{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T21:37:42Z","timestamp":1792705062616,"version":"4.5.0"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100004331","name":"Johnson and Johnson","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100004331","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dementia prevention is a global health priority, yet most large-scale population studies come from Western settings. Japan, a rapidly aging society, provides a unique non-Western epidemiological context for characterizing cognitive decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess whether the Tohoku Medical Megabank (TMM) cohorts replicate established dementia-related associations, and to identify correlates that are statistically significant across three prespecified operational classifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from &gt;81,000 participants in the TMM cohorts. Participants were classified using (i) self-reported physician-diagnosed dementia and screening-defined impairment using (ii) Mini-Mental State Examination (MMSE)\u2009\u2264\u200927 and (iii) Japanese version of the Montreal Cognitive Assessment (MoCA-J)\u2009\u2264\u200925. Associations with 14 established dementia-related correlates and &gt;3,800 exploratory variables were assessed using false-discovery-rate control, semantic clustering, and sequential multivariable logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants with self-reported dementia had lower MMSE and MoCA-J scores. Established correlates replicated in expected directions for at least one classification, including lower education, hypertension, depressive symptoms, and hearing difficulty. We identified 106 significant correlates across all three classifications; for self-reported dementia, digital device non-use was associated with higher odds (fully adjusted OR up to 2.97, 95%\u202fCI:\u202f1.42\u20136.18), while smartphone use showed inverse associations (OR = 0.47, 95% CI:\u202f0.26\u20130.86); directions were consistent for screening-defined impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this study, leveraging existing cognitive classifications available in TMM cohorts, we found that established dementia-related associations largely replicated and identified correlates across three operational classifications. Digital disengagement emerged as a correlate that may reflect early functional change; given the cross-sectional design, causal inference requires further examination. Longitudinal validation with adjudicated diagnoses is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261498425","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:26:08Z","timestamp":1792423568000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing operational definitions of screening-based cognitive impairment in the Tohoku Medical Megabank cohort: Focus on digital engagement"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9439-6377","authenticated-orcid":false,"given":"Ryo","family":"Takano","sequence":"first","affiliation":[{"name":"Johnson &amp; Johnson, Chiyoda-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3418-0095","authenticated-orcid":false,"given":"John A.","family":"Moyer","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson, Titusville, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson, Chiyoda-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3068-0559","authenticated-orcid":false,"given":"Jennings","family":"Xu","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson, Titusville, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4472-5719","authenticated-orcid":false,"given":"Kinya","family":"Okada","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson, Chiyoda-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"World Health Organization. World failing to address dementia challenge www.who.int\/news\/item\/02-09-2021-world-failing-to-address-dementia-challenge (2021 accessed 21 January 2026)."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2012.11.007"},{"key":"e_1_3_3_4_2","unstructured":"Alzheimer\u2019s Disease International. World Alzheimer Report 2023 www.alzint.org\/resource\/world-alzheimer-report-2023\/ (2023 accessed 21 January 2026)."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(22)00044-5"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.70444"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504327"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.12.1683"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-007-9199-x"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-018-0579-z"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-025-01909-1"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000003800"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-018-0336-y"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE20150268"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41439-021-00175-5"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-012-9668-8"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-021-03495-6"},{"key":"e_1_3_3_18_2","article-title":"Assessment of cognition using surveys and neuropsychological assessment: the Health and Retirement Study and the Aging, Demographics, and Memory Study","volume":"66","author":"Crimmins EM","year":"2011","unstructured":"Crimmins EM, Kim JK, Langa KM, et al. Assessment of cognition using surveys and neuropsychological assessment: the Health and Retirement Study and the Aging, Demographics, and Memory Study. J Gerontol B Psychol Sci Soc Sci 2011; 66: i162\u2013i171.","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30367-6"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01296-0"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2015.04.036"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2017.00436"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.31662\/jmaj.2022-0220"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.04.021"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/21501319241239228"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0594.2010.00585.x"},{"key":"e_1_3_3_27_2","unstructured":"World Health Organization. WHO guidelines on physical activity and sedentary behaviour www.who.int\/publications\/i\/item\/9789240015128 (2020 accessed 21 January 2026)."},{"key":"e_1_3_3_28_2","unstructured":"National Institutes of Biomedical Innovation Health and Nutrition. The National Health and Nutrition Survey (NHNS) Japan 2018 Summary www.nibiohn.go.jp\/eiken\/kenkounippon21\/download_files\/eiyouchousa\/2018.pdf (2018 accessed 21 January 2026)."},{"key":"e_1_3_3_29_2","unstructured":"UNESCO Institute for Statistics. International Standard Classification of Education ISCED 2011 www.uis.unesco.org\/en\/methods-and-tools\/isced (2012 accessed 21 January 2026)."},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/46.4.503"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ23-0593"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.106.25.3143"},{"key":"e_1_3_3_33_2","first-page":"1039","article-title":"Advancements in whole-genome sequencing protocols: a decade of in-house operations and quality controls at the Tohoku Medical Megabank","volume":"8","author":"Katsuoka F","year":"2025","unstructured":"Katsuoka F, Kawashima J, Tadaka S, et al. Advancements in whole-genome sequencing protocols: a decade of in-house operations and quality controls at the Tohoku Medical Megabank. JMA J 2025; 8: 1039\u20131052.","journal-title":"JMA J"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13742-015-0047-8"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2021.08.005"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1997.03550160069041"},{"key":"e_1_3_3_37_2","doi-asserted-by":"crossref","unstructured":"Reimers N Gurevych I. Sentence-BERT: sentence embeddings using Siamese BERT-Networks. In: Proceedings of the 2019 conference on empirical methods in natural language processing and the 9th international joint conference on natural language processing (EMNLP-IJCNLP) Hong Kong China 3\u20137 November 2019 pp. 3982\u20133992. Stroudsburg PA: Association for Computational Linguistics.","DOI":"10.18653\/v1\/D19-1410"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0044239"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610219000668"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2021.104488"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-025-06561-w"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41562-025-02159-9"}],"container-title":["Journal of Alzheimer\u2019s Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877261498425","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13872877261498425","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877261498425","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:48:34Z","timestamp":1792702114000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13872877261498425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":41,"alternative-id":["10.1177\/13872877261498425"],"URL":"https:\/\/doi.org\/10.1177\/13872877261498425","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]},"article-number":"13872877261498425"}}