Perceived Level of Life Enjoyment and Risk of Developing Disabling Dementia: The Japan Public Health Center–Based Study

  • Tomokazu Tajima
    Department of Public Health, Juntendo University Graduate School of Medicine , Tokyo , Japan
  • Ai Ikeda
    Department of Public Health, Juntendo University Graduate School of Medicine , Tokyo , Japan
  • Takeshi Tanigawa
    Department of Public Health, Juntendo University Graduate School of Medicine , Tokyo , Japan
  • Hiroyasu Iso
    Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine , Osaka , Japan
  • Kazumasa Yamagishi
    Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba , Ibaraki , Japan
  • Takumi Matsumura
    Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine , Osaka , Japan
  • Nobufumi Yasuda
    Department of Public Health, Kochi University Medical School , Kochi , Japan
  • Manami Inoue
    Division of Prevention, National Cancer Center Institute for Cancer Control , Tokyo , Japan
  • Shoichiro Tsugane
    Division of Cohort Research, National Cancer Center Institute for Cancer Control , Tokyo , Japan
  • Norie Sawada
    Division of Cohort Research, National Cancer Center Institute for Cancer Control , Tokyo , Japan

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<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objectives</jats:title> <jats:p>Life enjoyment, linked to the ability to engage pleasurably with one’s environment, may be related to the risk of developing dementia. This prospective cohort study examined the association between level of life enjoyment and disabling dementia incidence among Japanese community residents.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>The participants were Japanese, aged 45–74 years old at 5-years follow-up, in the Japan Public Health Center–based Study (N = 38,660). Psychological conditions and other confounding variables were identified through self-administered questionnaires. Incident disabling dementia registered based on the Japan’s Long-Term Care Insurance system from 2006 to 2016. Hazard ratios [95% confidence intervals] were assessed using Cox proportional hazards models.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Over a median follow-up period of 9.4 years, a total of 4,642 cases of disabling dementia developed. Level of life enjoyment was inversely associated with the risk of disabling dementia: the multivariable hazard ratios were 0.75 [0.67–0.84] (p &lt; .001) and 0.68 [0.59–0.78] (p &lt; .001) with medium and high life enjoyment, respectively, compared to low life enjoyment. Furthermore, the association between greater life enjoyment and low risk for disabling dementia was strongest in the subgroup with low–medium mental stress. In the high mental stress group, this association was evident for poststroke disabling dementia, but not for disabling dementia without a history of stroke.</jats:p> </jats:sec> <jats:sec> <jats:title>Discussion</jats:title> <jats:p>A higher level of life enjoyment was associated with a lower risk of disabling dementia, particularly in the low–medium mental stress group. This finding suggests the importance of having life enjoyment by managing mental stress for reducing risk of disabling dementia.</jats:p> </jats:sec>

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