{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:08:04Z","timestamp":1783508884049,"version":"3.55.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018117","name":"Aichi Health Promotion Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018117","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to evaluate the relationship between laughter frequency, disease activity, physical function, and frailty in rheumatoid arthritis (RA) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 679 consecutive RA patients from a multicenter observational study conducted in 2023 were included. Laughter frequency was assessed using a standardized questionnaire, and patients were divided into the following four laughter frequency groups: \u2018almost every day\u2019, \u20181\u20135 days per week\u2019, \u20181\u20133 days per month\u2019, and \u2018never or almost never\u2019. Patient characteristics for each frequency group were compared by analysis of variance. Multivariable logistic regression analyses were conducted to identify factors associated with frequent laughter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Laughter frequency was \u2018almost every day\u2019 in 48.6% of patients, \u20181\u20135 days per week\u2019 in 34.7%, \u20181\u20133 days per month\u2019 in 9.9%, and \u2018almost never\u2019 in 6.8%. Laughter frequency was significantly associated with the Health Assessment Questionnaire-Disability Index (HAQ-DI) and social frailty. However, no significant correlation was observed between laughter frequency and disease activity. Patients with social frailty laughed less frequently than those without, and higher HAQ-DI scores were associated with less frequent laughter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Laughter frequency in RA patients is more strongly influenced by physical function and social frailty than by disease activity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/mr\/roaf065","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T07:19:52Z","timestamp":1751872792000},"page":"25-31","source":"Crossref","is-referenced-by-count":2,"title":["The impact of social frailty and physical function on laughter frequency in rheumatoid arthritis patients: data from a multicenter observational study (Tsurumai-frailty and locomotive syndrome of rheumatoid arthritis for globalization)"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4895-5028","authenticated-orcid":false,"given":"Mochihito","family":"Suzuki","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine , Nagoya ,","place":["Japan"]},{"name":"Department of Orthopedic Surgery, Japan Community Health care Organization Kani Tono Hospital , Gifu ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4030-8793","authenticated-orcid":false,"given":"Shuji","family":"Asai","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine , Nagoya ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshifumi","family":"Ohashi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Yokkaichi Municipal Hospital , Yokkaichi ,","place":["Japan"]},{"name":"Department of Orthopedic Surgery, Aichi Medical University , Nagakute ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasumori","family":"Sobue","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Japanese Red Cross Nagoya Daiichi Hospital , Nagoya ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenya","family":"Terabe","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine , Nagoya ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine , Nagoya ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine , Nagoya ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Ohno","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine , Nagoya ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaya","family":"Sugiura","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine , Nagoya ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Imagama","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine , Nagoya ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"2025122205121581400_ref1","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1016\/S0140-6736(16)30173-8","article-title":"Rheumatoid arthritis","volume":"388","author":"Smolen","year":"2016","journal-title":"Lancet."},{"key":"2025122205121581400_ref2","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1016\/S0140-6736(10)60826-4","article-title":"Rheumatoid arthritis","volume":"376","author":"Scott","year":"2010","journal-title":"Lancet."},{"key":"2025122205121581400_ref3","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1136\/ard.2009.123919","article-title":"Treating rheumatoid arthritis to target: recommendations of an international task force","volume":"69","author":"Smolen","year":"2010","journal-title":"Ann Rheum 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