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      Laughter is the Best Medicine? A Cross-Sectional Study of Cardiovascular Disease Among Older Japanese Adults Translated title: 笑いは癒しになるか? 日本の高齢者の循環器疾患に関する横断研究

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          Abstract

          Background

          We sought to evaluate the associations between frequency of daily laughter with heart disease and stroke among community-dwelling older Japanese women and men.

          Methods

          We analyzed cross-sectional data in 20 934 individuals (10 206 men and 10 728 women) aged 65 years or older, who participated in the Japan Gerontological Evaluation Study in 2013. In the mail-in survey, participants provided information on daily frequency of laughter, as well as body mass index, demographic and lifestyle factors, and diagnoses of cardiovascular disease, hyperlipidemia, hypertension, and depression.

          Results

          Even after adjustment for hyperlipidemia, hypertension, depression, body mass index, and other risk factors, the prevalence of heart diseases among those who never or almost never laughed was 1.21 (95% CI, −1.03–1.41) times higher than those who reported laughing every day. The adjusted prevalence ratio for stroke was 1.60 (95% CI, 1.24–2.06).

          Conclusions

          Daily frequency of laughter is associated with lower prevalence of cardiovascular diseases. The association could not be explained by confounding factors, such as depressive symptoms.

          Translated abstract

          背景:

          普段の笑いの頻度と心疾患および脳卒中有病の関連について、地域在住の日本の高齢者を対象として調査した。

          方法:

          日本老年学的評価研究(JAGES)の2013年度の調査の対象者のうち65才以上の20,934人(男性10,206人、女性10,728)のデータを分析した。郵送法の自記式調査により笑いの頻度、BMI、人口統計情報およびライフスタイル関連の要因、循環器疾患、高脂血症、高血圧、抑うつ症状についての情報を収集した。

          結果:

          高脂血症、高血圧、抑うつ症状、BMI、その他の要因を調整した上でも、ほとんど笑わない群の心疾患の有病割合はほぼ毎日笑う群に比べて1.21倍(95%信頼区間:1.03–1.41) 高かった。 同様に脳卒中の有病割合は1.60倍 (95% 信頼区間:1.24–2.06)高かった。

          結論:

          普段よく笑う高齢者は循環器疾患(心疾患または脳卒中)が少ないという関連が見られた。この関連は抑うつ症状など要因では説明がつかなかった。

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          Most cited references34

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          Physical activity and stroke risk: a meta-analysis.

          Whether physical activity reduces stroke risk remains controversial. We used a meta-analysis to examine the overall association between physical activity or cardiorespiratory fitness and stroke incidence or mortality. We searched MEDLINE from 1966 to 2002 and identified 23 studies (18 cohort and 5 case-control) that met inclusion criteria. We estimated the overall relative risk (RR) of stroke incidence or mortality for highly and moderately active individuals versus individuals with low levels of activity using the general variance-based method. The meta-analysis documented that there was a reduction in stroke risk for active or fit individuals compared with inactive or unfit persons in cohort, case-control, and both study types combined. For cohort studies, highly active individuals had a 25% lower risk of stroke incidence or mortality (RR=0.75; 95% CI, 0.69 to 0.82) compared with low-active individuals. For case-control studies, highly active individuals had a 64% lower risk of stroke incidence (RR=0.36; 95% CI, 0.25 to 0.52) than their low-active counterparts. When we combined both the cohort and case-control studies, highly active individuals had a 27% lower risk of stroke incidence or mortality (RR=0.73; 95% CI, 0.67 to 0.79) than did low-active individuals. We observed similar results in moderately active individuals compared with inactive persons (RRs were 0.83 for cohort, 0.52 for case-control, and 0.80 for both combined). Furthermore, moderately and highly active individuals had lower risk of both ischemic and hemorrhagic strokes than low-active individuals. We conclude that moderate and high levels of physical activity are associated with reduced risk of total, ischemic, and hemorrhagic strokes.
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            • Record: found
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            • Article: not found

            Depression and the risk for cardiovascular diseases: systematic review and meta analysis.

            Depression and cardiovascular diseases are both common among elderly. Depression is suspected to be an independent risk factor for the onset of coronary heart disease, yet it is not clear to what extent and if depression also is associated with the onset of other diseases of the circulatory system. To estimate the risk of depression as an independent risk factor for various cardiovascular diseases (CVD) and explore the effects of heterogeneity and methodological quality. Meta-analyses and meta-regression analyses of longitudinal cohort and case-control studies reporting depression at baseline and CVD outcomes at follow-up. MEDLINE (1966-2005) and PSYCHINFO (1966-2005). Of the 28 studies that met the inclusion criteria, 11 were assesed as high quality studies. Although depressed mood increased the risk for a wide range of CVDs, heterogeneity was substantial in most cases. Only the overall combined risk of depression for the onset of myocardial infarctions (n=8, OR=1.60, 95%CI 1.34-1.92) was homogenous. Clinically diagnosed major depressive disorder was identified as the most important risk factor for developing CVD. Depression seems to be an independent risk factor for the onset of a wide range of CVDs, although this evidence is related to a high level of heterogeneity.
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              • Article: not found

              THE EVOLUTION AND FUNCTIONS OF LAUGHTER AND HUMOR: A SYNTHETIC APPROACH

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                Author and article information

                Journal
                J Epidemiol
                J Epidemiol
                JE
                Journal of Epidemiology
                Japan Epidemiological Association
                0917-5040
                1349-9092
                5 October 2016
                12 March 2016
                2016
                : 26
                : 10
                : 546-552
                Affiliations
                [01] [1 ]Faculty of Medicine, the University of Tokyo, Tokyo, Japan [1 ]東京大学医学部医学科
                [02] [2 ]Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States [2 ]ハーバード大学公衆衛生大学院
                [03] [3 ]Department of Epidemiology, Fukushima Medical University, Fukushima, Japan [3 ]福島県立医科大学 医学部疫学講座
                [04] [4 ]Center for Well-being and Society, Nihon Fukushi University, Chita, Aichi, Japan [4 ]日本福祉大学
                [05] [5 ]Center for Preventive Medical Sciences, Chiba University, Chiba, Japan [5 ]千葉大学 予防医学センター 社会予防医学研究部門
                [06] [6 ]Department of Human Sciences, School of Law and Letters, University of the Ryukyus, Naha, Japan [6 ]琉球大学法文学部人間科学科
                [07] [7 ]Department of Health and Social Behavior/Department of Health Education and Health Sociology, School of Public Health, the University of Tokyo, Tokyo, Japan [7 ]東京大学大学院医学系研究科
                Author notes
                Address for correspondence. Naoki Kondo, Department of Health and Social Behavior/Department of Health Education and Health Sociology, School of Public Health, the University of Tokyo, Medical Building #3 S310, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan (e-mail: naoki-kondo@ 123456umin.ac.jp , nkondo@ 123456m.u-tokyo.ac.jp ).
                Article
                JE20150196
                10.2188/jea.JE20150196
                5037252
                26972732
                f048c72e-ef81-46e5-b3d3-cdadf910780f
                © 2016 Kei Hayashi et al.

                This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 24 July 2015
                : 30 November 2015
                Funding
                Funded by: Japan Society for the Promotion of Science http://dx.doi.org/10.13039/501100001691
                Award ID: 20319338, 22390400, 23243070, 23590786, 23790710,
                Funded by: Japan Society for the Promotion of Science http://dx.doi.org/10.13039/501100001691
                Award ID: 24140701, 24390469, 24530698, 24653150, 24683018,
                Funded by: Japan Society for the Promotion of Science http://dx.doi.org/10.13039/501100001691
                Award ID: 25253052, 25870881,15KT0007
                Funded by: Ministry of Health, Labour and Welfare http://dx.doi.org/10.13039/501100003478
                Award ID: H24-Junkanki(Syosyu)-Ippan-0
                Funded by: Ministry of Health, Labour and Welfare http://dx.doi.org/10.13039/501100003478
                Award ID: H25-Choju-Ippan-003, H26-Choju-Ippan-006,
                Funded by: Ministry of Health, Labour and Welfare http://dx.doi.org/10.13039/501100003478
                Award ID: H25-Kenki-Wakate-015,
                Funded by: Japan Agency for Medical Research and Development (AMED)
                Award ID: 15k0107012h0002
                Funded by: AXA Life Insurance Co. LTD.
                Award ID: CR Fixed Income Fund
                Funded by: National Center for Geriatrics and Gerontology, Japan
                Award ID: 24-17, 24-23, J09KF00804
                Categories
                Original Article
                Social Epidemiology

                laughter,aged,stroke,cardiovascular diseases,japan
                laughter, aged, stroke, cardiovascular diseases, japan

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