Water balance in Japanese male kendo college athletes during training: a pilot study assessing seasonal differences with adjusted energy expenditure.

BACKGROUND: Due to various factors, water balance may vary across seasons. These effects may be particularly prominent in athletes and dependent upon energy expenditure during training. METHODS: Japanese male kendo college athletes participated in this study during their training sessions. The participants were observed for three days each season, i.e., in spring, summer, and winter. The energy expenditure of the participants during training was monitored using the heart rate method. Data regarding the total amount of sweating, rate of sweating, amount of water intake, and rate of water intake were collected for each season and the differences were assessed using analysis of covariance, with energy expenditure as the covariate. RESULTS: The water balance parameter values observed during a kendo training session in summer were the highest, whereas these values were significantly reduced in winter. Energy expenditure was the highest in spring. The amount of sweating per energy expenditure varied seasonally, reaching as high as 2.14 g/kcal in summer. After adjusting for the influence of energy expenditure, the amount of sweating, amount of water intake, and water intake rate varied significantly by seasons, with the highest values in summer (P<0.001). The sweating rate was high in all the seasons, but the highest rate was observed in summer, followed by spring and then winter. There was a significant difference in the sweating rate in each season (P<0.001). The rehydration rate was 28% in spring, 39% in summer, and 22% in winter. CONCLUSIONS: After adjusting for the influence of energy expenditure, seasonal differences in water balance were observed in Japanese male kendo college athletes during training. These results suggest that water intake is essential after training in any season to maintain the water balance of the body.

Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts.

BACKGROUND: Although 10 000 steps per day is widely promoted to have health benefits, there is little evidence to support this recommendation. We aimed to determine the association between number of steps per day and stepping rate with all-cause mortality. METHODS: In this meta-analysis, we identified studies investigating the effect of daily step count on all-cause mortality in adults (aged ≥18 years), via a previously published systematic review and expert knowledge of the field. We asked participating study investigators to process their participant-level data following a standardised protocol. The primary outcome was all-cause mortality collected from death certificates and country registries. We analysed the dose-response association of steps per day and stepping rate with all-cause mortality. We did Cox proportional hazards regression analyses using study-specific quartiles of steps per day and calculated hazard ratios (HRs) with inverse-variance weighted random effects models. FINDINGS: We identified 15 studies, of which seven were published and eight were unpublished, with study start dates between 1999 and 2018. The total sample included 47 471 adults, among whom there were 3013 deaths (10·1 per 1000 participant-years) over a median follow-up of 7·1 years ([IQR 4·3-9·9]; total sum of follow-up across studies was 297 837 person-years). Quartile median steps per day were 3553 for quartile 1, 5801 for quartile 2, 7842 for quartile 3, and 10 901 for quartile 4. Compared with the lowest quartile, the adjusted HR for all-cause mortality was 0·60 (95% CI 0·51-0·71) for quartile 2, 0·55 (0·49-0·62) for quartile 3, and 0·47 (0·39-0·57) for quartile 4. Restricted cubic splines showed progressively decreasing risk of mortality among adults aged 60 years and older with increasing number of steps per day until 6000-8000 steps per day and among adults younger than 60 years until 8000-10 000 steps per day. Adjusting for number of steps per day, comparing quartile 1 with quartile 4, the association between higher stepping rates and mortality was attenuated but remained significant for a peak of 30 min (HR 0·67 [95% CI 0·56-0·83]) and a peak of 60 min (0·67 [0·50-0·90]), but not significant for time (min per day) spent walking at 40 steps per min or faster (1·12 [0·96-1·32]) and 100 steps per min or faster (0·86 [0·58-1·28]). INTERPRETATION: Taking more steps per day was associated with a progressively lower risk of all-cause mortality, up to a level that varied by age. The findings from this meta-analysis can be used to inform step guidelines for public health promotion of physical activity. FUNDING: US Centers for Disease Control and Prevention.

Salt Restriction Affects the Excretions of Minerals (Na, K, Ca, Mg, P and Zn) in the Second Voided Fasting Early Morning Urine.

The plasma concentrations of mineral (sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), phosphorus (P), and zinc (Zn)) are kept within narrow ranges to maintain homeostasis; hence, it is difficult to use them as indicators of nutritional status. We selected the excretion of these minerals in the second voided fasting early morning urine (EMU) as potential indicators of nutritional status. We previously reported that Na restriction caused a negative balance of Ca and Mg. Therefore, Na restriction can cause changes in EMU-minerals. This study aimed to examine the relationship between dietary Na restriction and urinary mineral excretion. The study lasted for 21 d, including 16 d of balance period and 3 d of recovery period. The participants (11 healthy young women) were divided into the Na restriction group (n=5) (NaCl: 6 g/d) and control group (n=6) (NaCl: 12 g/d). The Na restriction group changed to the control diet (NaCl: 12 g/d) during only the recovery period. The EMU-Na, Ca, Mg, P and Zn in the Na restriction group significantly decreased compared with that of the control group. The EMU-Na, K, Ca, Mg, and Zn in the group with NaCl intake of 6 g/d significantly decreased compared with that of the group with NaCl intake of 12 g/d (in the Na restriction group). We conclude that the decrease in excretion of Na, Ca, Mg and Zn in the EMU can lead to Na restriction. This result can serve as basis when considering EMU as an indicator of mineral status.

Promoting Stair Climbing as an Exercise Routine among Healthy Older Adults Attending a Community-Based Physical Activity Program.

Stair climbing provides a feasible opportunity for increasing physical activity (PA) in daily living. The purpose of this study was to examine the daily walking and stair-climbing steps among healthy older adults (age: 74.0 ± 4.9 years; Body Mass Index (BMI): 22.3 ± 2.5 kg/m²). Participants (34 females and 15 males) attended a weekly 6-month community-based PA program. During the entire program period, daily walking and stair-climbing steps were recorded using a pedometer (Omron, HJA-403C, Kyoto, Japan). Before and after the 6-month program, height, body weight and leg muscle strength were assessed. After the 6-month program, the mean walking and stair-climbing steps in both women and men increased significantly (p ≤ 0.01). Daily stair-climbing steps increased about 36 steps in women and 47 steps in men. At the end of 6 months, only male participants had significant correlation between the number of stair steps and leg muscle strength (r = 0.428, p = 0.037). This study reported that healthy older adults attending the community-based PA program had regular stair-climbing steps during daily living. Promoting stair climbing as an exercise routine was feasible to increase their walking and stair-climbing steps.

Dietary Salt (Sodium Chloride) Requirement and Adverse Effects of Salt Restriction in Humans.

Inevitable sodium loss under sodium restriction must not be construed as evidence for the estimated average requirement (EAR) for sodium (Na) in humans. We conducted human mineral balance studies to determine the EAR for some minerals (Na, K, Ca, Mg, P, Zn, Fe, Cu and Mn). Na concentration in arm sweat was low while those of calcium (Ca) and magnesium (Mg) were high, during relatively heavy bicycle-ergometer exercise under relatively low Na intake (100 mmol/d). This suggests that Na was released from the bone, the sole pool of Na, with Ca and Mg. Additionally, the negative balances of Ca and Mg was observed under a relatively low sodium intake (100 mmol/d) even with the sufficient supply and intake of Ca and Mg into human body. Finally, we found no correlation between the Na intake and the Na balance, while the Na-intake was correlated significantly to the balances of K, Ca and Mg. The Na intake necessary to keep the balances of Ca and Mg positive was calculated to be 68 mg/kg body weight/d. To learn the signs and symptoms of low sodium intake, we compared the results of a metabolic study in which subjects consumed diets with 6 g and 12 g salt/d respectively. The blood pressure decreased only with the 6 g/d group. Fecal moisture contents of the 6 g/d group were lower than for the 12 g/d group, suggesting the fecal Na was strongly reabsorbed with water when the dietary Na was insufficienct. Indiscriminate Na restriction may have adverse effects on health.

Daily step count and all-cause mortality in a sample of Japanese elderly people: a cohort study.

BACKGROUND: This study aimed to examine the relationship between pedometer-assessed daily step count and all-cause mortality in a sample of elderly Japanese people. METHODS: Participants included 419 (228 males and 191 females) physically independent, community-dwelling 71-year-old Japanese people. The number of steps per day was measured by a waist-mounted pedometer for seven consecutive days at baseline. Participants were divided into quartiles based on their average number of steps/day (first quartile, < 4503 steps/day; second quartile, 4503-6110 steps/day; third quartile, 6111-7971 steps/day; fourth quartile, > 7972 steps/day) and were followed up over a mean period of 9.8 years (1999-2010) for mortality. RESULTS: Seventy-six participants (18.1%) died during the follow-up period. The hazard ratios (adjusted for sex, body mass index, cigarette smoking, alcohol intake, and medication use) for mortality across the quartiles of daily step count (lowest to highest) were 1.00 (reference), 0.81 (95%CI, 0.43-1.54), 1.26 (95%CI, 0.70-2.26), and 0.46 (95%CI, 0.22-0.96) (P for trend = 0.149). Participants in the highest quartile had a significantly lower risk of death compared with participants in the lowest quartile. CONCLUSION: This study suggested that a high daily step count is associated with a lower risk of all-cause mortality in physically independent Japanese elderly people.

Sleep disorder risk factors among student athletes.

OBJECTIVE: To clarify sleep disorder risk factors among student athletes, this study examined the relationship between lifestyle habits, competition activities, psychological distress, and sleep disorders. METHODS: Student athletes (N = 906; male: 70.1%; average age: 19.1 ± 0.8 years) in five university sports departments from four Japanese regions were targeted for analysis. Survey items were attributes (age, gender, and body mass index), sleep disorders (recorded through the Pittsburgh Sleep Quality Index), lifestyle habits (bedtime, wake-up time, smoking, drinking alcohol, meals, part-time jobs, and use of electronics after lights out), competition activities (activity contents and competition stressors), and psychological distress (recorded through the K6 scale). The relation between lifestyle habits, competition activities, psychological distress, and sleep disorders was explored using logistic regression analysis. RESULTS: Results of multivariate logistic regression analysis with attributes as adjustment variables showed that "bedtime," "wake-up time," "psychological distress," "part-time jobs," "smartphone/cellphone use after lights out," "morning practices," and "motivation loss stressors," were risk factors that were independently related to sleep disorders. CONCLUSIONS: Sleep disorders among student athletes are related to lifestyle habits such as late bedtime, early wake-up time, late night part-time jobs, and use of smartphones/cellphones after lights out; psychological distress; and competition activities such as morning practices and motivation loss stressors related to competition. Therefore, this study suggests the importance of improving these lifestyle habits, mental health, and competition activities.

Dentition status and frailty in community-dwelling older adults: A 5-year prospective cohort study.

AIM: To examine the longitudinal association between dentition status and incidence of frailty in older adults. METHODS: The present prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Dental examinations, biochemical blood examinations, physical performance and anthropometric measurements, and structured questionnaires were carried out at baseline. The presence of ≥20 teeth with nine or more occluding pairs of teeth was defined as functional dentition. Annual follow-up examinations, including physical performance, anthropometric measurements and structured questionnaires, were carried out over a 5-year period to determine the incidence of frailty, defined as three or more of the following five components derived from the Cardiovascular Health Study: weight loss, weakness, slowness, poor energy and low physical activity level. Adjusted hazard ratios of frailty incidence according to dentition status were calculated from Cox proportional hazards regression analyses. RESULTS: At baseline, 118 participants (36.6%) were defined as having functional dentition. During the follow up, 48 participants (14.9%) developed frailty. The adjusted hazard ratio for frailty in participants with functional dentition was 0.50 (95% confidence interval 0.25-0.98) compared with participants without functional dentition, after adjusting for sex, income, education, smoking status, body mass index, serum biomarkers and comorbidities. CONCLUSIONS: Functional dentition was significantly associated with a lower risk of frailty defined by the Cardiovascular Health Study frailty index in older Japanese adults. These results suggest that maintaining healthy and functional dentition into later life is important for frailty prevention. Geriatr Gerontol Int 2018; 18: 256-262.

Physical Activity: A Viable Way to Reduce the Risks of Mild Cognitive Impairment, Alzheimer's Disease, and Vascular Dementia in Older Adults.

A recent alarming rise of neurodegenerative diseases in the developed world is one of the major medical issues affecting older adults. In this review, we provide information about the associations of physical activity (PA) with major age-related neurodegenerative diseases and syndromes, including Alzheimer's disease, vascular dementia, and mild cognitive impairment. We also provide evidence of PA's role in reducing the risks of these diseases and helping to improve cognitive outcomes in older adults. Finally, we describe some potential mechanisms by which this protective effect occurs, providing guidelines for future research.

CD56(dim)CD16(high) and CD56(bright)CD16(-) cell percentages associated with maximum knee extensor strength and incidence of death in elderly.

Physical fitness is an indicator of systemic well-being in humans. Little is known about the role of physical fitness for maintaining systemic health in the elderly. Here, we study elderly subjects to determine the relationships between physical fitness and CD56 and CD16 surface NK cell markers on peripheral blood lymphocytes, as well as to analyze the relationship between the surface markers and incidence of death. We selected 253 independent elderly subjects (122 female; 131 male) who were 79-80 years old. Subjects having a higher proportion of CD56(dim)CD16(high) within CD56(+)CD16(+) cells, or ration of CD56(dim)CD16(high) and CD56(dim)CD16(-) cells had a significant positive correlation with maximum bilateral knee extensor strength/weight (kg) (r = 0.425; P < 0.0001 or r = 0.323; P < 0.0001). In contrast, an increased proportion of CD56(bright)CD16(-) cells within lymphocyte significantly negatively correlated with the maximum bilateral knee extensor strength/weight (kg) (r = -0.290; P = 0.0004); and these subjects had a significantly lower mortality during the 5 years following measurement of death. Therefore, we found that a synergistic effect of the right and left leg muscle strength was associated with proportion of matured NK and NKT cells and induced a low proportion of CD56(bright)CD16(-) cells within lymphocyte. Moreover, the low proportion of CD56(bright)CD16(-) cells was associated with incidence of death. In conclusion, measurements of physical fitness, the proportion of CD56(dim)CD16(high) within CD56(+)CD16(+) cells, the ratio of CD56(dim)CD56(high) and CD56(dim)CD16(-) cells, and the proportion of CD56(bright)C16(-) cells in lymphocytes are important indicators to check elderly health.

Tracking of Pedometer-Determined Physical Activity in Healthy Elderly Japanese People.

BACKGROUND: Tracking refers to the tendency for an individual to maintain their rank within a group over time. This study longitudinally investigated the 8-year tracking of pedometer-determined physical activity among physically independent elderly Japanese people aged 72 to 80 years. METHODS: Steps/day were measured when participants were aged 72 and assessed again after 2, 5, and 8 years. The number of participants with a 2-year follow-up (72 to 74 years) was 177 (101 males, 76 females), with a 5-year follow-up (72 to 77 years) was 183 people (110 males, 73 females), and with an 8-year follow-up (72 to 80 years) was 145 people (91 males, 54 females). Step counts were continuously measured for 1 week in January, April, July, and October during each year of assessment. RESULTS: A high rank correlation coefficient for steps/day exceeding 0.60 was obtained at the 2-, 5- and 8-year follow-up examinations for both males and females. CONCLUSION: This study suggests that the rank within a group of pedometer-determined steps/day remains stable over up to 8 years in healthy Japanese people aged between 72 to 80 years old.

The effect of fast eating on the thermic effect of food in young Japanese women.

The relationship between eating speed and the thermic effect of food (TEF) remains unclear. We investigated the difference in the TEF when meals containing the same amount of energy were eaten in 5 min (fast eating) or 15 min (regular eating). Subjects were nine non-obese young women. Following a 350 kcal (1464 kJ) meal, energy expenditure and autonomic nervous system activity were measured. The frequency of mastication was also calculated. The TEF for the 15-min period after the start of eating with fast eating was significantly lower than with regular eating (p < 0.01). There was a significant positive correlation between the low-frequency/high-frequency ratio and TEF at 5-min intervals up to 20 min after the start of eating and between total mastication frequency and TEF during ingestion. Fast eating may reduce the TEF, potentially because a decrease in mastication frequency decreases sympathetic nervous system activity.

Physical performance and 10-year mortality in a 70-year-old community-dwelling population.

BACKGROUND AND AIMS: Poor physical performance is known to be inversely related to mortality. The purpose of the present study was to determine whether an association between physical performance and 10-year mortality could be extended to a Japanese 70-year-old community-dwelling population, and to compare findings with those found in an octogenarian population. METHODS: Seventy-year-old subjects residing in Niigata city, Japan, participated. Baseline examinations, including a physical performance test of four tests of muscle strength, one test of balance, and one test of agility, were carried out in June 1998 for 600 participants, and these individuals were then followed for 10 years. RESULTS: During the 10-year follow up, 80 subjects died. Cox regression analysis with adjustment for confounding factors showed that high scores in muscle strength tests for lower extremities, such as single-leg and double-leg extensor strength and isokinetic leg extensor power, were found to be related to decreases in total cause mortality. CONCLUSIONS: In an elderly 70-year-old Japanese community-dwelling population, poor muscle strength was found to be an independent predictor of total mortality. Together with our previous findings in an 80-year-old population, the association between poor strength and high mortality may have effects at 70 but not 80 years of age.

Estimated equilibrated dietary intakes for nine minerals (Na, K, Ca, Mg, P, Fe, Zn, Cu, and Mn) adjusted by mineral balance medians in young Japanese females.

The present study sought to determine estimated equilibrated dietary intakes (EEDIs) for nine essential minerals: sodium (Na), potassium (K), calcium (Ca), magnesium (Mg), phosphorus (P), iron (Fe), zinc (Zn), copper (Cu), and manganese (Mn), using data from 17 human mineral balance studies conducted from 1986 to 2007 (subjects=178). Among these studies, two used male subjects, two subjected some or all subjects to sodium restriction, and one study utilized a low protein diet; these subjects were not included in the present analysis. Consequently, data from 13 studies of young female subjects (n=131) consuming a standard diet were selected. Balance distribution medians for six of the minerals (Na, K, Mg, Fe, Zn and Cu) were positive, so the data were adjusted to set the medians of the balances to zero. Medians for the other minerals (Ca, P and Mn) were close to zero and were not adjusted. Intake and balance for each mineral were divided by body weight (BW), lean body mass (LBM), and standard body weight (SBW), which was calculated using height and standard body mass index (BMI=22), and EEDIs were calculated as the intercept of a simple regression equation. When relationships between intake and balance of a mineral were not significant in the regression equation, a significant regression equation comparing intake and balance of another mineral was used to calculate the intercept. Significant simple regression equations were not obtained from any of the three parameters of Na or Zn, or for two of the parameters of P; thus, K, Fe and Ca balances were used to determine the intercepts for Na, Zn and P, respectively. EEDIs for the minerals were: Na (67.9, 89.0, 62.5), K (39.5, 53.5, 37.4), Ca (11.0, 14.4, 10.1), Mg (4.18, 5.51, 3.86), P (18.7, 24.6, 17.3) (mg/kg BW/d, mg/kg LBM/d, mg/kg SBW/d), Fe (180, 237, 165), Zn (181, 241, 166), [corrected] Cu (32.3, 42.6, 29.7), [corrected] Mn (55.1, 72.1, 50.7) (µg/kg BW/d, µg/kg LBM/d, µg/kg SBW/d), respectively. These values are nearly identical to the mean dietary intakes.

Physical fitness and 6.5-year mortality in an 85-year-old community-dwelling population.

Although poor physical fitness is known to be associated with increased mortality in adult and elderly populations, this association is not conclusive in very elderly. The purpose of the present study was to evaluate the association for a very old community-dwelling population. The participants (90 males, 117 females) were 85-year-old individuals residing in Fukuoka, Japan. Baseline examinations including muscle strength of the handgrip and leg extension, one-leg standing, leg stepping rate, and walking were performed in 2003 and these subjects were followed for 6.5 years. During the follow-up period, 81 individuals (49 males and 32 females) died. Handgrip strength and leg extension strength at age 85 were stronger in surviving men than in non-survivors. Total mortality adjusted for both gender and serum level of total cholesterol fell 5-6% with a 1-kg increase in the handgrip strength of a single hand or both hands. Total mortality also decreased 2% with a 1 kg increase in the leg extension strength of both legs. With adjustment for gender and total cholesterol, mortality fell by 57% in participants of the walking test and fell by 45% in participants of the stepping-rate test compared to mortality in nonparticipants. No association was found between mortality and participation in the handgrip strength test, leg extension strength test, or one-leg standing time test. In conclusion, not only poor muscle strength in handgrip or leg extension, but also nonparticipation in walking test or leg-stepping test were independent predictors of total mortality in a very elderly population.

Equilibrium energy intake estimated by dietary energy intake and body weight changes in young Japanese females.

To determine the energy intake (EI) required to maintain body weight (equilibrium energy intake: EEI), we investigated the relationship between calculated energy intake and body weight changes in female subjects participating in 14 human balance studies (n=149) conducted at the National Institute of Health and Nutrition (Tokyo). In four and a half studies (n=43), sweat was collected from the arm to estimate loss of minerals through sweating during exercise on a bicycle ergometer; these subjects were classified in the exercise group (Ex G). In nine and a half experiments (n=106) subjects did not exercise, and were classified in the sedentary group (Sed G). The relationship between dietary energy intake (EI) and body weight (BW) changes (ΔBW) was analyzed and divided by four variables: body weight (BW), lean body mass (LBM), standard body weight (SBW), and body surface area (BSA). Equilibrium energy intake (EEI) and 95% confidence interval (CI) for EEI in Ex G were 34.3 and 32.8-35.9 kcal/kg BW/d, 32.0 and 30.8-33.1 kcal/kg SBW/d, 46.3 and 44.2-48.5 kcal/kg LBW/d, and 1,200 and 1,170-1,240 kcal/m(2) BSA/d, respectively. EEI and 95% CI for EEI in Sed G were 34.5 and 33.9-35.1 kcal/kg BW/d, 31.4 and 30.9-32.0 kcal/kg SBW/d, 44.9 and 44.1-45.8 kcal/kg LBM/d, and 1,200 and 1,180-1,210 kcal/m2 BSA/d, respectively. EEIs obtained in this study are 3 to 5% higher than estimated energy requirement (EER) for Japanese. In five out of six analyses, EER in a population (female, 18-29 y, physical activity level: 1.50) was under 95% CI of EEI obtained in this study.

Influence of dental occlusion on physical fitness decline in a healthy Japanese elderly population.

The aim of this study was to clarify the relationship between dental occlusion and physical fitness by a longitudinal survey. A sample of 348 subjects (171 men and 177 women) aged 71 was investigated by Eichner index (EI) as an occlusal condition (Class A: no loss; Class B: partial loss; Class C: complete loss) and five types of physical fitness tests and were re-examined 8 years later. The upper 50% were sampled to analyze the correlation between each physical fitness decline and the EI at the baseline by logistic regression models. Logistic regression analyses revealed that leg extensor power (Class B vs. Class A; odds ratio=OR=4.61, p=0.010) and one-leg standing time with eyes open (Class C vs. Class A; OR=4.27, p=0.031) showed significant correlations with the EI at the baseline. In this study, partial or complete loss of occlusion was associated with a decline in leg extensor power or a decrease in one-leg standing time with eyes open. These findings suggest that maintenance of dental occlusion may prevent a decrease in activities of daily living in the elderly.

The relationship between physical fitness and ambulatory activity in very elderly women with normal functioning and functional limitations.

The effect of daily ambulatory activity on physical fitness has not yet been identified by quantitatively measuring the time spent on the intensity levels of ambulatory activity in elderly women over 75 with different functional capacity levels. The subjects consisted of 147 elderly women over 75 years old (82.8±4.3 years old) who were all capable of performing basic daily activities by themselves. Physical fitness was measured for 7 items (handgrip strength, knee extensor strength, postural stability, stepping, one-legged standing time with eyes open, 10 m walking, and the Timed Up and Go Test). The subjects wore a triaxial accelerometer for 2 consecutive weeks to measure their daily physical activities. The functional capacity level was assessed by the Tokyo Metropolitan Institute of Gerontology Index of Competence. The subjects were divided into two groups, a group with a score ≥10 points (high functional capacity group, n=59) and a score <10 points (low functional capacity group, n=88), and the relationship between physical fitness and physical activity was examined in both groups. In both the high and low functional capacity groups, 10 m walking, the Timed Up and Go Test, and one-legged standing time with eyes open significantly correlated with either the total steps/day or the ambulatory activity intensity. In the high functional capacity group, the knee extensor strength also significantly correlated with the total steps/day and moderate ambulatory activity. It is suggested that very elderly women with a reduced functional capacity should maintain their mobility by simply increasing their daily ambulatory activity.

Quality of life and physical fitness in an 85-year-old population.

Since little is known about the very elderly population aged 80 years and older, we evaluated the association of quality of life (QoL) in an 85-year-old population with physical fitness measurements assessed at age 80 and 85 years. Two hundred seven individuals (90 males, 117 females) aged 85 years underwent the Short Form-36 (SF-36) questionnaires for QoL assessment and physical fitness measurements (handgrip strength, leg-extensor strength, one-leg standing time, stepping rate of legs, walking speed). In 85-year-olds, significant associations were found, by multiple regression analysis or logistic regression analysis, with adjustment for various influencing factors in QoL assessed by SF-36 with physical fitness measurements examined at the age of 85 and 80 years. Physical scales and scores in SF-36, such as physical functioning (PF), limitation in role functioning for physical reasons (role physical; RP), bodily pain (BP), and the physical component score (PCS) tended to be more tightly associated with fitness measurements than mental scales and scores such as limitation in role functioning for emotional reasons (role emotional; RE), and emotional well-being (mental health; MH), and mental component score (MCS). Three scales the general health perceptions (GH), the vitality (VT), and the social functioning (SF) consisting of both physical and mental components were associated with fitness, the extent being intermediate between physical scales and mental scales. Of the several physical fitness measurements, leg-extensor strength and the walking speed of 85-year-olds, and the stepping rate of 80-year-olds were most closely associated with QoL. In a very elderly population of 85- and 80-year-olds, significant associations were found between QoL by SF-36 and physical fitness measurements, suggesting that increases in the levels of physical fitness, even in the very elderly, can contribute to improvements in QoL.

Physical fitness and 4-year mortality in an 80-year-old population.

BACKGROUND: Because little is known about the relationship between physical fitness and mortality among very elderly people, we evaluated this association in a Japanese population of 80-year-old community residents. METHODS: Among 1282 80-year-old residents of Fukuoka Prefecture, Japan, 697 individuals (277 men and 420 women) underwent physical fitness tests of handgrip strength, isometric leg extensor strength, isokinetic leg extensor power, stepping rate, and one-leg standing time. Four years later, the dates and causes of death among the participants during those years were analyzed based on data from resident registration cards and from official death certificates. RESULTS: During the 4-year follow-up period, 107 individuals (58 men and 49 women) died. Of these deaths, 27 were due to cardiovascular disease (CVD), 27 to cancer, 22 to pneumonia, and the rest to other causes. The relative hazard ratios (HR) for all-cause mortality, adjusted for various confounding factors, fell with increases in stepping rate, and the HR for pneumonia mortality fell with increases in leg extensor strength. In contrast, there was no association between cardiovascular or cancer mortality and physical fitness. CONCLUSIONS: A partial association was found between impaired physical fitness at the age of 80 years and increased mortality in the 4 years thereafter. Mortality due to all causes was related only to stepping rate, and mortality due to pneumonia was related to leg extensor strength. Mortality due to CVDs or cancers was not associated with physical fitness.