Study of aromas as reminiscence triggers in community-dwelling older adults in Japan.

Objective: This study investigates the presence or absence of reminiscence experiences in older adults when using aromas. Focusing on 40 scents familiar to Japanese people, our objective was to determine points of caution for aroma selection and use in reminiscence therapy. Materials and Methods: The participants were 118 community-dwelling older adults aged 65 years and older. They were asked about the experience of recalling the past in response to stimuli of 40 aromas on the Japanese version of the University of Pennsylvania Smell Identification Test (UPSIT-J). In addition, an olfactory visual analog scale (VAS) was used to evaluate olfactory function. Furthermore, a questionnaire-based survey was administered instead of asking participants to actually smell the odorants in the UPSIT-J. Results: At least 70% of the participants experienced recalling the past triggered by 16 aromas including sandalwood and yuzu fruit. Furthermore, 15 of the scents demonstrated a significant association with age, gender, and olfactory function. Conclusion: These results suggest the importance of considering method, age, and gender when selecting olfactory stimuli. In addition, frequently recalled aromas might evoke reminiscence in older adults.

Effects of olfactory stimulation on reminiscence practice in community-dwelling elderly individuals.

BACKGROUND: There has been little research on reminiscence cues and their effectiveness. The purpose of the present study was to measure the effects of reminiscence practice using olfactory stimuli on the mental health and cognitive functions of community-dwelling elderly individuals. METHODS: Written consent was obtained from 72 eligible community-dwelling elderly individuals. They were non-randomly divided into an intervention group and a control group. In the intervention group (n = 35), reminiscence practice was carried out bi-weekly using olfactory stimulation as the cue for eight sessions. In the control group (n = 37), reminiscence practice was carried out without olfactory stimulation. The Geriatric Depression Scale-15 and the Five-cog Test were used as the methods of assessment at baseline and again after completion of the intervention. Participants in the final analysis were 27 individuals in the intervention group and 33 individuals in the control group. RESULTS: At baseline, a significant difference was seen between the groups depending on the existence of a spouse. Repeated measures analysis of covariance with the existence of a spouse as a covariate showed a significant difference between the two groups in changes in Geriatric Depression Scale-15 scores (P = 0.038). Furthermore, analysis of the participants sorted into a depression symptoms group and a non-depression symptoms group showed a significant group main effect (P = 0.033) and interaction (P = 0.049) in the depression symptoms group. CONCLUSION: The results suggest that reminiscence intervention using olfactory stimulation may maintain the mental health of community-dwelling elderly individuals.

Pedometers Affect Changes in Lower-Extremity Physical Function During a Square-Stepping Exercise Program in Older Japanese Adults.

BACKGROUND AND PURPOSE: Pedometers are often used as motivational tools to increase physical activity. Hence, providing a pedometer during an exercise intervention may enhance the benefit of exercise on lower-extremity physical function (LEPF) by maintaining or increasing daily physical activity. The purpose of this study was to compare the effect on LEPF between an exercise intervention with and without the use of a pedometer. METHODS: The subjects of this study were 68 community-dwelling older adults (mean age: 70.0 ± 3.6 years) in Kasama City, rural Japan. All subjects participated in a fall-prevention exercise program called square-stepping exercise (SSE) conducted once a week for 11 weeks. Participants were allocated to 2 groups: SSE with pedometer group (n = 34) and SSE without pedometer group (n = 34). We matched the participants of both groups by their standardized score of physical function tests. To ascertain the LEPF benefits induced by the exercise intervention, we measured 5 physical function tests: single-leg balance with eyes open, 5-repetition sit-to-stand, timed up and go, 5-m habitual walk, and choice stepping reaction time. We used a 2-way analysis of variance to confirm the interaction between the 2 groups. RESULTS: Significant group-by-time interactions were observed on timed up and go (P < .01) and 5-m habitual walk (P = .02); participants in the SSE with pedometer group enhanced their physical function more than the SSE without pedometer group participants. CONCLUSIONS: This study suggests that providing a pedometer during an exercise intervention is an effective addition to an exercise program to improve LEPF.

[Effects of Square-Stepping Exercise inducing activation of the brain's cognitive function in community-dwelling older Japanese females--Focus on the baseline cognitive function level and age].

AIM: The purpose of this study was to investigate whether the degree of improvement in cognitive function achieved with an exercise intervention in community-dwelling older Japanese women is affected by the participant's baseline cognitive function and age. METHODS: Eighty-eight women (mean age: 70.5±4.2 years) participated in a prevention program for long-term care. They completed the Square-Stepping Exercise (SSE) program once a week, 120 minutes/session, for 11 weeks. We assessed participants' cognitive function using 5 cognitive tests (5-Cog) before and after the intervention. We defined cognitive function as the 5-Cog total score and defined the change in cognitive function as the 5-cog post-score minus the pre-score. We divided participants into four groups based on age (≤69 years or ≥70 years) and baseline cognitive function level (above vs. below the median cognitive function level). We conducted two-way analysis of variance. RESULTS: All 4 groups improved significantly in cognitive function after the intervention. There were no baseline cognitive function level×age interactions and no significant main effects of age, although significant main effects of baseline cognitive function level (P=0.004, η(2)=0.09) were observed. CONCLUSION: Square-Stepping Exercise is an effective exercise for improving cognitive function. These results suggest that older adults with cognitive decline are more likely to improve their cognitive function with exercise than if they start the intervention with high cognitive function. Furthermore, during an exercise intervention, baseline cognitive function level may have more of an effect than a participant's age on the degree of cognitive improvement.

Right half-field eye patching may not be an effective approach for chronic hemispatial neglect--a two-case investigation.

Right half-field eye-patched glasses intervention was performed in two chronic stroke patients with unilateral spatial neglect. Eye movement on the neglect side, the center of gravity as an index of the internal midline bias, neglect sign tests, and the regional cerebral blood flow (rCBF) were measured before and after intervention. The improvement of eye movement was not shown clearly after intervention. The center of gravity shifted significantly to the right and backward. Letter and star cancellation tests were improved in both the cases. Line bisection test showed improvement in one patient. However, line cancellation and line bisection tests were worsened in the other. The rCBF was not changed after intervention. This case study suggests that right half-field eye patching might not be an effective intervention.

[Determinants of changes in physical fitness after a square-stepping exercise program in community-dwelling older Japanese females].

AIM: The purpose of this study was to investigate determinants of changes in physical fitness after a fall-prevention exercise program in older females. METHODS: The study subjects included 83 community-dwelling females 65 years of age or older (mean age: 70.4±4.0 years) living in Kasama City, rural Japan. All subjects participated in a fall-prevention exercise program called square-stepping exercise (SSE) conducted once a week for 11 weeks. In order to assess the physical fitness benefits of by the exercise program, we measured the results of five physical performance tests: grip strength, one leg stand, sit and reach, timed up and go and the choice-stepping reaction time. In addition, we evaluated comprehensive physical fitness scores based on the standardized total score of the five physical performance tests. The changes in the comprehensive physical fitness score between baseline and after the program was used as the dependent variable, while the baseline values of age, education, clinical history, physical activity, Lubben social network scale, geriatric depression scale, five cognitive function test result, comprehensive physical fitness score and percentage of attendance were treated as independent variables. RESULTS: A stepwise multiple regression analysis revealed that the change in comprehensive physical fitness score correlated significantly with the baseline values of age (ß=-0.273), the five cognitive function test result (ß=0.293) and comprehensive physical fitness score (ß=-0.607). CONCLUSIONS: These results suggest that older females with a low level of physical fitness at baseline are more likely to improve their physical fitness with a period of exercise training. However, the improvements in physical fitness are lower in older females with a low level of cognitive function than in those with a high level of cognitive function.

[Association of the physical activity of community-dwelling older adults with transportation modes, depression and social networks].

AIM: The purpose of this study was to cross-sectionally examine the relationships among leisure, household and occupational physical activity with the frequency of going out by various transportation modes, depression and social networks in older adults. METHODS: We randomly selected a total of 2,100 community-dwelling adults aged 65 to 85 years of age from the Basic Resident Register. Of these, 340 people were the subjects of this study. The scales of measurement used were the Physical Activity Scale for the Elderly, the Lubben Social Network Scale (LSNS) and the Geriatric Depression Scale (GDS). RESULTS: In a regression model, leisure-time physical activity significantly correlated with frequency of going out by bicycle (ß=0.17) and LSNS score (ß=0.17). Household physical activity and occupational physical activity were significantly correlated with LSNS score (ß=0.21) and frequency of going out by motor vehicle (ß=0.25), respectively. For total physical activity, in the 3 above-mentioned activities a significant correlation was observed among frequency of going out by bicycle (ß=0.10), by motor vehicle (ß=0.23), GDS score (ß=-0.16) and LSNS score (ß=0.23). CONCLUSION: These results indicate that the frequency of going out by bicycle and by motor vehicle were significant factors to predict leisure and occupational physical activity. Furthermore, social networks appear to be important determiners in leisure and household physical activity in community-dwelling older adults.

Prism intervention helped sustainability of effects and ADL performances in chronic hemispatial neglect: a follow-up study.

PURPOSE: To investigate the sustainability of effect and the changes in basic and instrumental activities of daily living (ADL and IADL) after long-term prism intervention, we carried out a follow-up assessment on five subjects with hemispatial neglect in the chronic stage. METHOD: At 2-3.5 years after the end of prism intervention, we measured six parameters: 1) eye movement of the neglect side when watching three different video clips, 2) center of gravity as an index of subjective internal midline bias, 3) star and letter cancellation tests, 4) the line bisection test, and ADL scales: 5) Barthel Index and 6) Lawton's IADL scale. In addition, we interviewed and observed the subjects' present ADL performance at home. RESULTS: The eye movement on the neglect side significantly increased compared with that before intervention. The center of gravity was shifted significantly to the left side and forward. The improvement in cancellation and line bisection tests was also observed. All subjects showed improvement in ADL performance. Two of the subjects could return to work after intervention. CONCLUSION: The results suggested that long-term prism intervention might effectively exert long-lasting effects and bring benefits to ADL performance for subjects with hemispatial neglect.

[Association of physical functions with leisure-time, household, and occupational physical activity in community-dwelling older adults].

AIM: The study objective was to cross-sectionally examine the relationships among leisure-time, household, and occupational physical activity with physical functions in Japanese older adults. METHODS: We randomly enrolled 189 community-dwelling older adults, aged 65 to 85 years, as subjects from the Basic Resident Register of Kasama City, Ibaraki prefecture. Physical activity was assessed by the Physical Activity Scale for the Elderly. Analysis of covariance was performed to determine the relationships between physical activity and physical functions, after adjustment for age and sex. RESULTS: Leisure-time physical activity significantly correlated with one-leg balance with eyes open, sit and reach, timed standing test from along sitting position on the floor, functional reach, 5-repetition sit-to-stand, timed up and go, 5-m habitual walk, choice stepping reaction time, and power in sit-to-stand tests. Household physical activity was significantly related to 5-repetition sit-to-stand and ability in sit-to-stand. Total (leisure-time plus household plus occupational) activity was significantly correlated with one-leg balance with eyes open, functional reach, and power in sit-to-stand tests. Post-hoc testing indicated that the levels of physical functions were higher in the subjects of the third tertile than in those of the first or second tertile. No difference was found in physical functions between the first and second tertile. CONCLUSION: Leisure-time physical activity was related to many physical functions. Household physical activity was also related to lower-extremity functions. Our data suggest that medium- or high-level physical activity may be necessary for older adults to maintain their physical functions.

Long-term effects of prism adaptation on chronic neglect after stroke.

UNLABELLED: Previous studies have discussed the effectiveness or ineffectiveness of prism adaptation for neglect patients. PURPOSE: The aim of present study was to determine the long-term effect of prism adaptation with activity performance instead of pointing performance on chronic neglect patients. SUBJECTS: Seven patients with chronic unilateral spatial neglect were recruited. METHODS: We performed an 8-week intervention using prismatic glasses. Changes in eye movement before and after intervention were measured using an eye mark recorder system. We also assessed intentional spatial bias in terms of center of gravity in the standing position using a tactile sensor scan system. Additionally, regional cerebral blood flow was measured using SPECT (IMP) before and after intervention. RESULTS: Eye movements significantly improved on the neglected side (p<0.01), and the effects were sustained for up to 6 weeks after the removal of the prism. The center of gravity significantly moved to the left and forward. Furthermore, rCBF showed a significant increase at the parietal cortex, pericalleosal area of the left hemisphere (P<0.05). CONCLUSION: These results suggest that intervention using prismatic glasses could improve eye movement on the neglected side and correct intentional spatial bias. Prism intervention might be one valuable method for the activation of the important areas of the brain in neglect patients.

Investigation of age-related developmental differences of button ability.

BACKGROUND: There is little standardized information on simple and easy-to-use evaluation of fine motor skills in disabled children. The purpose of the present study was to determine the relationship between unbuttoning and buttoning ability and age and sex difference. METHODS: One hundred and forty-four children (63 boys and 81 girls; age range, 36-83 months) and 14 young adults took part in the present study. The children were categorized into four groups according to age. Every subject went to nursery school and/or kindergarten. On the basis of Montessori education system, unbuttoning and buttoning were performed. The time from beginning to end was measured individually. All the participants were instructed to do the task in the same way. RESULTS: The mean time required for unbuttoning activity was decreased until 4 years old, while that for buttoning was also reduced until 5 years old, respectively. There were no significant differences between boys and girls except in unbuttoning activity at the age of 3 years. CONCLUSION: More attention should be paid to unbuttoning and buttoning activities in children. It might be a simple and easy-to-use evaluation method in the clinical setting.