要約のみTohoku University辻一郎課

NURRIKA DIETA

博士学位論文の要旨及び審査結果の要旨 (Summary of Thesis(DR))othe

NURRIKA, DIETA

Tohoku University Repository (TOUR) / 東北大学機関リポジトリ

Research on socioeconomic status, mediatingfactors, incident functional disability andhealthy aging in older population著者 NURRIKA DIETA号 89学位授与機関 Tohoku University学位授与番号 医博第4077号URL http://hdl.handle.net/10097/00129536

Research on socioeconomic status, mediating factors, incident functional disability and healthy aging in older population

Tohoku University博士（医学）博士学位論文 (Thesis(doctor))要約のみthesi

DIETA, NURRIKA

Research on socioeconomic status, mediatingfactors, incident functional disability andhealthy aging in older population著者 DIETA NURRIKA学位授与機関 Tohoku University学位授与番号 11301甲第19153号URL http://hdl.handle.net/10097/00129298（書式１８） 1  学 位 論 文 要 約  （ A b s t r a c t ）    博士論文題目 Title of dissertation Research on socioeconomic status, mediating factors, incident functional disability and healthy aging in older                                             Population (高齢者における社会経済的状態、媒介因子、要介護およびヘルシーエイジングに関する研究)    東北大学大学院医学系研究科医科学専攻 情報健康医学講座  公衆衛生学分野 学籍番号（＊論文博士は受付番号）Student Number  B6MD5137      氏名 Name         Dieta Nurrika      Introduction: Previous studies have indicated that the association between SES and health were mediated by lifestyle and social factors. In Japan, SES-mediator-disability pathway might differ according to age because age-specified causes of disability are different; additionally, compared to developed countries, Indonesia (as a developing country) has different SES and public health problems, suggesting the SES-mediator-healthy aging pathway might be unique. However, neither the age-specified SES-mediator-disability association in Japan nor the SES-mediator-healthy aging association in Indonesia has been investigated yet. Higher SES is associated with better health and might be mediated by certain mediating factors. Thus, this study aimed to investigate the association between SES and health (incident functional disability and healthy aging), and whether mediating factors on these associations differ among the elderly population in both Japan and Indonesia. Methods: 1) To investigate age-specified SES-mediator-disability association in Japan, we follow-up 8,680 Japanese individuals (≥65 years) living in Ohsaki city, Japan, for 9 years. In a baseline survey, we collected data on education level and potential mediators. Data on incident functional disability were retrieved from the Long-term Care Insurance database. Mediating effects were estimated using accelerated failure time model and a logistic regression model. 2) To investigate SES-mediator-healthy aging association in Indonesia, longitudinal data of 696 elderly Indonesian individuals (≥50 years) living in 13 different provinces in Indonesia were collected twice (2007 and 2014). In the 2007 survey, data on education level, monthly per-capita expenditure (PCE) and potential mediators were collected. Information on healthy aging was obtained both in 2007 and 2014. The mediating effect of mediating factors was estimated using the four-way effect decomposition. Results: 1) Participation in community activities had the largest mediating effect (34.7%) on the association between education level and incident functional disability. This effect remained among those aged 65-74 years (19.9%) but became negligible among those aged ≥75 years. Other potential modifiable risk factors (such as smoking and drinking status) were also tested, but these showed only small mediating effects. 2) Higher education level was associated with healthy aging. However, monthly PCE （書式１８） 2  was not associated with healthy aging among older Indonesian individuals. The associations between education level, monthly PCE and healthy aging were not mediated by modifiable factors. Conclusions: Education level was significantly associated with better health in both Japan and Indonesia. This association was largely mediated by participation in community activities among elderly Japanese, but no mediators were identified in Indonesia.   

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高齢者における社会経済的状態、媒介因子、要介護およびヘルシーエイジングに関する研究

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