Fumikazu Hayashi

Background: Large-scale disasters may increase cardiovascular disease (CVD) risk through psychological distress, disrupted healthcare access, and lifestyle changes, but existing CVD risk scores may not adequately capture disaster-related vulnerability.Methods: We analysed data from 23,452 participants aged 30–79 years in the Fukushima Health Management Survey after the 2011 Great East Japan Earthquake and Fukushima Daiichi nuclear accident. Incident CVD, defined as stroke or myocardial infarction, was monitored during follow-up. LASSO logistic regression and XGBoost were used only as exploratory screening tools, and predictors selected by both approaches were incorporated into a Cox proportional hazards model to develop the Questionnaire-based Post-Disaster Cardiovascular Risk Score Incorporating Psychological Distress (Q-DISC). Performance was assessed using C-statistics, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and calibration analyses.Findings: During a median follow-up of 8.0 years, 1,368 participants developed incident CVD. Psychological distress assessed using the Kessler-6 Psychological Distress Scale (K6) was selected by both screening approaches and was independently associated with incident CVD. Adding K6 improved discrimination, NRI, and IDI across established CVD risk models. In the test dataset, Q-DISC showed acceptable discrimination (C-statistic, 0.770 [95% CI 0.745–0.800]) and calibration, with performance comparable to established laboratory- and non-laboratory-based models.Interpretation: Psychological distress provided prognostic information beyond conventional cardiovascular risk factors after a large-scale disaster. Q-DISC may support preliminary questionnaire-based cardiovascular risk stratification when laboratory testing or physical measurements are unavailable. External validation and, if necessary, recalibration are required before clinical implementation.

We investigated the association of steatotic liver disease (SLD) and metabolic dysfunction-associated SLD (MASLD) with the occurrence of post-traumatic stress symptoms (PTSS) after the Great East Japan Earthquake in participants of the Fukushima Health Management Survey (FMHS), a cohort that was initiated after the disaster. This cohort study used data from the FMHS (2011–2018) and included 16,392 participants aged 40–90 years (7505 men and 8,887 women) who were able to be assessed for PTSS. SLD was defined by the fatty liver index. To further identify the association between PTSS and SLD/MASLD, Cox regression models were used to estimate hazard ratios and 95% confidence interval (CI) for PTSS. Results of multivariable Cox regression modeling for the entire participant population revealed that SLD (hazard ratio: 1.109, 95% CI: 1.002–1.227) had a significant positive association with the occurrence of PTSS. In the multivariate Cox regression model incorporating SLD classification, MASLD (1.154 [1.036–1.286]) was significantly positively associated with the occurrence of PTSS. This study suggests that SLD/MASLD may be a risk for the development of PTSS after a disaster.

Aim: There is limited research on the relationship between exercise habits during early adulthood and their continuation into later life, as well as the impact on physical function in older adults. Methods: The study involved community‐dwelling residents aged 60–79 years who participated in health examinations, physical function tests and questionnaire surveys in 2020 and 2021. After excluding duplicates, 862 participants (400 men and 462 women) were included. Exercise habits were defined as regular physical activity between ages 18 and 22 years, and from age 22 years to the present. Prefrailty and frailty were assessed using the revised Japanese Cardiovascular Health Study criteria. Results: Among participants, 53.9% were prefrail and 2.8% were frail. Those with exercise habits between ages 18 and 22 years tended to have a lower probability of prefrailty/frailty compared with those without, with a multivariate‐adjusted odds ratio (OR) of 0.77 (95% confidence interval [CI] 0.57–1.04). Similarly, those who exercised after age 22 had a lower probability, with ORs of 0.61 (95% CI 0.42–0.88) for 1–10 years, 0.51 (95% CI 0.32–0.82) for 11–20 years, 0.55 (95% CI 0.32–0.96) for 21–30 years and 0.32 (95% CI 0.20–0.51) for >30 years of exercise. Conclusions: Exercise experience during young adulthood, particularly the continuation of regular physical exercise from age 22 years onward, might reduce the probability of prefrailty and frailty later in life. Encouraging lifelong exercise might be a key preventive strategy against frailty. Geriatr Gerontol Int 2025; 25: 1495–1502 .

Context: Examining how overweight/obesity impacts thyroid nodule development in children and adolescents by sex and age allows speculation on the mechanism. Objective: We examined whether overweight/obesity in children and adolescents is associated with thyroid nodule development by sex and age. Methods: Approximately 300 000 participants who underwent thyroid ultrasonography in the Fukushima Health Management Survey after a nuclear accident were enrolled. Those without nodules in the initial 2 examinations (1-3 and 4-5 years postaccident) were prospectively assessed for nodule development in the third examination (6-7 years postaccident) relative to baseline overweight status, with an average follow-up of 4.2 years. This was a population-based prospective cohort study. The first and second thyroid examinations involved 299 939 and 237 691 participants, respectively, excluding those with thyroid nodules. After the third examination, 184 519 participants were finalized for analysis. Multivariable adjusted odds ratios of new detected thyroid nodules for overweight participants were compared with normal-weight participants. Results: New thyroid nodules were detected in 660 participants. Being overweight was positively associated with thyroid nodules. The adjusted odds ratio (95% CI) of thyroid nodules for overweight participants compared with other participants was 1.27 (1.04-1.57). Additionally, the multivariable adjusted odds ratios for overweight males and females were 1.21 and 1.32, respectively, and those for different age groups (0-9, 10-14, and 15-19 years) ranged from 1.17 to 1.75. Conclusion: Being overweight was associated with thyroid nodules in children and adolescents, mostly adolescent females, regardless of their proximity to the nuclear power plant.

In recent years, positive psychological factors, such as subjective happiness and laughter, have been reported to be associated with cardiovascular disease. In this study, we examined the relationship of hypertension with subjective happiness and frequency of laughter using the data from the Japan Gerontological Evaluation Study (JAGES). Of the 138,294 respondents, 26,368 responded to a version of the self-administered questionnaire that included a question about the frequency of laughter in the JAGES 2013. In total, 22,503 (10,571 men and 11,932 women) were included in the analysis after excluding those with missing responses regarding a history of hypertension, frequency of laughter, and subjective happiness. The prevalence of hypertension in this study was 10,364 (46.1%). Multivariate logistic regression analysis showed that age, female sex, obesity, infrequent chewing, former and current drinker, seeing three to five friends, and the absence of hobbies were positively associated with hypertension. However, infrequent laughter/high level of subjective happiness, frequent laughter/high level of subjective happiness, being underweight, and current smoker were negatively associated with hypertension. As per the findings of this study, it was determined that subjective happiness was negatively associated with hypertension. Therefore, this study suggests that having more opportunities to feel happiness may be important in preventing hypertension.

Background: The objectives of this study were to determine the longer‐term trends in childhood obesity and glucose metabolism abnormalities among residents of Fukushima Prefecture 5 years after the Great East Japan Earthquake.Methods: We evaluated the changes in height, weight, body mass index (BMI), BMI SD score, fasting plasma glucose (FPG) concentration, and hemoglobin A1c (HbA1c) among elementary and junior high school residents who had lived in the evacuation zone between 2011 and 2015.Results: Of the residents, 11,112 received health checks in 2011, while in 2012, 2013, 2014, and 2015, 5,737, 4522, 4297 and 3405 received health checks, respectively. The mean BMI SD score for all participants in 2011 was 0.149, and this score gradually decreased from 2011 to 2015. FPG levels and HbA1c levels for all participants with a BMI value +2SD or more in 2011 were higher than those in residents with a BMI value of less than +2SD. The frequency of participants with a FPG level of 126 mg/dl or more and the frequency of participants with a HbA1c level of 6.5% or more in 2011 were higher than those in 2012, 2013, and 2015.Conclusions: These results suggest that a number of pediatric residents suffered from obesity and glucose metabolism abnormalities. However, the longer‐term observations indicated an improvement in obesity and glucose metabolism abnormalities. There was a strong association observed between obesity and glucose metabolism, thus, it is important to continue with health checks for children with obesity and strive to improve their health.

Since the Great East Japan Earthquake in March 2011, an increase in lifestyle-related diseases due to changes in living environment following the nuclear power plant accident has been reported in Fukushima Prefecture, especially among evacuees. However, no long-term studies covering the entire Fukushima Prefecture have been conducted. The study aim was to investigate the effects of post-disaster evacuation life on the prevalence of dyslipidemia in Fukushima Prefecture using a national database. The data from 3,866,674 people who underwent specific health checkups between fiscal year (FY) 2008 and FY2017 were analyzed. Fukushima Prefecture was divided into four areas, and the prevalence of dyslipidemia and related parameters were compared. The prevalence of dyslipidemia increased overall, with a particularly sharp increase after FY2011 in the evacuation area. The sex- and age-adjusted odds ratio (95% confidence intervals) of having dyslipidemia in the evacuation area compared with that in the control area was 0.951 (0.929–0.973) in FY2008–2010, which increased to 1.130 (1.105–1.155) in FY2012–2014 and 1.117 (1.092–1.143) in FY2015–2017. Since the prevalence of dyslipidemia has increased and remained high after the earthquake in Fukushima Prefecture, especially in the evacuation area, continued measures to prevent cardiovascular diseases among the residents are needed.