Makiko Tomida

Dietary diversity decreases the risk of cognitive decline among Japanese older adults

To clarify the effectiveness of dietary diversity, calculated by dietary records, on cognitive decline.

Age-related changes in energy intake and weight in community-dwelling middle-aged and elderly Japanese

ObjectiveThis study attempts to describe trends in energy intake and weight change over 12 years according to age at first participation in the study.DesignProspective cohort study.SettingThe National Institute for Longevity Sciences - Longitudinal Study of Aging (NILS-LSA), a community-based study.ParticipantsParticipants included 922 men and 879 women who participated in the first study-wave (age 40–79 years) and also participated in at least one study-wave from the second to seventh study-wave. Each study-wave was conducted biennially. For individuals, the entire follow-up period was 12 years.MeasurementsEnergy intake was calculated from 3-day dietary records with photographs. Weight and height were measured under a fasting state. To estimate linear changes in energy intake and weight over 12 years according to age at first study-wave, we used the mixed-effects model.ResultsMean (SD) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8) times, respectively. The fixed effect of the interaction of age and time in energy intake and weight was statistically or marginally statistically significant both in men (p<0.01) and in women (p<0.06). In men, when energy intake was estimated according to age, the rate of decrease in energy intake increased from -6.8 to -33.8 kcal/year for ages 40-79 years. In women, the rate of decrease in energy intake slightly increased in older age groups (-9.1 to -16.7 kcal/year for ages 40-79 years). Weight increased in males in their 40s (0.07 kg/year from age 40) and started to decline by age 53. In women, weight started to decline around age 47 (-0.04 kg/year).ConclusionTwelve-year longitudinal data showed energy intake declined both in men and women in their 40s, and the rate of decrease increased in older males. Weight started to decline in men in their mid-50s and women in their late 40s. Further studies that focus on energy intake and weight reduction are needed to prevent weight loss or underweight in an increasingly aging society.

The effect of modifiable healthy practices on higher-level functional capacity decline among Japanese community dwellers.

This study aimed to clarify the effects of the accumulation of 8 modifiable practices related to health, including smoking, alcohol drinking, physical activity, sleeping hours, body mass index, dietary diversity, ikigai (life worth living), and health checkup status, on higher-level functional capacity decline among Japanese community dwellers. Data were derived from the National Institute for Longevity Sciences - Longitudinal Study of Aging. Subjects comprised 1269 men and women aged 40 to 79 years at baseline (1997–2000) who participated in a follow-up postal survey (2013). Higher-level functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence (total score and 3 subscales: instrumental self-maintenance, intellectual activity, and social role). The odds ratio (OR) and 95% confidence interval (CI) for a decline in higher-level functional capacity in the follow-up study according to the total number of healthy practices were analyzed using the lowest category as a reference. Multivariate adjusted ORs (95% CIs) for the total score of higher-level functional capacity, which declined according to the total number of healthy practices (0–4, 5–6, 7–8 groups) were 1.00 (reference), 0.63 (0.44–0.92), and 0.54 (0.31–0.94). For the score of social role decline, multivariate adjusted ORs (95% CIs) were 1.00 (reference), 0.62 (0.40–0.97), and 0.46 (0.23–0.90), respectively (P for trend = 0.04). Having more modifiable healthy practices, especially in social roles, may protect against a decline in higher-level functional capacity among middle-aged and elderly community dwellers in Japan.

Personality and global cognitive decline in Japanese community-dwelling elderly people: A 10-year longitudinal study

OBJECTIVES To examine the longitudinal associations between the big five personality and changes in global cognitive function among community-dwelling elderly people involved in the National Institute for Longevity Sciences - Longitudinal Study of Aging. METHODS The participants were 594 individuals (age range 60-81years) and followed for 10years and tested six times. Personality was assessed by the Japanese version of NEO five factor inventory at baseline. Cognitive function was assessed by the Japanese version of Mini Mental State Examination (MMSE) at all visits. For participants with a baseline MMSE score≥28, logistic generalized estimating equation models estimated the odds ratio (OR) and 95% confidence interval (CI) for MMSE score≤27 at each follow-up visit, according to a 1-SD increase of the baseline personality score. Post hoc analyses were performed for mild cognitive deficits, baseline MMSE score≥24 and ≤27, to estimate the OR and CI for MMSE score≤23. RESULTS The adjusted OR for MMSE score≤27 was 0.78 (95% CI, 0.69-0.88), with a 1-SD increase in Openness to Experience score. In post hoc analyses, the adjusted OR for MMSE score≤23 was 0.50 (95% CI, 0.35-0.72) with a 1-SD increase in Conscientiousness score. Relationships between other personality traits and the decline in MMSE score were not significant. CONCLUSIONS Higher Openness to Experience was associated with a reduction in risk for cognitive decline in community-dwelling older adults. Higher Conscientiousness might also predict lower risk for severe cognitive decline, especially for individuals with mild cognitive deficits.

Higher gait speed and smaller sway area decrease the risk for decline in higher-level functional capacity among middle-aged and elderly women

OBJECTIVE This study assessed whether physical function can indicate a risk of decline in higher-level functional capacity. METHODS Data were derived from the National Institute for Longevity Sciences-Longitudinal Study of Aging. Subjects comprised 466 men and 495 women aged 40-79 years at baseline (1997-2000), whose total score for the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) at baseline was ≥11 and who participated in the follow-up survey. Baseline physical function examination included grip strength, comfortable gait speed, and sway area with eyes open. A decline in higher-level functional capacity was defined as a ≥2-point decrease in the TMIG-IC score after 14 years. The odds ratios (OR) and 95% confidence intervals (CI) for decline in the TMIG-IC score for 14 years according to a 1-standard deviation (SD) increase in physical function measurements at baseline were estimated. RESULTS Subjects with decreased TMIG-IC scores included 78 (16.7%) men and 80 (16.2%) women. In women, the multivariate-adjusted OR (95% CI) for a TMIG-IC score decrease with a 1-SD increase in comfortable gait speed was 0.68 (0.50-0.92; p=0.013), and that with a 1-SD increase in sway area with eyes open was 1.49 (1.17-1.90; p=0.001). Grip strength was not associated with TMIG-IC score decline. None of the physical performance measures affected TMIG-IC score declines in men. CONCLUSION These results suggest that gait speed decreases and sway area increases might predict a risk of decline in higher-level functional capacity among middle-aged and elderly women.

Age-Related 12-Year Changes in Dietary Diversity and Food Intakes Among Community-Dwelling Japanese Aged 40 to 79 Years

ObjectivesThis study describes trends in dietary diversity and food intake over 12 years according to age at first participation in the study.DesignProspective cohort study.SettingThe National Institute for Longevity Sciences-Longitudinal Study of Aging, a community-based study.ParticipantsParticipants included 922 men and 879 women who participated in the first study-wave (age, 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Study-waves were conducted biennially.MeasurementsDietary intake was calculated from 3-day dietary records with photographs. Dietary diversity was determined using the Quantitative Index for Dietary Diversity based on food intake. A mixed-effects model was used to estimate linear changes in dietary diversity and food intake over 12 years according to age at first study-wave.ResultsMean (standard deviation (SD)) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8), respectively. Mean (SD, range) dietary diversity score was 0.86 (0.06, 0.52-0.96) in men and 0.88 (0.04, 0.66-0.96) in women, respectively. Fixed effects for interactions of age and time with dietary diversity score were statistically significant (p<0.05). The slope of dietary diversity among men aged 40 to 55 years increased (40-year-old slope = 0.00093/year, p<0.01; 55-year-old slope = 0.00035/year, p=0.04), with a decreasing trend started at 65 years old, although this trend was not significant (65-year-old slope = -0.00003/year, p=0.88; 79-year-old slope = -0.00057/year, p=0.21). The slope of dietary diversity among women aged 40 to 44 years increased (40-year-old slope = 0.00053/year, p=0.02; 44-year-old slope = 0.00038/year, p=0.04), whereas the slope of dietary diversity among women aged 63 to 79 years decreased (63-year-old slope = -0.00033/year, p=0.03; 79-year-old slope = -0.00092/year, p<0.001). Fruit, milk and dairy intake decreased in men around their 60s; milk and dairy intake decreased in women around their 50s; and beans and fruit intake decreased in women from their 70s.ConclusionTwelve-year longitudinal data showed dietary diversity declined in women in their 60s. In terms of food intake, fruit, milk and dairy intake decreased in both sexes in their 50s and 60s; such declines would lower dietary diversity.

Polypharmacy is associated with frailty in Japanese community-dwelling older adults: Polypharmacy and frailty

The association between polypharmacy and the development of frailty is unknown. The present study assessed the longitudinal relationship between polypharmacy and frailty risk in Japanese community‐dwelling older adults.

Physical frailty and mortality risk in Japanese older adults: Frailty and mortality

The association between frailty and increased mortality risk is unknown. The present study assessed the longitudinal relationship between frailty and mortality risk in Japanese community‐dwelling older adults.

Soy food and isoflavone intake reduces the risk of cognitive impairment in elderly Japanese women

Data were derived from the National Institute for Longevity Sciences-Longitudinal Study of Aging. Subjects comprised 403 men and 373 women aged 60–81 years at baseline who participated in the follow-up study at least once. Bean, soy product and soy isoflavone intake was assessed using a 3-day dietary record at baseline. Cognitive function was assessed by the Mini-Mental State Examination (MMSE). MMSE scores of ≤23 were used to define cognitive impairment. The relationship between bean, soy product and soy isoflavone intake and cognitive impairment was assessed using a generalized estimating equation. Multivariate-adjusted odds ratios (95% confidence intervals) for cognitive impairment with a 1 s.d. increase in total bean, total soybean and total soy isoflavone intakes were 0.48 (0.28–0.81; p = 0.006), 0.51 (0.32–0.83; p = 0.007), and 0.55 (0.32–0.93; p = 0.026), respectively, in women. Total soybean and soy isoflavone intake might decrease the risk of cognitive impairment in elderly Japanese women.

Cognitive abilities predict death during the next 15 years in older Japanese adults

The longitudinal relationship between cognitive abilities and subsequent death was investigated among community‐dwelling older Japanese adults.