Co-rumination is a communication process that has been linked to depressive symptoms among adolescents. The first aim of this study was to examine the directionality of the associations, regarding co-rumination with peers and mothers, as well as comparing co-rumination about the mothers’ and the adolescents’ problems. The second aim was to investigate if gender moderates the associations between co-rumination with peers and depressive symptoms. We used self-report data from two measurement points with a one year interval from the 5-year longitudinal “Three City Study”. Participants were pupils aged 15-17 years at the first measurement point (n = 2,914) and mothers to a subset of the adolescents (n = 44). The results showed that co-rumination with peers was associated with increases in depressive symptoms. Depressive symptoms were associated with decreases in co-rumination with mothers about the mothers’ problems. Preliminary analyses showed that co-rumination with mothers about the mothers’ problems was correlated with co-ruminating about adolescents’ problems. The findings support the notion that co-rumination, especially with friends, is related to depressive symptoms among youth. This, as well as the ways in which mothers communicate with their adolescents, might be important to consider when discussing interventions for adolescents’ depressive symptoms.

Objectives: To examine associations between maternal smoking and overweight among school-aged children and also identify mothers and offspring characteristics that affect children's weight. Methods: We used data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCY). Childhood overweight was defined as having Body Mass Index (BMI) of 85th percentile or above. Smoking patterns among mothers were assessed by questioning smoking behaviour 1 year before birth of the target child: never or ever smoking. Standardized procedures were used to measure height and weight. Descriptive statistics and generalized estimating equations (GEE) were used for the analysis. Results: Descriptive results showed that children of mothers who smoked anytime within 1 year before birth were more likely to be overweight and have higher BMI percentile averages. GEE results showed that children of mothers who were ever smokers 1 year before birth were more likely to be overweight (OR = 1.39, 95% CI: 1.01, 1.94) and have higher BMI percentile averages (b = 4.46, P = 0.036) from grades 1 through 6 than those of mothers who were never smokers. Additionally, the level of mother's education and birth weight were significantly associated with childhood overweight. Conclusions: Confirmed relationships between maternal smoking and overweight among school-aged children have important implications for public health policy because this evidence can be used to enhance smoking cessation 1 year before birth to improve the health status of mothers and offspring.

Objectives: To examine associations between maternal smoking and overweight among school-aged children and also identify mothers and offspring characteristics that affect children's weight. Methods: We used data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCY). Childhood overweight was defined as having Body Mass Index (BMI) of 85th percentile or above. Smoking patterns among mothers were assessed by questioning smoking behaviour 1 year before birth of the target child: never or ever smoking. Standardized procedures were used to measure height and weight. Descriptive statistics and generalized estimating equations (GEE) were used for the analysis. Results: Descriptive results showed that children of mothers who smoked anytime within 1 year before birth were more likely to be overweight and have higher BMI percentile averages. GEE results showed that children of mothers who were ever smokers 1 year before birth were more likely to be overweight (OR = 1.39, 95% CI: 1.01, 1.94) and have higher BMI percentile averages (b = 4.46, P = 0.036) from grades 1 through 6 than those of mothers who were never smokers. Additionally, the level of mother's education and birth weight were significantly associated with childhood overweight. Conclusions: Confirmed relationships between maternal smoking and overweight among school-aged children have important implications for public health policy because this evidence can be used to enhance smoking cessation 1 year before birth to improve the health status of mothers and offspring.

No study has focussed on the longitudinal effect of APOE-ε4 genotype on the logical memory delayed recall total (LDELTOTAL) score in late-onset Alzheimer’s disease (AD). The LDELTOTAL scores were collected at baseline, 12, 24, 36 and 48 months from 382 participants with AD, 503 with cognitive normal (CN), 1293 with mild cognitive impairment (MCI) in the Alzheimer's Disease Neuroimaging Initiative (ADNI). A linear mixed model (LMM) was used to investigate the effect of APOE-ε4 on the longitudinal changes in the LDELTOTAL scores adjusted for age, gender, education and baseline Mini Mental State Examination score. There were significant differences in LDELTOTAL scores among AD, CN, and MCI (P < 0.0001) and among APOE-ε4 alleles at baseline (P < 0.0001). In the multivariable LMM, elders with 75+ years (P = 0.0051), females (P < 0.0001), lower education (P < 0.0001), AD and MCI (both P values < 0.0001) were associated with decreased LDELTOTAL values, while the individuals with 1 or 2 APOE-ε4 allele revealed significantly lower LDELTOTAL scores (both P values <0.0001) compared with individuals without APOE-ε4 allele. Further, APOE-ε4 alleles had significant interactions with four follow-up visits, where all follow-up visits showed significantly higher LDELTOTAL score. In addition, gender showed interaction with age, education and APOE-ε4 with follow-up visits. Our findings provide the first evidence of the effect of APOE-ε4 genotype on the logical memory declines related to AD. Further, APOE-ε4 alleles showed interactions with gender and follow-up visits.

Introduction: Oral health impacts much more than a person’s teeth and smile. Research indicates a connection between oral health and illnesses like cardiovascular disease and depression. Poor oral health could lead to social stigmatization and affects a person’s quality of life. Increased dental visits help detect and treat dental disease and offer opportunities for preventive care. Notably, the proportion of older adults in Tennessee is rapidly increasing, coupled with the growing complexity of older adults’ dental treatment. The first aim of this longitudinal study was to examine the prevalence of dental care visits among older persons (≥60 years) in Tennessee from 2010 to 2018. Our second aim was to examine the determinants of dental care visits among our target population. Methods: This study used five even years of Behavioral Risk Factor Surveillance system (BRFSS) data including years 2010, 2012, 2014, 2016, and 2018. BRFSS is a network of health-related telephone surveys conducted by all 50 states, the District of Columbia, and participating US territories. Our data was limited to Metropolitan and Micropolitan statistical areas, including East, Middle, and West Tennessee, while focusing on seniors (≥60 years old). Descriptive statistics were conducted. Weighting was conducted to account for the complex sampling design. Logistic regression analysis was performed to determine the factors associated with dental clinic visits among Tennessee seniors from 2010 to 2018. A p-value<0.05 was considered statistically significant. Results: The current study comprised of 5,362 Tennessee seniors. The year 2012 had the most seniors (1,324) and 2018 had the least number of seniors (787). About 64% of participants visited dentists or dental clinics within the past year while 18% reported that their last dental visit was ≥ 5 years ago. The percentage of older individuals visiting dental clinics within one year gradually decreased from 76.46% in 2010 to 71.17% in 2018. The majority of participants were females (51.7%), Whites (81.3%), never-smokers (46.3%), had good/better health (71.2%), and were located in Middle Tennessee (43.5%). Approximately 19% of Tennessee seniors removed all their permanent teeth. Logistic regression showed that those more likely to visit dentists or dental clinics included females (OR: 1.40; 95% CI: 1.11-1.77), former smokers (OR: 2.23; 95% CI: 1.46-3.41), never-smokers (OR: 2.21;95% CI: 1.46-3.35), individuals who had some college education (OR: 1.64 ;95% CI: 1.11-2.44), and graduated from college (OR: 2.74; 95% CI: 1.78-4.20). Likewise, individuals with a higher level of socioeconomic status, including a high income of $>50,000 (OR: 5.49; 95%CI: 3.60-8.36), were more likely to report dental visits. Conversely, Blacks (OR: 0.60; 95% CI: 0.43-0.82), participants with fair/poor health (OR: 0.67; 95% CI: 0.51-0.84), and those that have never-married (OR: 0.46;95% CI: 0.29-0.74) were less likely to report dental visits. Conclusions: The percent of Tennessee seniors visiting dental clinics within one year has gradually decreased from 76.46% in 2010 to 71.17% in 2018. The factors associated with a higher likelihood of seeking dental care include non-smoking status, identifying as females, and high socioeconomic status. Effective interventions to improve dental visits should take the identified factors into account.

Objectives: Our goal was to explore the association between vision with cognitive change scores and incident depression. Methods: A 3-year prospective cohort study was performed. Incident depression was defined using a cut-off score of 10 on the Center for Epidemiologic Studies Depression scale. Cognitive change was examined by calculating the difference between baseline and follow-up cognitive tests scores. Multivariable Poisson and linear regression were used. Results: Cataract was associated with incident depression (relative risk=1.20, 95% confidence interval 1.05, 1.37). Visual impairment was associated with the 3-year change in Rey Auditory Verbal Learning Test (RAVLT) (β=-0.18, 95% CI= -0.28, -0.07), RAVLT-Delayed (β=-0.13, 95% CI= -0.25, -0.02), and Animal Naming Test (β=-0.95, 95% CI= -1.44, -0.45) scores. Glaucoma was associated with 3-year Mental Alternation Test change scores (β=-0.40, 95% CI -0.77, -0.04). Conclusions: Cataract was associated with increased depression risk. VI and glaucoma are associated with 3-year changes in cognitive test scores.

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13140号 / 論医博第2140号 / 新制||医||1026(附属図書館) / (主査)教授 小西 靖彦, 教授 羽賀 博典, 教授 万代 昌紀 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

The current study aims at investigating the mixed effect of family and neighborhood contexts on juveniles’ violence in South Korea. By addressing four different theoretical frames, the current study assumes that family and neighborhood are directly or indirectly influencing juveniles’ delinquency. The target of analysis is respondents of Korean Youth Panel Survey (KYPS)(N=2,248). By using Stata 14, the current study conducted multi-level regression. The current study suggests several meaningful findings as follow: 1) positive family (i.e. parental attachment and parental supervision) and neighborhood (i.e. collective efficacy) contexts directly reduce juvenile’s violence, 2) negative family aspects (i.e. family conflict and emotional strain by family) directly increase juvenile’s violence, 3) negative neighborhood contexts do not necessarily lead to juveniles’ violence, and 4) family contexts mediate the relationship between neighborhood environments and juveniles’ violence. Based on the finding, the current study explains South Korean cultural background, which contributed to the unique findings. In addition, policy implication is also addressed.

Overweight and obesity among children and youth in the United States is a serious public health concern. The longitudinal relationships between maternal depression and childhood overweight and obesity were examined using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD SECCYD). A national cohort of 1,384 children was followed from birth to adolescence and longitudinal data collected on multiple variables, including child weight and height, maternal depression, maternal influence, and family context. Maternal Depression was assessed by the Center of Epidemiological Studies Depression Scale (CES-D) and defined as a score of 16 or greater. Overweight and obesity were defined according to the recommended BMI age- and sex-specific percentiles. Maternal depression was assessed when the child was 1 month old, 36 months, and in grade 1. Overweight and obesity status was assessed at 36 months, grade 1, grade 3, and grade 6. The effect of changes or persistence in the pattern of maternal depression for different childhood age points on the development of childhood overweight and obesity was evaluated. A variety of statistical methods were used including t-test, ANOVA, multiple linear regression, multiple logistic regression, and generalized estimation equation (GEE). Results: After adjustment for confounding, compared with mothers with no depression at child's age of 1 month, 36 months, and in grade 1, mothers with depression at 1 or 2 of those time points had a 45% higher risk for childhood overweight and obesity at grade 3 (OR= 1.45, 95% CI= 1.01-2.07). For mothers with depression at all 3 time points, there was an even greater increase in risk at grade 3 (OR= 2.25, 95% CI= 1.05-4.84) and grade 6 (OR= 3.36, 95% CI= 1.46-7.77). Conclusion: Maternal depression is associated with childhood overweight and obesity. Child overweight and obesity intervention efforts may benefit from identifying strategies to improve maternal mental health status, including depression.

This study examined the longitudinal associations of family income level, maternal marital status, and maternal employment with body mass measurements and the development of overweight and obesity. Multiple linear and logistic regressions were used to assess the effects of the exposure variables on weight status with simultaneous adjustment for the exposure variables and the covariates. Key findings include: Children in families with incomes below the poverty line at child's 24 or 54 months of age were at a higher risk of becoming overweight and obese at child's third grade than children in families with incomes above the poverty line; longer maternal working hours at child's 54 months of age was associated with an increased risk of overweight and obesity at child's third grade. In conclusion, this study confirms that family poverty status and maternal working hours are associated with child's overweight and obesity risk.