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Primary varicella zoster virus (VZV) infection can cause varicella (chicken pox), which is generally a mild, self-limiting disease; however, VZV infection can also rarely lead to serious complications, such as [...]

Background: The association between obesity and cardiovascular disease (CVD) remains unclear, particularly for those with established CVD risk factors. We analyzed follow-up data from the Aichi Workers’ Cohort Study. We studied the association between the degree of obesity and risk of CVD and its subtypes specifically among individuals with hypertension, hyper-low-density lipoprotein (LDL)-cholesterolemia, or diabetes. Methods: Pooled data of 8972 adults (7076 men and 1896 women) who were recruited between 2002 and 2008 were used in the current analysis. We used multivariable Cox proportional hazard model to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between the degree of obesity assessed with body mass index (BMI) and the risk of CVD and its subtypes, i.e., coronary heart disease (CHD) and stroke. Results: During a median of 12 years, there were 197 CVDs (80 CHDs and 117 strokes). BMI ≥ 27.5 compared to 21.0–22.9 kg/m2 was positively and significantly associated with the risks of CVD, CHD, and total stroke. Hypertension, hyper-LDL-cholesterolemia, and diabetes mediated 15.9%, 5.8%, and 8.7% of obesity-CVD associations, respectively, and 28.3% by their combination. In the stratified analyses by the presence of risk factors, BMI ≥ 25.0 (overweight/obesity) compared to BMI < 25 kg/m2 was associated with a higher risk of CVD in those with and without hypertension, but only with hyper-LDL-cholesterolemia, and without diabetes. Conclusions: Overweight/obesity was associated with the risk of CVD and its subtypes. About 30% of the risk was explained by hypertension, hyper-LDL-cholesterolemia, and diabetes, of which hypertension accounted for approximately the half of the explained risk. However, overweight/obesity increased the risk of CVD even in those without hypertension. These findings highlight the importance of controlling and preventing overweight/obesity regardless of chronic disease status.

OBJECTIVE: This study examined the longitudinal association of perceived stress, ikigai, and having someone one can count on in middle age with the advanced-level functional competency in older age, which is crucial for the maintenance of independent life among older adults. The issue is especially relevant in super-aged countries like contemporary Japan, where more and more older people live in a household consisting only of older people. METHODS: Data were collected in 2019 from a total of 1692 retirees of the Aichi Workers Cohort Study participants in which baseline survey including psychological factors was conducted during their employment in 2002. Japan Science and Technology Agency Index of Competence (JST-IC) was used to measure the advanced-level functional competency. Multivariable-adjusted odds ratios (ORs) were obtained for having low JST-IC in later life by the degrees of psychological factors reported in the middle age adjusting for the presence of depressive mood in 2019. RESULTS: Those who were not sure about ikigai (OR: 2.02, 95 % CI: 1.33 to 3.08) and who have no one to count on (OR: 2.19, 95 % CI: 1.52 to 3.16) in the middle age were significantly associated with low JST-IC after retirement. Having much stress was significantly inversely associated with a low JST-IC (OR: 0.69, 95 % CI: 0.50 to 0.97). CONCLUSION: Having ikigai and someone reliable, and stress during middle age might play a role in preventing impaired advanced-level functional competency. Improved ikigai and increased social interaction and support might improve functional competency. Further research might explore avenues for improving ikigai.

Aim: Japan faces a public health challenge of dementia, further complicated by the increasing complications from diabetes within its rapidly aging population. This study assesses the impact of diabetes on mortality and hospitalization among individuals aged ≥75 years with new dementia diagnoses. Methods: We analyzed administrative claims data in Japan from 73 324 individuals aged ≥75 years with dementia, of whom 17% had comorbid diabetes. Dementia and diabetes were identified from the International Classification of Diseases, Tenth Revision codes. We used Kaplan–Meier survival analysis, Cox proportional hazards analysis, and population attributable fractions (PAFs) to evaluate the impact on mortality and hospitalization after dementia diagnosis. Results: One‐year mortality and 1‐year hospitalization probabilities in individuals with dementia and diabetes (10.3% and 31.7%, respectively) were higher than those without diabetes (8.3% and 25.4%, respectively). The adjusted hazard ratios for individuals with diabetes, as compared to those without, were 1.126 (95% confidence interval [CI], 1.040–1.220) for mortality and 1.191 (95% CI, 1.140–1.245) for hospitalization. The PAFs from the comorbidity of dementia and diabetes were 2.2% for mortality and 3.1% for hospitalization. Subgroup analysis showed that the PAFs were highest in men aged 75–79 years and women aged 80–84 years for mortality and in individuals aged 75–79 for hospitalization. Conclusion: During the early postdiagnosis period, comorbid diabetes increases mortality and hospitalization risks in older adults with dementia. The variation in disease burden across age groups underscores the need for age‐specific health care strategies to manage comorbid diabetes in individuals with dementia. Geriatr Gerontol Int 2024; 24: 773–781. [ABSTRACT FROM AUTHOR]

Aim: Several studies have shown that dairy consumption in old age is effective in preventing frailty. However, there is a lack of evidence regarding the association between milk consumption during middle age and the development of frailty in old age. Therefore, we carried out an investigation to explore the association between milk consumption during middle age and development of frailty examined after over 15 years of follow up in a long‐term cohort study in Japan. Methods: We studied 265 participants aged 60–79 years (212 men and 53 women) in 2018, who participated in both the baseline survey in 2002 and the frailty assessment in 2018. The amount of milk consumption (g/day) at baseline was age‐ and energy‐adjusted, and classified into three categories (no, low and high consumption: 0 g/day, ≤135.86 g/day, >135.86 g/day in men and 0 g/day, ≤126.44 g/day, >126.44 g/day in women). Odds ratios (OR) and 95% confidence intervals (CI) for prefrailty/frailty after adjusting for lifestyles at baseline, stratified by sex, were estimated using logistic regression analysis. Results: The prevalence of prefrailty/frailty in 2018 was 37.7% and 28.3% in men and women, respectively. Milk consumption categories were inversely associated with the prevalence of prefrailty/frailty in men (OR 0.34, 95% CI 0.14–0.84 in low consumption; OR 0.31, 95% CI 0.10–0.95 in high consumption; P < 0.05), but not in women (OR 0.53, 95% CI 0.11–2.65; P = 0.44). Conclusions: In this study, milk intake in middle‐aged men was inversely associated with the prevalence of prefrailty/frailty later in life. Geriatr Gerontol Int 2024; 24: 700–705. [ABSTRACT FROM AUTHOR]

Background and Objective: Excellent generalizability is the precondition for the widespread practical implementation of machine learning models. In our previous study, we developed the schizophrenia classification model (SZ classifier) to identify potential schizophrenia patients in the Japanese population. The SZ classifier has exhibited impressive performance during internal validation. However, ensuring the robustness and generalizability of the SZ classifier requires external validation across independent sample sets. In this study, we aimed to present an external validation of the SZ classifier using outpatient data. Methods: The SZ classifier was trained by using online survey data, which incorporate demographic, health-related, and social comorbidity features. External validation was conducted using an outpatient sample set which is independent from the sample set during the model development phase. The model performance was assessed based on the sensitivity and misclassification rates for schizophrenia, bipolar disorder, and major depression patients. Results: The SZ classifier demonstrated a sensitivity of 0.75 when applied to schizophrenia patients. The misclassification rates were 59% and 55% for bipolar disorder and major depression patients, respectively. Conclusions: The SZ classifier currently encounters challenges in accurately determining the presence or absence of schizophrenia at the individual level. Prior to widespread practical implementation, enhancements are necessary to bolster the accuracy and diminish the misclassification rates. Despite the current limitations of the model, such as poor specificity for certain psychiatric disorders, there is potential for improvement if including multiple types of psychiatric disorders during model development. [ABSTRACT FROM AUTHOR]

Nonpharmaceutical interventions (NPIs) to control COVID‐19 have decreased the incidence of many pediatric infectious diseases. The epidemiology of β‐ and γ‐herpesvirus infections might have been affected by NPIs. The aim of this study was to elucidate changes in trends in β‐ and γ‐herpesvirus infections and complex febrile seizures (cFS) of viral etiology before and during the COVID‐19 pandemic. Between April 2017 and March 2021, febrile children aged ≤5 years were enrolled. Detection of EBV, CMV, HHV‐6B, and HHV‐7 DNA in serum was performed using real‐time PCR. The epidemiology of viral infections and cFS were compared between the prepandemic and pandemic periods. During the observation period, 1432 serum samples were collected. The mean number of febrile children decreased during the pandemic period, but the number of patients with HHV‐6B infection increased from 35 (9.3% of all febrile children) per year before the pandemic to 43 (15.5%) during the pandemic. The change in the proportion of patients with primary HHV‐6B infection was 6.50% (95% confidence interval [CI], 2.05%–11.3%; p = 0.0047). The mean number of patients with cFS decreased during the pandemic period, but the number of patients with HHV‐6B–associated cFS was stable throughout the observation period. Therefore, the change in proportion of patients with cFS caused by primary HHV‐6B infection was 49.5% (95% CI, 12.2%–60.5%; p = 0.0048). The disease burden of primary HHV‐6B infection among patients in the emergency room remained unchanged, with a significant increase in the relative proportion after the COVID‐19 pandemic began. [ABSTRACT FROM AUTHOR]

Background: Research on the influence of heart failure on mortality after Alzheimer's disease diagnosis is limited., Objective: To evaluate the association between comorbid heart failure and mortality following Alzheimer's disease diagnosis, particularly considering sex differences., Methods: We analyzed administrative claims data from Japan, involving 32,363 individuals (11,064 men and 21,299 women) aged 75 or older newly diagnosed with Alzheimer's disease, with 7% having comorbid heart failure. Cox proportional hazard models and population attributable fractions (PAFs) were used to evaluate the association between comorbid heart failure and mortality within one year following Alzheimer's disease diagnosis., Results: Individuals with Alzheimer's disease and heart failure had a multivariate-adjusted hazard ratio of 1.51 (95% confidence interval [CI], 1.32-1.73) for mortality during the one-year follow-up period compared to those with Alzheimer's disease and without heart failure. Subgroup analysis by sex revealed a higher mortality hazard ratio in women of 1.63 (95% CI, 1.36-1.95) than that in men of 1.39 (95% CI, 1.13-1.71). Further age and sex subgroup analysis indicated that women across all age brackets-75-79, 80-84, and ≥ 85 years-had higher mortality hazard ratios. The PAF for heart failure increased with age in both sexes, with women having higher PAFs than men, and the sex difference in PAF being most pronounced in the 75-79 age category (men: 1.4%, women: 4.0%)., Conclusions: Hazard ratios and PAFs for mortality associated with comorbid heart failure in newly diagnosed Alzheimer's disease are higher in women than in men, which persists across all age subgroups., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives　We evaluated the number of hospitalizations among public assistance recipients for each major classification according to the International Classification of Diseases 10th Revision (ICD-10), adjusting for sex and age differences in the general Japanese population. This study aimed to provide a comprehensive assessment of hospitalization patterns among public assistance recipients by disease category.Methods　We used indirect methods to adjust for sex and age, with public assistance recipients and the entire Japanese population as the observation and reference groups, respectively. We calculated the standardized hospitalization ratios (SHRs) for each major classification based on the ICD-10. We only used publicly available government statistics, including data from the 2020 Patient Survey, for hospitalization rates according to sex, age, and major classification. Additionally, we used data from the 2020 National Survey on Public Assistance Recipients conducted for the number of public assistance recipients by sex and age groups and data from the 2020 Survey on the Actual Status of Medical Assistance conducted for the number of hospitalizations by major classification.Results　After adjusting for age, the overall SHR was 1.49. The major classifications with the high SHRs for men and women were "V. Mental and behavioural disorders" (SHR for men; 4.06, women; 3.45) and "IV. Endocrine, nutritional, and metabolic diseases" (SHR for men; 2.40, women; 1.47). Conversely, the major classifications with low SHRs were "XVI. Certain conditions originating in the perinatal period" (SHR; 0.43) and "VII. Diseases of the eye and adnexa" (SHR; 0.44) for men. For women, these were "XV. Pregnancy, childbirth, and the puerperium" (SHR; 0.17) and "VII. Diseases of the eye and adnexa" (SHR; 0.27).Conclusion　After adjusting for age, hospitalization status among public assistance recipients was higher overall than in the general Japanese population. However, if divided based on major classifications, higher and lower rates were observed compared with the general population. In assessing the status of medical assistance for public assistance recipients, research should be conducted by disease classification, considering the significant differences in age composition between public assistance recipients and the general Japanese population.

Background: The term "nonrestorative sleep (NRS)" refers to an unrefreshed feeling at wake-up and is a domain of poor sleep quality. Previous research has demonstrated that NRS is linked to a number of diseases and adverse health outcomes, but less is known regarding the link between NRS and diabetes, particularly in Japanese., Methods: We studied 3,665 middle-aged male participants of the Aichi Workers' Cohort Study who were followed-up from 2002 through 2019. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) of incident type 2 diabetes mellitus (T2DM) in relation to NRS adjusted for potential confounding variables., Results: During a median follow-up of 14.6 years, 421 type 2 diabetes cases were identified. Participants with NRS had a higher crude incidence rate of T2DM (11.2/1,000 person-years), compared to participants without NRS (9.3/1,000 person-years). In the fully adjusted model, individuals who reported having NRS had a significantly higher risk of developing T2DM (HR1.36; 95% CI, 1.10-1.67). The association was observed only in participants under 50 years old (HR 1.82; 95% CI, 1.36-2.43), not in the older (50 years or older) participants (P for interaction = 0.025). In contrast, stratified analyses by the presence of shift work, obesity, or sleep duration showed similar associations in all the strata., Conclusion: NRS was associated with higher risk of T2DM in middle-aged Japanese male workers independent of a variety of lifestyle factors and other sleep problems.

Aims: The associations between low-density lipoprotein cholesterol (LDL-C) and the risk of cardiovascular disease (CVD) subtypes are not well established among the Japanese population. This study used longitudinal data from the Aichi Workers' Cohort Study to explore the association between LDL-C levels and the risk of coronary heart disease (CHD) and stroke subtypes., Methods: Pooled data of 8966 adults (7093men and 1903 women) who were recruited between (2002) and (2008) were used for the current analysis. Propensity scores for the LDL-C categories were generated using multinomial logistic regression. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated from the inverse probability weighted Cox proportional hazards model for LDL-C category associations with risks of CHD, stroke subtypes, and CVD., Results: During a median follow-up of 12 years, 122 strokes (57 ischemic strokes, 25 intracerebral hemorrhage, and 40 unknown subtypes) and 82 cases of CHD were observed. LDL-C 160- mg/dL compared to LDL-C 100-119 mg/dL was positively and significantly associated with the risk of CHD (HR: 4.56; 95% CI: 1.91-10.9) but not with ischemic stroke (HR: 0.99; 95% CI: 0.44-2.22). LDL-C was inversely associated with the risk of intracerebral hemorrhage (P for trend=0.009)., Conclusion: In middle-aged Japanese workers, LDL-C was significantly and positively associated with CHD, but not with ischemic stroke. LDL-C was inversely significantly associated with intracerebral hemorrhage.

Competing Interests: None to declare.