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      Ikigai and subsequent health and wellbeing among Japanese older adults: Longitudinal outcome-wide analysis

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          Summary

          Background

          Having a purpose in life has been linked to improved health and wellbeing; however, it remains unknown whether having “ Ikigai”—a related but broader concept in Japan—is also beneficial for various physical and psychosocial outcomes.

          Methods

          Using data from a nationwide longitudinal study of Japanese older adults aged ≥65 years, we examined the associations between having Ikigai in 2013 and a wide range of subsequent outcomes assessed in 2016 across two databases (n = 6,441 and n = 8,041), including dimensions of physical health, health behavior, psychological distress, social wellbeing, subjective wellbeing, and pro-social/altruistic behaviors. We adjusted for sociodemographic characteristics and the outcome values (whenever data were available) in the prior wave (2010).

          Findings

          Having Ikigai (vs. not having Ikigai) was associated with a 31% lower risk of developing functional disability [95% confidence interval (CI) for risk ratio: 0.58, 0.82] and 36% lower risk of developing dementia [95% CI for risk ratio: 0.48, 0.86] during the three-year follow-up. Having Ikigai was associated with decreased depressive symptoms and hopelessness as well as higher happiness, life satisfaction, instrumental activity of daily living, and certain social outcomes (e.g., more frequent participation in hobby clubs). Some of these associations were stronger for men than women, and among individuals with high socioeconomic status (p-values for effect measure modification < 001).

          Interpretation

          Having Ikigai may promote health and wellbeing outcomes among Japanese older adults, but particularly men and individuals with high socioeconomic status.

          Funding

          NIH, John Templeton Foundation, JSPS, AMED, MHLW, MEXT, and WPE Foundation.

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          Most cited references55

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          A modified poisson regression approach to prospective studies with binary data.

          G Zou (2004)
          Relative risk is usually the parameter of interest in epidemiologic and medical studies. In this paper, the author proposes a modified Poisson regression approach (i.e., Poisson regression with a robust error variance) to estimate this effect measure directly. A simple 2-by-2 table is used to justify the validity of this approach. Results from a limited simulation study indicate that this approach is very reliable even with total sample sizes as small as 100. The method is illustrated with two data sets.
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            Sensitivity Analysis in Observational Research: Introducing the E-Value.

            Sensitivity analysis is useful in assessing how robust an association is to potential unmeasured or uncontrolled confounding. This article introduces a new measure called the "E-value," which is related to the evidence for causality in observational studies that are potentially subject to confounding. The E-value is defined as the minimum strength of association, on the risk ratio scale, that an unmeasured confounder would need to have with both the treatment and the outcome to fully explain away a specific treatment-outcome association, conditional on the measured covariates. A large E-value implies that considerable unmeasured confounding would be needed to explain away an effect estimate. A small E-value implies little unmeasured confounding would be needed to explain away an effect estimate. The authors propose that in all observational studies intended to produce evidence for causality, the E-value be reported or some other sensitivity analysis be used. They suggest calculating the E-value for both the observed association estimate (after adjustments for measured confounders) and the limit of the confidence interval closest to the null. If this were to become standard practice, the ability of the scientific community to assess evidence from observational studies would improve considerably, and ultimately, science would be strengthened.
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              The structure of psychological well-being revisited.

              A theoretical model of psychological well-being that encompasses 6 distinct dimensions of wellness (Autonomy, Environmental Mastery, Personal Growth, Positive Relations with Others, Purpose in Life, Self-Acceptance) was tested with data from a nationally representative sample of adults (N = 1,108), aged 25 and older, who participated in telephone interviews. Confirmatory factor analyses provided support for the proposed 6-factor model, with a single second-order super factor. The model was superior in fit over single-factor and other artifactual models. Age and sex differences on the various well-being dimensions replicated prior findings. Comparisons with other frequently used indicators (positive and negative affect, life satisfaction) demonstrated that the latter neglect key aspects of positive functioning emphasized in theories of health and well-being.
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                Author and article information

                Contributors
                Journal
                Lancet Reg Health West Pac
                Lancet Reg Health West Pac
                The Lancet Regional Health: Western Pacific
                Elsevier
                2666-6065
                03 February 2022
                April 2022
                03 February 2022
                : 21
                : 100391
                Affiliations
                [a ]Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., MA, USA
                [b ]Department of Global Health Promotion, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan
                [c ]Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., MA, USA
                [d ]Human Flourishing Program, Harvard Institute for Quantitative Social Science, 1737 Cambridge St., MA, USA
                [e ]Department of Psychology, University of British Columbia, Vancouver BC V6T 1Z4, Canada
                [f ]Department of Public Health, Graduate School of Medicine, Osaka University, 1-1 Yamadaoka, Suita, Osaka, Japan
                [g ]Department of Social Epidemiology, Kyoto University School of Public Health, Yoshidahonmachi, Sakyo Ward, Kyoto, Japan
                [h ]Department of Gerontological Evaluation, National Center for Geriatrics and Gerontology, 7-430 Moriokacho, Obu, Aichi, Japan
                [i ]Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inage Ward, Chiba, Japan
                [j ]Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., MA, USA
                [k ]Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, 677 Huntington Ave., MA, USA
                Author notes
                [* ]Corresponding author at: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., MA, USA. sshiba@ 123456hsph.harvard.edu
                [1]

                These authors contributed equally to this work.

                Article
                S2666-6065(22)00010-4 100391
                10.1016/j.lanwpc.2022.100391
                8814687
                35141667
                fb65ee6c-151f-45b2-8e8d-0d6383c63ffa
                © 2022 The Author(s)

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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                Articles

                ikigai,purpose in life,aging,wellbeing,asia
                ikigai, purpose in life, aging, wellbeing, asia

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