Hirohiko Hirano

Development of a simple screening test for sarcopenia in older adults

To develop a simple screening test to identify older adults at high risk for sarcopenia.

Relationship between nutrition status and dental occlusion in community‐dwelling frail elderly people

Aim:  This study aimed to determine the risk of malnutrition in some communities where the frail elderly receive public long‐term care insurance. We also clarified the dental problems in those at risk of malnutrition.

Reference Values and Age and Sex Differences in Physical Performance Measures for Community-Dwelling Older Japanese: A Pooled Analysis of Six Cohort Studies

Objectives To determine age- and sex-specific reference values for six physical performance measures, i.e. hand-grip strength, one-legged stance, and gait speed and step length at both usual and maximum paces, and to investigate age and sex differences in these measures among community-dwelling older Japanese adults. Methods We conducted a pooled analysis of data from six cohort studies collected between 2002 and 2011 as part of the Tokyo Metropolitan Institute of Gerontology-Longitudinal Interdisciplinary Study on Aging. The pooled analysis included cross-sectional data from 4683 nondisabled, community-dwelling adults aged 65 years or older (2168 men, 2515 women; mean age: 74.0 years in men and 73.9 years in women). Results Unweighted simple mean (standard deviation) hand-grip strength, one-legged stance, usual gait speed, usual gait step length, maximum gait speed, and maximum gait step length were 31.7 (6.7) kg, 39.3 (23.0) s, 1.29 (0.25) m/s, 67.7 (10.0) cm, 1.94 (0.38) m/s, and 82.3 (11.6) cm, respectively, in men and 20.4 (5.0) kg, 36.8 (23.4) s, 1.25 (0.27) m/s, 60.8 (10.0) cm, 1.73 (0.36) m/s, and 69.7 (10.8) cm, respectively, in women. All physical performance measures showed significant decreasing trends with advancing age in both sexes (all P<0.001 for trend). We also constructed age- and sex-specific appraisal standards according to quintiles. With increasing age, the sex difference in hand-grip strength decreased significantly (P<0.001 for age and sex interaction). In contrast, sex differences significantly increased in all other measures (all P<0.05 for interactions) except step length at maximum pace. Conclusion Our pooled analysis yielded inclusive age- and sex-specific reference values and appraisal standards for major physical performance measures in nondisabled, community-dwelling, older Japanese adults. The characteristics of age-related decline in physical performance measures differed between sexes.

Factors affecting independence in eating among elderly with Alzheimer's disease

Aim:  In elderly patients with dementia, disturbed eating behavior is understood to be a core symptom or a behavioral and psychological symptom of dementia (BPSD). The purpose of the present study was to investigate the factors affecting self‐feeding in elderly patients with Alzheimers disease (AD).

Relationship between chewing ability and sarcopenia in Japanese community-dwelling older adults.

It has been reported that if nutrient intake is unbalanced, muscle mass, muscle strength and physical performance declines, and therefore it is important to maintain chewing ability to keep a balanced nutrient intake. However, the relationship between chewing ability and sarcopenia has not been previously reported. Therefore, the present study investigated the relationship between chewing ability and sarcopenia in addition to known sarcopenia‐related factors.

Sarcopenia: Prevalence and associated factors based on different suggested definitions in community-dwelling older adults.

The age‐related loss of muscle mass and/or strength and performance, sarcopenia, has been associated with geriatric syndromes, morbidity and mortality. Although sarcopenia has been researched for many years, currently there is a lack of consensus on its definition. Some studies define sarcopenia as low muscle mass alone, whereas other studies have recently combined low muscle mass, strength and physical performance suggested by the European Working Group on Sarcopenia in Older People, as well as the Asian Working Group for Sarcopenia. The arbitrary use of various available sarcopenia definitions within the literature can cause discrepancies in the prevalence and associated risk factors. The application of population‐specific cut‐off values in any sample population can be problematic, particularly among different ethnicities. Using commonly used cut‐off points to define sarcopenia, including solely muscle mass and combined definitions, on a community‐dwelling elderly Japanese population, the prevalence of sarcopenia ranged from 2.5 to 28.0% in men and 2.3 to 11.7% in women, with muscle mass measured by dual‐energy X‐ray absorptiometry, and 7.1–98.0% in men and 19.8–88.0% in women measured by bioelectrical impedance analysis. Body mass index was the most prominent related factor for sarcopenia across the definitions in this Japanese sample. However, other associated hematological and chronic condition factors varied depending on the definition. Geriatr Gerontol Int 2016; 16 (Suppl. 1): 110–122.

Relationship Between Frailty and Oral Function in Community‐Dwelling Elderly Adults

To determine the standard values of and age‐related changes in objective oral function of healthy older people; compare oral function of robust, prefrail, and frail older people; and determine the association between oral function and frailty.

Masseter muscle tension and chewing ability in older persons

Aim:  Mastication is an important function to maintain, not only for oral health, but also for quality of life. An easy‐to‐use method to evaluate the chewing ability of elderly people in any environment is necessary. Few studies have discussed the effectiveness of the masseter muscle by palpation. The purpose of this study was to clarify the availability of masseter muscle tension assessment methods by investigating its relationship with oral health status, and comparing it with other methods of assessing chewing ability.

Detecting signs of dysphagia in patients with Alzheimer's disease with oral feeding in daily life

It is important to understand dysphagia in patients with dementia, as it is associated with malnutrition and aspiration pneumonia. Particularly in patients with Alzheimers disease (AD), mortality from pneumonia is high and accounts for 70% of the causes of death. However, the standard swallowing tests are often difficult to use for patients with dementia, and methods to assess daily swallowing function are required. Therefore, the purpose of the present study was to identify signs of dysphagia in AD patients in daily life.

Relationship between swallowing function and the skeletal muscle mass of older adults requiring long-term care.

The present study investigated the risk factors for dysphagia among older adults who require long‐term care, and also examined their systemic decrease in skeletal muscle mass.