title: Sense of life worth living (ikigai) and mortality in Japan: Ohsaki Study.
abstract: OBJECTIVE
  To investigate the association between the sense of "life worth living (ikigai)" and the cause-specific mortality risk. The psychological factors play important roles in morbidity and mortality risks. However, the association between the negative psychological factors and the risk of mortality is inconclusive.
  
  
  METHODS
  The Ohsaki Study, a prospective cohort study, was initiated on 43,391 Japanese adults. To assess if the subjects found a sense of ikigai, they were asked the question, "Do you have ikigai in your life?" We used Cox regression analysis to calculate the hazard ratio of the all-cause and cause-specific mortality according to the sense of ikigai categories.
  
  
  RESULTS
  Over 7 years' follow-up, 3048 of the subjects died. The risk of all-cause mortality was significantly higher among the subjects who did not find a sense of ikigai as compared with that in the subjects who found a sense of ikigai; the multivariate adjusted hazard ratio (95% confidence interval) was 1.5 (1.3-1.7). As for the cause-specific mortality, subjects who did not find a sense of ikigai were significantly associated with an increased risk of cardiovascular disease (1.6; 1.3-2.0) and external cause mortality (1.9; 1.1-3.3), but not of the cancer mortality (1.3; 1.0-1.6).
  
  
  CONCLUSIONS
  In this prospective cohort study, subjects who did not find a sense of ikigai were associated with an increased risk of all-cause mortality. The increase in mortality risk was attributable to cardiovascular disease and external causes, but not cancer.
authors.affiliation: Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan. sone-t@umin.ac.jp
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Sone
authors.forename: Naoki
authors.initials: N
authors.lastname: Nakaya
authors.forename: Kaori
authors.initials: K
authors.lastname: Ohmori
authors.forename: Taichi
authors.initials: T
authors.lastname: Shimazu
authors.forename: Mizuka
authors.initials: M
authors.lastname: Higashiguchi
authors.forename: Masako
authors.initials: M
authors.lastname: Kakizaki
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Kikuchi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kuriyama
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tsuji
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology; D010549:Personal Satisfaction; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires