Journal of Epidemiology最新文献

{"title":"Validation of Self-reported Medical Condition in the Taiwan Biobank.","authors":"Chi-Shin Wu, Le-Yin Hsu, Chen-Yang Shen, Wei J Chen, Shi-Heng Wang","doi":"10.2188/jea.JE20240110","DOIUrl":"10.2188/jea.JE20240110","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to validate self-reported medical conditions in the Taiwan Biobank (TWBB), in which participants were inquired about 30 disease conditions, by comparing them with claims records from Taiwan's National Health Insurance (NHI) claims database.</p><p><strong>Methods: </strong>We identified 30 clinical diagnoses using International Classification of Diseases - Clinical Modification codes from ambulatory and hospital claims within the NHI claims database, matching diseases included in the TWBB. The concordance between self-reports and claims records was evaluated using tetrachoric correlation to assess the correlation between binary variables.</p><p><strong>Results: </strong>A total of 131,834 participants aged 30-70 years with data from the TWBB and NHI records were included. Concordance analysis revealed tetrachoric correlations ranged from 0.420 (chronic obstructive pulmonary disease) to 0.970 (multiple sclerosis). However, several disorders exhibited lower tetrachoric correlations. The concordance was higher among those with higher education attainment, and lower among married individuals.</p><p><strong>Conclusion: </strong>The concordance between self-reports in the TWBB and NHI claims records varied across clinical diagnoses, showing inconsistencies depending on participant characteristics. These findings underscore the need for further investigation, especially when these variables are crucial to research objectives. Integrating complementary databases, such as clinical diagnoses, prescription records, and medical procedures, can enhance accuracy through customized algorithms based on disease categories and participant characteristics and optimize sensitivity or positive predictive values to align with specific research objectives.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"141-146"},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-cancer-related Deaths in Cancer Survivors: A Nationwide Population-based Study in Japan.","authors":"Yasufumi Gon, Ling Zha, Toshitaka Morishima, Yasuyoshi Kimura, Kanako Asai, Haruka Kudo, Tsutomu Sasaki, Hideki Mochizuki, Isao Miyashiro, Tomotaka Sobue","doi":"10.2188/jea.JE20240230","DOIUrl":"10.2188/jea.JE20240230","url":null,"abstract":"<p><strong>Background: </strong>Advancements in cancer care have improved survivorship, potentially leading to changes in mortality causes. This study aimed to investigate the causes of death among cancer survivors, specially focusing on non-cancer-related mortality.</p><p><strong>Methods: </strong>This nationwide population-based cohort study analyzed the causes of death based on the time since cancer diagnosis using data from the National Cancer Registry in Japan between January 2016 and December 2019. Non-cancer-related deaths were identified, and mortality risks associated with non-cancer diseases were compared to those of the Japanese general population using standardized mortality ratios (SMRs) with 95% confidence intervals (CIs). The follow-up period was up to 4 years after cancer diagnosis.</p><p><strong>Results: </strong>A total of 3,990,661 patients (45.8% women) were included in the analysis, yielding 6,237,269 person-years of follow-up. Of these, 1,001,857 (25.1%) patients died during the study period. Cancer-related and non-cancer-related causes accounted for 86.6% and 13.4% of deaths, respectively. The proportion of non-cancer-related deaths increased from 10.2% at 6 months to 31.6% at 4 years after cancer diagnosis. Heart disease (21.8%), cerebrovascular disease (9.8%), and pneumonia (9.1%) were the leading cause of non-cancer-related deaths: the SMRs for these diseases were 2.69 (95% CI, 2.66-2.72), 2.07 (95% CI, 2.03-2.10), and 2.41 (95% CI, 2.36-2.45), respectively. The SMR for suicide was 1.81 (95% CI, 1.74-1.89); however, it lost significance in males and females 2 and 2.5 years after cancer diagnosis, respectively.</p><p><strong>Conclusion: </strong>The proportion of non-cancer-related deaths among cancer patients has increased over time, emphasizing the need to manage cancer and its comorbidities carefully.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"147-153"},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Variations and Inequalities in Testing for Early Detection of Breast and Cervical Cancer: Evidence From a Nationally Representative Survey in India.","authors":"Md Mahfuzur Rahman, Md Shafiur Rahman, Md Rashedul Islam, Stuart Gilmour, Rei Haruyama, Atul Budukh, Abhishek Shankar, Gauravi Mishra, Ravi Mehrotra, Tomohiro Matsuda, Manami Inoue, Sarah Krull Abe","doi":"10.2188/jea.JE20240065","DOIUrl":"10.2188/jea.JE20240065","url":null,"abstract":"<p><strong>Background: </strong>The burden of cancer in India has been rising, yet testing for early detection remains low. This study explored inequalities in the uptake of breast cancer (BC) examination and cervical cancer (CC) among Indian women, focusing on socioeconomic, regional, and educational differences.</p><p><strong>Methods: </strong>Data from the 2019-21 National Family Health Survey (n = 353,518) were used to assess the uptake of BC examination and CC testing. Inequalities were quantified using the slope index of inequality (SII), relative index of inequality (RII), and relative concentration index (RCI). SII measured absolute inequality, while RII and RCI assessed relative inequality between disadvantaged and advantaged groups.</p><p><strong>Results: </strong>The ever uptake of tests for early detection of BC and CC were low at 9 and 20 per 1,000 women, respectively. Higher uptake was observed among women from the richest households compared to the poorest (SII: 1.1 for BC and 1.8 for CC). The magnitude of relative socioeconomic inequalities was more pronounced in rural areas (RCI: 22.5 for BC and 21.3 for CC) compared to urban areas. Similarly, higher-educated women were 4.84 times (RII: 4.84) and 2.12 times (RII: 2.12) more likely to undergo BC examination and CC testing, respectively, compared to non-educated women. The Northeastern region exhibited greater socioeconomic inequality, while the Western region showed more education-based inequality.</p><p><strong>Conclusion: </strong>The lower uptake of BC examination and CC testing and the marked inequalities underscore the need for targeted interventions to improve access and utilization of testing services, especially among lower-educated women, and those in rural areas.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"129-140"},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sentinel Surveillance of COVID-19: The Importance of Epidemiologic Concepts and Reasoning.","authors":"Yuzo Arima, Takuri Takahashi, Ayu Kasamatsu, Takeshi Arashiro, Yusuke Kobayashi, Miyako Otsuka, Osamu Takahara, Reiko Shimbashi, Katsuhiro Komase, Taro Kamigaki, Motoi Suzuki","doi":"10.2188/jea.JE20240200","DOIUrl":"10.2188/jea.JE20240200","url":null,"abstract":"","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"106-107"},"PeriodicalIF":3.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Disparities in Measles Vaccination Coverage and Their Associated Factors: An Ecological Study in Japan.","authors":"Masaki Machida, Shinji Fukushima, Takahiro Tabuchi, Tomoki Nakaya, Wakaba Fukushima, Shigeru Inoue","doi":"10.2188/jea.JE20240129","DOIUrl":"10.2188/jea.JE20240129","url":null,"abstract":"<p><strong>Background: </strong>The decline in measles vaccination coverage is a global concern. In Japan, coverage of the first dose of measles vaccine, which had exceeded the target of 95.0% since fiscal year (FY) 2010, fell to 93.5% in FY 2021. Vaccination coverage increased to 95.4% in FY 2022 but varied by municipality. Few studies have focused on regional disparities in measles vaccination coverage. This study aimed to clarify the regional disparities in measles vaccination coverage by municipality in Japan and their associated factors.</p><p><strong>Methods: </strong>In this ecological study, the measles vaccination coverage in FY 2022; population density; area deprivation index (ADI; an indicator of socioeconomic status); proportion of foreign nationals, single-father households, single-mother households, and mothers aged ≥30 years; and number of medical facilities, pediatricians, and non-pediatric medical doctors in 1,698 municipalities were extracted from Japanese government statistics. Negative binomial regression was performed with the number of children vaccinated against measles as the dependent variable, number of children eligible for measles vaccination as the offset term, and other factors as independent variables.</p><p><strong>Results: </strong>Vaccination coverage was less than 95.0% in 54.3% of municipalities. Vaccination coverage was significantly positively associated with population density and negatively associated with the proportion of single-father households, mothers aged ≥30 years, and the ADI (incidence rate ratios: 1.004, 0.976, 0.999, and 0.970, respectively).</p><p><strong>Conclusion: </strong>This study showed regional disparities in measles vaccination coverage in Japan. Single-father households, age of mothers, and socioeconomic status may be key factors when municipalities consider strategies to improve vaccination coverage.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"100-105"},"PeriodicalIF":3.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Much Lower Prevalence and Mortality of Chronic Obstructive Pulmonary Disease in Japan Than in the United States Despite Higher Smoking Rates: A Meta-Analysis/Systematic Review.","authors":"Akira Sekikawa, Mengyi Li, Niva Joshi, Brandon Herbert, Curtis Tilves, Chendi Cui, Shiyao Gao, Yuefang Chang, Yasutaka Nakano, Frank C Sciurba","doi":"10.2188/jea.JE20240085","DOIUrl":"10.2188/jea.JE20240085","url":null,"abstract":"<p><strong>Background: </strong>A recent systematic review showed Japan's mortality from chronic obstructive pulmonary disease (COPD) is the lowest among 204 countries, despite notably higher smoking rates in men in Japan than in the United States. This study aims to compare (1) trends in smoking rates, (2) trends in COPD mortality, and (3) the spirometry-based COPD prevalence in the general adult population between Japan and the United States.</p><p><strong>Methods: </strong>Age- and sex-specific smoking rates from the 1980s through 2010s and COPD mortality from 1999 through 2019 were obtained from national surveys and official statistics (International Classification of Diseases-10^th codes J40-44), respectively. A systematic review and meta-analysis was performed to estimate COPD prevalence in Japan, while the National Health and Nutrition Examination Survey 2007-2012 was used for the United States. A fixed ratio of 0.7 of forced expiratory volume in the first second of forced vital capacity was used to define COPD.</p><p><strong>Results: </strong>Over the past 4 decades, men in Japan consistently had 20-30% higher smoking rates than their United States counterparts. From 1999-2019, age-adjusted COPD mortality in men in Japan was only a third of the United States, whereas that in women was less than a tenth in 2019. Synthesizing data from 11 studies, involving 89,955 participants, Japan's COPD prevalence was more than 10% lower than in the United States in almost all age groups for both sexes.</p><p><strong>Conclusion: </strong>This study showed markedly lower rates of COPD in Japan than in the United States. Investigating factors contributing to the paradoxical observations could lead to advancing COPD risk reduction strategies.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"90-99"},"PeriodicalIF":3.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Alcohol Consumption During and After the Covid-19 Pandemic From 2020 to 2023 in a Prospective Cohort of Italian Adults.","authors":"Sonia Cerrai, Giulia Carreras, Filippo Monti, Chiara Stival, Alessandra Lugo, Cristina Bosetti, Silvia Biagioni, Tiziana Fanucchi, Giuseppe Gorini, Andrea Amerio, Luisa Mastrobattista, Claudia Mortali, Anna Odone, Sabrina Molinaro, Luc Smits, Silvano Gallus","doi":"10.2188/jea.JE20230340","DOIUrl":"10.2188/jea.JE20230340","url":null,"abstract":"<p><strong>Background: </strong>The lockdowns imposed by the government during coronavirus disease 2019 (COVID-19) pandemic have had a significant impact on the Italian population habits.</p><p><strong>Methods: </strong>LOckdown and lifeSTyles in Italy and in Tuscany studies collected data on a representative sample of the Italian adult population in 2020 (n = 6,003) followed up through 2023 via four additional surveys (3,000 ≤ n ≤ 6,600) through an online self-administered questionnaire. The Alcohol Use Disorders Identification Test-Concise was used to identify at-risk drinkers. Considering the cohort of individuals who took part to the first and at least one other wave (n = 5,378), a multilevel logistic model was used to derive odds ratios (ORs) and corresponding 95% confidence intervals (CIs) of being at-risk drinkers.</p><p><strong>Results: </strong>The prevalence of at-risk drinkers was 26.4% before, 23.4% during the first lockdown, and stabilized around 30.0% thereafter. Being at-risk alcohol consumers decreased with decreasing economic status (P for trend <0.001), was less frequent among middle-aged compared to younger (OR 0.73; 95% CI, 0.60-0.89) and among divorced/separated (OR 0.77; 95% CI, 0.60-0.99) or single (OR 0.75; 95% CI, 0.64-0.89) compared to married individuals. It was more frequent among individuals with anxiety or depressive symptoms (OR 1.24; 95% CI, 1.12-1.37), those using psychotropic drugs (OR 1.99; 95% CI, 1.69-2.35) and users of conventional and/or alternative nicotine products (OR 3.67; 95% CI, 3.00-4.48).</p><p><strong>Conclusion: </strong>The long-term trends in alcohol consumption after the COVID-19 pandemic are unfavorable in Italy. The results point to an increased vulnerability for at-risk alcohol consumption among younger individuals, women with higher economic status, and married individuals. At-risk drinking is strongly related to mental health symptoms and nicotine consumption.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"63-70"},"PeriodicalIF":3.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Maternal Physical Activity From Pre-pregnancy to Child-rearing and Their Children's Physical Activity in Early Childhood Among Japanese.","authors":"Aya Yamada, Haruki Momma, Nozomi Tatsuta, Kunihiko Nakai, Takahiro Arima, Chiharu Ota, Nobuo Yaegashi, Ryoichi Nagatomi","doi":"10.2188/jea.JE20240041","DOIUrl":"10.2188/jea.JE20240041","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to determine the association between cumulative maternal physical activity level and their children's physical activity in early childhood. We also compared the influence of each maternal physical activity on children's physical activity in early childhood.</p><p><strong>Methods: </strong>We analyzed the data from 1,067 Japanese mother-child pairs. Maternal physical activity was assessed using the International Physical Activity Questionnaire. Cumulative physical activity level in mothers was computed based on the categories (low, moderate, and high) of physical activity from five time points (pre-pregnancy, during pregnancy, 1.5, 3.5, and 5.5 years postpartum). Children's physical activity level was measured at age 5.5 years using the WHO Health Behaviour School-aged Children questionnaire and defined as engaging in physical activity for at least 60 minutes per day for more than 5 days. Logistic regression analysis was used to determine the association between maternal and children's physical activity levels.</p><p><strong>Results: </strong>The results showed the positive association between cumulative maternal physical activity and children's physical activity level (P for trend < 0.001). Furthermore, maternal physical activity during pregnancy (P for trend = 0.031) and 5.5 years postpartum (P for trend < 0.001) was positively associated with children's physical activity.</p><p><strong>Conclusion: </strong>A positive association was observed between the cumulative maternal physical activity level and the physical activity level of their children at 5.5 years of age. Furthermore, maternal physical activity during pregnancy and at 5.5 years postpartum were positively associated with the level of children's physical activity.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"81-89"},"PeriodicalIF":3.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of Self-reported Participation in Cancer Screenings and Health Checkups in Japan.","authors":"Isao Muraki, Tomotaka Sobue, Kazumasa Yamagishi, Shoichiro Tsugane, Norie Sawada, Hiroyasu Iso","doi":"10.2188/jea.JE20240090","DOIUrl":"10.2188/jea.JE20240090","url":null,"abstract":"<p><strong>Background: </strong>The participation rate for screening is regarded as a useful indicator for preventing cancer and cardio-metabolic disease. However, the validity of self-reported screening participation has not yet been thoroughly evaluated in Japan. We aimed to examine its validity using the municipal screening records among the Japanese population.</p><p><strong>Methods: </strong>We included 3,060 men and 3,860 women insured by the National Health Insurance for residents aged <75 years or the Medical Care System for the Elderly aged ≥75 years in the Chikusei area of the Japan Public Health Center-based Prospective Study for the Next Generation. They were asked about their participation in cancer screenings and health checkups during the previous year. We compared their responses to the municipal records and calculated the sensitivity and specificity of self-reported screening participation.</p><p><strong>Results: </strong>The sensitivity and specificity of self-reported participation were 0.49 and 0.86 for lung cancer screening, 0.67 and 0.85 for colorectal cancer screening, 0.77 and 0.79 for stomach cancer screening, and 0.86 and 0.65 for health checkup, respectively. Among women, the sensitivity and specificity were 0.83 and 0.81 for breast cancer and 0.85 and 0.90 for cervical cancer, respectively.</p><p><strong>Conclusion: </strong>Self-reported cancer screening participation for colorectal, stomach, breast, and cervical cancers had moderate-to-high sensitivity and specificity. Self-reported participation, especially for lung cancer screening and health checkups, should be carefully interpreted when assessing the performance of preventive measures.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"47-52"},"PeriodicalIF":3.7,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Principal Component Analysis of Metabolome and Cognitive Decline Among Japanese Older Adults: Cross-sectional Analysis Using Tohoku Medical Megabank Cohort Study Data.","authors":"Sakura Kiuchi, Kumi Nakaya, Upul Cooray, Kenji Takeuchi, Ikuko N Motoike, Naoki Nakaya, Yasuyuki Taki, Seizo Koshiba, Shunji Mugikura, Ken Osaka, Atsushi Hozawa","doi":"10.2188/jea.JE20240099","DOIUrl":"10.2188/jea.JE20240099","url":null,"abstract":"<p><strong>Background: </strong>Dementia is the leading cause of disability and imposes a significant burden on society. Previous studies have suggested an association between metabolites and cognitive decline. Although the metabolite composition differs between Western and Asian populations, studies targeting Asian populations remain scarce.</p><p><strong>Methods: </strong>This cross-sectional study used data from a cohort survey of community-dwelling older adults aged ≥60 years living in Miyagi, Japan, conducted by Tohoku Medical Megabank Organization between 2013 and 2016. Forty-three metabolite variables quantified using nuclear magnetic resonance spectroscopy were used as explanatory variables. Dependent variable was the presence of cognitive decline (≤23 points), assessed by the Mini-Mental State Examination. Principal component (PC) analysis was performed to reduce the dimensionality of metabolite variables, followed by logistic regression analysis to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for cognitive decline.</p><p><strong>Results: </strong>A total of 2,940 participants were included (men: 49.0%, mean age: 67.6 years). Among them, 1.9% showed cognitive decline. The first 12 PC components (PC1-PC12) accounted for 71.7% of the total variance. Multivariate analysis showed that PC1, which mainly represented essential amino acids, was associated with lower odds of cognitive decline (OR 0.89; 95% CI, 0.80-0.98). PC2, which mainly included ketone bodies, was associated with cognitive decline (OR 1.29; 95% CI, 1.11-1.51). PC3, which included amino acids, was associated with lower odds of cognitive decline (OR 0.81; 95% CI, 0.66-0.99).</p><p><strong>Conclusion: </strong>Amino acids are protectively associated with cognitive decline, whereas ketone metabolites are associated with higher odds of cognitive decline.</p>","PeriodicalId":15799,"journal":{"name":"Journal of Epidemiology","volume":" ","pages":"39-46"},"PeriodicalIF":3.7,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11637816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}