BackgroundAlthough the feasibility of randomized trials for investigating the long-term association between oral health and cognitive decline is low, deriving causal inferences from observational data is challenging. We aimed to investigate the association between poor oral status and subjective cognitive complaints (SCC) using fixed-effects model to eliminate the confounding effect of unobserved time-invariant factors.MethodsWe used data from Japan Gerontological Evaluation Study (JAGES) which was conducted in 2010, 2013, and 2016. β regression coefficients (95% confidence intervals) were calculated using fixed-effects models to determine the effect of deteriorating oral status on developing SCC. Onset of SCC was evaluated using the Kihon Checklist-Cognitive function score. Four oral status variables were used: awareness of swallowing difficulty, decline in masticatory function, dry mouth, and number of teeth.Results13,594 participants (55.8% women) without SCC at baseline were included. The mean age was 72.4 (SD = 5.1) for men and 72.4 (SD=4.9) for women. Within the 6-year follow-up, 26.6% of men and 24.9% of women developed SCC. The probability of developing SCC was significantly higher when participants acquired swallowing difficulty (β= 0.088; 0.065-0.111 for men, β= 0.077; 0.057-0.097 for women), decline in masticatory function (β=0.039; 0.021-0.057 for men, β= 0.030; 0.013-0.046 for women), dry mouth (β= 0.026; 0.005-0.048 for men, β= 0.064; 0.045-0.083 for women), and tooth loss (β= 0.043; 0.001-0.085 for men, β= 0.058; 0.015-0.102 for women).ConclusionsThe findings suggest that good oral health needs to be maintained to prevent the development of SCC, which increases the risk for future dementia.

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

Background Smoking behaviour may have changed due to the COVID-19 pandemic, the April 2020 revised smoke-free policy and the high prevalence of heated tobacco product (HTP) use in Japan (10.9% in 2020). This study examined the association between these three events and smoking behaviour changes using 6-month follow-up data from before and during the pandemic. Method Using longitudinal data from an internet survey conducted in February 2020 (baseline) and follow-up in August to September 2020, prevalence ratios (PR) and 95% confidence intervals (95% CIs) for smoking behaviour changes (increase and quit) were calculated using multivariable Poisson regression with adjustments for potential covariates including three event-related five factors: fear of COVID-19, living in a COVID-19 endemic area, workplace smoking rules, self-imposed smoking rules at home and type of tobacco use (cigarette only/HTP only/dual use). A smoker who reported an increase in smoking intensity in the last month was defined as an increase. A smoker who had stopped both cigarettes and HTPs at follow-up was defined as a quit. Results We analysed 1810 tobacco users (1448 males (80%); mean age 50.8 years±13.2 SD). At baseline, 930 participants used cigarettes only, 293 HTPs only and 587 both. While 214 (11.8%) users increased smoking intensity, 259 (14.3%) quit both tobacco products. Those who feared COVID-19 were less likely to quit (PR=0.77, 95% CI 0.68 to 0.95), while living in a COVID-19 endemic area was not associated with either smoking behaviour change. Workplace smoking rules were not associated with either smoking behaviour change, but those with no home smoking ban were less likely to quit. Compared with cigarette-only users, HTP-only users were more likely to quit (PR=1.57, 95% CI 1.17 to 2.11), while dual users were more likely to increase smoking intensity (PR=1.35, 95% CI 1.01 to 1.79). Conclusion During the pandemic, dual cigarette and HTP use increased smoking intensity, whereas HTP-only use was associated with quitting but fear of COVID-19 and not having a home smoking ban made it harder to quit.

Risk perception and individual reactions to risk are not necessarily comparable, and socioeconomic status may affect individual reactions to risk. This study aimed to investigate the association between socioeconomic status and reactions to radiation exposure risk. This cross-sectional study, based on a self-reported online survey was conducted between 3 March and 21 March 2012, one year after the accident at Fukushima Daiichi nuclear power station. We used feelings of anxiety and risk-averse behavior concerning radiation exposure as dependent variables, and equivalent income and educational attainment as independent variables. Multiple logistic regression analysis was applied to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) with adjustment for possible confounders. Among 10 000 participants, 23.0% felt anxious and 12.0% engaged in risk-averse behavior for radiation exposure. Participants with a higher socioeconomic status tended not to feel anxious but undertook risk-averse behavior. Participants in the highest quartile income category did not report feeling anxious but showed prevalent undertaking of risk-averse behavior for radiation exposure compared to the lowest income category (for anxiety, aOR, 0.77; 95% CI, 0.64–0.93, for risk-averse behavior, aOR, 1.33; 95% CI, 1.04–1.69). University or graduate-school graduates were associated with greater risk-averse behavior compared to junior high school or high school graduates (aOR, 1.49; 95% CI, 1.29–1.73). Socioeconomic status may affect reactions to radiation exposure risk. Risk communication strategies should consider the socioeconomic status of those affected.

Aim: This study examined the effects of a “community‐based center” intervention to prevent the onset of functional disability among residents in disaster‐affected areas.Methods: We used data from a prospective cohort study conducted from 2010 to 2016 in Iwanuma City, Japan. Participants were community‐dwelling independent adults aged ≥65 years. The exposure variable was the experience of using a community‐based center. The outcome variable was functional disability onset. The average treatment effect on the treated (ATET) was estimated by adjusting for possible confounders. Additional analysis stratified by sex was conducted considering the sex differences in social participation rates.Results: Among 3794 participants (mean ± SD age = 72.9 ±5.3 years, 46.0% men), 196 (5.2%) used the community‐based center, and 849 (22.4%) exhibited disability onset. Of those with functional disabilities, 40 (20.4%) used the community‐based center, while 809 (22.5%) did not. The ATET for functional disability onset with community‐based center activities across all participants were not significant (ATET: 0.51 years [95% confidence interval [CI] = −0.23; 1.27]). However, the direction of the effect of community‐based center activities differed by sex (ATET: −0.14, 95% CI = −2.59; 2.31 for men [n = 18], and 0.66, 95% CI = 0.18; 1.16 for women [n = 178]). Women exhibited a 15.63% (95% CI = 3.58; 27.68) increase in the time until functional disability onset.Conclusions: The use of community‐based centers was associated with a longer period without functional disability in women. Geriatr Gerontol Int 2022; 22: 465–470.