Associations of Frequency of Laughter With Risk of All-Cause Mortality and Cardiovascular Disease Incidence in a General Population: Findings From the Yamagata Study

• Published in: Journal of epidemiology Vol. 30; no. 4; pp. 188 - 193
• Main Authors: Sakurada, Kaori, Konta, Tsuneo, Watanabe, Masafumi, Ishizawa, Kenichi, Ueno, Yoshiyuki, Yamashita, Hidetoshi, Kayama, Takamasa
• Format: Journal Article
• Language: English
• Published: Japan Japan Epidemiological Association 05.04.2020
• Subjects: Adult; Aged; Aged, 80 and over; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - mortality; Cause of Death; Confidence intervals; Drinking behavior; Female; Follow-Up Studies; Health hazards; Health risk assessment; Health risks; Humans; Hypertension; Incidence; Japan - epidemiology; Kaplan-Meier Estimate; Laughter; Male; Middle Aged; Mortality; Original; Population studies; Prospective Studies; Psychological factors; Public Health; Risk analysis; Risk Factors; Statistical models; yamagata study; Japan; mortality; cardiovascular disease; Yamagata study; laughter
• ISSN: 0917-5040; 1349-9092
• DOI: 10.2188/jea.JE20180249

Positive and negative psychological factors are associated with mortality and cardiovascular disease. This study prospectively investigated associations of daily frequency of laughter with mortality and cardiovascular disease in a community-based population. This study included 17,152 subjects ≥40 years old who participated in an annual health check in Yamagata Prefecture. Self-reported daily frequency of laughter was grouped into three categories (≥1/week; ≥1/month but <1/week; <1/month). Associations of daily frequency of laughter with increase in all-cause mortality and cardiovascular disease incidence were determined using Cox proportional hazards modeling. During follow-up (median, 5.4 years), 257 subjects died and 138 subjects experienced cardiovascular events. Kaplan-Meier analysis revealed that all-cause mortality and cardiovascular disease incidence were significantly higher among subjects with a low frequency of laughter (log-rank P < 0.01). Cox proportional hazard model analysis adjusted for age, gender, hypertension, smoking, and alcohol drinking status showed that risk of all-cause mortality was significantly higher in subjects who laughed <1/month than in subjects who laughed ≥1/week (hazard ratio [HR] 1.95; 95% confidence interval [CI], 1.16-3.09). Similarly, risk of cardiovascular events was higher in subjects who laughed ≥1/month but <1/week than in subjects who laughed ≥1/week (HR 1.62; 95% CI, 1.07-2.40). Daily frequency of laughter represents an independent risk factor for all-cause mortality and cardiovascular disease in a Japanese general population.