Hunkyung Kim

effects of Exercise and Amino Acid Supplementation on Body Composition and Physical Function in Community-dwelling Elderly Japanese Sarcopenic Women: A Randomized Controlled Trial

To evaluate the effectiveness of exercise and amino acid supplementation in enhancing muscle mass and strength in community‐dwelling elderly sarcopenic women.

The effects of multidimensional exercise treatment on community-dwelling elderly Japanese women with stress, urge, and mixed urinary incontinence: A randomized controlled trial

BACKGROUNDnUrinary incontinence is one of the most prevalent health problems and a significant cause of disability and dependence in the elderly. Pelvic floor exercise is effective in reducing stress urinary incontinence, but few studies have investigated the effect of behavioral management on urge and mixed incontinence.nnnOBJECTIVESnTo determine the effects of multidimensional exercise treatment on reducing urine leakage in elderly Japanese women with stress, urge, and mixed urinary incontinence.nnnDESIGNnRandomized controlled, follow-up trial.nnnSETTINGSnUrban community-based study.nnnPARTICIPANTSn127 community-dwelling women aged 70 and older with stress, urge, and mixed urinary incontinence were randomly assigned to the intervention (n=63) or the control group (n=64).nnnMETHODSnUrine leakage and fitness data were collected at baseline, and after the intervention and follow-up. The intervention group received a multidimensional exercise treatment twice a week for 3-month. After treatment, the participants were followed for 7-month.nnnRESULTSnThere were significant differences in changes of functional fitness and incontinence variables between the intervention and control groups. The intervention group showed urine leakage cure rates of 44.1% after treatment and 39.3% after follow-up (χ(2)=21.96, p<0.001); whereas, the control group showed no significant improvement. The multidimensional exercise treatment was significantly effective in decreasing all three types of urinary incontinence. However, the effects of the exercise treatment were greater on stress urinary incontinence than on urge or mixed urinary incontinence. At the 7-month follow-up, while cure rates of all three types of urinary incontinence were significantly maintained, a slight reversal was seen only in the urge and mixed urinary incontinence (χ(2)=10.28, p=0.008). According to the logistic regression model, urine leakage volume (adjusted odds ratio OR=0.69, 95% confidence interval CI=0.39-0.98), compliance (OR=1.03, 95%CI=1.01-1.16), and BMI reduction (OR=0.67, 95%CI=0.48-0.89) were significantly associated with the cure of urine leakage after intervention. The cure rate of urine leakage after the follow-up was significantly associated with compliance (OR=1.13, 95%CI=1.02-1.29) and BMI reduction (OR=0.78, 95%CI=0.60-0.96).nnnCONCLUSIONSnThe intervention group showed higher urine leakage cure rates than control group. This result suggests that multidimensional exercise strategies may be effective for all three types of urinary incontinence. BMI reduction and compliance to the intervention was the consistent predictor for the effectiveness of the exercise treatment.

Effects of exercise and tea catechins on muscle mass, strength and walking ability in community‐dwelling elderly Japanese sarcopenic women: A randomized controlled trial

Aim:u2003 To investigate the effects of exercise and/or tea catechin supplementation on muscle mass, strength and walking ability in elderly Japanese women with sarcopenia.

Plasma heat shock protein 72 as a biomarker of sarcopenia in elderly people

Sarcopenia is a geriatric syndrome in which there is a decrease of muscle mass and strength with aging. In age-related loss of muscle strength, there are numerous observations supporting the assertion that neural factors mediate muscle strength. A possible contributing cause may be that aging changes systemic extracellular heat shock protein (eHsp)72 activity. The present study was designed to assess the plasma levels of eHsp72 in elderly people and to investigate its potential interaction with components of sarcopenia. A total of 665 men and women participated in an official medical health examination and an integrated health examination, including psychological and physical fitness tests. Blood samples were assayed for levels of plasma Hsp72, serum C-reactive protein, interleukin 6, tumor necrosis factor α, and regular biomedical parameters. We found that higher Hsp72 in plasma is associated with lower muscle mass, weaker grip strength, and slower walking speed, and may be a potential biomarker of sarcopenia in elderly people. This finding was supported by other results in the present study: (1) older age and shrinking body and lower hemoglobin levels, all of which characterize sarcopenia, were related to higher eHsp72 tertiles and (2) the ORs of the highest tertile of eHsp72 for the lowest tertiles of muscle mass, grip strength, and walking speed were 2.7, 2.6, and 1.8, respectively. These ORs were independent of age, sex, and the incidence of related diseases. Our results would reveal that eHsp72 in plasma is linked to sarcopenia factors and is a potential biomarker or predictor of sarcopenia.

The effects of multidimensional exercise on functional decline, urinary incontinence, and fear of falling in community-dwelling elderly women with multiple symptoms of geriatric syndrome: A randomized controlled and 6-month follow-up trial

This study assessed the effects of multidimensional exercises on functional decline, urinary incontinence, and fear of falling in community-dwelling Japanese elderly women with multiple symptoms of geriatric syndrome (MSGS). Sixty-one participants were randomly assigned either to an intervention (n=31) or to a control group (n=30). For 3-month period, the intervention group received multidimensional exercise, twice a week, aiming to increase the muscle strength, walking ability, and pelvic floor muscle (PFM). Outcome variables were measured at baseline, and after intervention and follow-up. The functional decline of the intervention group decreased from 50.0% at baseline to 16.7% after intervention and follow-up (Q=16.67, p<0.001). For urinary incontinence, the intervention group decreased from 66.7% at baseline to 23.3% after intervention and 40.0% at follow-up (Q=13.56, p=0.001), whereas the control group showed no improvement. Intervention group showed greater and significant decrease in the score of MSGS compared to control group (F=12.66, p=0.001). Within the subjects that showed improvement to normal status of MSGS, a significantly higher proportion demonstrated increased maximum walking speed at follow-up (Q=6.50, p=0.039). These results suggest that multidimensional exercise is an effective strategy for reducing geriatric syndromes in elderly population. An increase in walking ability may contribute to the improvement of MSGS.

Effects of exercise treatment with or without heat and steam generating sheet on urine loss in community-dwelling Japanese elderly women with urinary incontinence

Aim:u2003 To determine the effects of exercise treatment with or without heat and steam generating sheet (HSGS) on reducing urine loss in community‐dwelling elderly women with urinary incontinence (UI).

Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people

BackgroundObjective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST) to screen for fall risks and falls and fall-related fractures in frail elderly people.MethodsThe SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotomous questions to screen for fall risks during movements and behaviours such as walking, transferring, and wandering. The history of falls and fall-related fractures during the previous year was reported by participants or determined from an interview with the participants family and care staff.ResultsAll SRRST items showed significant differences between the participants with and without falls and fall-related fractures. In multiple logistic regression analysis adjusted for age, sex, diseases, and behavioural variables, the SRRST score was independently associated with history of falls and fractures. Odds ratios for those in the high-risk SRRST group (≥ 5 points) compared with the no risk SRRST group (0 point) were 6.15 (p < 0.01) for a single fall, 15.04 (p < 0.01) for recurrent falls, and 5.05 (p < 0.01) for fall-related fractures. The results remained essentially unchanged in subgroup analysis accounting for locomotion status.ConclusionThese results suggest that subjective ratings by care staff can be utilized to determine the risks of falls and fall-related fractures in the frail elderly, however, these preliminary results require confirmation in further prospective research.

Behavioral Treatment for Geriatric Syndrome

Geriatric syndrome is a term used to capture complex clinical conditions such as frailty, falls and fractures, urinary incontinence, malnutrition, and declining mental health, which do not fit into discrete disease categories but are serious problems among the elderly population. They are highly prevalent in the elderly, especially in frail adults with low levels of functional capacity. These geriatric syndromes have a large effect on the development of disability, dependence, decrease in quality of life, morbidity, and mortality. Having multiple underlying factors involving impairments in multiple organ systems contribute to the occurrence of geriatric syndromes (Tinetti et al., 1995). Thus, prevention and treatment of geriatric syndromes such as frailty, falls, and urinary incontinence in its early stages are important strategies in maintaining health and independence among the elderly.