Kazushige Ihara

Depression status as a reliable predictor of functional decline among Japanese community-dwelling older adults: a 12-year population-based prospective cohort study

This study aimed to examine a longitudinal relationship between depression status and functional decline among Japanese community‐dwelling older adults, using a 12‐year population‐based, prospective cohort study design.

The Prevalence, Diagnostic Significance and Demographic Characteristics of Schneiderian First-Rank Symptoms in an Epidemiological Sample of First-Episode Psychoses

Background: The diagnostic significance of first-rank symptoms (FRSs) remains uncertain. Ethnic differences in FRSs may account for high rates of schizophrenia in minority groups. This study aims to examine the prevalence of FRSs in an epidemiological sample of first-episode psychoses stratified by relevant demographic variables. Sampling and Method: We identified everyone aged 16–64 presenting with their first psychosis over 2 years in 3 UK centres. Results: A total of 426 subjects had consensus diagnoses of DSM-IV and ICD-10 psychotic conditions. Thirty-eight percent (95% CI = 33–42) reported FRSs; more frequent in those classified as having schizophrenia (DSM-IV: 55%, 95% CI = 47–63; ICD-10: 51%, 95% CI = 44–58) than those with affective psychoses (DSM-IV: 31%, 95% CI = 22–39; ICD-10: 29%, 95% CI = 21–38). FRSs in schizophrenia were more common in white British subjects, while in affective psychoses, they were more frequent in the black group. The sensitivities, specificities and positive predictive values for schizophrenia of FRSs were 55, 69 and 72% according to DSM-IV and 51, 71, 74% according to ICD-10, respectively. The sensitivities were higher in white British than in the black group. Conclusions: FRSs were common but unhelpful for differentiating schizophrenia from other psychoses as they occurred frequently in both diagnoses. Phenomenological differences did not explain the higher incidence of schizophrenia in black ethnic minority groups.

Classification of frailty using the Kihon checklist: A cluster analysis of older adults in urban areas.

Frailty is an important predictor of the need for long‐term care and hospitalization. Our aim was to categorize frailty in community‐dwelling older adults.

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.

Factors associated with self‐rated oral health among community‐dwelling older Japanese: A cross‐sectional study

A cross‐sectional study was carried out to investigate the determinants of self‐rated oral health among community‐dwelling older people in Japan.

Prevalence of depressive symptoms among the elderly: A longitudinal study

Aim:  Depression is a common psychiatric problem in late life. The purpose of the present study was to assess the prevalence of depressive symptoms among community‐dwelling elderly, both cross‐sectionally and longitudinally.

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.

Factors relating to place of death of Japanese people from a small town in a rural area

The objective of our retrospective study was to clarify factors relating to place of death of Japanese people from a small town in a rural area who had been bedridden for at least one week before dying. The caregivers of subjects aged 40 and above who died during a three-year period were surveyed by trained interviewers. Of 352 subjects who died, 312 caregivers responded and agreed to a face-to-face interview. A total of 213 subjects were considered as an eligible sample. The main outcome measures were odds ratios for death at home in relation to age, pain, cause of death, and home visit service. One hundred and two people died at home, while 112 people died in a hospital. Multivariate logistic regression analysis showed that the probability of home death increased with age of the bedridden, lack of pain during the bedridden period, not having cancer as a cause of death, having senility as a cause of death, and receiving regular home visits by a Public Health Nurse. In conclusion, expansion of the home visit programs by Public Health Nurses may enable people to die at home as they so desire. Further prospective research is needed to explore the association between the attitude toward terminal care and the place of death.

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.

Serum BDNF levels before and after the development of mood disorders: a case-control study in a population cohort

Serum levels of brain-derived neurotrophic factor (BDNF) are low in major depressive disorder (MDD), and were recently shown to decrease in chronic depression, but whether this is a trait or state marker of MDD remains unclear. We investigated whether serum BDNF levels decrease before or after the developments of MDD and other mood disorders through a case–control study nested in a cohort of 1276 women aged 75–84 years in 2008. Psychiatrists using the Structured Clinical Interview for DSM-IV identified incident cases of mood disorders at follow-up surveys in 2010 and 2012: 28 of MDDs, 39 of minor depressive disorders (minDDs) and 8 of minor depressive episodes with a history of major depressive episodes (minDEs with MDE history). A total of 106 representative non-depressed controls were also identified in the 2012 follow-up. We assayed BDNF levels in preserved sera of cases and controls at baseline and at follow-up. Serum BDNF levels at baseline in cases of MDD, minDD or minDE with MDE history were no lower than those in controls. The decrease in the serum BDNF level from baseline to follow-up was greater in cases of MDD or minDE with MDE history than in controls or cases of minDD. These results show that serum BDNF levels are not a trait marker of MDD in old women but appeared to be a state marker. The different changes in BDNF levels among diagnostic groups suggest that MDD has a pathophysiologic relation to minDE with MDE history, rather than to minDD.