Hisashi Kawai

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.

Realization of linguistic information in the voice fundamental frequency contour of the spoken Japanese

Although it has been well known that prosody plays an important role both in the intelligibility and in the naturalness of speech, the process of generating natural prosody from linguistic information has not been fully understood. The authors first define units of prosody of spoken Japanese on the basis of analysis of fundamental frequency contours. Prosodic words are defined by the presence of an accent component, while prosodic phrases and clauses are defined by the presence/absence of a pause and resetting/addition of a phrase component. It is shown that the accent components, representing the information concerning lexical word accent, are modified systematically by the syntactic and the discourse information. Classifications of prosodic boundaries are also presented, and the relationship between these two kinds of boundary is described.<<ETX>>

Generation of prosodic symbols for rule-synthesis of connected speech of Japanese

In a text-to-speech conversion system, the prosodic features of speech should be synthesized strictly by rules. In order to construct a set of rules to generate the symbols for the prosodic features, such as the pause duration, the phrase command magnitude, and the accent command amplitude, speech samples of Japanese texts were analyzed quantitatively using the model for fundamental frequency contour generation. The analysis made clear the relationships between the prosodic features and the linguistic information, such as the accent type of a word, the syntactic structure of a sentence, and the discourse structure of a text. Based on these relationships, rules were constructed which generate the prosodic symbols from the linguistic information. Text-to-speech conversion was conducted using these rules. The naturalness of the intonation of the synthesized speech indicated the validity of the rules.

Physical and Sociopsychological Characteristics of Older Community Residents With Mild Cognitive Impairment as Assessed by the Japanese Version of the Montreal Cognitive Assessment

Background: Although mild cognitive impairment (MCI) criteria are disputable, characterizing various aspects of operational MCI (O-MCI) may lead to a better understanding of potential modulators of cognitive decline and contribute to more effective public health strategies. The aim of the study is to examine characteristics of community-dwelling elderly people with MCI assessed using Japanese version of Montreal Cognitive Assessment (MoCA-J). Methods: A total of 913 community-dwelling Japanese (65-84 years) participated in health examinations in Tokyo, 2011. The MoCA-J, Mini-Mental State Examination (MMSE), and other physical and mental tests were conducted. Excluded were those with <24 MMSE scores. Those with <26 in MoCA-J were divided into 2 subgroups, (A) participants independent of instrumental activities of daily living (IADL) and no memory complaints and (B) participants independent of IADL with memory complaints or partially dependent on IADL with/without memory complaints. Those with ≥26 in MoCA-J and subgroup (A) of MCI were the normal controls (NCs, 57.4%), and subgroup (B) of MCI was O-MCI, 36.5%. We compared each variable between NC and O-MCI, using logistic regression analysis, adjusted for gender and age. Results: The majority of all the groups were independent of IADL. The O-MCI characteristics were increased depressive symptom, worse self-rated health, lower systolic blood pressure, poorer intellectual activities, no hobbies, weaker grip strength, and slower than usual walking speed compared to the NC group. Conclusions: Older persons with O-MCI defined by MoCA-J have partially decreased cognition and physical and sociopsychological functions.

Eating Alone as Social Disengagement is Strongly Associated With Depressive Symptoms in Japanese Community-Dwelling Older Adults.

OBJECTIVESnDepression in later life poses a grave challenge for the aging countries. The reported key risk factors include social disengagement, but the lack of social companionship during mealtimes, namely eating alone, has not been examined extensively, especially in relation to living arrangement. Past studies on changes along geriatric trajectories in the association between social engagement and depression also remain inadequate. This study aims to examine the association between social engagement and depressive symptoms with a particular focus on eating alone and how the association changes along the aging and mental frailty trajectories.nnnDESIGNnA cross-sectional study.nnnSETTINGnKashiwa-city, Chiba-prefecture in Japan.nnnPARTICIPANTSnA total of 1856 community-dwelling older adults.nnnMEASUREMENTSnThe 15-item Geriatric Depression Scale was used to measure depressive symptoms. The indicators used to assess social engagement included eating alone, living arrangement, reciprocity of social support, social participation, social stressors and social ties.nnnRESULTSnSocial engagement was significantly associated with depressive symptoms. Those who live with their families yet eat alone were found to be at particular risk (odds ratio = 5.02, 95% confidence interval 2.5-9.9 for young-old; odds ratio = 2.41, 95% confidence interval 1.2-4.8 for old-old). Younger and less mentally frail populations showed stronger associations.nnnCONCLUSIONSnEating alone was a key risk factor for depressive symptoms in community-dwelling older adults. The living arrangement in which they eat alone is important in identifying those with the greatest risk. Mental health management for older adults requires comprehensive assessment of their social relations that takes into account their companionship during mealtimes. Social preventive measures need to involve early interventions in order to augment their effectiveness against mental frailty.

One-Year Change in the Japanese Version of the Montreal Cognitive Assessment Performance and Related Predictors in Community-Dwelling Older Adults

To examine the distribution and associated predictors of 1‐year changes in the Japanese version of the Montreal Cognitive Assessment (MoCA‐J) in community‐dwelling older adults.

Relationship between sensory perception and frailty in a community-dwelling elderly population

BackgroundAging anorexia, defined as loss of appetite and/or reduced food intake, has been postulated as a risk factor for frailty. Impairments of taste and smell perception in elderly people can lead to reduced enjoyment of food and contribute to the anorexia of aging.ObjectiveTo evaluate the relationship between frailty and taste and smell perception in elderly people living in urban areas.DesignData from the baseline evaluation of 768 residents aged ≥ 65 years who enrolled in a comprehensive geriatric health examination survey was analyzed. Fourteen out of 29-items of Appetite, Hunger, Sensory Perception questionnaire (AHSP), frailty, age, sex, BMI, chronic conditions and IADL were evaluated. AHSP was analyzed as the total score of 8 taste items (T) and 6 smell items (S). Frailty was diagnosed using a modified Fried’s frailty criteria.ResultsThe area under the receiver operator curves for detection of frailty demonstrated that T (0.715) had moderate accuracy, but S (0.657) had low accuracy. The cutoffs, sensitivity, specificity and Youden Index (YI) values for each perception were T: Cutoff 26.5 (YI: 0.350, sensitivity: 0.639, specificity: 0.711) and S: Cutoff 18.5 (YI: 0.246, sensitivity: 0.690, specificity: 0.556). Results from multiple logistic regression models, after adjusting for age, sex, IADL and chronic conditions showed that participants under the T cutoff were associated with exhaustion and those below the S cutoff were associated with slow walking speed. The adjusted logistic models for age, sex, IADL and chronic conditions showed significant association between T and frailty (OR 2.81, 95% CI 1.29-6.12), but not between S and frailty (OR 1.73, 95% CI 0.83-3.63).ConclusionsTaste and smell perception, particularly taste perception, were associated with a greater risk of frailty in community-dwelling elderly people. These results suggest that lower taste and smell perception may be an indicator of frailty in old age.

A system for synthesizing Japanese speech from orthographic text

A text-to-speech conversion system for Japanese, developed for the purpose of producing high-quality speech output, is presented. It consists of four processing stages: (1) linguistic processing, (2) phonological processing, (3) control parameter generation, and (4) speech waveform generation. An overview of the whole system is presented. The innovations introduced into the second and the fourth stages, i.e. rules for generating prosodic symbols from the linguistic information in the second stage and the configuration of a new type of terminal analog speech synthesizer designed as the fourth stage, are described. The validity of the approach is confirmed by the improvements both in the prosodic and in the segmental qualities of synthesized speech.<<ETX>>

Frailty Severity and Dietary Variety in Japanese Older Persons: A Cross-Sectional Study

Providing older person individuals with an appropriate intervention at the time of frailty onset is important to prevent the progression of the condition and the need for long-term care. However, the proper timing of starting nutritional and dietary interventions for frail older person subjects has not been fully elucidated. Therefore, in this cross-sectional study, we aimed to clarify the association between frailty and dietary variety among older persons in Japan. We surveyed sex, age, body height, body weight, body mass index, serum albumin level, dietary variety, and nutritional intake indexes in 747 community-dwelling older person individuals who underwent a comprehensive health examination in October 2014. Frailty was determined using the Kihon Checklist (25 questions). Kihon Checklist is widely used to assess frailty in Japan, and their physical, cognitive and social function was evaluated. After excluding those who did not complete the Kihon Checklist and those who required long-term care, frailty status was analyzed in 665 older person individuals. The numbers and percentages of frail, pre-frail and robust older persons were found to be 77 (11.6%), 182 (27.4%) and 406 (61.0%) respectively. Significant differences among robust, pre-frail, and frail subjects were observed in terms of age, serum albumin level, alcohol consumption, smoking, and history of diabetes. Among the nutritionrelated indexes, only the dietary variety showed a significant difference. The results of ordinal logistic regression analysis showed a significant association between frailty and sex, age, smoking status, diabetes, and dietary variety score. Dietary variety was significantly associated with the progression of frailty among older persons in the community.

Comparison of body composition and physical and cognitive function between older Japanese adults with no diabetes, prediabetes and diabetes: A cross-sectional study in community-dwelling Japanese older people: Reduced physical function in diabetes

Diabetes is associated with not only cardiovascular and cerebrovascular disease, but also reductions in physical and cognitive function. The purpose of the present study was to determine whether muscle strength, walking ability and balance declined in Japanese community‐dwelling older adults with diabetes or prediabetes.