BackgroundDepression is a common mental disorder. Several studies suggest that lifestyle and health status are associated with depression. However, only a few large-scale longitudinal studies have been conducted on this topic.MethodsThe subjects were middle-aged and elderly Japanese adults between the ages of 40 and 69 years. A total of 9,650 respondents completed questionnaires for the baseline survey and participated in the second wave of the survey, which was conducted 7 years later. We excluded those who complained of depressive symptoms in the baseline survey and analyzed data for the remaining 9,201 individuals. In the second-wave survey, the DSM-12D was used to determine depression. We examined the risks associated with health status and lifestyle factors in the baseline survey using a logistic regression model.ResultsAn age-adjusted analysis showed an increased risk of depression in those who had poor perceived health and chronic diseases in both sexes. In men, those who were physically inactive also had an increased risk of depression. In women, the analysis also showed an increased risk of depression those with a BMI of 25 or more, in those sleeping 9 hours a day or more and who were current smokers. A multivariate analysis showed that increased risks of depression still existed in men who had chronic diseases and who were physically inactive, and in women who had poor perceived health and who had a BMI of 25 or more.ConclusionsThese results suggest that lifestyle and health status are risk factors for depression. Having a chronic disease and physical inactivity were distinctive risk factors for depression in men. On the other hand, poor perceived health and a BMI of 25 or more were distinctive risk factors for depression in women. Preventive measures for depression must therefore take gender into account.

This study provides evidence that social networks are an important predictor of mortality risk for middle-aged and elderly Japanese men and women. Lack of participation, for men, and being single and lack of meeting close relatives, for women, were independent risk factors for mortality.

BACKGROUND: Few studies have examined the association of perceived health with socio-economic status, especially income, and social isolation and support in Japan. The purpose of this study is to clarify the associations among perceived health, lifestyle, and socio-economic status, as well as social isolation and support factors, in middle-aged and elderly Japanese. METHODS: Subjects were 9,650 participants aged 47-77 years who completed a self-administered questionnaire in 2000 in the second survey of a population-based cohort (the Komo-Ise study). The questionnaire included items on sociodemographic and socio-economic factors, social isolation and support, lifestyle, past history of chronic disease and perceived health. Perceived health was dichotomized into excellent or good health and fair or poor health. A logistic regression analysis was used to determine the odds ratios of socio-economic status, social characteristics and lifestyle in relation to self-reported fair or poor health. RESULTS: We found that household income, physical activity, sleeping, smoking habit, and BMI had a strong association with self-reported fair or poor health in middle-aged and elderly Japanese men and women. Male subjects tended to report fair or poor health as household income decreased. The results for women differed in that social isolation and low social support had a stronger association for self-reported fair or poor health than low household income. CONCLUSIONS: The results indicated that perceived health was associated with socio-economic and social characteristics among middle-aged and elderly residents in Japan.

The relative risks of mortality in subjects with low and high body mass index (BMI) have been assessed in many large prospective studies, and it has been reported that the relationship between BMI and mortality can be represented by a J-, L-, or U-shaped curve, or is linear, 1-12 although the interpretation still remains under debate. In western countries, higher BMIs have been shown to be associated with a higher mortality.

To examine rural-urban differences in the relationships of sociodemographic, social network, and lifestyle factors to mortality in middle-aged men , we used the data from a community based prospective cohort study, the Komo-Ise study. The subjects were all men aged 40-69 years living in Komochi Village, the rural group (n=2,295), or the downtown district of Isesaki City, the urban group (n=3,334), as of 1993. They completed a self-administered questionnaire in 1993 and were followed for all-cause deaths until 2000. The Cox proportional hazards model was used to compute relative risks (RRs) with 95% confidence intervals (CIs). Low educated men and men without a spouse in the rural group had an increased risk of mortality (RR=4.4; 95%Cl: 1.1-18.2, RR=2.4; 95%Cl: 1.2-4.5). Men who did not enjoy good fellowship with their neighbors in the rural group had a decreased risk of mortality (RR=0.58; 95%Cl: 0.35-0.97). Mortality risks were significantly higher in urban men not participating in hobbies, club activities or community groups (RR=1.6; 95%Cl: 1.1-2.4). These variables remained significant risk factors, even after controlling for all sociodemographic, social network, lifestyle, and health status variables. Educational level, marital status and relation to neighborhoods showed significant rural-urban differences.J Epidemiol, 2002;12:93-104 rural-urban differences, sociodemographic factors, lifestyle, social networks, mortality INTRODUCTIONThe dramatic shift in the major causes of disability and death from infectious to chronic diseases has made theories of disease etiology shift from a single factor to multiple factors including behavioral and environmental as well as biologic and genetic factors. Among these factors, many epidemiologists have focused on health behavior or lifestyle factors, such as smoking habit, overweight, alcohol consumption, physical inactivity and so on, for the past several decades 1-4). A number of prospective studies based on randomly selected cohort groups have indicated these to be the major determinants of premature and preventable disease and/or death 1-4). In addition to health behavior and lifestyle factors, poor social networks and social support have been recognized as independent risk factors for mortality 5-7), since Cassel8) hypothesized that psychosocial effects in the environment increased a person's resistance to risk factors.Among the earlier large investigations of the relationship between health and human ties, was the study performed in Alameda County, California. Berkman et al. 5) examined four social network sources: 1) marriage; 2) contacts with close friends and relatives; 3) church membership, and 4) informal and formal group associations. Their findings revealed social and community ties to be associated with mortality risk and each of the four sources to be a predicted risk factor for mortality independently from the other three. However, the Tecumseh Community Health Study 9) and the Evans County Cardiovascular Epidemiologic Study 10) results were not consiste...