{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T18:49:47Z","timestamp":1791139787743,"version":"4.1.0"},"reference-count":45,"publisher":"BMJ","issue":"7","funder":[{"DOI":"10.13039\/100009619","name":"the Japan Agency for Medical Research and Development","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001691","name":"the Japan Society for the Promotion of Science","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]},{"name":"a grant from the National Center for Geriatrics and Gerontology, Japan"},{"name":"the Ministry of Health, Labour and Welfare, Japan"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,4,16]]},"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Laughter has a positive and quantifiable effect on certain aspects of health, and previous studies have suggested that income influences the emotion. However, it is unknown whether social relationship-related factors modify the association between equivalised income and laughter among older people. In the present study, we examined the relationship between equivalised income and the frequency of laughter. In addition, we examined the impact of social relationship-related factors on the association between equivalised income and frequency of laughter using a cross-sectional study design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study and binomial regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>We sampled from 30 municipalities in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We examined 20\u2009752 non-disabled Japanese individuals aged \u226565 years using data from the Japan Gerontological Evaluation Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome<\/jats:title>\n                    <jats:p>Frequency of laughter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Laughter increased significantly with an increase in equivalent income (p for trend &lt;0.0001). Prevalence ratios (PR) for laughing almost every day were calculated according to quartile equivalised income after adjusting for age, instrumental activities of daily living, depression, frequency of meeting friends, number of social groups and family structure. The results revealed that PRs in Q4 (men; \u2265\u20ac24 420, women; \u2265\u20ac21 154) were 1.21 (95% CI 1.13 to 1.30) among men and 1.14 (95% CI 1.08 to 1.20) among women, as compared with Q1 (men; &lt;\u20ac12 041, women; &lt;\u20ac9518), respectively. After excluding participants with depression, the association remained significant. In addition, we found inadequate social relationships and living alone were associated with a lower frequency of laughter. In comparison with the lowest equivalent income with meeting friends less frequently and living alone, the PRs of the highest equivalent income with meeting friends frequently and living with someone were higher, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results revealed a significant relationship between equivalent income and the frequency of laughter. Social relationships and family structure were also associated with the frequency of laughter.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019104","type":"journal-article","created":{"date-parts":[[2018,7,6]],"date-time":"2018-07-06T00:05:19Z","timestamp":1530835519000},"page":"e019104","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Impact of social relationships on income\u2013laughter relationships among older people: the JAGES cross-sectional study"],"prefix":"10.1136","volume":"8","author":[{"given":"Yurika","family":"Imai","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Nagai","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan"},{"name":"Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan"},{"name":"Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Ohira","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan"},{"name":"Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kokoro","family":"Shirai","sequence":"additional","affiliation":[{"name":"Department of Human Sciences, School of Law and Letters, University of the Ryukyus, Okinawa, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Tokyo, Japan"},{"name":"Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsunori","family":"Kondo","sequence":"additional","affiliation":[{"name":"Center for Preventive Medical Science, Chiba University, Chiba, Japan"},{"name":"Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,7,5]]},"reference":[{"key":"2025120518042421000_8.7.e019104.1","unstructured":"Cabinet Office. The Status of Aging and Implementation of Measures for the Aging Society in FFY 2003. 2004 http:\/\/www8.cao.go.jp\/kourei\/english\/annualreport\/2004\/04wp-e.html (Accessed 4 March 2016)."},{"key":"2025120518042421000_8.7.e019104.2","unstructured":"Cabinet Office. The State of Aging and Implementation of the Measures for an Aging Society in FY2015. 2016 http:\/\/www8.cao.go.jp\/kourei\/english\/annualreport\/2016\/2016pdf_e.html (Accessed 17 January 2018)."},{"key":"2025120518042421000_8.7.e019104.3","doi-asserted-by":"publisher","DOI":"10.1002\/gps.2545"},{"key":"2025120518042421000_8.7.e019104.4","doi-asserted-by":"crossref","first-page":"200","DOI":"10.7150\/ijms.6.200","article-title":"Laugh yourself into a healthier person: a cross cultural analysis of the effects of varying levels of laughter on health","volume":"6","author":"Hasan","year":"2009","journal-title":"Int J Med Sci"},{"key":"2025120518042421000_8.7.e019104.5","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/j.1447-0594.2010.00680.x","article-title":"Effects of laughter therapy on depression, cognition and sleep among the community-dwelling elderly","volume":"11","author":"Ko","year":"2011","journal-title":"Geriatr Gerontol Int"},{"key":"2025120518042421000_8.7.e019104.6","unstructured":"Sakai Y , Takayanagi K , Ohno M , et al . A trial of improvement of immunity in cancer patients by laughter therapy. Jpn Hosp 2013:53\u2013-59."},{"key":"2025120518042421000_8.7.e019104.7","doi-asserted-by":"publisher","DOI":"10.3200\/BMED.29.4.149-154"},{"key":"2025120518042421000_8.7.e019104.8","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.jpsychores.2006.12.007","article-title":"Laughter elevates the levels of breast-milk melatonin","volume":"62","author":"Kimata","year":"2007","journal-title":"J Psychosom Res"},{"key":"2025120518042421000_8.7.e019104.9","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.jpsychores.2006.05.006","article-title":"Increase in dermcidin-derived peptides in sweat of patients with atopic eczema caused by a humorous video","volume":"62","author":"Kimata","year":"2007","journal-title":"J Psychosom Res"},{"key":"2025120518042421000_8.7.e019104.10","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.10-8-651"},{"key":"2025120518042421000_8.7.e019104.11","unstructured":"Noji S , Takayanagi K . A case of laughter therapy that helped improve advanced gastric cancer. 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Lifestyle factors and social ties associated with the frequency of laughter after the Great East Japan Earthquake: Fukushima Health Management Survey. Qual Life Res 2018;27. 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