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Article ; Online: Association between physical activity and kidney function decline in patients with type 2 diabetes: a prospective cohort study (Diabetes Distress and Care Registry at Tenri [DDCRT 11]).

Okamura, Shintaro / Niihata, Kakuya / Nishiwaki, Hiroki / Tsujii, Satoru / Ishii, Hitoshi / Hayashino, Yasuaki / Kurita, Noriaki

Journal of nephrology

2023 Volume 36, Issue 9, Page(s) 2657–2660

MeSH term(s)	Humans ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/epidemiology ; Exercise ; Kidney/physiology ; Prospective Studies ; Registries
Language	English
Publishing date	2023-06-29
Publishing country	Italy
Document type	Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	1093991-x
ISSN	1724-6059 ; 1120-3625 ; 1121-8428
ISSN (online)	1724-6059
ISSN	1120-3625 ; 1121-8428
DOI	10.1007/s40620-023-01691-z
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Zs.A 3369: Show issues

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Article ; Online: Association between urinary C-megalin levels and progressive kidney dysfunction: a cohort study based on the diabetes distress and care registry at Tenri (DDCRT 24).

Niihata, Kakuya / Nishiwaki, Hiroki / Kinoshita, Maki / Kurosawa, Kentaro / Sakuramachi, Yui / Matsunaga, Satoshi / Okamura, Shintaro / Tsujii, Satoru / Hayashino, Yasuaki / Kurita, Noriaki

Acta diabetologica

2023 Volume 60, Issue 12, Page(s) 1643–1650

Abstract: Aims: The aim of this cohort study was to evaluate the association between urinary levels of C-megalin, a full-length form of megalin, and kidney dysfunction progression and its dependence on the urinary albumin-creatinine ratio (UACR) in individuals ... ...

Abstract	Aims: The aim of this cohort study was to evaluate the association between urinary levels of C-megalin, a full-length form of megalin, and kidney dysfunction progression and its dependence on the urinary albumin-creatinine ratio (UACR) in individuals with diabetes. Methods: We enrolled 1,547 individuals with diabetes who visited the ambulatory clinic at Tenri Hospital, a regional tertiary-care hospital in Tenri City, Nara Prefecture, Japan, with an estimated glomerular filtration (eGFR) of ≥ 30 mL/min/1.73 m Results: Urinary C-megalin level was not associated with ≥ 40% eGFR decline in an age-, sex-, eGFR-, systolic blood pressure-, hemoglobin-, and UACR-adjusted model in the 1,547 patients enrolled in the study. However, urinary C-megalin levels were associated with a ≥ 40% decline in eGFR when accounting for the relationship between urinary C-megalin levels and UACR in the model. This association was UACR-dependent. Conclusions: High urinary C-megalin levels were associated with progressive kidney dysfunction in individuals with diabetes, and this association was attenuated by high UACRs.
MeSH term(s)	Humans ; Cohort Studies ; Low Density Lipoprotein Receptor-Related Protein-2 ; Diabetes Mellitus, Type 2/complications ; Kidney ; Registries ; Glomerular Filtration Rate ; Albuminuria/etiology ; Albuminuria/complications
Chemical Substances	Low Density Lipoprotein Receptor-Related Protein-2
Language	English
Publishing date	2023-07-13
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1097676-0
ISSN	1432-5233 ; 0940-5429
ISSN (online)	1432-5233
ISSN	0940-5429
DOI	10.1007/s00592-023-02144-6
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Zs.A 611: Show issues

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Article ; Online: Association of coping strategies with mortality and health-related quality of life in hemodialysis patients: The Japan Dialysis Outcomes and Practice Patterns Study.

Niihata, Kakuya / Fukuma, Shingo / Akizawa, Tadao / Fukuhara, Shunichi

PloS one

2017 Volume 12, Issue 7, Page(s) e0180498

Abstract: Background: Hemodialysis patients are exposed to disease- and treatment-related stresses, and use various coping strategies to deal with these stresses. Although some studies have reported the association of coping strategies with mortality or health- ... ...

Abstract	Background: Hemodialysis patients are exposed to disease- and treatment-related stresses, and use various coping strategies to deal with these stresses. Although some studies have reported the association of coping strategies with mortality or health-related quality of life (QOL) in some populations, the effect of coping strategies on clinical outcomes in hemodialysis patients remains unclear. We investigated the association in a longitudinal design among Japanese hemodialysis patients. Methods: We examined Japanese hemodialysis patients who participated in the Dialysis Outcomes and Practice Patterns Study (DOPPS) IV, which was conducted between 2009 and 2012. The exposure variable was stress coping strategy, as assessed using subscales in Coping Strategies Inventory Short Form: problem-focused engagement, problem-focused disengagement, emotion-focused engagement, and emotion-focused disengagement. Hazard ratios were estimated using Cox proportional hazard model for all-cause mortality and mean differences for change in health-related QOL in 1 year were estimated using a regression model. Results: Among 1,354 patients, only problem-focused engagement was significantly associated with longer survival; other subscales were not associated with all-cause mortality after adjustment for potential confounding factors. In terms of health-related QOL, the subscale of problem-focused engagement was also associated with improvement in physical functioning and mental health among 1,045 patients. Emotion-focused disengagement was associated with deterioration in mental health, but not with change in physical functioning. The other subscales were not associated with change in physical functioning or mental health. Conclusions: Among hemodialysis patients, "problem-focused engagement" coping strategies were associated with longer survival and also with improvement in physical functioning and mental health. To achieve greater longevity and improve QOL in hemodialysis patients under ongoing stresses, problem-focused engagement should be encouraged.
MeSH term(s)	Adaptation, Psychological ; Adult ; Aged ; Emotions ; Female ; Humans ; Japan/epidemiology ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Proportional Hazards Models ; Quality of Life ; Renal Dialysis/mortality ; Renal Dialysis/psychology ; Stress, Psychological
Language	English
Publishing date	2017
Publishing country	United States
Document type	Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0180498
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Article ; Online: Initiation of renin-angiotensin system inhibitors and first complete remission in patients with primary nephrotic syndrome: a nationwide cohort study.

Shimizu, Sayaka / Niihata, Kakuya / Nishiwaki, Hiroki / Shibagaki, Yugo / Yamamoto, Ryohei / Nitta, Kosaku / Tsukamoto, Tatsuo / Uchida, Shunya / Takeda, Asami / Okada, Hirokazu / Narita, Ichiei / Isaka, Yoshitaka / Kurita, Noriaki

Clinical and experimental nephrology

2023 Volume 27, Issue 5, Page(s) 480–489

Abstract: Background: Evidence on renin-angiotensin system inhibitors (RASis) effect in reducing urinary protein levels in patients with nephrotic syndrome is insufficient. We determined whether RASis can induce complete remission (CR) in patients on ... ...

Abstract	Background: Evidence on renin-angiotensin system inhibitors (RASis) effect in reducing urinary protein levels in patients with nephrotic syndrome is insufficient. We determined whether RASis can induce complete remission (CR) in patients on immunosuppressive therapy. Methods: This cohort study included 84 adults (median age, 65 years; males, 57%) with primary nephrotic syndrome (excluding minimal change disease) not receiving RASis during enrollment in the Japanese Nephrotic Syndrome Cohort Study from January 2009 to December 2010, and were followed up for 5 years. Exposure and outcome were RASi initiation and first CR, respectively. Marginal structural models and Poisson regression were used to account for time-varying covariates and estimate causal effects of RASis on CR. Results: Overall, 51 (61%), 73 (87%), and 55 (66%) patients had membranous nephropathy, were prescribed immunosuppressive agents at baseline (1-month post-renal biopsy and/or at start of immunosuppressive therapy), and were prescribed RASis during the study period, respectively. Sixty-five patients experienced first CR (incidence rate, 5.05/100 person-months). RASi use was associated with a higher (adjusted incidence rate ratio [aIRR] 2.27, 95% confidence interval [CI] 1.06-4.84), and lower (aIRR: 0.17, 95% CI 0.04-0.68) first CR in patients with membranous nephropathy and other pathologies, respectively. Conclusion: RASis are beneficial as adjuvant therapy for inducing remission in patients with membranous nephropathy.
MeSH term(s)	Male ; Adult ; Humans ; Aged ; Nephrotic Syndrome/complications ; Glomerulonephritis, Membranous/pathology ; Cohort Studies ; Renin-Angiotensin System ; Immunosuppressive Agents/therapeutic use ; Immunosuppressive Agents/pharmacology ; Antihypertensive Agents ; Enzyme Inhibitors/pharmacology
Chemical Substances	Immunosuppressive Agents ; Antihypertensive Agents ; Enzyme Inhibitors
Language	English
Publishing date	2023-02-25
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1338768-6
ISSN	1437-7799 ; 1342-1751
ISSN (online)	1437-7799
ISSN	1342-1751
DOI	10.1007/s10157-023-02331-3
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Zs.A 4922: Show issues

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Article ; Online: Urinary C-megalin as a novel biomarker of progression to microalbuminuria: A cohort study based on the diabetes Distress and Care Registry at Tenri (DDCRT 22).

Nishiwaki, Hiroki / Niihata, Kakuya / Kinoshita, Maki / Fujimura, Maki / Kurosawa, Kentaro / Sakuramachi, Yui / Takano, Kiyoko / Matsunaga, Satoshi / Okamura, Shintaro / Kitatani, Mako / Tsujii, Satoru / Hayashino, Yasuaki / Kurita, Noriaki

Diabetes research and clinical practice

2022 Volume 186, Page(s) 109810

Abstract: Aims: Megalin is a multiligand receptor expressed in proximal tubular cells that reabsorbs filtered albumin and correlates cross-sectionally with albuminuria. We investigated the association between urinary C-megalin levels and the incidence of ... ...

Abstract	Aims: Megalin is a multiligand receptor expressed in proximal tubular cells that reabsorbs filtered albumin and correlates cross-sectionally with albuminuria. We investigated the association between urinary C-megalin levels and the incidence of microalbuminuria in patients with diabetes mellitus. Methods: This cohort study included 752 patients with type 1 or 2 diabetes mellitus and a urinary albumin-to-creatinine (Cr) ratio (UACR) within the normoalbuminuric range (<30 mg/g Cr). The association between urinary C-megalin and persistent microalbuminuria, accounting for the possible interaction between baseline UACR and urinary C-megalin, was estimated using a Cox proportional hazards model. Results: During a median follow-up period of 1.99 years, 179 cases of persistent microalbuminuria were observed. The association between urinary C-megalin and persistent microalbuminuria was UACR-dependent (P for interaction < 0.001), with the highest association observed in the absence of UACR (per 100 fM/gCr of urinary C-megalin: adjusted hazard ratio, 1.13; 95% CI 1.07-1.19), gradually decreasing as UACR increased to 30 mg/g Cr. UACR dependence was confirmed by sensitivity analyses according to low-normal (<10 mg/gCr) or high-normal (10-<30 mg/gCr) UACR. Conclusions: Urinary C-megalin is associated with progression to microalbuminuria, especially in those with low-normal UACR levels, and its usefulness to identify high risk patients requires further investigation.
MeSH term(s)	Albumins ; Albuminuria/urine ; Biomarkers ; Cohort Studies ; Creatinine/urine ; Diabetes Mellitus, Type 2/epidemiology ; Female ; Humans ; Low Density Lipoprotein Receptor-Related Protein-2 ; Male ; Registries
Chemical Substances	Albumins ; Biomarkers ; Low Density Lipoprotein Receptor-Related Protein-2 ; Creatinine (AYI8EX34EU)
Language	English
Publishing date	2022-03-02
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	632523-3
ISSN	1872-8227 ; 0168-8227
ISSN (online)	1872-8227
ISSN	0168-8227
DOI	10.1016/j.diabres.2022.109810
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Zs.A 2047: Show issues

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Article ; Online: Variations and characteristics of quality indicators for maintenance hemodialysis patients: A systematic review.

Niihata, Kakuya / Shimizu, Sayaka / Tsujimoto, Yasushi / Ikenoue, Tatsuyoshi / Fukuhara, Shunichi / Fukuma, Shingo

Health science reports

2018 Volume 1, Issue 11, Page(s) e89

Abstract: Aims: Several quality indicators (QIs) to improve the quality of practice for hemodialysis patients have been implemented. However, the variations and characteristics of these indicators in terms of their use and feasibility have not been investigated. ... ...

Abstract	Aims: Several quality indicators (QIs) to improve the quality of practice for hemodialysis patients have been implemented. However, the variations and characteristics of these indicators in terms of their use and feasibility have not been investigated. We conducted a systematic review to evaluate the variations and characteristics of existing QIs for maintenance hemodialysis patients. Methods: We conducted a systematic literature search of MEDLINE via PubMed, Scopus, the Cochrane Library, and CINAHL, without date limits, on February 26, 2016. We selected the English-written articles regarding QIs for patients aged ≥18 years who were on maintenance hemodialysis therapy ≥3 months, and extracted the definition and development process of the reported QIs. We categorized each indicator into one of four types, namely, structure, process, surrogate outcome, and outcome, and assessed the data sources that were necessary to measure it. Results: We included 70 articles and identified 101 indicators, and found that most of the consensus processes for selecting indicators were unclear. We also found that most indicators were not process indicators and that the measurement of some indicators required a chart review, which limits their use and feasibility. Conclusions: Development of QIs for hemodialysis patients in the future should use a definitive consensus process and consider process-centered indicators that can be measured automatically using claims data and test results contained in electronic medical records, to improve usability and feasibility.
Language	English
Publishing date	2018-09-05
Publishing country	United States
Document type	Journal Article
ISSN	2398-8835
ISSN (online)	2398-8835
DOI	10.1002/hsr2.89
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Article ; Online: Incidence and factors associated with prescribing renin-angiotensin-system inhibitors in adult idiopathic nephrotic syndrome: A nationwide cohort study.

Nishiwaki, Hiroki / Niihata, Kakuya / Shimizu, Sayaka / Shibagaki, Yugo / Yamamoto, Ryohei / Nitta, Kosaku / Tsukamoto, Tatsuo / Uchida, Shunya / Takeda, Asami / Okada, Hirokazu / Narita, Ichiei / Isaka, Yoshitaka / Kurita, Noriaki

Journal of clinical hypertension (Greenwich, Conn.)

2021 Volume 23, Issue 5, Page(s) 999–1007

Abstract: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are prescribed as conservative or adjunctive therapies for adult idiopathic nephrotic syndrome. However, studies on real-world practice patterns are scarce. This ... ...

Abstract	Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are prescribed as conservative or adjunctive therapies for adult idiopathic nephrotic syndrome. However, studies on real-world practice patterns are scarce. This study aimed to examine the prevalence and incidence of ACEI/ARB prescription and their associated factors. This nationwide cohort study included adult Japanese patients with idiopathic nephrotic syndrome including minimal change disease (MCD), membranous nephropathy (MN), focal segmental glomerulosclerosis (FSGS), and others. The outcomes were the prevalence of ACEI/ARB prescription at baseline (date of renal biopsy or date of immunosuppressant initiation) and at 2 months after baseline. Of the 326 eligible patients, 122 (37.4%) had already been prescribed ACEIs/ARBs. Of the remaining 204 patients, 67 (32.7%) were newly prescribed within the 2-month period. MN/FSGS (vs. MCD, adjusted odds ratio [AOR]: 4.96 [95% confidence interval {CI} 2.53-9.72] and 3.95 [95% CI 1.61-9.66], respectively), higher age (per 1-yr increase, AOR: 1.02 [95% CI 1.00-1.04]), other hypertensive agents (AOR: 2.18 [95% CI 1.21-3.92]), antidiabetic drug (AOR: 6.57 [95% CI 1.77-24.4]) were associated with a higher prevalence of ACEI/ARB prescription. MN (vs. MCD, AOR: 6.00 [95% CI 2.57-14.0]) and higher baseline systolic blood pressure (SBP) (per 10-mmHg increase, AOR: 1.36 [95% CI 1.09-1.70]) were associated with a higher incidence of ACEI/ARB prescription. On average, incidence of ACEI/ARB prescription increased from 19.2% to 40.8% as baseline SBP increased from 100 to 140 mmHg. Thus, Japanese nephrologists are likely to prescribe ACEIs/ARBs for nephrotic patients with MN or high baseline SBP, even below the hypertensive range.
MeSH term(s)	Adult ; Angiotensin Receptor Antagonists/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Angiotensins ; Cohort Studies ; Humans ; Hypertension ; Incidence ; Nephrosis, Lipoid ; Nephrotic Syndrome ; Renin ; Retrospective Studies
Chemical Substances	Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Angiotensins ; Renin (EC 3.4.23.15)
Language	English
Publishing date	2021-03-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2077222-1
ISSN	1751-7176 ; 1524-6175
ISSN (online)	1751-7176
ISSN	1524-6175
DOI	10.1111/jch.14224
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Article ; Online: Variations in actual practice patterns and their deviations from the clinical practice guidelines for nephrotic syndrome in Japan: certified nephrologists' questionnaire survey.

Niihata, Kakuya / Nishiwaki, Hiroki / Kurita, Noriaki / Okada, Hirokazu / Maruyama, Shoichi / Narita, Ichiei / Shibagaki, Yugo / Nakaya, Izaya

Clinical and experimental nephrology

2019 Volume 23, Issue 11, Page(s) 1288–1297

Abstract: Background: Few good-quality clinical trials on adults with nephrotic syndrome exist. Thus, there are discrepancies between real-world practice and clinical practice guidelines. We conducted a questionnaire-based survey to investigate potential ... ...

Abstract	Background: Few good-quality clinical trials on adults with nephrotic syndrome exist. Thus, there are discrepancies between real-world practice and clinical practice guidelines. We conducted a questionnaire-based survey to investigate potential discrepancies and the factors associated with variations in clinical practice. Methods: A questionnaire was administered electronically to all board-certified nephrologists in Japan. To examine clinical practice variations in relation to physician characteristics, we estimated the ratio of the mean duration of steroid therapy using a generalized linear model, and the odds ratio of higher level ordinal variables using an ordered logistic regression model. Results: Responses of the 116 participants showed some variation for the majority of questions. Most participants (94.8%) indicated that screening for malignant tumors was "Conducted for almost all patients". The duration of steroid therapy was found to be longer among physicians seeing ≥ 30 patients with nephrotic syndrome per month, both for minimal-change disease (ratio of mean 1.69; 95% CI 1.07-2.66) and membranous nephropathy (ratio of mean 1.71; 95% CI 1.09-2.69). Conclusions: We identified practice patterns for nephrotic syndrome and discrepancies between clinical practice guidelines and actual practice. Defining the standard therapy for nephrotic syndrome may be necessary to generate high-quality evidence and develop clinical guidelines.
MeSH term(s)	Adrenal Cortex Hormones/therapeutic use ; Early Detection of Cancer ; Glomerulonephritis, Membranous/drug therapy ; Guideline Adherence/statistics & numerical data ; Humans ; Immunosuppressive Agents/therapeutic use ; Japan ; Kidney Neoplasms/diagnosis ; Nephrology/standards ; Nephrology/statistics & numerical data ; Nephrosis, Lipoid/drug therapy ; Nephrotic Syndrome/drug therapy ; Practice Guidelines as Topic ; Practice Patterns, Physicians'/statistics & numerical data ; Surveys and Questionnaires
Chemical Substances	Adrenal Cortex Hormones ; Immunosuppressive Agents
Language	English
Publishing date	2019-08-05
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1338768-6
ISSN	1437-7799 ; 1342-1751
ISSN (online)	1437-7799
ISSN	1342-1751
DOI	10.1007/s10157-019-01772-z
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Article ; Online: Both low and high serum ferritin levels predict mortality risk in hemodialysis patients without inflammation.

Shoji, Tetsuo / Niihata, Kakuya / Fukuma, Shingo / Fukuhara, Shunichi / Akizawa, Tadao / Inaba, Masaaki

Clinical and experimental nephrology

2017 Volume 21, Issue 4, Page(s) 685–693

Abstract: Background: Serum ferritin concentration >100 ng/mL was associated with a higher risk of death in hemodialysis patients in Japan, whereas such an association was less clear in hemodialysis patients in Western countries. Since Japanese dialysis patients ... ...

Abstract	Background: Serum ferritin concentration >100 ng/mL was associated with a higher risk of death in hemodialysis patients in Japan, whereas such an association was less clear in hemodialysis patients in Western countries. Since Japanese dialysis patients are generally less inflamed than those in Western countries, inflammation may modify the association between serum ferritin and the adverse outcomes. Methods: We performed an observational cohort study using data from 2606 Japanese hemodialysis patients who participated in the Dialysis Outcomes and Practice Patterns Study (DOPPS) III (2005-2008) or DOPPS IV (2009-2012). The predictor was serum ferritin category (<50, 50-99.9, 100-199.9, and ≥200 ng/mL), and the primary and secondary outcomes were all-cause mortality and cardiovascular hospitalization, respectively. C-reactive protein (CRP, cut-off by 0.3 mg/dL) and serum albumin (cut-off by 3.8 g/dL) were stratification factors related to systemic inflammation. Results: After adjustment for relevant confounding factors, a U-shaped association was observed between serum ferritin and all-cause mortality in the group with low CRP levels, whereas such relationship was not significant in the high CRP counterparts. In contrast, we found a linear association between serum ferritin and cardiovascular hospitalization in the low CRP and high CRP groups commonly. Similar results were obtained when the total cohort was stratified by serum albumin. Conclusions: Serum ferritin showed different patterns of association with all-cause mortality in hemodialysis patients with versus without inflammation, whereas its association with cardiovascular hospitalization was similar regardless of inflammatory conditions.
Language	English
Publishing date	2017-08
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1338768-6
ISSN	1437-7799 ; 1342-1751
ISSN (online)	1437-7799
ISSN	1342-1751
DOI	10.1007/s10157-016-1317-1
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Article ; Online: Association between vision-specific quality of life and falls in community-dwelling older adults: LOHAS.

Niihata, Kakuya / Fukuma, Shingo / Hiratsuka, Yoshimune / Ono, Koichi / Yamada, Masakazu / Sekiguchi, Miho / Otani, Koji / Kikuchi, Shinichi / Konno, Shinichi / Fukuhara, Shunichi

PloS one

2018 Volume 13, Issue 4, Page(s) e0195806

Abstract: Background: Falls and fall-related fractures are a major public health problem among the older adults. Although objective measures of poor vision have been reported to be associated with falls, the association of self-reported visual function and vision- ...

Abstract	Background: Falls and fall-related fractures are a major public health problem among the older adults. Although objective measures of poor vision have been reported to be associated with falls, the association of self-reported visual function and vision-specific quality of life (QOL) with falls has been inconsistent across several studies. We investigated the association of self-reported visual function and vision specific QOL with falls in community-dwelling older adults. Methods: We conducted a cross-sectional analysis using the baseline data from participants of the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS), which is an ongoing population-based cohort study to evaluate the association of physical dysfunction with the clinical outcomes in community-dwelling people. In the present study, the participants aged over 65 years in 2010 were eligible. The exposure variable was the composite score of the VFQ-J11, which was newly developed using item response theory to evaluate vision specific QOL, and the self-reported outcomes were any fall and frequent falls (≥2) over a 1-month period. We estimated odds ratios using separate logistic regression models adjusted for relevant confounding factors. Results: Among 1624 participants, the median (interquartile range) composite score of VFQ-J11 was 86.8 (76.0-95.9). Any fall and frequent falls were reported by 13.9% and 5.4% of participants, respectively. The composite score of the VFQ-J11 was significantly associated with both frequent falls (adjusted ORs per 10 points, 0.80; 95% CI, 0.68-0.93) and any fall (adjusted ORs per 10 points, 0.84; 95% CI, 0.76-0.94). Conclusions: We found that the composite score of the VFQ-J11 was associated with falls in community-dwelling older adults. Detecting individuals with visual impairments associated with falls using the VFQ-J11 and improvement in the score by interventions could prevent falls. We may consider adding self-reported visual function and vision-specific QOL to conventional risk factors for fall among older adults.
MeSH term(s)	Accidental Falls/statistics & numerical data ; Aged ; Aged, 80 and over ; Cohort Studies ; Cross-Sectional Studies ; Female ; Humans ; Independent Living ; Logistic Models ; Male ; Quality of Life ; Self Report ; Vision, Low/complications ; Vision, Low/diagnosis ; Visual Acuity
Language	English
Publishing date	2018
Publishing country	United States
Document type	Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0195806
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