日本の地域在住高齢者における浴槽入浴頻度と認知症発症の関連：JAGESコホートデータによる9年間追跡研究
【背景・目的】フィンランド式サウナ入浴には，高血圧や認知症のリスクを低減するなど，健康に有益な効果があることが報告されてきた．日本で日常的に行われている浴槽入浴はサウナ入浴とは異なるものの，心血管疾患や抑うつのリスク低減との関連が報告されている．しかし日本において認知症との関連は明らかではない．そこで本研究では，大規模縦断データを用いて，日本の地域在住高齢者における浴槽入浴頻度と認知症発症との関連を検討することを目的とした． 【方法・結果】要介護認定を受けていない65歳以上の地域在住高齢者を対象とする日本老年学的評価研究（JAGES）のデータを使用した．ベースライン調査は2010年に実施...
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| Published in | 日本温泉気候物理医学会雑誌 Vol. 88; no. 2; pp. 73 - 82 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
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一般社団法人 日本温泉気候物理医学会
25.05.2025
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| Abstract | 【背景・目的】フィンランド式サウナ入浴には，高血圧や認知症のリスクを低減するなど，健康に有益な効果があることが報告されてきた．日本で日常的に行われている浴槽入浴はサウナ入浴とは異なるものの，心血管疾患や抑うつのリスク低減との関連が報告されている．しかし日本において認知症との関連は明らかではない．そこで本研究では，大規模縦断データを用いて，日本の地域在住高齢者における浴槽入浴頻度と認知症発症との関連を検討することを目的とした． 【方法・結果】要介護認定を受けていない65歳以上の地域在住高齢者を対象とする日本老年学的評価研究（JAGES）のデータを使用した．ベースライン調査は2010年に実施され，認知症の発症は介護保険制度の自立度の記録を用いて評価した．夏と冬の浴槽入浴頻度について欠損値のある者を除外したところ，解析対象者は夏で7,509人，冬で7,590人であった．浴槽入浴頻度を低頻度群（0～6回/週）と高頻度群（7回以上/週）の2群に分け，認知症発症との関連を調べるため，競合リスクモデルを用いた生存分析を行った．浴槽入浴の低頻度群を基準として，サブハザード比（SHR）と95%信頼区間（CI）を算出した．9年間の追跡期間中に8,317人のうち1,430人（17.2%）が認知症と判定された．高頻度入浴群は認知症発症リスクが有意に低く，この関連は性別，年齢，身体状況などの共変量で調整した後も有意であった（夏季；SHR＝0.74，95% CI：0.62～0.88，冬季；SHR＝0.82，95% CI：0.70～0.97）． 【結論】地域在住日本人高齢者において，高頻度の浴槽入浴と認知症の発症に関連がみられた．日本人高齢者の浴槽入浴の習慣による認知症予防の可能性が示唆された． |
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| AbstractList | 【背景・目的】フィンランド式サウナ入浴には，高血圧や認知症のリスクを低減するなど，健康に有益な効果があることが報告されてきた．日本で日常的に行われている浴槽入浴はサウナ入浴とは異なるものの，心血管疾患や抑うつのリスク低減との関連が報告されている．しかし日本において認知症との関連は明らかではない．そこで本研究では，大規模縦断データを用いて，日本の地域在住高齢者における浴槽入浴頻度と認知症発症との関連を検討することを目的とした． 【方法・結果】要介護認定を受けていない65歳以上の地域在住高齢者を対象とする日本老年学的評価研究（JAGES）のデータを使用した．ベースライン調査は2010年に実施され，認知症の発症は介護保険制度の自立度の記録を用いて評価した．夏と冬の浴槽入浴頻度について欠損値のある者を除外したところ，解析対象者は夏で7,509人，冬で7,590人であった．浴槽入浴頻度を低頻度群（0～6回/週）と高頻度群（7回以上/週）の2群に分け，認知症発症との関連を調べるため，競合リスクモデルを用いた生存分析を行った．浴槽入浴の低頻度群を基準として，サブハザード比（SHR）と95%信頼区間（CI）を算出した．9年間の追跡期間中に8,317人のうち1,430人（17.2%）が認知症と判定された．高頻度入浴群は認知症発症リスクが有意に低く，この関連は性別，年齢，身体状況などの共変量で調整した後も有意であった（夏季；SHR＝0.74，95% CI：0.62～0.88，冬季；SHR＝0.82，95% CI：0.70～0.97）． 【結論】地域在住日本人高齢者において，高頻度の浴槽入浴と認知症の発症に関連がみられた．日本人高齢者の浴槽入浴の習慣による認知症予防の可能性が示唆された． |
| Author | 早坂, 信哉 近藤, 克則 尾島, 俊之 柳, 奈津代 |
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| Copyright | 2025 日本温泉気候物理医学会 |
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| References | 17) Noda H, Yamagishi K, Ikeda A, et al: Identification of dementia using standard clinical assessments by primary care physicians in Japan. Geriatr Gerontol Int 2018; 18: 738-744. 27) Kalmar B, Greensmith L: Induction of heat shock proteins for protection against oxidative stress. Adv Drug Deliv Rev 2009; 61: 310-318. 28) Iwasaki Y, Deguchi A, Suzumura E, et al: The relation between bathing habits, cognitive impairment, and depressive state in patients with Alzheimer disease. J Jpn Soc Balneol Climatol Phys Med 2012; 75: 186-194 (in Japanese). 14) Hayasaka S, Ojima T, Yagi A, et al: Association between tub bathing frequency and onset of depression in older adults: A six-year cohort study from the JAGES project. J Jpn Soc Balneol Climatol Phys Med 2024; 87: 49-55. 7) Laukkanen T, Khan H, Zaccardi F, et al: Association between sauna bathing and fatal cardiovascular and all-cause mortality events. JAMA Intern Med 2015; 175: 542-548. 21) Kim JH, Lee Y: Dementia and death after stroke in older adults during a 10-year follow-up: Results from a competing risk model. J Nutr Health Aging 2018; 22: 297-301. 29) Hayasaka S, Shibata Y, Noda T, et al: Incidence of symptoms and accidents during baths and showers among the Japanese general public. J Epidemiol 2011; 21: 305-308. 4) Laukkanen T, Kunutsor S, Kauhanen J, et al: Sauna bathing is inversely associated with dementia and Alzheimer’s disease in middle-aged Finnish men. Age Ageing 2017; 46: 245-249. 6) Zaccardi F, Laukkanen T, Willeit P, et al: Sauna bathing and incident hypertension: A prospective cohort study. Am J Hypertens 2017; 30: 1120-1125. 10) Tochihara Y: A review of Japanese-style bathing: its demerits and merits. J Physiol Anthropol 2022; 41: 5. 30) Suzuki M, Shimbo T, Ikaga T, et al: Incidence and characteristics of bath-related accidents. Intern Med 2019; 58: 53-62. 25) Tei C: The progress of Waon therapy and the next deployment. J Jpn Coll Angiol 2021; 61: 123-130. 9) Ishizawa T, Watanabe S, Yano S, et al: Relationship between bathing habits and physical and psychological state. J Jpn Soc Balneol Climatol Phys Med 2012; 75: 227-237. 11) Laukkanen JA, Laukkanen T, Kunutsor SK: Cardiovascular and other health benefits of sauna bathing: A review of the evidence. Mayo Clin Proc 2018; 93: 1111-1121. 18) Takasugi T, Tsuji T, Hanazato M, et al: Community-level educational attainment and dementia: a 6-year longitudinal multilevel study in Japan. BMC Geriatr 2021; 21: 661. 5) Knekt P, Järvinen R, Rissanen H, et al: Does sauna bathing protect against dementia? Prev Med Rep 2020; 20: 101221. 23) Brunt VE, Howard MJ, Francisco MA, et al: Passive heat therapy improves endothelial function, arterial stiffness and blood pressure in sedentary humans. J Physiol 2016; 594: 5329-5342. 19) Fujihara S, Tsuji T, Nakagomi A, et al: Association of community-level social capital with dementia: A multilevel nine-year longitudinal study using data from the Japan Gerontological Evaluation Study. Soc Sci Med 2023; 338: 116316. 15) Kondo K: Progress in aging epidemiology in Japan: The JAGES project. J Epidemiol 2016; 26: 331-336. 20) Koyano W, Shibata H, Nakazato K, et al: Measurement of competence: reliability and validity of the TMIG index of competence. Arch Gerontol Geriatr 1991; 13: 103-116. 22) Dorsey CM, Teicher MH, Cohen-Zion M, et al: Core body temperature and sleep of older female insomniacs before and after passive body heating. Sleep 1999; 22: 891-898. 24) Pizzey FK, Smith EC, Ruediger SL, et al: The effect of heat therapy on blood pressure and peripheral vascular function: A systematic review and meta-analysis. Exp Physiol 2021; 106: 1317-1334. 13) Yagi A, Hayasaka S, Ojima T, et al: Bathing frequency and onset of functional disability among Japanese older adults: A prospective 3-year cohort study from the JAGES. J Epidemiol 2019; 29: 451-456. 2) Livingston G, Huntley J, Liu KY, et al: Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet 2024; 404: 572-628. 3) Ministerial Council on Dementia Policy Promotion: Dementia Policy Promotion Outline (https://www.mhlw.go.jp/content/000522832.pdf) 2019 (in Japanese). Accessed 2024.11.6. 8) Laukkanen T, Laukkanen JA, Kunutsor SK: Sauna bathing and risk of psychotic disorders: A prospective cohort study. Med Princ Pract 2018; 27: 562-569. 26) Okada M, Hasebe N, Aizawa Y, et al: Thermal treatment attenuates neointimal thickening with enhanced expression of heat-shock protein 72 and suppression of oxidative stress. Circulation 2004; 109: 1763-1768. 1) GBD 2019 Dementia Forecasting Collaborators: Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health 2022; 7: e105-e125. 16) Hisano S: The relationship between Revised Hasegawa Dementia Scale (HDS-R), Mini-Mental State Examination (MMSE), bed-fast scale, Dementia Scale. Jpn J Geriatr Psychiatry 2009; 20: 883-891 (in Japanese). 12) Ukai T, Iso H, Yamagishi K, et al: Habitual tub bathing and risks of incident coronary heart disease and stroke. Heart 2020; 106: 732-737. |
| References_xml | – reference: 27) Kalmar B, Greensmith L: Induction of heat shock proteins for protection against oxidative stress. Adv Drug Deliv Rev 2009; 61: 310-318. – reference: 8) Laukkanen T, Laukkanen JA, Kunutsor SK: Sauna bathing and risk of psychotic disorders: A prospective cohort study. Med Princ Pract 2018; 27: 562-569. – reference: 9) Ishizawa T, Watanabe S, Yano S, et al: Relationship between bathing habits and physical and psychological state. J Jpn Soc Balneol Climatol Phys Med 2012; 75: 227-237. – reference: 17) Noda H, Yamagishi K, Ikeda A, et al: Identification of dementia using standard clinical assessments by primary care physicians in Japan. Geriatr Gerontol Int 2018; 18: 738-744. – reference: 19) Fujihara S, Tsuji T, Nakagomi A, et al: Association of community-level social capital with dementia: A multilevel nine-year longitudinal study using data from the Japan Gerontological Evaluation Study. Soc Sci Med 2023; 338: 116316. – reference: 29) Hayasaka S, Shibata Y, Noda T, et al: Incidence of symptoms and accidents during baths and showers among the Japanese general public. J Epidemiol 2011; 21: 305-308. – reference: 7) Laukkanen T, Khan H, Zaccardi F, et al: Association between sauna bathing and fatal cardiovascular and all-cause mortality events. JAMA Intern Med 2015; 175: 542-548. – reference: 11) Laukkanen JA, Laukkanen T, Kunutsor SK: Cardiovascular and other health benefits of sauna bathing: A review of the evidence. Mayo Clin Proc 2018; 93: 1111-1121. – reference: 12) Ukai T, Iso H, Yamagishi K, et al: Habitual tub bathing and risks of incident coronary heart disease and stroke. Heart 2020; 106: 732-737. – reference: 13) Yagi A, Hayasaka S, Ojima T, et al: Bathing frequency and onset of functional disability among Japanese older adults: A prospective 3-year cohort study from the JAGES. J Epidemiol 2019; 29: 451-456. – reference: 18) Takasugi T, Tsuji T, Hanazato M, et al: Community-level educational attainment and dementia: a 6-year longitudinal multilevel study in Japan. BMC Geriatr 2021; 21: 661. – reference: 15) Kondo K: Progress in aging epidemiology in Japan: The JAGES project. J Epidemiol 2016; 26: 331-336. – reference: 2) Livingston G, Huntley J, Liu KY, et al: Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet 2024; 404: 572-628. – reference: 6) Zaccardi F, Laukkanen T, Willeit P, et al: Sauna bathing and incident hypertension: A prospective cohort study. Am J Hypertens 2017; 30: 1120-1125. – reference: 5) Knekt P, Järvinen R, Rissanen H, et al: Does sauna bathing protect against dementia? Prev Med Rep 2020; 20: 101221. – reference: 22) Dorsey CM, Teicher MH, Cohen-Zion M, et al: Core body temperature and sleep of older female insomniacs before and after passive body heating. Sleep 1999; 22: 891-898. – reference: 16) Hisano S: The relationship between Revised Hasegawa Dementia Scale (HDS-R), Mini-Mental State Examination (MMSE), bed-fast scale, Dementia Scale. Jpn J Geriatr Psychiatry 2009; 20: 883-891 (in Japanese). – reference: 1) GBD 2019 Dementia Forecasting Collaborators: Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health 2022; 7: e105-e125. – reference: 3) Ministerial Council on Dementia Policy Promotion: Dementia Policy Promotion Outline (https://www.mhlw.go.jp/content/000522832.pdf) 2019 (in Japanese). Accessed 2024.11.6. – reference: 21) Kim JH, Lee Y: Dementia and death after stroke in older adults during a 10-year follow-up: Results from a competing risk model. J Nutr Health Aging 2018; 22: 297-301. – reference: 26) Okada M, Hasebe N, Aizawa Y, et al: Thermal treatment attenuates neointimal thickening with enhanced expression of heat-shock protein 72 and suppression of oxidative stress. Circulation 2004; 109: 1763-1768. – reference: 20) Koyano W, Shibata H, Nakazato K, et al: Measurement of competence: reliability and validity of the TMIG index of competence. Arch Gerontol Geriatr 1991; 13: 103-116. – reference: 23) Brunt VE, Howard MJ, Francisco MA, et al: Passive heat therapy improves endothelial function, arterial stiffness and blood pressure in sedentary humans. J Physiol 2016; 594: 5329-5342. – reference: 4) Laukkanen T, Kunutsor S, Kauhanen J, et al: Sauna bathing is inversely associated with dementia and Alzheimer’s disease in middle-aged Finnish men. Age Ageing 2017; 46: 245-249. – reference: 14) Hayasaka S, Ojima T, Yagi A, et al: Association between tub bathing frequency and onset of depression in older adults: A six-year cohort study from the JAGES project. J Jpn Soc Balneol Climatol Phys Med 2024; 87: 49-55. – reference: 25) Tei C: The progress of Waon therapy and the next deployment. J Jpn Coll Angiol 2021; 61: 123-130. – reference: 28) Iwasaki Y, Deguchi A, Suzumura E, et al: The relation between bathing habits, cognitive impairment, and depressive state in patients with Alzheimer disease. J Jpn Soc Balneol Climatol Phys Med 2012; 75: 186-194 (in Japanese). – reference: 30) Suzuki M, Shimbo T, Ikaga T, et al: Incidence and characteristics of bath-related accidents. Intern Med 2019; 58: 53-62. – reference: 24) Pizzey FK, Smith EC, Ruediger SL, et al: The effect of heat therapy on blood pressure and peripheral vascular function: A systematic review and meta-analysis. Exp Physiol 2021; 106: 1317-1334. – reference: 10) Tochihara Y: A review of Japanese-style bathing: its demerits and merits. J Physiol Anthropol 2022; 41: 5. |
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| Title | 日本の地域在住高齢者における浴槽入浴頻度と認知症発症の関連：JAGESコホートデータによる9年間追跡研究 |
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