological conditions (monthly average temperature and relative humidity) and seasonal variations between years (2014-2020). RESULTS: The average number of monthly HRSV case notifications in 2020 decreased by approximately 85% (p < 0.001) compared to those in the preceding 6 years (2014-2019). For every average \1 billion (approximately £680,000/$9,000,000) spent on hand hygiene products during the current month and 1 month before there was a 0.29% (p = 0.003) decrease in HRSV infections. An increase of average 1000 domestic and international airline passenger arrivals during the previous 1-2 months was associated with a 3.8 × 10- 4% (p < 0.001) and 1.2 × 10- 3% (p < 0.001) increase in the monthly number of HRSV infections, respectively. CONCLUSIONS: This study suggests that there is an association between the decrease in the monthly number of HRSV cases and improved hygiene and sanitary measures and travel restrictions for COVID-19 in Japan, indicating that these public health interventions can contribute to the suppression of HRSV activity. These findings may help in public health policy and decision making.

DOI： 10.1186/s12879-021-06461-5

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.jinf.2021.08.016

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Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: Inequalities exist between the 23-valent pneumococcal polysaccharide vaccination (PPSV23) rate in each municipality among Japanese older adults. Exploring individual-level and community-level intervenable factors is necessary to improve the vaccination rates. We examined the associations between community-level and individual-level social capital and the PPSV23 vaccination among older Japanese adults using multilevel Poisson regression analyses. DESIGN: Cross-sectional study. SETTING: We used data from the Japan Gerontological Evaluation Study, conducted between 3 October 2016 and 10 January 2017 in 631 districts, 39 municipalities and 18 prefectures. PARTICIPANTS: The target population comprised persons aged 65 years or older who are physically and cognitively independent (that is, not certified as needing long-term care). Further, 180 021 older adults from 39 Japanese municipalities were enrolled. PRIMARY OUTCOME MEASURE: The primary outcome was the PPSV23 vaccination among the Japanese older adults aged 65 years or older who did not have physical or cognitive disabilities. RESULTS: After adjusting for municipality-, community-, individual-levels effects with multiple imputation, 137 075 individuals who participated in one/more of the civic participation (participation of social groups), social cohesion (social tie), or reciprocity (mutual exchange of social support) were significantly associated with more vaccinations than those without the three social capitals among the 137 075 older adults (13.0% (95% CI 11.0% to 14.9%), 5.0% (95% CI 2.4% to 7.6%) or 33.9% (95% CI23.6% to 44.2%) increase, respectively, p>0.001 for all). The rich (≥+1 SD) community-level civic participation was significantly associated with 3.4% increase [95% CI 0.02% to 6.78%, p<0.05] of the PPSV23 vaccination among the older adults compared to those with the poor or standard one. CONCLUSIONS: Older adults with one/more of the three social capitals at the both levels received more PPSV23 vaccinations than those without those social capitals. Therefore, fostering of those social capitals may improve the inequality of the PPSV23 vaccination rate among older adults in each municipality.

DOI： 10.1136/bmjopen-2020-043723

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Pneumonia is a leading cause of mortality among older adults worldwide. Recently, several studies reported that frailty was associated with mortality among older adults hospitalized due to respiratory infectious diseases, including pneumonia. However, it is unknown whether frailty is associated with susceptibility to and severity of pneumonia in functionally-independent community-dwelling older adults. In this study, we examined whether frailty increased the susceptibility to pneumonia and hospitalization in older adults. We used cross-sectional data from the Japan Gerontological Evaluation Study; the data was collected by using mail-based, self-reported questionnaires from 177,991 functionally-independent community-dwelling older adults aged ≥ 65 years. Our results showed that frailty was significantly associated with both occurrence of and hospitalization due to pneumonia after adjustments with covariates; (Preference ratio {PR} 1.92, 95% confidence interval {95% CI} [1.66-2.22] and PR 1.80, 95% CI [1.42-2.28], respectively, p < 0.001 for the both). Pre-frailty was associated only with the occurrence of pneumonia. Besides, the instrumental activity of daily living, physical strength, nutrition status, oral function, homeboundness, and depression status in frail older adults were associated with either or both occurrence of and hospitalization due to pneumonia. Our results suggest that frailty influenced the susceptibility to and severity of pneumonia in older adults.

DOI： 10.1038/s41598-021-86854-3

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BACKGROUND: The hippocampus is a brain structure important for memory and cognitive function. Physical activity may help prevent hippocampal atrophy. However, few studies have measured sedentary behavior (SB) and intensity-specific physical activity using an accelerometer. This study aimed to examine the cross-sectional associations of objectively-determined SB, light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) measured by an accelerometer with hippocampal volume among community-dwelling older adults using compositional data analysis (CoDa) approach. METHODS: This cross-sectional study was part of the Neuron to Environmental Impact across Generations (NEIGE) study. A randomly recruited sample of 485 Japanese older adults (47% male; aged 65-84 years) wore tri-axial accelerometers (Omron Healthcare) for seven consecutive days in 2017. Hippocampal volume was measured with magnetic resonance imaging and the left and right hippocampal volumes were automatically segmented using FreeSurfer software. Associations of sedentary and physically active behaviors with hippocampal volume were examined with compositional linear regression analysis based on isometric log-ratio transformations of time use adjusted for potential confounding factors. RESULTS: The relative proportion of time spent in MVPA, compared to the other two activities, was significantly positively associated with right hippocampal volume (β: 57.1, p-value = 0.027).However, no association existed between higher proportions of MVPA and left hippocampal volume, or between proportions of SB or LPA with either left or right hippocampal volumes. CONCLUSIONS: The proportion of time spent in MVPA, relative to the other two activities, was significantly positively associated with right hippocampal volume. MVPA may be beneficial for maintaining hippocampal volume.

DOI： 10.2188/jea.JE20200534

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Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.

DOI： 10.3390/ijerph18062818

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The overall coronavirus disease secondary attack rate (SAR) in family members was 19.0% in 10 prefectures of Japan during February 22-May 31, 2020. The SAR was lower for primary cases diagnosed early, within 2 days after symptom onset. The SAR of asymptomatic primary cases was 11.8%.

DOI： 10.3201/eid2703.203882

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BACKGROUND: Increasing the coverage of vaccinations recommended by the World Health Organization in the older adult population is an urgent issue, especially in the context of avoiding co-epidemics during the current coronavirus disease 2019 crisis. The aim of this study was to examine factors associated with the quality of perceived patient-physician communication and whether this variable was associated with increased odds of vaccination. METHODS: We used cross-sectional data from the Japan Gerontological Evaluation Study conducted from October 2016 to January 2017. The participants were 22,253 physically and cognitively independent individuals aged 65 or older living in 39 municipalities in Japan. Multilevel logit models were used to estimate the odds of vaccination. RESULTS: Among the participants, 40.0% and 58.8% had received pneumococcal and influenza vaccinations as per the recommended schedule, respectively. People with low educational levels were more likely to have a family physician but rate their experience in asking questions lower than those with higher educational levels. Having a family physician and high rating for physicians' listening attitude were positively associated with increased odds of pneumococcal and influenza vaccinations. High rating for patients' questioning attitude and shared decision-making, compared to an ambiguous attitude toward medical decision-making, were positively associated with increased odds of pneumococcal vaccination. CONCLUSION: The results suggest that promotion of having a family physician, better patient-physician communication, and shared decision-making may encourage older adults to undergo recommended vaccinations.

DOI： 10.2188/jea.JE20200505

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

DOI： 10.3390/ijerph18020730

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.exger.2020.111149

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Low objective socioeconomic status (SES) has been correlated with poor physical and mental health among older adults. Some studies suggest that subjective SES is also important for ensuring sound physical and mental health among older adults. However, few studies have been conducted on the impact of both objective and subjective SES on mental health among older adults. This study examines whether objective or subjective SES is associated with depressive symptoms in older adults in Myanmar. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from two regions of Myanmar, for face-to-face interviews. The Geriatric Depression Scale (GDS) was used to evaluate the depressive symptoms. Participants were classified as having no depressive symptom (GDS score <5) and having depressive symptoms (GDS score ≥5). Objective and subjective SES were assessed using the wealth index and asking participants a multiple-choice question about their current financial situation, respectively. The relationship between objective/subjective SES and depressive symptoms was examined using a multivariable logistic regression analysis. The mean age of the 1,186 participants aged 60 years and above was 69.7 (SD: 7.3), and 706 (59.5%) were female. Among them, 265 (22.3%) had depressive symptoms. After adjusting for objective SES and other covariates, only low subjective SES was positively associated with depressive symptoms (adjusted odds ratio, AOR: 4.18, 95% confidence interval, CI: 2.98-5.87). This association was stronger among participants in the rural areas (urban areas, AOR: 2.10, 95% CI: 1.08-4.05; rural areas, AOR: 5.65, 95% CI: 3.69-8.64). Subjective SES has a stronger association with depressive symptoms than objective SES, among older adults of the two regions in Myanmar, especially in the rural areas. Interventions for depression in older adults should consider regional differences in the context of subjective SES by reducing socioeconomic disparities among the communities.

DOI： 10.1371/journal.pone.0245489

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Background: Recent findings indicate that leisure activity (LA) delays cognitive decline and reduces the risk of dementia. However, the association between LA and brain volume remains unclear. This study aimed to examine the association between LA variety and brain volume with a focus on the hippocampus and gray matter. Methods: Data were obtained from the baseline survey of the Neuron to Environmental Impact across Generations study, which had targeted community-dwelling older adults living in Niigata, Japan. We divided LAs into 10 categories, and counted the number of categories of activities in which the participants engaged. We classified them as follows: 0 (i.e., no activity), 1, 2, or ≥ 3 types. Brain volume was assessed through magnetic resonance imaging, and hippocampal and gray matter volumes were ascertained. Results: The sample size was 482. Multiple linear regression analysis showed that hippocampal and gray matter volumes were significantly greater among participants with ≥ 3 types of LAs than among their no-activity counterparts. Hippocampal volume was significantly greater among those who engaged in one type of LA than among those who engaged in no such activity. Sex-stratified analysis revealed that hippocampal volumes were significantly greater among males who engaged in ≥ 3 types of LAs and one type of LA. However, no such association was found among females. Conclusion: The present findings suggest that engaging in a wide range of LAs is related to hippocampal and gray matter volumes. Furthermore, there was a sex difference in the association between LA variety and brain volume.

DOI： 10.3389/fnagi.2021.758562

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Language：Japanese   Publisher：グローバルヘルス合同大会事務局  

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DOI： 10.1016/j.antiviral.2020.104951

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Language：Japanese   Publisher：日本公衆衛生学会  

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<sec><title>Purpose</title>Myanmar is rapidly ageing. It is important to understand the current condition of older adults in the country. To obtain such information, we conducted home-visit surveys to collect data for evaluating social determinants of health on older adults in Yangon (representative of an urban) and Bago (representative of a rural) regions of Myanmar.

</sec><sec><title>Participants</title>Overall, 1200 individuals aged 60 years or older and who were not bedridden or had severe dementia (defined as an Abbreviated Mental Test score ≤6) were recruited from Yangon and Bago in 2018. A population-proportionate random-sampling method was used for recruitment.

</sec><sec><title>Findings to date</title>Overall, 600 individuals from Yangon (222 men; 378 women) and 600 from Bago (261 men; 339 women) were surveyed. The average age of Yangon-based men and women was 69.4±7.6 and 69.4±7.3 years; in Bago, this was 69.2±7.1 and 70.6±7.5 years, respectively. Compared to their Yangon-based counterparts, Bago-based respondents showed significantly lower socioeconomic status and more commonly reported poor self-rated health (Bago-based men: 32.2%, women: 42.5%; Yangon: 10.8% and 24.1%, respectively). Meanwhile, some Yangon-based respondents rarely met friends (men: 17.1%, women: 27.8%), and Yangon-based respondents scored higher for instrumental activities of daily living and body mass index when compared to their Bago-based counterparts. For both regions, women showed higher physical-function decline (Yangon-based women: 40.7%, men: 17.1%; Bago: 46.3% and 23.8%, respectively) and cognitive-function decline (Yangon: 34.1% and 10.4%, respectively; Bago: 53.4% and 22.2%, respectively). Being homebound was more common in urban areas (urban-based men: 11.3%, rural-based men: 2.3%; urban-based women: 13.0%, rural-based women: 4.7%, respectively).

</sec><sec><title>Future plans</title>A follow-up survey is scheduled for 2021. This will afford longitudinal data collection concerning mortality, becoming bedridden, and developing dementia and long-term care-related diseases. This will allow us to calculate long-term care risks for older adults in Myanmar.

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DOI： 10.1136/bmjopen-2020-042877

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DOI： 10.3201/eid2609.202272

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DOI： 10.1186/s12889-020-09343-8

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DOI： 10.1097/INF.0000000000002626

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DOI： 10.3390/ijerph17124480

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DOI： 10.1080/14397595.2019.1621428

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DOI： 10.3390/ijerph17041398

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DOI： 10.2188/jea.JE20190036

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DOI： 10.7883/yoken.JJID.2020.271

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DOI： 10.1371/journal.pone.0224683

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BACKGROUND: Physical activity can help to protect against cognitive decline in older adults. However, little is known about the potential combined relationships of time spent in sedentary behavior (SB), light-intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with indices of cognitive health. We examined the cross-sectional associations of objectively-determined sedentary and physically-active behaviors with an indicator of cognitive function decline (CFD) in older adults. METHODS: A randomly-recruited sample of 511 Japanese older adults (47% male; aged 65-84 years) wore a tri-axial accelerometer (HJA-750C, Omron) for seven consecutive days in 2017. Cognitive function was assessed by interviewers using the Japanese version of Mini-Mental State Examination, with a score of ≤23 indicating CFD. Associations of sedentary and physically-active behaviors with CFD were examined using a compositional logistic regression analysis based on isometric log-ratio transformations of time use, adjusting for potential confounders. RESULTS: Forty one (9.4%) of the participants had an indication of CFD. Activity compositions differed significantly between CFD and normal cognitive function (NCF); the proportion of time spent in MVPA was 39.1% lower, relatively to the overall mean composition in those with CFD, and was 5.3% higher in those with NCF. There was a significant beneficial association of having a higher proportion of MVPA relative to other activities with CFD. LPA and SB were not associated with CFD when models were corrected for time spent in all activity behaviors. CONCLUSIONS: Larger relative contribution of MVPA was favorably associated with an indicator of CFD in older adults.

DOI： 10.2188/jea.JE20190141

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DOI： 10.1186/s12889-019-7702-4

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DOI： 10.1249/01.mss.0000561149.75370.cd

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DOI： 10.1007/s00586-019-05938-x

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DOI： 10.1007/s00774-018-0937-9

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Early detection of dementia provides opportunities for interventions that could delay or prevent its progression. We developed the Japanese version of the Quick Mild Cognitive Impairment (Qmci-J) screen, which is a performance-based, easy-to-use, valid and reliable short cognitive screening instrument, and then we examined its validity. Community-dwelling adults aged 65⁻84 in Niigata prefecture, Japan, were concurrently administered the Qmci-J and the Japanese version of the standardized Mini-Mental State Examination (sMMSE-J). Mild cognitive impairment (MCI) and dementia were categorized using established and age-adjusted sMMSE-J cut-offs. The sample (n = 526) included 52 (9.9%) participants with suspected dementia, 123 (23.4%) with suspected MCI and 351 with likely normal cognition. The Qmci-J showed moderate positive correlation with the sMMSE-J (r = 0.49, p &lt; 0.001) and moderate discrimination for predicting suspected cognitive impairment (MCI/dementia) based on sMMSE-J cut-offs, area under curve: 0.74, (95%CI: 0.70⁻0.79), improving to 0.76 (95%CI: 0.72 to 0.81) after adjusting for age. At a cut-off of 60/61/100, the Qmci-J had a 73% sensitivity, 68% specificity, 53% positi

DOI： 10.3390/ijerph16060917

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DOI： 10.3390/ijerph16060917

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DOI： 10.1016/j.annepidem.2018.10.010

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DOI： 10.1371/journal.pone.0210550

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DOI： 10.1007/s00774-017-0863-2

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DOI： 10.1016/j.meegid.2018.04.016

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DOI： 10.1136/bmjopen-2017-016876

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DOI： 10.1371/journal.pone.0192085

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DOI： 10.1016/j.socscimed.2017.04.008

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BACKGROUND: Although living in a hilly environment may promote muscular activity in the daily lives of residents, and such activity may prevent diabetes mellitus, few studies have focused on the impact of living in a hilly environment on diabetes mellitus. The purpose of this study was to investigate the impact of a hilly neighborhood environment on DM in older people. METHODS: We used data from the Japan Gerontological Evaluation Study, a population-based, cross-sectional study of individuals aged 65 or older without long-term care needs in Japan, which was conducted in 2010. A total of 8904 participants in 46 neighborhoods had responded to the questionnaire and undergone a health check. Diabetes mellitus was diagnosed as HbA1c ≥ 6.5% and those undergoing treatment for diabetes mellitus. Poorly controlled diabetes mellitus was diagnosed in those without other chronic diseases who had an HbA1c > 7.5%, and in those with other chronic diseases if their HbA1c was >8.0%. Neighborhood environment was evaluated based on the percentage of positive responses in the questionnaire and geographical information system data. A multilevel analysis was performed, adjusted for individual-level risk factors. Furthermore, sensitivity analysis was conducted for those who were undergoing treatment for diabetes mellitus (n = 1007). RESULTS: After adjustment for other physical environmental and individual covariates, a 1 interquartile range increase (1.48°) in slope in the neighborhood decreased the risk of poorly controlled diabetes mellitus by 18% (odds ratio [OR]: 0.82, 95% confidence interval [CI]: 0.70-0.97). Sensitivity analysis confirmed that larger slopes in the neighborhood showed a significant protective effect against diabetes mellitus among those who were undergoing treatment for diabetes mellitus (OR: 0.73, 95% CI: 0.59-0.90). CONCLUSION: A hilly neighborhood environment was not associated with diabetes mellitus, but was protective against poorly controlled diabetes mellitus.

DOI： 10.1016/j.socscimed.2017.04.008

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DOI： 10.1111/hepr.12712

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Language：Japanese   Publisher：Japanese Society of Public Health  

<p><b>Objectives</b> Personal income affects dental status in older people. However, the impact of income inequality on dental status at the community level (junior high school district) is unclear. The purpose of this study was to examine the association between dental status and community level income inequity after adjust for individual socio-economic status in Japanese older adults, and to verify the relative income hypothesis, also known as the Wilkinson hypothesis.</p><p><b>Methods</b> We used data from the Japan Gerontological Evaluation Study (JAGES) conducted in Niigata city. JAGES is a postal survey of functionally independent adults aged 65 years or older. We enrolled 4,983 respondents (response rate 62.3%) and used data on 3,980 of them after excluding incomplete data. We evaluated health condition and socio-economic status using questionnaires. The Gini coefficient, as an indicator of income inequality, was calculated by junior high school district (57 districts) based on the data from the questionnaire. Additionally, the Pearson's coefficient of correlation was calculated to evaluate the association between the mean number of remaining teeth and the community level Gini coefficient. Then we evaluated the mean number of remaining teeth among the groups stratified by the Gini coefficient conditions. Next, we conducted a multilevel analysis using an ordinal logistic regression model. The number of remaining teeth was set as the dependent variable, while sex, age, household size, education, smoking status, diabetes treatment, current living conditions, and equivalent income were used as independent variables at the individual level. The Gini coefficient and average equivalent income in the junior high school district were used as independent variables at the community level.</p><p><b>Results</b> The Pearson's correlation coefficient for the relationship between the Gini coefficient and the mean number of remaining teeth in the junior high school district was −0.44 (<i>P</i><0.01). Wider income disparity area (Gini coefficient≧0.35) revealed a significantly small number of remaining teeth (<i>P</i><0.001). The multilevel analysis showed that a higher Gini coefficient and a lower average equivalent income at the community level were significantly associated with a lower number of remaining teeth, and with educational attainment, smoking status, current living conditions, and equivalent income at the individual level, after adjusting for sex and age. On the other hand, educational attainment at the individual level, and average equivalent income at the community level were not significant factors after adjusting for all individual level variables.</p><p><b>Conclusion</b> This study showed that, in addition to individual socio-economic status, income inequality at the community level was significantly associated with number of remaining teeth in Japanese older adults. Although the precise mechanism of this association is still unclear, our result supports the relative income hypothesis.</p>

DOI： 10.11236/jph.64.4_190

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Publishing type：Research paper (international conference proceedings)   Publisher：Journal of the Physical Society of Japan  

DOI： 10.7566/jpscp.11.070007

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DOI： 10.1186/s12917-016-0844-z

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Publishing type：Research paper (scientific journal)   Publisher：Informa {UK} Limited  

DOI： 10.1080/2373566x.2016.1238721

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DOI： 10.1371/journal.pone.0155022

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DOI： 10.3389/fmicb.2016.00262

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DOI： 10.1620/tjem.238.113

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Language：Japanese   Publisher：(一財)厚生労働統計協会  

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DOI： 10.1007/s12928-014-0306-0

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DOI： 10.1017/S0950268814000697

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DOI： 10.1620/tjem.232.97

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Influenza vaccination is considered the single most important medical intervention for the prevention of influenza. The dose of trivalent influenza vaccine in children was increased almost double since 2011/12 season in Japan. We estimated the influenza vaccine effectiveness for children 1-11 years of age using rapid test kits in Isahaya City, involving 28,884 children-years, over two consecutive influenza seasons (2011/12 and 2012/13). Children were divided into two groups, vaccinated and unvaccinated, according to their vaccination record, which was obtained from an influenza registration program organized by the Isahaya Medical Association for all pediatric facilities in the city. There were 14,562 and 14,282 children aged from 1-11 years in the city in 2011 and 2012 respectively. In the 2011/12 season, the overall vaccine effectiveness in children from 1-11 years of age, against influenza A and B were 23% [95% confidence interval (CI): 14%-31%] and 20% [95% CI: 8%-31%], respectively. In the 2012/13 season, vaccine effectiveness against influenza A and B was 13% (95% CI: 4%-20%) and 9% (95% CI: -4%-21%), respectively. The vaccine effectiveness was estimated using the rapid diagnosis test kits. Age-stratified estimation showed that vaccine effectiveness was superior in younger children over both seasons and for both virus types. In conclusion, the trivalent influenza vaccine has a significant protective effect for children 1-11 years of age against influenza A and B infection in the 2011/12 season and against influenza A infection in the 2012/13 season in a community in Japan.

DOI： 10.1620/tjem.232.97

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Two new influenza virus neuraminidase inhibitors (NAIs), peramivir and laninamivir, were approved in 2010 which resulted to four NAIs that were used during the 2010-2011 influenza season in Japan. This study aims to monitor the susceptibility of influenza virus isolates in 2009-2010 and 2010-2011 influenza seasons in Japan to the four NAIs using the fluorescence-based 50% inhibitory concentration (IC₅₀) method. Outliers were identified using box-and-whisker plot analysis and full NA gene sequencing was performed to determine the mutations that are associated with reduction of susceptibility to NAIs. A total of 117 influenza A(H1N1)pdm09, 59 A(H3N2), and 18 type B viruses were tested before NAI treatment and eight A(H1N1)pdm09 and 1 type B viruses were examined from patients after NAI treatment in the two seasons. NA inhibition assay showed type A influenza viruses were more susceptible to NAIs than type B viruses. The peramivir and laninamivir IC₅₀ values of both type A and B viruses were significantly lower than the oseltamivir and zanamivir IC₅₀ values. Among influenza A(H1N1)pdm09 viruses, the prevalence of H274Y viruses increased from 0% in the 2009-2010 season to 3% in the 2010-2011 season. These H274Y viruses were resistant to oseltamivir and peramivir with 200-300 fold increase in IC₅₀ values but remained sensitive to zanamivir and laninamivir. Other mutations in NA, such as I222T and M241I were identified among the outliers. Among influenza A(H3N2) viruses, two outliers were identified with D151G and T148I mutations, which exhibited a reduction in susceptibility to oseltamivir and zanamivir, respectively. Among type B viruses, no outliers were identified to the four NAIs. For paired samples that were collected before and after drug treatment, three (3/11; 27.3%) H274Y viruses were identified among A(H1N1)pdm09 viruses after oseltamivir treatment but no outliers were found in the laninamivir-treatment group (n=3). Despite widespread use of NAIs in Japan, the prevalence of NAI-resistant influenza viruses is still low.

DOI： 10.1016/j.antiviral.2013.06.003

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DOI： 10.1016/j.antiviral.2013.06.003

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DOI： 10.1371/journal.pone.0071696

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The clinical effectiveness of the newly released neuraminidase inhibitors (NAIs) laninamivir and peramivir has not been sufficiently evaluated in influenza-infected patients in clinical and practical settings. In this study, we analyzed the clinical data of 211 patients infected with influenza A virus subtype H3N2 (A(H3N2)) and 45 patients infected with influenza A virus subtype H1N1pdm (A(H1N1)pdm09) who received the NAIs oseltamivir, zanamivir, laninamivir, or peramivir during the 2010-2011 influenza season. The duration of fever from the first dose of the NAI to fever alleviation to <37.5 °C was evaluated as an indicator of the clinical effectiveness of the NAIs in the influenza-infected patients. For the A(H3N2)-infected patients, Kaplan-Meier analysis showed the peramivir treatment group had the fastest time of fever alleviation to <37.5 °C (median 17.0 h, 95 % confidence interval [CI] 7.2-26.8 h) of the four treatment groups. No significant difference was found in the time to fever alleviation among the other antivirals, oseltamivir, zanamivir, and laninamivir. Results of multivariate analysis, using a Cox proportional-hazards model (hazard ratio 3.321) adjusted for the factors age, sex, body weight, vaccination status, time from onset to the clinic visit, and body temperature showed significantly faster fever alleviation in the peramivir treatment group compared with the oseltamivir treatment group. For the A(H1N1)pdm09-infected patients, only the oseltamivir and zanamivir treatment groups were compared, and no significant difference in time to alleviation of fever was observed between the two groups. Based on a cycling probe real-time polymerase chain reaction (PCR) assay, none of the A(H1N1)pdm09 strains in this study had the H275Y mutation conferring oseltamivir resistance. Further evaluation of the clinical effectiveness of the newly released NAIs for influenza-infected patients, including those infected with A(H1N1)pdm09, is needed.

DOI： 10.1007/s10156-012-0428-1

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DOI： 10.1007/s10156-012-0428-1

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DOI： 10.1186/1476-072X-11-20

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DOI： 10.1186/1476-072X-11-20

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DOI： 10.1371/journal.pone.0036455

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Publishing type：Research paper (international conference proceedings)   Publisher：IEEE  

DOI： 10.1109/GHTC.2012.18

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Other Link： https://dblp.uni-trier.de/db/conf/ghtc/ghtc2012.html#KawanoSSGSAOIYKTHSN12

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DOI： 10.1128/JCM.00646-10

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DOI： 10.1128/JCM.00115-09

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DOI： 10.18888/sh.0000000395

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DOI： 10.1017/S095026881600220X

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DOI： 10.1371/journal.pone.0169904

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DOI： 10.1017/S0950268816000984

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DOI： 10.1017/S0950268814000697

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DOI： 10.1371/journal.pone.0099638

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DOI： 10.1109/GHTC.2012.18

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