Background: In Asia, there has been no population-based epidemiological study using the K6, a 6-item instrument that assesses nonspecific psychological distress. Methods: Using cross-sectional data from 2006, we studied 43 716 (20 168 men and 23 548 women) communitydwelling people aged 40 years or older living in Japan. We examined the association between psychological distress and demographic, medical, lifestyle, and social factors by using the K6, with psychological distress defined as 13 or more points out of a total of 24 points. Results: The following variables were significantly associated with psychological distress among the population: female sex, young and old age, a history of serious disease (hypertension, diabetes mellitus, stroke, myocardial infarction, or cancer), current smoking, former alcohol drinking, low body mass index, shorter daily walking time, lack of social support (4 of 5 components), and lack of participation in community activities (4 of 5 components). Among men aged 40 to 64 years, only "lack of social support for consultation when in trouble"and a history of diabetes mellitus remained significant on multivariate analysis. Among men aged 65 years or older, age was not significantly associated with psychological distress, and the significant association with current smoking disappeared on multivariate analysis. Among women aged 40 to 64 years, a history of stroke was not associated with psychological distress. Among women aged 65 years or older, the significant association with current smoking disappeared on multivariate analysis. Conclusions: A number of factors were significantly associated with psychological distress, as assessed by the K6. These factors differed between men and women, and also between middle-aged and elderly people.
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