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Associations between vision, hearing and tooth loss and social interactions: the JAGES cross-sectional study
  1. Ayaka Igarashi1,
  2. Jun Aida2,3,
  3. Tatsuo Yamamoto4,
  4. Yoshimune Hiratsuka5,
  5. Katsunori Kondo6,7,
  6. Ken Osaka1
  1. 1 Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
  2. 2 Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Japan
  3. 3 Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
  4. 4 Department of Disaster Medicine and Dental Sociology, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
  5. 5 Department of Ophthalmology, Juntendo University School of Medicine Graduate School of Medicine, Bunkyo-ku, Japan
  6. 6 Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
  7. 7 Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
  1. Correspondence to Jun Aida, Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; j-aida{at}


Background Difficulties in communication due to vision, hearing and tooth loss have a serious impact on health. We compared the association between and attribution of each of these factors on social interaction.

Methods This cross-sectional study examined data from the 2016 Japan Gerontological Evaluation Study (n=22 295) on community-dwelling people aged ≥65 years in Japan. The dependent variable was the frequency of meeting friends as a measure of social interaction, and less-than-monthly was defined as fewer social interactions. The independent variables were self-reported degrees of vision, hearing (5-point Likert scale) and tooth loss (five categories), with ‘poor’ or ‘0 teeth’ defined as the worst category. Sex, age, educational attainment, comorbidity and residential area were used as covariates. Poisson regression analysis with multiple imputations was used to estimate the prevalence ratios (PRs) of fewer social interactions by each status. Subsequently, the population attributable fraction (PAF) was calculated to assess the public health impact.

Results The number of participants with fewer social interactions was 5622 (26.9%). Proportions of fewer social interactions among those with the worst vision, hearing and number of teeth categories were 48.7%, 40.1% and 32.0%, respectively. Their corresponding PRs of fewer social interactions were 1.72 (95% CI 0.97 to 3.05), 1.35 (95% CI 0.99 to 1.85) and 1.23 (95% CI 1.10 to 1.37), respectively. The total PAF for vision, hearing and number of teeth was 8.3%, 5.0% and 6.4%, respectively.

Conclusion Self-reported vision, hearing and tooth loss were associated with fewer social interactions. The magnitude of these impairments was largest in vision, followed by tooth and hearing loss.

  • Dental health
  • Epidemiology
  • Gerontology
  • Ophthalmology
  • Social activities

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  • Contributors AI participated in the study design, performed the statistical analysis and drafted the manuscript as the principal author. JA conceived the study concept, participated in the acquisition of data and study design, performed analysis and interpretation of data, and edited the manuscript. KO, TY and YH participated in the study design and critically revised the manuscript. KK is the principal investigator of the JAGES project and helped develop the idea for the study, performed interpretation of data and critically revised the manuscript. All authors read and approved the final manuscript.

  • Funding This study used data from the Japan Gerontological Evaluation Study (JAGES), which was supported by JSPS (Japan Society for the Promotion of Science) KAKENHI (grant numbers; 15H01972, 15H04781, 15H05059, 16H05556, 25253052, 18H03018, 18H04071, 18H03047, 18H00953, 18KK0057, 19H03915, 19H03860, 19K04785, 20H00557), Health Labour Sciences Research Grant (H28-Choju-Ippan-002, H29-Chikyukibo-Ippan-001, 18H04071, 19FA2001), Japan Agency for Medical Research and Development (AMED) (JP17dk0110017, JP18dk0110027, JP18ls0110002, JP18le0110009, JP20dk0110034, JP20dk0110037, 20dk0310108), Open Innovation Platform with Enterprises, Research Institute and Academia (OPERA, JPMJOP1831) from the Japan Science and Technology (JST), a grant from Innovative Research Program on Suicide Countermeasures (1-4), a grant from Sasakawa Sports Foundation, a grant from Japan Health Promotion and Fitness Foundation, a grant from Chiba Foundation for Health Promotion and Disease Prevention, the 8020 Research Grant for fiscal 2019 from the 8020 Promotion Foundation (19-2-06), a grant from Niimi University (1915010), grants from Meiji Yasuda Life Foundation of Health and Welfare and the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology (29-42, 30-22).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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