Agreement in depression determination among four self-rating depression scales applied to Japanese community-dwelling elderly

<p><b>OBJECTIVE</b>In this study, we examined the characteristics of depression determination using four representative self-rating depression scales (Geriatric Depression Scale, GDS; Self-rating Depression Scale, SDS; Center for Epidermiologic Studies Depression Scale, CES-D; and Carroll Rating Scale, CRS) applied to Japanese community-dwelling elderly.</p><p><b>METHODS</b>Subjects were 563 community-dwelling independent elderly living in twelve prefectures (330 males, 68,9±6.3 yr; 233 females, 68.1±5.8 yr).</p><p><b>RESULTS</b>Depression rates determined using SDS (45.8%) and CES-D (68.6%) were higher than those determined using GDS (5.7%) and CRS (14.7%). Although correlations of depression scale scores among the four scales were significant and comparable (r: 0.61 (GDS vs. SDS, p<0.01) to 0.78 (SDS vs. CES-D, p<0.01)), the agreement in depression determination varied among scales (kappa coefficients: 0.05 (GDS vs. CES-D, p>0.05) to 0.46 (SDS vs. CES-D, p<0.01)).</p><p><b>CONCLUSIONS</b>Similarities in depression determination were found between GDS and CRS, and between CES-D and SDS. Depression rates determined on the basis of cut-off point for each scale were higher for CES-D and SDS than for GDS and CRS. Depression determination using a four-point rating scale may overestimate a slightly depressive symptom, compared with that using a two-point scale.</p>

Agreement in Depression Determination among Four Self-Rating Depression Scales Applied to Japanese Community-Dwelling Elderly

Objective: In this study, we examined the characteristics of depression determination using four representative self-rating depression scales (Geriatric Depression Scale, GDS; Self-rating Depression Scale, SDS; Center for Epidemiologic Studies Depression Scale, CES-D; and Carroll Rating Scale, CRS) applied to Japanese community-dwelling elderly. Methods: Subjects were 563 community-dwelling independent elderly living in twelve prefectures (330 males, 68.9±6.3 yr; 233 females, 68.1±5.8 yr). Results: Depression rates determined using SDS (45.8%) and CES-D (68.6%) were higher than those determined using GDS (5.7%) and CRS (14.7%). Although correlations of depression scale scores among the four scales were significant and comparable (r: 0.61 (GDS vs. SDS, p<0.01) to 0.78 (SDS vs. CES-D, p<0.01)), the agreement in depression determination varied among scales (kappa coefficients: 0.05 (GDS vs. CES-D, p>0.05) to 0.46 (SDS vs. CES-D, p<0.01)). Conclusions: Similarities in depression determination were found between GDS and CRS, and between CES-D and SDS. Depression rates determined on the basis of cut-off point for each scale were higher for CES-D and SDS than for GDS and CRS. Depression determination using a four-point rating scale may overestimate a slightly depressive symptom, compared with that using a two-point scale.

RELATIONSHIPS BETWEEN PHYSICAL FITNESS ELEMENTS OF HEALTHY OLDER ADULTS : GENDER AND AGE DIFFERENCES / 体力科学

The aim of this study was to clarify the relationship between physical fitness elements in healthy older adults, considering the differences between gender and between age. Subjects were 1042 active and non-injured people aged from 60 years to under 90 years. The subjects were classified into two different age groups of under 75 years group and 75 years and over group. A total of 11 variables representing four physical fitness elements (muscular, joint, neural, and respiratory functions) were selected through examination of safety and validity. Two-way ANOVA was used to examine gender and age differences in each physical fitness element. Pearson's correlation coefficient and partial correlation coefficient excluding age factor were calculated for each gender and age group.<BR>As a result of examining the relationship among physical fitness elements, the correlation coefficients within variables consisting of the following each function, muscular function, joint function and agility of extremities, were significant in both age groups, and these tendencies were consistent in both gender groups. Similarly, significant correlation coefficients between standing-reach and muscular function variables, and between trunk twist and foot balance with eyes open and reaction time were found in the under 75 years group, but not in the over 75 years group. On the other hand, different tendencies between genders were found in the relationship between the muscular function variables and trunk twist and foot balance with eyes open, and between the reaction time and stepping and muscular function variables. As the relationships among physical fitness elements tended to decline in the over 75 years group, it is inferred that this tendency is influenced by the change with aging of physical fitness characteristics and environmental factors around the older adults.

Relationship between strength exertion and subjective muscle-fatigue sensation in the relative sustained static hand gripping / 体力科学

The purpose of this study was to examine the individual differences in relative grip-strengthendurance (RGE) variables and relations between force, endurance time and level of subjective musclefatigue sensation (SMS) of RGE. Endurance time and SMS during grip-strength exertion using various relative demand values to the maximal grip-strength-value (MAX) were analyzed. Subjects were 23 healthy adults (male 10 and female 13) . Four demand values of 25, 35, 50 and 75% were selected as relative demand values to MAX. The grip-strength-exertion value was input into a personal computer using the system of grip-strength with a strain-gauge (Yagami : ED-D 100 R) . The results are summarized as follows:<BR>1) Muscle group related to grip-strength exertion recovered up to about 60% of initial within 10-15 sec after grip-strength exertion stopped regardless of the degree of relative demand values.<BR>2) The SMS in any relative demand values reached a peak after continuing relative demand values became impossible, and the tendency is stronger with a higher demand value.<BR>3) With about 25% relative demand values, physiological muscle fatigue and SMS advanced at almost the same time, and the grip-strength exertion was possible for a little while after the SMS reached a peak.<BR>4) With the lower relative demand values under 50%, the influence of SMS appeared stronger by extending the endurance time and the decline-delay of grip-strength-exertion.<BR>5) With relative demand values over 50%, continuing relative demand values became impossible within a short time, and the peak SMS appeared earlier than that of relative demand values. On the other hand, the continuing the lower relative demand values was possible to some extent, and individual differences in the continuance and peak arrival-times of SMS were large.

Development of ADL index for older community people / 体力科学

The purposes of this study were to examine reliability and validity of ADL index for older people at home, and relationships between ADL score and various factors (ex. self-assessment of health status and physical fitness level, and exercise frequency/week), and to examine the screening basis for execution of physical fitness test based on distribution of ADL score. A questionnaire consisting of 12 ADL items and a physical fitness test of Ministry of Education, Science and Clture were administered to 5, 715 subjects 65 years or more age (male: 2, 745; female: 2, 970) . As a result of examining test-retest reliability of the ADL index, significant high correlations were shown among 12 ADL items (0.674≤r≤0.886), and in overall score (r=0.943) . The ADL score was significantly related to age and physical fitness test scores, and tended to be higher in subjects with a higher self-assessment of health status and physical fitness level, and with more frequency. It was suggested that these results prove the utility of the present ADL index. Further, as the result of examining relationships between distribution of overall ADL score and physical fitness test scores, the following screening bases were considered to be valid for judgement whether the physical fitness tests could be executed. The three screening bases using overall ADL score were: 1) 12 or under; 2) over 13 to under 24; 3) 24 and over. The four bases using item score were: 1) a category 1 response for items 1, 5 and 6; 2) a category 2 or 3 response for items 1, 5 and 6, and a category 1 response for items 3 and 4; 3) a category 3 response for items 2 and 14; 4) a category 1 response for items 10 and 12.

Examination of useful ADL items and scales to assess ADL ability in older community people. Regarding aging, physical fitness level, and interrelationships among ADL items / 体力科学

The purpose of this study was to propose useful ADLs (activities of daily living) and scales to estimate ADL ability on community older people from the viewpoints of aging, physical fitness level, and interrelationship among ADL. The survey constructing of 15 ADL items and physical fitness test of Ministry of Education, Science and Culture were carried out on 458 older people. Each ADL item was constructed with 3 level scales.<BR>As the results of this study, the following 12 ADLs were proposed as useful ADL items; in the locomotion domain, jumping across a ditch, walking, running, up and down stairs, and transfer; in the manipulation domain, taking bedding in and out, buttoning a shirt; in stability domain, standing in the bus or train, dressing while standing (trousers), standing on one foot with eyes open; in the posture-change domain, sitting up, standing up from the floor. These items were significantly related to age and physical fitness elements contributed largely to achievement of each ADL. Since significant high correlation was found between the index using 12 ADL items and that using 15 items, it is considered that the 12 items scale can account for the variance corresponded enough to that of 15 items scale, and that the new index is practical and simple.<BR>In further research, it will be required to examine validity of each ADL item and index by using more large sample, and to clarify the relation to various factors influenced to ADL ability level.

Examining reproducibility of force-exertion pattern and reliability of force-time parameters in the development phase during static explosive grip exertion / 体力科学

The evaluation of muscular power function has been mainly limited to dynamic contraction, but force-time parameters in static explosive contraction may be useful. The purpose of this study was to examine the trial-to-trial differences of exertion pattern and the reliability of the force-time parameters in the development phase of static maximal explosive grip (SEG) using seventy healthy young male subjects (age 18.8±2.3yr) . In SEG measurement, subjects were instructed to exert maximal isometric force with a dominant hand as fast and forcefully as possible. Data was collected from two trials with 3 minutes rest between trials. Eleven variables (time to fixed level, average force, integrated area, maximal rate of force development, and equivalent for mechanical power parameter) were selected as force-time parameters.<BR>The reliability of maximal grip strength (MAX) was very high (ICC=0.944, p<0.05) . In the above-stated instruction condition, the trial-to-trial difference expanded from 0.1- 0.4 sec, then re-duced in the vicinity of MAX during SEG exertion. Significant differences, however, were not found at any exertion time and reproducibility of SEG exertion pattern was very high between the two trials. The trial-to-trial reliability in all force-time parameters was significant (ICC=0.346-0.878, p<0.05) .<BR>Reliability of the parameters measuring the earlier phase (about 0.1-0.5 sec) was low or moderate (ICC<0.7), while reliability of the parameters measuring the MAX vicinity tended to be high. The MAX relationship to force-time parameters in the MAX vicinity is high, but is low or moderate for the other parameters. It was suggested that the force-time parameters in the vicinity of MAX in SEG exertion might be useful for evaluating static power function in a clinical setting.

The effects of kinesio taping on isokinetic muscle exertions of lower limb / 体力科学

This study aims to examine the effects of kinesio taping (KT) on explosive muscle and sustained maximal muscle exertions of lower limbs in pre- and post-strenuous exercises (SE) up to exhaustion. Twenty healthy college males (mean age 20.4 ± 1.08 yr) participated in the experiment for both the conditions of strapping KT (KT group) and no strapping KT (control group) . They all took pre- and post-SE isokinetic tests (IK test) .<BR>The KT was strapped around muscle groups related to flexion and extension motions of a knee joint before the experiment. The effects of KT were confirmed on the exertion of the explosive muscle strength in flexion motion of post-SE, and the sustained muscle strength in pre- and post-SEs. It was inferred that the effects of KT relate to the fatigue state of muscle groups related to motion and motion types, and interpretation of these effects differs by the load intensity and the variables used for evaluation.

The changind of physique and physical fitness with age and its sex-difference in elderly people / 体力科学

A study was performed to examine sex and age differences in physique and physical fitness and the sex differences in the change of these parameters with age, and to clarify the relationship between the amount of exercise and fundamental physical fitness in 326 healthy elderly individuals over 60 years of age.<BR>A total of 22 variables consisting of 9 items concerning body linearity, quantitative growth, circumference growth and posture, and 13 items representing 4 domains (muscular, joint, neural, and cardiorespiratory functions) were selected. The exercise performance index (EPI) was calculated as the product of frequency and duration (yr) of exercise. The sex and age differences in physique and physical fitness were examined using two-way ANOVA (sex × age group) . Post hoc tests using Ryan's procedure were carried out when the main effect of these factors proved significant. To examine the characteristics of changes in physique and physical fitness with age, Pearson's correlation coefficient was calculated, and linear regression analysis [test item was the dependent variable (X) and age was the independent variable (Y) ] was applied. Then significant differences in the regression coefficient and intercept between males and females were examined. Furthermore, curved-line regression analysis was executed for the above variables. Applying principal component analysis for 13 physical fitness items, the first principal component was interpreted as fundamental physical fitness for performance, and the above analysis was applied to the fundamental physical fitness score (FPS) . To examine the relationship between EPI and FPS, the difference in FPS among the three EPI groups was examined using analysis of co-variance (ANCOVA) with age as the co-variable.<BR>The main findings of this study can be summarized as follows.<BR>1. With regard to physique, males showed greater body linearity, and females had more skinfold. Sex differences in circumference growth were not as significant as those in body linearity and quantitative growth. Changes in physique with age were greater in females than in males, the change becoming obvious in individuals over 80 years of age.<BR>2. With regard to physical fitness, males had superior muscular function and vital capacity, while females outperformed males in standing-reach. However, there was little sex difference in neural function. The trend for deterioration in physical fitness with age differed between the sexes among 4 domains of physical fitness. For example, in males muscular, neural, and joint functions deterioration significantly with age, while in females, all physical fitness variable did so. In addition, the age-related trends of deterioration in muscular function (grip strength and vertical jump), cardiorespiratory function (duration of breath-holding and vital capacity), and neural function (stepping) were differed between the sexes.<BR>3. The FPS was higher in males than in females. However, FPS decreased significantly with age in both sexes.<BR>4. It was inferred that among active and healthy elderly males and females who exercised regularly, FPS was not influenced by EPI.

Sex differences of fatigue in young men and women. From the viewpoint of experience of awareness and cognitive appraisal / 体力科学

A study was conducted to examine sex differences in subjective symptoms of fatigue in men and women with reference to the experience of awareness and cognitive appraisal based on symptom of fatigue content. A total of 54 questionnaire items were administered to 730 people (290 men and 440 women) . The subjects indicated whether or not they were aware of the content, and to what degree the content of the question for each item was important. Sex differences in the response to the ratio of awareness and the degree of importance were then. The mean importance scores for subjective symptoms of fatigue in men and women were 3.9-5.4 and 4.5-5.6, respectively. It was found that a majority of the men and women showed awareness of each item. A significant difference was recognized in the factor of awareness in all items as a result of two-way ANOVA of the degree of importance by which the presence of awareness and its sex difference were assumed to be factors, and those who were aware deemed the degree of importance high. On the other hand, the 28 items for which a significant sex difference was recognized showed a high value, and there was a marked content of Languor, Loss of Vigor, and A Feeling of Impatience and Physical Disintegration in women. In the same items, it was inferred that persons who were more aware than the persons who were not aware regarded subjective symptoms of fatigue as important. Most items in which a main effect of sex was recognized were content of Loss of Vigor and a Feeling of Impatience and Physical Disintegration. It was thought that women considered these symptoms more important than men. The sex difference in symptoms of fatigue was inferred to be due to the difference in the level of acknowledgment based on experienced knowledge.

Relationships of fundamental physical fitness and health-conditions, activities of daily living, and food habits in elderly women / 体力科学

The purpose of this study was to investigate the relationships of fundamental physical fitness (FPF) and health-conditions, activities of daily living, and food habits in elderly women.<BR>A total of 338 women aged 60 to 89 years were the subjects for this study. Fourteen tests were selected from 4 physical fitness domains of muscle function, joint function (flexibility), neuromuscular function and lung function, considering the validity, safety and convenience of tests. To measure the above-stated living conditions, a questionnaire consisting of 30 items was constructed. Principal component analysis was applied to the correlation matrix, which was calculated from physical fitness variables. The first principal component could be interpreted as the FPF factor, since it correlated significantly with all physical fitness variables and showed the greatest contribution (about 36%) to total variance. Statistical techniques of contingency coefficient and theory of quantification I were used to determine the influence of the above-stated living conditions to FPF.<BR>It was inferred that each living condition influences FPF as a composite factor, and the elements of exercise habit, the existence of the trouble caused by past disease and injury, bedtime and age have greater influence on the decline of FPF. Fundamental physical fitness showed a decreasing trend with age, but the continuous exercise enforcement on one day or more a week, seemed to be effective in postponing the decline of FPF related to age. Further, it was inferred that influence of each living condition to FPF differs in the 60 and 70 age levels.

PHYSICAL CHARACTERISTICS IN WELL-TRAINED YOUNG SWIMMERS / 体力科学

Well-trained young swimmers seem to have different physical characteristics as compared with non-athletes of the same age group. The purpose of this study was to determine physical characteristics of well-trained young competitive swimmers from a standpoint of differences in training, sex, and growth and development. A total of 47 boy and girl swimmers and 124 untrained boys and girls were selected as subjects.<BR>All swimmers began to swim regularly in an elementary school age and continued hard swimming training for at least 2 years. A battery of 53 parameters representing each physical domain such as physique, muscular strength, flexibility, neuromuscular function, cardio-respiratory function, were selected to examine subject's physical characteristics. The following results were found : boy swimmers have less body fat, superior physique, mascular strength, flexibility, agility, and also superior cardio-respiratory function as compared with untrained boys. Also girl swimmers have almost the same physical characteristics except for physique and general static strength. Boy swimmers possess larger stature and bone width, and superior muscular strength and cardio-respiratory function as compared with girl swimmers. A similar sex difference is found in non-athletes. High school swimmers have more solid body mass, and superior dynamic and static strength, relating to an achievement of swimming speed, than junior high school swimmers.

Physical characteristics on well-trained young swimmers / 体力科学

Well-trained young swimmers seem to have different physical characteristics as compared with non-athletes of the same age group. The purpose of this study was to determine physical characteristics of well-trained young competitive swimmers from a standpoint of differences in training, sex, and growth and development. A total of 47 boy and girl swimmers and 124 untrained boys and girls were selected as subjects.<BR>All swimmers began to swim regularly in an elementary school age and continued hard swimming training for at least 2 years. A battery of 53 parameters representing each physical domain such as physique, muscular strength, flexibility, neuromuscular function, cardio-respiratory function, were selected to examine subject's physical characteristics. The following results were found : boy swimmers have less body fat, superior physique, mascular strength, flexibility, agility, and also superior cardio-respiratory function as compared with untrained boys. Also girl swimmers have almost the same physical characteristics except for physique and general static strength. Boy swimmers possess larger stature and bone width, and superior muscular strength and cardio-respiratory function as compared with girl swimmers. A similar sex difference is found in non-athletes. High school swimmers have more solid body mass, and superior dynamic and static strength, relating to an achievement of swimming speed, than junior high school swimmers.

PHYSICAL TRAITS OF FOUR GROUPS WITH DIFFERENT RUNNING ABILITIES / 体力科学

As physical elements appear to relate independently to the achievement in each running performance, it may be appropriate to separate the general population into several groups when physical traits specific to the achievement in each running performance are investigated. For this reason, the following four groups were arbitrary set: Group FF with higher running speed in both 100m and 10km runs, Group SS with slower running speed in both 100m and 10km runs, Group FS with higher running speed only in 100m run, and Group SF with higer running speed only 10km run. The purpose of this study was to compare physical elements and their developmental balance between 4 different groups in terms of running ability. The subjects were 166 high school boys aged 15 to 18 (X=16.9yr) . Within the limitation of the present study, the folowing conclusions were drawn:<BR>1) Group SS was much inferior to the other groups in many tests representing power, agility, balance, coordination, and leg muscular endurance. This group also possessed higher body fat. And scores in such traits as power and agility were significantly higher in FF group than in SF group.<BR>2) Factor analysis showed that physical fitness domain represented by 30 variables would be divided into six factors. While group SS possessed greater body bulk (F1) than the other groups, it had much inferior ability in power and agility (F5) . Cardio-respiratory function (F4) was significantly better in FF and SF groups as compared with SS and FS groups. However, no distinct differences existed beween groups in any of static strength (F2), body linearity (F3), and flexibility (F6) factors.<BR>3) Finally, this study supports the hypothesis that the developmental balance of physical elements is specific to each running group. Particularly, it is interesting to note that group SS showed higher scres in body bulk and lower scores in cardio-respiratory function, power and agility as compared with scores in the other factors.