Fumiko Miyamae

Effects of Intervention Using a Community-Based Walking Program for Prevention of Mental Decline: A Randomized Controlled Trial

To evaluate the efficacy of a municipality‐led walking program under the Japanese public Long‐Term Care Insurance Act to prevent mental decline.

The impact of subjective memory complaints on quality of life in community-dwelling older adults

The aim of this study was to evaluate the impact of memory complaints on quality of life (QOL) in elderly community dwellers with or without mild cognitive impairment (MCI).

Walking exercise and cognitive functions in community-dwelling older adults: preliminary results of a randomized controlled trial.

The number of epidemiological studies reporting that physical activity (e.g., walking, jogging, yoga, aerobic exercise, strength training) may reduce the risk of cognitive decline in older adults has increased recently. Among the activities, walking exercise is widely adopted as an intervention program to prevent mental decline in many municipalities. However, it is not well known whether these exercise interventions were found to have robust benefits for cognition in older adults. We conducted a pilot study of a randomized controlled trial to evaluate the effectiveness of 20-week walking exercise intervention in maintaining and/or improving cognitive function in community-dwelling older adults and to determine what types of cognitive domains are more susceptible to the intervention. Sixty-five healthy community-dwelling older individuals were randomly allocated to an exercise (N=31) or to control (N=34) groups (see Table 1). The intervention was intended to facilitate walking habits. Each exercise session was conducted once a week and consisted of 30min exercise period and 60min group walk with six to seven people. Cognitive measures were collected at baseline and after 20weeks. The following neuropsychological tests were administered to assess four different domains of cognition (attention/cognitive speed, memory, language, visuospatial function).

Association between polypharmacy and cognitive impairment in an elderly Japanese population residing in an urban community.

Polypharmacy is a serious medical problem among older adults. Polypharmacy can cause adverse drug reactions and is associated with frailty. Several drugs, particularly psychotropic medications, can cause cognitive impairment. Recent research also suggests that polypharmacy can cause cognitive impairment. We investigated the prevalence of polypharmacy, and examined the association between polypharmacy and cognitive impairment in a large sample of community‐dwelling older adults in Japan.

Development of the dementia assessment sheet for community-based integrated care system

A series of our studies on the development of the Dementia Assessment Sheet for Community‐based Integrated Care System 21‐items (DASC‐21) were reviewed. Study 1: to examine the distribution of scores and internal reliability of DASC‐21, trained nurses and researchers visited the homes of 1341 participants aged 65 years and older and living in the community. The nurses interviewed the participants and, when possible, their family members, to complete the DASC‐21. Then, the Mini‐Mental State Examination was carried out to select the participants of study 2. Study 2: to examine the concurrent and discriminant validity, experienced psychiatrists and psychologists, who were blind to the findings of study 1, visited the homes of 131 subjects who were selected from the participants of study 1 and completed the Clinical Dementia Rating (CDR), the Mini‐Mental State Examination and the Frontal Assessment Battery (FAB). Cronbachs coefficient alpha of the DASC‐21 was 0.808–0.950. Scores of the DASC‐21 significantly correlated with CDR total and box scores, Mini‐Mental State Examination and Frontal Assessment Battery. In an analysis of variance, CDR had the main effect on the score of the DASC‐21. Receiver operating characteristic analysis showed that the DASC‐21 had sufficient discriminatory ability between dementia (CDR1+) and non‐dementia (CDR0 or CDR0.5; area under the curve = 0.804–0.895). When using a cut‐off point of 30/31, sensitivity was 83.3–94.1% and specificity was 77.3–86.4%. The DASC‐21 has sufficient reliability and validity as a tool to evaluate impairments in daily functioning and in cognitive functions, to detect dementia, and to assess the severity of dementia in the community. Geriatr Gerontol Int 2016; 16 (Suppl. 1): 123–131.

Distribution of Mini-Mental State Examination scores among urban community-dwelling older adults in Japan.

The Mini‐Mental State Examination (MMSE) is widely used as a cognitive screening test for older adults; however, cognitive performance can be affected by age, education, and sample selection bias, including time and place. The aims of this study were to examine the distribution of scores on the Japanese version of the MMSE in an urban community sample and to provide normative data for older Japanese adults.

Excessive daytime sleepiness is related to subjective memory impairment in late life: a cross-sectional community-based study

The aim of this study was to determine whether daytime sleepiness is related to subjective memory impairment among community‐dwelling elderly people, after adjustment for psychosocial variables.

Prevention of cognitive and physical decline by enjoyable walking‐habituation program based on brain‐activating rehabilitation

Evaluating effects of an enjoyable walking‐habituation program.

Is community social capital associated with subjective symptoms of dementia among older people? A cross-sectional study in Japan: Social capital and dementia symptoms

Many studies have reported the preventive effects of community social capital on health outcomes, such as mortality and incidence of diseases. However, evidence on the association between community social capital and dementia‐related outcomes remains sparse. The present study examined the contextual association of social capital with subjective symptoms of dementia among community‐dwelling older adults in Japan, using a population‐based, large‐scale questionnaire survey.

Prevalence of depressed mood and loss of interest among community-dwelling older people: Large-scale questionnaire survey and visiting intervention: Depressed mood and loss of interest

Late‐life depression is identified less often by general practitioners than depression in younger adults, but failure to have late‐life depression recognized in a primary care setting can have fatal consequences. The aim of the present study was to examine the prevalence of depressed mood and loss of interest, and identify associated factors among community‐dwelling older adults in a large‐scale study.