{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:04:49Z","timestamp":1792677889017,"version":"4.5.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001691","name":"JSPS","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Although the impact of underweight and dementia on mortality is clear, no large study has examined the synergistic impact of underweight and dementia on acute myocardial infarction (AMI) in real-world settings. Therefore, this study aimed to investigate the synergistic effects of underweight and dementia on in-hospital mortality in AMI patients using a nationwide administrative database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This nationwide retrospective cohort study was performed using the Japanese nationwide administrative data (Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination) of 474 979 AMI patients between April 2012 and March 2021. Of these patients, 424 500 with AMI were divided into four groups according to body mass index (&amp;lt;18.5\u2005kg\/m\u00b2 or \u226518.5\u2005kg\/m\u00b2) and dementia status (presence or absence). We investigated the association of underweight and dementia with in-hospital mortality. In-hospital mortality was highest in the underweight\/dementia group (17.5%), followed by the non-underweight\/dementia group (13.2%), the underweight\/non-dementia group (11.6%), and lowest in the non-underweight\/non-dementia group (5.0%). Multilevel mixed-effects logistic regression analysis with multiple imputation and complete cases showed underweight and dementia to be associated alone and in combination with an increased risk of in-hospital mortality. In the subgroup analysis of age categories (&amp;lt;75\u2005years vs. \u226575\u2005years), the synergistic effects of underweight and dementia on in-hospital mortality for AMI were greater for those &amp;lt;75\u2005years of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This nationwide study suggested that the coexistence of underweight and dementia significantly increases the risk of in-hospital mortality in AMI patients and especially younger patients. Early detection and management of both conditions may be crucial for improving survival in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjcn\/zvaf158","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T11:55:28Z","timestamp":1754049328000},"page":"1354-1362","source":"Crossref","is-referenced-by-count":3,"title":["Synergistic effects of underweight and dementia on in-hospital mortality during acute myocardial infarction"],"prefix":"10.1093","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7780-4224","authenticated-orcid":false,"given":"Kodai","family":"Ishihara","sequence":"first","affiliation":[{"name":"Department of Public Health, Graduate School of Health Sciences, Kobe University , 10-2 Tomogaoka 7-chome, Suma-ku, Kobe, Hyogo 654-0142 ,","place":["Japan"]},{"name":"Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women\u2019s University , 2-23 Morikitamachi 6-chome, Higashinada-ku, Kobe, Hyogo 658-0001 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4165-0267","authenticated-orcid":false,"given":"Masato","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Public Health, Graduate School of Health Sciences, Kobe University , 10-2 Tomogaoka 7-chome, Suma-ku, Kobe, Hyogo 654-0142 ,","place":["Japan"]},{"name":"Division of Rehabilitation Medicine, Graduate School of Medicine , Kobe University, 5-1 kusunokichou 7-chome, Chuo-ku, Kobe, Hyogo 650-0017 ,","place":["Japan"]},{"name":"Department of Rehabilitation Science, Osaka Health Science University , 9-27 Temma 1-chome, Kita-ku, Osaka 530-0043 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0162-6318","authenticated-orcid":false,"given":"Yuji","family":"Kanejima","sequence":"additional","affiliation":[{"name":"Department of Public Health, Graduate School of Health Sciences, Kobe University , 10-2 Tomogaoka 7-chome, Suma-ku, Kobe, Hyogo 654-0142 ,","place":["Japan"]},{"name":"Department of Rehabilitation, Kobe City Medical Center General Hospital , 1-1 Minatojimaminamicho 2-chome, Chuo-ku, Kobe, Hyogo 650-0047 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3949-0089","authenticated-orcid":false,"given":"Naofumi","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical Technologies, National Cerebral and Cardiovascular Center , 6-1 Kishibeshimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7900-7835","authenticated-orcid":false,"given":"Koshiro","family":"Kanaoka","sequence":"additional","affiliation":[{"name":"Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center , 6-1 Kishibeshimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1424-145X","authenticated-orcid":false,"given":"Yoko","family":"Sumita","sequence":"additional","affiliation":[{"name":"Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center , 6-1 Kishibeshimmachi, Suita, Osaka 564-8565 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1391-2864","authenticated-orcid":false,"given":"Yoshitaka","family":"Iwanaga","sequence":"additional","affiliation":[{"name":"Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center , 6-1 Kishibeshimmachi, Suita, Osaka 564-8565 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