Lack of Social Support and Social Trust as Potential Risk Factors for Dry Eye Disease: JPHC-NEXT Eye Study

Background: Dry eye disease (DED) is chronic, and substantially reduces the people's quality of life. However, the risk factors for DED including social determinants of DED have not been fully investigated or listed.  The objective is to investigate whether social support and social trust are associated with DED.   Methods: Cross-sectional data from the Japan Public Health Center-Based Prospective Study for the Next Generation (JPHC-NEXT) were used. Subjects are 96,227 Japanese men and women aged 40 to 74. Data from respondents included information on DED, social support and social trust. DED was defined as the presence of clinically diagnosed DED or severe symptoms. Social support was measured by emotional support and tangible support. Social trust was measured by level of general trust in others. Multiple logistic regression analysis was conducted to assess the association of social determinants for DED.   Findings: Individuals with high levels of social support and social trust were less likely to have severe symptoms of DED and clinically diagnosed DED (P for trend < 0.001 in both cases). Those with the highest levels of social support and social trust were least likely to have DED (ORs and 95% CIs were 0.64, 0.61-0.67 and 0.63, 0.60-0.67) for severe symptoms of DED; and 0.88, 0.83-0.93 and 0.85, 0.80-0.91 for clinically diagnosed DED).   Interpretation: High levels of social support and social trust were associated with a lower prevalence of DED.   Funding Statement: This study was supported by National Cancer Centre research and development fund. Declaration of Interests: All authors declare that they have no conflicts of interest. Ethics Approval Statement: Written informed consent was obtained from all participants of the JPHC-NEXT. The study followed the tenets of the Declaration of Helsinki, and the Institutional Review Board of the National Cancer Center, Tokyo, Japan prospectively approved the protocol.