RESUMEN
It has been shown that community-level social capital may affect residents' health. The present mixed ecological study assesses the evidence for an association between the community-level social capital and the individual level of self-rated health. The Hakui City Health Interview Survey targeted 15,242 people aged 40 years and older from 11 communities. Among them, 6578 residents responded to the questionnaire (response rate, 43.2%). We examined whether the community-level social capital (general trust, norm, and civic participation) was associated with the individual level of self-rated health. Overall, 1919 (29.1%) answers of self-rated poor health were identified. Community-level civic participation was negatively associated with poor self-rated health after adjusting for individual demographic factors, individual social capitals, and community-level economic status, whereas community-level general trust, and norm were not significant. The findings suggest the importance of fostering communities with high civic participation to reduce the poor health status of residents.
Asunto(s)
Participación de la Comunidad/estadística & datos numéricos , Estado de Salud , Características de la Residencia/estadística & datos numéricos , Capital Social , Adulto , Anciano , Anciano de 80 o más Años , Escolaridad , Femenino , Humanos , Japón , Masculino , Persona de Mediana Edad , Autoinforme/estadística & datos numéricos , Clase SocialRESUMEN
BACKGROUND: Both cigarette smoking and diabetes mellitus are well-established risk factors for development of dementia. However, the interaction between smoking and diabetes is yet unknown. OBJECTIVE: In this study, we clarify association between smoking, diabetes, and dementia risk in older adults. METHODS: Participants in this study included community residents aged 65 years and older who had participated in a health checkup in 2006, followed for 10 years (nâ=â9,403) and had long-term care insurance information data. Furthermore, the risk estimates of smoking status and diabetes diagnosis on dementia adjusted for the competing risk of death prior to dementia were analyzed. RESULTS: During follow-up, 2,647 participants developed dementia. The smoking status-diabetes interaction on development of dementia was statistically significant (p≤0.001). Among those patients exposed to both factors, 17% of risk of development of dementia was attributable to the interaction of these factors. Current smokers with diabetes had significantly greater risks of development of dementia than never smokers without diabetes (reference): multivariable-adjusted risk of dementia in current smokers without diabetes (subdistribution hazard ratio [sHR], 1.25; 95% confidence interval [CI], 1.05-1.48); never smokers with diabetes (1.31, 1.16-1.47); and current smokers with diabetes (1.86, 1.39-2.48). However, no such association was noted for former smokers with and without diabetes. CONCLUSIONS: Current smoking, but not former smoking, was associated with increased risk of development of dementia in older adults with and without diabetes. Moreover, the synergistic effect of current smoking and diabetes on dementia was noted.