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1.
Front Aging Neurosci ; 15: 1005410, 2023.
Article in English | MEDLINE | ID: mdl-36993908

ABSTRACT

The present study aimed to determine the impact of a 10-month multidomain program using dual-task exercise and social activity conducted at a community-based facility on improved cognitive function in older adults with mild to moderate cognitive decline. The participants included 280 community-dwelling older adults (age 71-91 years) with mild to moderate cognitive decline. The intervention group exercised for 90 min/day, once a week. Their routine included aerobic exercise and dual-task training which cognitive tasks were performed in combination with exercise. The control group attended health education classes thrice. Before and after the intervention, we measured their cognitive function, physical function, daily conversation, and physical activity. The mean adherence rate of the intervention class was 83.0%. According to a repeated-measures multivariate analysis of covariance in an intent-to-treat analysis, logical memory and 6-min walking distance demonstrated a significant time and group interaction effect. Regarding daily physical activities, we observed significant differences in the daily step count and moderate-to-vigorous physical activity in the intervention group. Our non-pharmacological multidomain intervention resulted in a modest improvement in the cognitive or physical function and building health behavior. It may be a helpful program with a potential role in preventing dementia. Clinical Trial Registration: http://clinicaltrials.gov Identifier ID: UMIN000013097.

2.
Clin Interv Aging ; 13: 179-184, 2018.
Article in English | MEDLINE | ID: mdl-29416326

ABSTRACT

OBJECTIVES: The purpose of this study was to identify a method for assessing physical fitness age that is easy to use with both frail and healthy elderly women and to examine its validity. METHODS: Principal component analysis was used to develop a formula of physical fitness age from four motor function variables. The subjects comprised 688 (75.7±6.0 years) elderly women, in order to develop a physical fitness scale. The formula for calculating physical fitness age was expressed as physical fitness age =-0.419× grip strength -0.096× balancing on one leg with eyes open -0.737×30 s chair stand +0.503× figure-of-8 walking test +0.47× chronological age +52.68. RESULTS: Measures obtained from subjects in the frail elderly (n=11, 73.0±2.3 years) and exercise (n=10, 70.8±3.1 years) groups were used to examine the validity of the assessment. The mean physical fitness age of the frail elderly group (79.0±3.7 years) was significantly higher than its mean chronological age (73.0±2.3 years, p<0.05). The mean physical fitness age of the exercise group (65.6±3.1 years) was significantly lower than the chronological age (70.8±3.1 years, p<0.05). CONCLUSION: These findings confirm that physical fitness age scores are applicable to frail and healthy elderly women. Physical fitness age is a valid measure of motor function in elderly women.


Subject(s)
Frail Elderly , Motor Activity/physiology , Physical Fitness/physiology , Aged , Aged, 80 and over , Female , Health Promotion , Humans
3.
Health Psychol ; 37(4): 355-363, 2018 04.
Article in English | MEDLINE | ID: mdl-29369675

ABSTRACT

OBJECTIVE: Although previous studies have shown that good access to public transportation is positively related with physical activity, the moderators of this relationship have not been explored sufficiently in older adults. It is possible that driving status could moderate this relationship. The present study examined whether the objectively measured distance between public transportation and the home was associated with physical activity levels, and whether this association was moderated by driving status among Japanese older adults. METHOD: In this cross-sectional study, participants (n = 2,878) completed questionnaires and wore accelerometers for at least 7 days, to measure their average daily step counts and minutes spent engaging in moderate-to-vigorous physical activity. Road network distances between the home and the nearest bus stop or train station were measured using geographic information systems. Driving status was assessed using questionnaires. RESULTS: Multiple regression analyses stratified by driving status revealed that, among nondrivers, living further away from public transportation was associated with higher step counts (ß = 0.08, p < .001) and moderate-to-vigorous physical activity (ß = 0.06, p = .029). Among drivers, living closer to public transportation was significantly associated with higher moderate-to-vigorous physical activity levels (ß = -0.05, p = .042). CONCLUSION: Despite the small effect sizes, the direction of the association between distance from public transportation and physical activity was different for current drivers and nondrivers. These findings imply that good access to public transportation does not positively relate with greater engagement in physical activity among nondriving older adults. Shorter distances to public transportation might reduce opportunities for engaging in physical activity for them. (PsycINFO Database Record


Subject(s)
Exercise/physiology , Transportation/methods , Walking/statistics & numerical data , Aged , Asian People , Cross-Sectional Studies , Female , Humans , Male , Surveys and Questionnaires
4.
Geriatr Gerontol Int ; 18(1): 146-153, 2018 Jan.
Article in English | MEDLINE | ID: mdl-28762614

ABSTRACT

AIM: To develop intervention strategies that promote screening for cognitive impairment, it is essential to identify the modifiable predictors for participation in screening. The present study aimed to examine whether a shorter distance to the screening site predicted participation in screening for cognitive impairment, and whether interactive effects of the distance and psychological factors on the participation would be observed among community-dwelling older adults. METHODS: The study used a prospective design. After a baseline questionnaire survey, participation in screening for cognitive impairment was followed for 6 months (n = 9616). The distance to the screening site was measured by road distance from each residential address and categorized into four groups (<1 km, 1-1.99 km, 2-2.99 km, ≥3 km). The questionnaire measured psychological factors (behavioral intention and perceived benefits of screening), driving status and demographic factors. RESULTS: A logistic regression analysis showed that compared with the <1 km group, the 2-2.99 km (adjusted odds ratio 0.62, P = 0.040) and ≥3 km (adjusted odds ratio 0.54, P = 0.015) groups did not participate in screening after adjusting for psychological and demographic factors, and driving status. The interaction of the distances and psychological factors on participation were not significant. CONCLUSIONS: The distance to the screening site predicted participation in cognitive impairment screening among older adults regardless of their psychological status. This finding shows that improving access to screening sites would be effective for promoting screening for cognitive impairments among both low and highly motivated older adults. Geriatr Gerontol Int 2018; 18: 146-153.


Subject(s)
Cognitive Dysfunction/diagnosis , Mass Screening/statistics & numerical data , Aged , Geography , Health Services Accessibility , Humans , Independent Living , Prospective Studies , Surveys and Questionnaires
5.
J Aging Phys Act ; 26(1): 146-154, 2018 01 01.
Article in English | MEDLINE | ID: mdl-28605274

ABSTRACT

This study aimed to examine whether the expectation for physical activity to minimize dementia risk was associated with physical activity level and whether this association was moderated by perceived high value of dementia prevention among older adults. Participants (n = 2,824) completed questionnaires and wore accelerometers to measure their average daily steps and levels of physical activity. The expectation for physical activity to minimize dementia risk, perceived value of dementia prevention, and potential covariates (expectation of other desirable outcomes, demographics, and health-related factors) were also measured. The main effects of the expectation and perceived value and their interaction were not significant for physical activity variables in generalized linear models. These findings indicate that expecting physical activity in minimizing dementia risk might not be sufficient to influence physical activity behavior regardless of perceived high value of dementia prevention among older adults.


Subject(s)
Attitude to Health , Dementia/prevention & control , Exercise/psychology , Accelerometry , Aged/psychology , Dementia/psychology , Female , Humans , Male , Motivation
6.
J Cachexia Sarcopenia Muscle ; 8(4): 607-614, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28597612

ABSTRACT

BACKGROUND: The aim of this study was to describe the age-dependent changes in the parameters of physical performance and body composition in Japanese older adults who are independently dwelling in the community. We also examined whether the age-dependent changes differ among physical performance and body composition parameters. METHODS: Cross-sectional data from 10 092 community-dwelling older adults (mean age 73.6 years; 5296 women) were analyzed. The measures of physical performance included hand-grip strength, the five-times-sit-to-stand test, and walking speed. Body composition parameters (body weight, fat mass, and appendicular skeletal muscle mass) were measured with a bioelectrical impedance analyser. Correlations between age and the physical performance and body composition parameters were tested. The T-scores of physical performance and body composition measurements were calculated and presented according to 5-year age groups to examine the differences in age-dependent changes in physical performance and body composition parameters. RESULTS: All physical performance measures significantly decreased with aging. The cumulative mean T-scores according to age group showed different age-dependent changes between body mass index (BMI) and appendicular skeletal muscle mass index (ASMI) (cumulative mean T-score change of BMI and ASMI of -5.7 to -2.9 and -12.7 to -12.1, respectively). The slope declines in age-associated changes were greater in grip strength (ß = -0.77, 95% confidence interval = -0.82 to -0.76) for men and in walking speed (ß = -0.95, 95% confidence interval = -0.99 to -0.90) for women. CONCLUSIONS: The patterns of age-dependent decreases in physical performance measures differed among parameters and between sexes. There is a possibility of a difference in the age-related slope patterns among parameters; decreases in grip strength in men and walking speed in women may be more prominent with advancing age. Furthermore, the decrease in ASMI with age is more striking than that of BMI.


Subject(s)
Aging/physiology , Athletic Performance/physiology , Body Composition/physiology , Independent Living , Activities of Daily Living , Aged , Aged, 80 and over , Cross-Sectional Studies , Exercise/physiology , Female , Humans , Japan/epidemiology , Male , Surveys and Questionnaires
7.
Geriatr Gerontol Int ; 17(11): 2053-2059, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28485046

ABSTRACT

AIM: The aim of the present study was to investigate the association between various body composition parameters and the risk of mild cognitive impairment (MCI) in older Japanese adults, as well as potential sex-related differences in the risk of MCI. METHODS: Participants underwent cognitive tests, and were divided into 840 participants with MCI (mean age 71.9 ± 5.5 years) and 1740 without MCI (mean age 71.3 ± 5.2 years). Body composition parameters were measured using a bioelectrical impedance analyzer. Multiple logistic regression analysis was then carried out to examine the associations between body composition parameters and risk of MCI. RESULTS: After adjusting for confounding factors, those in the lowest quartile for fat-free mass had a higher risk of MCI than those in the highest quartile (men: odds ratio [OR] 1.96, 95% confidence interval CI 1.24-3.10; women: OR 1.49, 95% CI 1.01-2.19). Loss of muscle mass in the upper (OR 2.17, 95% CI 1.40-3.37) and lower (OR 1.99, 95% CI 1.25-3.15) limbs was associated with a higher MCI risk in men. However, only loss of muscle mass in the lower limbs was associated with a higher MCI risk (OR 1.61, 95% CI 1.06-2.44) in women. No associations were found between obesity measures and MCI. CONCLUSIONS: We found that loss of fat-free mass was associated with MCI in older adults, regardless of sex. We also found that appendicular muscle mass was more closely associated with MCI in men than in women. These results suggest that the association between appendicular muscle mass and MCI might have different underlying mechanisms based on sex. Geriatr Gerontol Int 2017; 17: 2053-2059.


Subject(s)
Body Composition , Cognitive Dysfunction/epidemiology , Aged , Electric Impedance , Female , Humans , Japan/epidemiology , Male , Odds Ratio , Risk Factors
8.
Geriatr Gerontol Int ; 17(5): 730-736, 2017 May.
Article in English | MEDLINE | ID: mdl-27295943

ABSTRACT

AIM: The aim of the present study was to evaluate the relationship between sedentary time and declines in kidney function among community-dwelling older adults. METHODS: Participants comprised 10 242 community-dwelling older adults who were participating in the National Center for Geriatrics and Gerontology - Study of Geriatric Syndromes. Sedentary time was determined by asking participants to record the total amount of hours usually spent sitting each day, with values divided into quartiles of 0 to <4 h (reference), 4 to <6 h, 6 to <8 h and ≥8 h of sitting time per day. The estimated glomerular filtration rate was determined according to creatinine levels, and participants were classified into two categories: ≥60.0 or <60 mL/min/1.73 m2 . RESULTS: After multivariate adjustment, the highest quartiles of sedentary time showed a higher rate of kidney function decline than those in the lowest quartile (odds ratio 1.42, 95% CI 1.02-1.37). In addition, participants with a history of cancer (odds ratio 1.18, 95% CI 1.01-1.39) or hypertension (odds ratio 1.38; 95% CI 1.07-1.60) had significantly increased risks of kidney function decline in the highest sedentary time group, regardless of multivariate control. Furthermore, analyses showed an increased risk of kidney function decline for a history of both cancer and hypertension (odds ratio 2.02, 95% CI 1.08-3.80). CONCLUSIONS: A higher level of sedentary time was associated with kidney function decline among community-dwelling older adults. Geriatr Gerontol Int 2017; 17: 730-736.


Subject(s)
Creatinine/blood , Geriatric Assessment/methods , Glomerular Filtration Rate/physiology , Independent Living/statistics & numerical data , Renal Insufficiency, Chronic/physiopathology , Risk Assessment/methods , Sedentary Behavior , Aged , Female , Humans , Japan/epidemiology , Kidney Function Tests , Male , Morbidity/trends , Odds Ratio , Prognosis , Renal Insufficiency, Chronic/blood , Renal Insufficiency, Chronic/epidemiology , Risk Factors , Self Report , Severity of Illness Index , Sex Distribution
9.
J Aging Phys Act ; 25(1): 140-148, 2017 01.
Article in English | MEDLINE | ID: mdl-27620962

ABSTRACT

This study examined associations between perceived neighborhood environment and physical activity among frail older adults and whether these associations are moderated by fear of falling. Participants were 238 frail older adults. Daily step counts and duration of moderate-to-vigorous physical activity were measured using an accelerometer. Participants completed the abbreviated Neighborhood Environment Walkability Scale; fear of falling and demographic and health-related factors were measured by a questionnaire. The interaction between crime safety and fear of falling was significantly associated with step count (p = .009) and moderate-to-vigorous physical activity (p = .018) in multiple regression analysis. Stratified according to fear of falling, crime safety was significantly associated with steps (p = .007) and moderate-to-vigorous physical activity (p = .030) in the low fear of falling group. The results suggest that crime safety is associated with physical activity among frail older adults, and this association is moderated by fear of falling.


Subject(s)
Accidental Falls , Exercise/physiology , Fear , Frail Elderly , Residence Characteristics , Accelerometry , Aged , Female , Humans , Japan , Male
10.
Geriatr Gerontol Int ; 17(8): 1197-1204, 2017 Aug.
Article in English | MEDLINE | ID: mdl-27427234

ABSTRACT

AIM: Detecting cognitive impairment in the earlier stages is important for preventing or delaying dementia. To develop intervention strategies that promote screening for cognitive impairment, it is essential to identify the modifiable predictors for participation in screening. The present study examined whether participation in screening for cognitive impairment was predicted by the constructs of the health belief model, dementia worry and behavioral intentions to undergo screening among older adults. METHODS: The study used a prospective design. After a baseline questionnaire survey, participation in screening for cognitive impairment was followed for 6 months (n = 10 023). Participation in the screening, constructs of the health belief model (perceived susceptibility to dementia, perceived severity of dementia, perceived benefits of screening, perceived barriers to screening), dementia worry, behavioral intentions and demographic factors were measured. RESULTS: A path analysis showed that the behavioral intention to undergo screening (path coefficient = 0.29) directly predicted participation in screening for cognitive impairment, whereas other psychological and demographic factors did not directly predict participation. The behavioral intention was explained by the perceived benefits of screening (path coefficient = 0.51), perceived barriers to screening (path coefficient = -0.19) and perceived susceptibility to dementia (path coefficient = 0.16). CONCLUSIONS: Participation in screening for cognitive impairment was positively predicted by higher behavioral intention to undergo screening. In turn, this behavioral intention was mainly predicted by the perceived benefits of screening among older adults. These findings suggest that emphasizing the perceived benefits and encouraging behavioral intentions might promote participation in screening for cognitive impairment. Geriatr Gerontol Int 2017; 17: 1197-1204.


Subject(s)
Cognition Disorders/diagnosis , Independent Living/psychology , Surveys and Questionnaires , Age Factors , Aged , Aging/psychology , Cohort Studies , Early Diagnosis , Female , Geriatric Assessment/methods , Humans , Japan , Male , Mass Screening/methods , Mass Screening/psychology , Middle Aged , Patient Participation/statistics & numerical data , Predictive Value of Tests , Prospective Studies , Risk Assessment , Sex Factors
11.
Geriatr Gerontol Int ; 16(1): 65-73, 2016 Jan.
Article in English | MEDLINE | ID: mdl-25597479

ABSTRACT

AIMS: Identifying the risk factors of cognitive impairment is essential for implementing effective prevention strategies for dementia. Previous studies have shown that the frequency of going outdoors is inversely associated with cognitive decline. Little research has examined whether the relationship between going outdoors and cognitive decline varies with physical functioning in older adults. The aim of the present study was to examine the relationship between going outdoors and cognitive function in older adults with and without physical function limitations. METHODS: The present study analyzed the data of 4450 individuals (aged 65 years or older) who participated in the Obu Study of Health Promotion for the Elderly. The measures were the Mini-Mental State Examination (MMSE), going outdoors (at least once a week or not), self-reported physical function limitations (with or without), and demographic and health-related factors as potential confounders. RESULTS: Analysis of covariance and post-hoc comparisons showed that although going outdoors at least once a week was associated with higher MMSE scores among older adults with limited physical function, it was not significantly associated with the MMSE scores among older adults without limited physical function. Similarly, logistic regression analyses, stratified by physical function, showed a significant association between going outdoors and MMSE (<24 points or not) among older adults with limited physical function. CONCLUSIONS: The results show that going outdoors less than once a week is associated with decreased cognitive function among older adults with limited physical function, but it is not associated with cognitive function among older adults without limited physical function.


Subject(s)
Activities of Daily Living , Cognition Disorders/etiology , Cognition/physiology , Environment , Age Factors , Aged , Aged, 80 and over , Female , Health Status , Humans , Independent Living , Japan , Male , Risk Factors , Self Report , Socioeconomic Factors , Time Factors
12.
Geriatr Gerontol Int ; 16(5): 625-30, 2016 May.
Article in English | MEDLINE | ID: mdl-26044450

ABSTRACT

AIM: Self-reported exhaustion (SE) is a clinical complaint that is associated with a wide range of chronic diseases. However, the association of SE with physical activity, physical function or cognitive function among the older adult Japanese population is unclear. The present study aimed to determine the prevalence of SE, as well as whether physical function, cognitive function and physical activity were significant covariates. METHODS: A total of 4607 adults (mean age 71 years) were considered eligible for participation based on the study criteria. SE was evaluated using the Study of Osteoporotic Fracture Index. We also evaluated physical activity, physical function (grip strength, Timed Up & Go) and cognitive function (Mini-Mental State Examination, Trail Making Test part A and B, Symbol Digit Substitution Task). RESULTS: The prevalence of SE ranged from 40.9% to 55.0%, and significantly increased with age. The results of the multiple logistic regression analyses showed that in the adjusted model of the 65-69 years age group, physical activity, Timed Up & Go and Symbol Digit Substitution Task were independently associated with SE. In the 70-79 years age group, physical activity, Timed Up & Go, Trail Making Test part A and B and Symbol Digit Substitution Task were independently associated with exhaustion. Only physical activity was associated with exhaustion in the ≥80 years age group. CONCLUSIONS: The prevalence of SE increased with age in the older adult Japanese population. Exhaustion was strongly associated with reduced daily physical activity, especially in those aged ≥80 years. Further studies should be carried out to determine if physical activity causes SE. Geriatr Gerontol Int 2016; 16: 625-630.


Subject(s)
Exercise , Fatigue/physiopathology , Fatigue/psychology , Age Factors , Aged , Aged, 80 and over , Cognition , Cohort Studies , Female , Hand Strength , Humans , Japan , Male , Self Report , Socioeconomic Factors , Task Performance and Analysis
13.
Am J Health Behav ; 39(3): 294-300, 2015 May.
Article in English | MEDLINE | ID: mdl-25741674

ABSTRACT

OBJECTIVE: To examine the relationships between smoking status and various domains of cognitive function in community-dwelling elderly subjects. METHODS: Participants (N = 4348) were asked about smoking status, demographic variables, and lifestyle factors, and underwent multidimensional neurocognitive tests. RESULTS: All analyses were conducted separately by sex. Women never smokers exhibited significantly better scores than past and/or current smokers in some neurocognitive tests. Among men, never smokers had significantly higher scores, such as in the Symbol Digit Substitution Test. Multiple linear regression analysis showed that pack-years (history of smoking) were significantly associated with the Symbol Digit Substitution Test in men. CONCLUSIONS: Smoking status may be associated with a decline in processing speed, and this decline varies by sex.


Subject(s)
Aging/physiology , Cognition/physiology , Neuropsychological Tests/statistics & numerical data , Smoking/epidemiology , Aged , Aging/drug effects , Cognition/drug effects , Female , Humans , Japan/epidemiology , Male , Sex Factors , Smoking/adverse effects
14.
J Am Med Dir Assoc ; 16(4): 349.e1-5, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25669668

ABSTRACT

OBJECTIVES: The aim of this study was to evaluate the relationship between chronic kidney disease (CKD) and cognitive decline in community-dwelling older adults without dementia. DESIGN: Cross-sectional. SETTING: Obu Study of Health Promotion for the Elderly in Japan. PARTICIPANTS: The participants were 4686 residents (community-dwelling older adults without dementia) who completed baseline assessments. MEASUREMENTS: The estimated glomerular filtration rate (eGFR, mL/min/1.73 m(2)) was determined according to the creatinine level, and participants were classified into three mutually exclusive categories: normal (≥60.0 mL/min/1.73 m(2)), mild CKD (45.0-59.9 mL/min/1.73 m(2)), or moderate to severe CKD (<45.0 mL/min/1.73 m(2)). Cognitive function was assessed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool. Multivariate logistic regression was used to examine the relationships between eGFR and cognitive decline. RESULTS: After multivariate adjustment, participants with lower eGFR had lower cognitive function scores on most domains (P < .05). In particular, participants with advanced CKD (eGFR <45 mL/min/1.73 m(2)) were more likely to have significant cognitive decline on the Trail Making Test part A (odds ratio = 2.347, 95% confidence interval = 1.525-3.614) and the Symbol Digit Substitution Task (odds ratio = 2.308, 95% confidence interval = 1.486-3.585) than those with normal and mild CKD. CONCLUSIONS: A lower level of kidney function was associated with lower cognitive performance in attention and processing speed. These results suggest that eGFR might be an effective method to screen for cognitive decline in community-dwelling older adults.


Subject(s)
Cognition Disorders/epidemiology , Glomerular Filtration Rate/physiology , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/epidemiology , Age Distribution , Aged , Aged, 80 and over , Cognition Disorders/diagnosis , Comorbidity , Confidence Intervals , Cross-Sectional Studies , Disease Progression , Female , Humans , Independent Living , Japan , Kidney Function Tests , Logistic Models , Male , Multivariate Analysis , Odds Ratio , Prevalence , Prognosis , Risk Assessment , Severity of Illness Index , Sex Distribution , Survival Analysis
15.
J Am Med Dir Assoc ; 16(3): 194-9, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25307294

ABSTRACT

OBJECTIVE: The purpose of this study was to determine whether frailty is an important and independent predictor of incident depressive symptoms in elderly people without depressive symptoms at baseline. DESIGN: Fifteen-month prospective study. SETTING: General community in Japan. PARTICIPANTS: A total of 3025 community-dwelling elderly people aged 65 years or over without depressive symptoms at baseline. MEASUREMENTS: The self-rated 15-item Geriatric Depression Scale was used to assess symptoms of depression with a score of 6 or more at baseline and 15-month follow-up. Participants underwent a structural interview designed to obtain demographic factors and frailty status, and completed cognitive testing with the Mini-Mental State Examination and physical performance testing with the Short Physical Performance Battery as potential predictors. RESULTS: At a 15-month follow-up survey, 226 participants (7.5%) reported the development of depressive symptoms. We found that frailty and poor self-rated general health (adjusted odds ratio 1.86, 95% confidence interval 1.30-2.66, P < .01) were independent predictors of incident depressive symptoms. The odds ratio for depressive symptoms in participants with frailty compared with robust participants was 1.86 (95% confidence interval 1.05-3.28, P = .03) after adjusting for demographic factors, self-rated general health, behavior, living arrangements, Mini-Mental State Examination, Short Physical Performance Battery, and Geriatric Depression Scale scores at baseline. CONCLUSIONS: Our findings suggested that frailty and poor self-rated general health were independent predictors of depressive symptoms in community-dwelling elderly people.


Subject(s)
Depression/diagnosis , Frail Elderly/psychology , Geriatric Assessment/methods , Health Promotion , Motor Activity/physiology , Age Distribution , Aged , Aged, 80 and over , Cohort Studies , Depression/epidemiology , Female , Humans , Incidence , Independent Living , Japan , Longitudinal Studies , Male , Neuropsychological Tests , Prognosis , Retrospective Studies , Severity of Illness Index , Sex Distribution
16.
Front Aging Neurosci ; 6: 69, 2014.
Article in English | MEDLINE | ID: mdl-24782766

ABSTRACT

OBJECTIVE: The clinical relationship between brain-derived neurotrophic factor (BDNF) and cognitive function or mild cognitive impairment (MCI) is not well-understood. The purpose of this study was to identify the relationship between serum BDNF and cognitive function and MCI, and determine whether serum BDNF level might be a useful biomarker for assessing risk for MCI in older people. MATERIALS AND METHODS: A total of 4463 individuals aged 65 years or older (mean age 72 years) participating in the study. We measured performance in a battery of neuropsychological and cognitive function tests; serum BDNF concentration. RESULTS: Eight hundred twenty-seven participants (18.8%) had MCI. After adjustment for sex, age, education level, diabetes, and current smoking, serum BDNF was associated with poorer performance in the story memory, and digit symbol substitution task scores. Serum BDNF was marginally associated with the presence of MCI (odds ratio, 95% confidence interval: 1.41, 1.00-1.99) when BDNF was 1.5 SD lower than the mean value standardized for sex and age, education level, diabetes, and current smoking. CONCLUSION: Low serum BDNF was associated with lower cognitive test scores and MCI. Future prospective studies should establish the discriminative value of serum BDNF for the risk of MCI.

17.
Maturitas ; 78(1): 62-6, 2014 May.
Article in English | MEDLINE | ID: mdl-24685290

ABSTRACT

OBJECTIVES: Few studies have reported the relationship between fear of falling (FoF) and mild and global cognitive impairment in community-dwelling older adults. We aimed to determine whether the status of cognitive impairment affects the prevalence of FoF in community-dwelling older adults. STUDY DESIGN: Cross-sectional study among 4474 community-dwelling older adults who participated in the Obu Study of Health Promotion for the Elderly. MAIN OUTCOME MEASURES: Participants underwent cognitive tests and were divided into three groups: cognitive healthy, mild cognitive impairment (MCI), and global cognitive impairment (GCI). FoF and related variables, such as fall history, physical function, and depression, were also investigated. RESULTS: The prevalence of FoF was significantly different by group (p<0.001; healthy: 43.6%, MCI: 50.6%, GCI: 40.6%). Logistic regression analysis showed that GCI (odds ratio=0.63; 95% confidence interval=0.526-0.76) was independently associated with FoF, after controlling for confounding factors. Older adults with GCI showed the lowest prevalence of FoF, although they had the lowest physical function comparing with the other groups (p<0.001). CONCLUSION: MCI and GCI in community-dwelling older adults affect the prevalence of FoF in a completely different manner. Further study is required to determine whether insensitivity to FoF with GCI increases the risk of falling in older adults.


Subject(s)
Accidental Falls , Cognition Disorders/psychology , Fear , Geriatric Assessment , Independent Living , Severity of Illness Index , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Logistic Models , Male , Odds Ratio , Prevalence , Residence Characteristics , Stress, Psychological/epidemiology , Stress, Psychological/etiology
18.
BMC Neurol ; 14: 67, 2014 Apr 01.
Article in English | MEDLINE | ID: mdl-24694100

ABSTRACT

BACKGROUND: Gait ability and cognitive function are interrelated during both normal walking (NW) and dual-task walking (DTW), and gait ability is thus adversely affected by cognitive impairment in both situations. However, this association is insufficiently understood in people with mild cognitive impairment (MCI). Here, we conducted a study with MCI participants, to examine whether the association depends on walking conditions and MCI subtypes. METHODS: We classified 389 elderly adults into amnestic MCI (n = 191) and non-amnestic MCI (n = 198), assessed their cognitive functions, and administered gait experiments under NW and DTW conditions. Gait ability was defined as gait speed. Five aspects of cognitive function were assessed: processing speed, executive function, working memory, verbal memory, and visual memory. RESULTS: Regression analysis adjusted for covariates showed a significant association between cognitive functions and gait speed. Processing speed and executive function correlated with gait speed during both NW and DTW (p < .05). Gait speed during DTW was also significantly associated with working memory (p < .001). Visual memory was associated during NW and DTW, particularly for amnestic MCI participants (p < .05). CONCLUSIONS: Our findings support the idea that the association between gait speed and cognitive function depends on walking condition and MCI subtypes. Additional studies are necessary to determine the neural basis for the disruption in gait control in older adults with MCI.


Subject(s)
Cognition , Cognitive Dysfunction/complications , Gait , Walking , Attention , Cohort Studies , Female , Humans , Male , Neuropsychological Tests , Task Performance and Analysis
19.
Arch Gerontol Geriatr ; 58(3): 327-31, 2014.
Article in English | MEDLINE | ID: mdl-24525136

ABSTRACT

The purpose of this study was to examine whether the combined factors of physical performance, depressive symptoms and cognitive status are significantly associated with a history of falling in community-dwelling elderly. We performed a cross-sectional community-based survey, the OSHPE, from August 2011 to February 2012. In total, 5104 community-dwelling older adults aged 65 years and older (mean age 72.0) participated in the OSHPE. Participants underwent a grip strength (GS) test, chair stand test (CST), Timed Up & Go (TUG) test, Geriatric Depression Scale (GDS), and Mini-Mental State Examination (MMSE). Of the 4481 participants who met our requirements, 645 (14.4%) participants reported falling at least once in the past year. In a signal detection analysis (SDA), we found that the combination of GDS (≥6 points) and TUG (≥10.6 s) had the highest fall rate (36.4%), and the combination of GDS (<6 points) and CST (<11.1 s) had the lowest fall rate (11.7%). The highest fall rate group had a significantly higher odds ratio (OR) compared with the lowest fall rate group after adjusting for other potentially confounding variables [OR 3.12 (95% confidence interval (CI) 2.08-4.68) p<0.001]. The combination of depressive symptoms, TUG, and CST performance was strongly associated with a history of falling in community-dwelling elderly.


Subject(s)
Accidental Falls/statistics & numerical data , Depression/complications , Geriatric Assessment/methods , Physical Fitness/psychology , Psychomotor Performance/physiology , Aged , Aged, 80 and over , Cognition/physiology , Cohort Studies , Cross-Sectional Studies , Depression/psychology , Female , Health Promotion/methods , Humans , Male , Odds Ratio , Regression Analysis , Residence Characteristics
20.
Geriatr Gerontol Int ; 14 Suppl 1: 46-51, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24450560

ABSTRACT

AIM: Several operative definitions and screening methods for sarcopenia have been proposed in previous studies; however, the opinions of researchers still differ. We compared the prevalence of sarcopenia using two different algorithms: (i) the European working group on sarcopenia in older people (EWGSOP)-suggested algorithm using gait speed as the first step; and (ii) the muscle mass and strength algorithm. METHODS: A population-based, cross-sectional survey of adults aged over 65 years was carried out. Data on a total of 4811 participants were available for analysis. Gait speed, grip strength and appendicular skeletal muscle mass were assessed to determine sarcopenia. Appendicular skeletal muscle mass was estimated from bioimpedance analysis measurements and expressed as skeletal muscle mass index. Grip strength and skeletal muscle mass index were considered to be low if they fell below the threshold of the lowest 20% of values measured in a subset of healthy subjects. We compared the prevalence rates of sarcopenia determined by the two algorithms. RESULTS: The prevalence rate of sarcopenia in a representative sample of older Japanese adults was 8.2% for men and 6.8% for women based on the EWGSOP algorithm. The two algorithms identified the same participants as sarcopenic, the only difference being the EWGSOP algorithm classified an additional seven participants (0.15%) into sarcopenia compared with the muscle mass and strength algorithm. CONCLUSION: It is debatable whether inclusion of gait speed is necessary when screening for sarcopenia in community-dwelling older adults. Future research should examine the necessity of including gait speed in algorithms and the validity of cut-off values.


Subject(s)
Algorithms , Geriatric Assessment/methods , Mass Screening/methods , Sarcopenia/epidemiology , Aged , Aged, 80 and over , Cross-Sectional Studies , Electric Impedance , Female , Follow-Up Studies , Gait/physiology , Humans , Japan/epidemiology , Male , Muscle Strength/physiology , Muscle, Skeletal/physiopathology , Prevalence , Retrospective Studies , Sarcopenia/physiopathology
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